Proposal for Funding Research on Autism
Proposal for Research on Autism
The Chairman,
Simons Foundation Autism Research Initiative (SAFARI)
New York, NY 10010.
Dear Sir,
This is a proposal for research into the current parameters of diagnosis of Autism and related disorders and the limitations these parameters place on clinicians and others associated with identification and intervention practices for Autism Spectrum Disorders. Further research can identify other conditions that have symptoms that are similar to ASD. Identifying the possibilities of misdiagnosis and missed diagnosis can help parents, teachers, practitioners, and others dealing with children who have Autism, provide better service to such children.
Introduction
Autism is a well known but little understood term. Although most people understand that autism is a neurodevelopmental disorder, few appreciate its complexities. One of the lesser understood facts about Autism is that Autism is not a specific disorder but a range of disorders characterized by atypical behaviour. The CDDH (2010) define ASD (Autism Spectrum Disorders) as neurodevelopmental disabilities that occur before 3 years of age, and are characterized by impaired social interaction. Social interaction includes both verbal as well as non-verbal communication. The individual shows stereotyped behaviour in his activities and areas of interest. Although there is a general agreement on this definition of Autism, the symptoms vary from one child to another. Autism is generally seen to affect more boys than girls. There is no particular culture, or ethnic group that has witnessed a predominance of the disorder. Autism has been classified as a Pervasive Developmental Disorder (PDD). There are a number of other disorders known as associated disorders that affect children with Autism. Other PDD’s include Asperger’s Syndrome, Retts Disorder, CDD (Childhood Disintegrative Disorder) and PDD-NOS (Pervasive Developmental Disorder – Not Otherwise Specified) (DII, 2000).
The DSM-V (Diagnostic and Statistical Manual – 5) defines ASD as persistent difficulty in social communication resulting in limitations to effective communication. The DSM specifies the characteristics of Autism and requires that all the characteristics be present to constitute a definite diagnosis. The DSM also requires that any other medical or neurological conditions be ruled out before diagnosing the condition as autism. The DSM is specific in stating that diagnosis for ASD can be given only when all the conditions are present (Autism Speaks). This places a limitation on the clinicians.
Statement of Need
The DSM-V places limitations on clinicians for diagnosis of ASD. However, the fact is that not all the symptoms may be present and yet the child may be autistic. Pomerantz (2013) describes the limitations on diagnosis and classification of disorders using DSM-5 with particular reference to ASD. Kendall-Jones(n.d.) on describes the possibilities of misdiagnosing Autism and the impact it can have on a child. The diagnosis of mental disorders does not rely on empirical tests such as imaging or pathological tests. Diagnosis is based on observation of behaviour and the environmental conditions surrounding the behaviour. As such, diagnosis is dependant on the skill of the observer and is subject to error (Watkins, 2009 and Simon, 1995 in Kandall-Jones, n.d.). O’Connor & Zennah, 2003 in Kendall-Jones, n.d. criticize the criteria laid out in the DSM-IV for imprecise language and ill-defined descriptions. The ambiguity of the descriptions creates room for error in diagnosis. That is not to say that these definitions are wrong or unnecessary. These definitions provide a framework for diagnosis. However, there is a need to investigate ASD further and define the contexts in which the symptoms must be viewed. The study by Kendall-Jones provides evidence there is a need to further investigate overlapping symptoms of ASD and other disorders such as Asperger’s, and attachment disorder. The study questions the accuracy of the diagnostic rating scales in differentiating between ASD and Attachment Disorder.
Objectives
This research aims to answer the following questions:
What are the parameters for diagnosis of ASD?
Which are the conditions that have symptoms similar to ASD?
What are the conditions in which a child can be misdiagnosed as having ASD?
What changes in policy and practice can help limit the incidence of misdiagnosis?
Methods
This study will be based on earlier research on the subject of Autism. Data from earlier research will be gathered and examined to understand the circumstances in which a child may be misdiagnosed as having ASD. Cases where children having ASD have failed to be identified will also be examined. We propose to identify the role of the parents and teachers as primary sources of identification and the factors that impede identification by these two sources. We also propose to examine the practices followed by clinicians for diagnosis of ASD. Based on this data, we propose to suggest ways in which the prevailing practices may be changed to ensure that every child having ASD is identified and there are minimum incidences of misdiagnosis.
Conclusion
Although autism is recognized by the DSM-V as a neurological disorder, there is still a great deal of ambiguity surrounding the condition. The causes of the disorder and indeed its scope are not clearly understood. There exists therefore, a possibility of misdiagnosis of the condition and also missed diagnosis. That is to say, symptoms of other disorders such as attachment disorder and Asperger’s syndrome can often be misdiagnosed as autism. It is also possible that a child fails to be identified as autistic if the condition is not severe. We propose to identify the players in the identification of the condition and those who can intervene to provide help. Our study will be based on earlier research on the subject in an effort to understand the symptoms, etymology, scope and treatment practices of ASD. We also propose to examine the provisions of NCLB and IDEA with particular reference to autism. We will then propose new methods of identification and treatment of the condition.
References
Autism Speaks, 'DSM-5 Diagnostic Criteria'. N.p., 2015. Web. 20 July 2015
CDDH 2010; Centre for Development Disability Health Victoria,. Autism Spectrum Disorders. 2010. Web. 20 July 2015.
DII, (Danya International Inc.). (2000). Life Journey Through Autism : A Guide for Transition to Adulthood. Danya International, Inc., 85006(602).
KENDALL-JONES, R. (n.d.). AN INVESTIGATION INTO THE LATE NEOLITHIC University of Birmingham Research Archive.
Pomerantz, A. M. (2013). Chapter 7 - What Defines Abnormality? In Clinical Psychology (pp. 151–181). Retrieved from http://www.sagepub.com/sites/default/files/upm-binaries/58622_Chapter_7_Pomerantz_(Clinical)_I_Proof_(Low_Res)_4.pdf
