Factors Influencing the Wellbeing of Individuals with Autism
Autism is a developmental disability that affects the normal development of the human brain, and eventually affects an individual’s ability to effectively communicate and to interact with other people, as well as their environment. Also known as Autism spectrum disorder, autism affects a person ability to understand what they see, hear or sense. The condition begins at birth or within the first two to three years of life. Autism spectrum disorder (ASD) is considered one of the Pervasive Developmental Disorders (Buron, 2008, p. 21). Prior to the mid-20th century, autism was a rare condition. The first case of autism was identified by child psychologists at John Hopkins Hospital in 1950s. Since then, cases of autism have been increasing over time. In fact, cases of autism during the last one and half decades have been increasing at a rapid rate. The data released by Centers for Disease Control and Prevention in 2009 by 2009 indicated that 1 out of 110 of all children born was diagnosed with ASD in the world (Dodd, 2010, p. 12). Recent surveys also indicated that four times as many males are diagnosed with ASD as compared to females.
There is not specific cure for autism. However, there are various interventions that can help to improve the overall wellbeing of individuals on the spectrum. During the last three decades, the problem has attracted the attention of many scholars. Psychologists and sociologists in particular have tried to explain the effects of autism to an individual and the factors that affect the wellbeing of individuals on the spectrum during lifetime (Dodd, 2010, p. 13). Sociologists and psychologists have found that autism affects three main areas of development, namely, communication, behavior and social interactions. Theories established by psychologists and sociologists try to explain the intervention strategies that should be adopted in order to improve the ability of the individuals in the aforementioned areas, or to maintain their wellbeing during the lifetime. The current section, therefore, examines the perspective of the psychological and sociological theories on the interventions that should be provided to individuals with autism to support their wellbeing.
Theoretical perspectives on needs
Cognitive theories of learning
The behaviors of individuals with autism and the needs that influence their overall wellbeing are comprehensively explained by the cognitive theories of learning. There are four main social cognitive theories that explain the differences between individuals with autism and normal persons, namely, the theory of mind, the extreme male brain theory, the central coherence theory and social cognitive theory. The theory of mind, established by Simon Baron-Cohen in 1995, posits that individuals with autism have a condition called ‘mind blindness.’ According to the theory, the individuals with autism are unable to intuit what other people are intending, perceiving or thinking. In other words, their minds are blind and are unable to read minds of others (Benjafield, 2008, p. 248).
Simon Baron-Cohen later in 2002 expanded the theory of mind to form the extreme male brain theory (Whitcomb & Merrell, 2013, p. 46). The theory posits that the brains of males are different from those of females; males have ‘empathizing brains,’ whereas the males have ‘systemizing brains.’ According to Baron-Cohen, the term ‘empathizing’ refers to the ability of an individual to understand the thoughts and emotions of another person and to respond to them in an appropriate manner. As such, empathizing enables an individual to predict the behaviors of another person and take care about how he/she feels. On the other hand, systemizing refers to the drive to analyze variables embedded in the system and to understand the rules that govern human behavior (Whitcomb & Merrell, 2013, p. 46). Systemizing enables individuals to understand the behaviors portrayed by individuals as a result of system influences. In other words, systemizing focuses on understanding the behaviors of the system and not individuals.
According to Baron-Cohen, a balanced person possesses equal measures of empathizing and systemizing abilities. However, the average man leans more on the side of systemizing, while the average woman leans more on the side of empathizing. According to Baron-Cohen, individuals with autism lack the empathizing abilities completely. As such, they do not have ability to read the behaviors of others through perception, intentions, word emotions and actions, body language and expressions (Tarkington & Anan, 2007, p. 141). However, individuals with autism have incredible systemizing abilities. As such, Baron-Cohen explains that they have ‘extreme male brain.’ Consequently, they are usually good in evaluating non-human systems. For instance, they are good in evaluating objects, scientific phenomena and machines. In fact, they have ability to predict changes in non-human systems. However, the ability varies depending on the level of disability. The fact that they are systemizing abilities and they lack emphasizing abilities explains the reason they tend to be obsessed to objects. Also, this explains the fact that most of them are resistant to change (Simpson, 2007, p. 37). Most of them are preoccupied with interests, routines and objects. A slight change in environment may cause a lot of distress to an individual with autism.
The central coherence theory, initially developed by Uta Frith in 1989, tries to explain the reason some of the individuals with autism have exceptional abilities. Frith noted that some individuals with autism have exceptional abilities such as making calculations, memory and music. People with such abilities tend to give deep focus to details, and thus, they are able to pick every little element pertaining to the subject matter of study (Whitcomb & Merrell, 2013, p. 47). However, when additional details from areas or subjects that they are not gifted, they become confused and the performance goes down.
Social cognitive theory, on the other hand, is a learning theory that suggests that individuals learn by observing others. Social cognitive theory focuses on how people are affected by the behaviors of others. The theory was developed by Albert Bandura, a Canadian psychologist (Rogers & Dawson, 2009, p. 68). While the proponents of the theory agree that the environment in which an individual grows influences his/her behavior, they argue that individual’s personality is equally important. There are five key concepts that are described in the social cognitive theory, namely, observational learning/modeling, self-efficacy, outcome expectations, self-efficacy and self-regulation.
The concept of observational learning or modeling posits that individuals learn from others within social contexts. For instance, a student learns how to behave by observing the behaviors of teachers, parents and peers. The teachers, parents and peers act as models to the student. An individual can learn from others either directly from live demonstrations or indirectly by observing the non-verbal, verbal and written behaviors of the models (Cervone & Pervin, 2013, p. 357). The concept of outcome expectation suggests that the consequences of behavior influences whether the behavior will be repeated or not. Depending on whether the outcomes are positive or negative, an individual may decide whether to repeat the behavior or not. Motivation to repeat a particular behavior is important since it influences whether the behavior will be successfully learnt or not (Powell, & Powell, 2010, p. 129). According to Powell and Powell (2010, p. 129), individuals with autism can learn effectively through observational learning, especially in cases they are attracted to specific behaviors. Also, they learn behaviors through practicing them repeatedly. However, they often require motivation to engage in certain behaviors initially.
The concept of self-efficacy suggests that an individual’s self-efficacy influences his/her ability to learn a particular behavior. Self-efficacy refers to an individual’s belief that he/she can learn a particular skill or not. Generally, individuals become highly motivated, more active, pay attention and become better learners when they believe that they have ability to master a particular skill or behavior (Carducci, 2009, p. 97). Goal setting is another core concept in the social cognitive theory framework. Goals refer to future desired outcomes that are embedded in an individual’s cognitive framework. Models can provide an individual with instructions that can help in formulating effective goals which can facilitate effective learning (Carducci, 2009, p. 97). Lastly, the concept of self-regulation suggests that individuals can control and evaluate their own learning behaviors. The concept posits that depending on goal setting, individuals can manage their own thoughts and actions in order to achieve desired outcomes. The attitudes and beliefs that influence an individual’s motivation for self-regulation and the skills that are needed to effectively manage behavior can be obtained through modeling (Carducci, 2009, p. 97). As Carducci (2009, p. 97) explains, individuals with autism often have a low level of self-efficacy. In other words, they do not understand their abilities and hardly set goals. However, as Carducci (2009, p. 97) argues, the individuals with autism have ability to develop self-efficacy through guidance and support. They can be assisted to set goals and with additional support, they can meet them. They can also learn to regulate their behaviors.
In short, the three cognitive theories try to explain the behaviors of the individuals on the autism spectrum. In addition, they give an understanding of how the individuals with autism should be assisted in order to perform optimally. In fact, the cognitive theory suggests that, if provided with the necessary assistance, some of the individuals on the spectrum can perform like the typical individuals. In some cases, they can even perform better, especially in areas where they have exceptional abilities. The cognitive theories of learning and development propose that engaging in physical activities can help individuals on the autism spectrum disorder develop and maintain physical wellbeing. Further, the cognitive theories propose that the psychological support can help to enhance the mental wellbeing of individuals with autism (McClannahan, MacDuff, & Krantz, 2002, p. 11). Psychological support can be provided through counseling.
Social Motivation Theory
The social motivation theory of autism is based on the works of Dawson and other sociologists. The theory tries to explain the effects, the special needs of individuals with autism and the suitable intervention approaches. The theory posits that most of the behavioral complications of individuals with autism stem from childhood. Precisely, the theory posits that individuals with autism have many deficits with they were not born with. According to Dawson, such individuals have impairments in imitation, affective sharing, emotional perception, joint perception and social orienting (Dawson & Zanolli, 2003, p. 271). The theory of social motivation suggests that individuals on the spectrum develop such impairments due to inability to interact effectively with other people during the early stages of growth and development.
Young children with autism usually fail to orient effectively to social stimuli. For instance, they often fail to orient to human sounds such as calling names and clapping. Also, they fail to distinguish and to prefer to human or non-human speech. Dawson suggests that such problems mainly occur due to the impact of autism on the ability of individuals to shift attention between different modalities and stimuli. The theory posits that autism affects the ability to rapidly shift attention between different modalities and stimuli (Dawson & Zanolli, 2003, p. 271). Dawson and colleagues argue that the inability to do so is mainly influenced by lack of motivation, as a result of abnormalities in neural systems. However, Dawson and colleagues argue that the ability to shift attention between different modalities and stimuli in individuals with autism can be enhanced through continuous motivation during the early years of development. In other words, acknowledging the special needs of the individuals with autism and trying to encourage them to be involved in social interaction contexts as early as possible in life can help to curb most of the deficits that they have. The needs and intervention strategies to enhance the wellbeing of the individuals with autism are explained in the next section (Dawson & Zanolli, 2003, p. 271).
The social motivation theorists acknowledge the significant role of early intervention in enhancing the wellbeing of individuals with autism. The process of training and educating individuals with autism is highly effective when started in early childhood. Individuals with autism are likely to respond to training more easily at earlier ages than when they become adults. According to McClannahan et al. (2002, p. 15), children with autism need to be assisted to develop a better understanding of their environment, enhance their social and communication skills, and develop the required career and personal planning for their future.
Both the cognitive and the social motivation theories agree that the level of social interaction skills and social support can help to enhance, restore or maintain emotional and social wellbeing of the individuals with autism. Secondly, the theories propose that enhancing communication skill of individuals with autism can help to enhance their interactional skills, as well as ability to learn and to work. In turn, this can help to enhance the social, financial and physical wellbeing of the individuals with autism (Gabriels, & Hill, 2007, p. 97). The cognitive and social motivation theorists acknowledge the importance of basic needs and finances in supporting the wellbeing of individuals with autism.
Part 2: Causes of Social Inequality in Health
Employment influences whether an individual has good access to health services or not. In many cases, people who have long-term employment contracts have health insurance, and are always able to access health services without struggle. Their health services are paid for by the employers. In many cases, employers pay health insurance for their workers (Goddard & Smith, 2001, p. 1152). On the other hand, people who are not employed, or do casual jobs may not have similar access to health services. Also, the kind of job that an individual does determines his or her overall health. Some jobs involve health hazards that end up damaging an individual’s organs. A good example is a job that involves cement manufacturing. Some of the workers in such a job have direct contact with the processes that involve mixing chemicals and thus, they inhale them, especially if they do not have good protection. On the other hand, some jobs, such as office secretary involve less exposure to health hazards that may have a huge impact on health. Lack of employment, on the other hand, leads to lack funds needed to access good adequate health services (Goddard & Smith, 2001, p. 1153). The problem often encounters individuals with limited opportunities for getting employment, yet they require constant treatment, such as persons with disabilities.
Individuals on with disabilities often lack capacity to work like the typical individuals.
In many cases, they lack some of the basic social and personal skills required for independent living (Ernsperger, 2008, p. 286). In other words, most of them are unable to engage in economic activities, especially when there are no interventions. In comparison with the normal individuals, individuals with disabilities required additional assistance to gain knowledge and skills required in the job market. In some cases, they may require additional assistive tools to enable them acquire the knowledge and skills. Without such support, they may not gain the required knowledge and skills to work effectively. In this regard, theorists suggest that individuals with disabilities should be provided with occupational therapy services (Gerhardt, 2007, p. 35). Occupational therapy is a service that helps to develop effective techniques to for working with the needs of such individuals and enhance independent living.
Occupational therapists can assist disabled individuals to develop skills that are applicable in various jobs. They can devise strategies that are essential for individuals with autism to help them during the transition from one setting one person to another, from one setting to another and from one life phase to another (Lundine & Smith, 2006, p. 56). According to Cameto Levine and Wagner (2007 p. 74), individuals with disabilities should be assisted to acquire problem-solving and decisional skills, in order to prepare them for independent living. Developing these skills should also be a leading objective when designing an educational strategy to educate individuals with disabilities. Such skills will help such persons perform an important task like organising, controlling, and coordinating their activities. The goals and aspirations of individuals with disabilities should not be seen as different from those of normal individuals. The goals are the same and similar to those of typical individuals (Myles et al., 2007, p. 45). According to Myles et al. (2007, p. 45), an individual with disabilities can achieve high level personality, and occupational success if they are taken care of properly.
Myles et al. (2007, p. 45) noted that, despite many effective measures which are taken by parents and professional bodies to facilitate the complete transition of children with disabilities to a promising future, many of them have been unable to get employment opportunities. Myles et al. (2007, p. 45) further explains that even those individuals on the spectrum but with relatively less severe symptoms continue to depend fully on their parents or guardians because only few opportunities are available for them. This shows a fault in the effectiveness of some of the training services provided for individuals with disabilities. Effective training should enable them to live up to their potential in their future lives especially through securing employment opportunities.
Unequal access to education prevents equal access to health services. One major aspect of education is that people to not have equal access to education. Education teaches people how to behave in order to maintain good health. For instance, educated persons are often aware of the benefits of recreation on health. As McGill-Franzen (2009, p. 75) explains, recreation is a very helpful tool in enhancing the health of all people. For instance, play can be very effective in assisting children with autism to explore their feelings, their relationships with parents, other people and the surrounding environment. In persons with disabilities, recreational therapy is essential in improving socialization skills, language development, physical, cognitive and eye-hand coordination. To this end, recreational therapy is an important component of personal planning for individual with disabilities (McGill-Franzen, 2009, p. 76). Also, education teaches people to adopt healthy eating habits. Educated persons understand the kinds of food they should avoid and those that they should take to enhance their health in the long-run. Further, educated persons are aware of the destinations where they can get the best health services for their health problems. Unlike the educated persons, the uneducated individuals may not understand the importance of recreation and adopting healthy eating habits. Also, they may not be aware of the destination where they can get good healthcare services (McGill-Franzen, 2009, p. 76).
In some cases, the problem of education is caused by unequal access to quality educational services. Various studies have been conducted to examine the availability of adequate access of quality education personal planning services for individuals with disabilities in both the public schools and special education institutions in different parts of the world. First, Hanafi conducted a research in the same topic in special education institutions in the year 2008 (Hanafi 2008, p. 2). The findings of the research showed that medical and health services were available to students with disabilities and both public schools and special education services institutions in different countries. However, the author found that services and social workers were not available in some of the institutions. Also, a study conducted by Al-Otaibi and Al-Sartawi in Asian countries under the same of research provided related results (Hollander, Kolevson & Coyle, 2010, p. 154). The researchers examined that public schools and special education institutes in Saudi Arabia provided physical therapy, medical and health services but social services were not present in most schools and institutions.
The effectiveness of personal planning services for children with disabilities is highly dependent on the perception of the teachers and administrators of such students. Cook (2001) explained that the negative perspective of such students by their teachers and administrators may impede the process of providing services provided by the education system for such students. The authors pointed out that some of the teachers dealing with students with disabilities prefer to work with moderate rather than severe disabilities. According to Cook (2004, p. 205), there have been numerous studies focusing on the role of teachers in enhancing the effectiveness of personal planning services provided in the education system for students with disabilities. But according to Kozub & Lienert (2003, p. 23), only a few of them indicated that teachers and administrators of students with disabilities both in public schools and in special education institutes have a negative attitude towards such students. An example of this is a study conducted by Cook (2001) (as cited in Kozub & Lienert, 2003, p. 23) on the same topic in Saudi Arabia. Cook concluded that some teachers hold negative attitudes towards their students with autism and other disabilities characterised by rejection nomination and indifference. According to cook, the depth of the feelings is usually dependent on the levels of disabilities. In addition, cook found out that children with severe disabilities are likely to be rejected by some teachers and administrators compared to those with moderate and mild disabilities. This explains that, such teacher and administrators may not provide the required education services and personal planning services to disabled persons, which are provided in the education system.
Religion may also be a source social inequality in health. There are cases where religion (especial cults) influences followers not to access health services. For instance, the leaders of cults such as Raelians and Church of God advise their followers that it is wrong to seek medical services from the hospitals. As such, the followers may not access the health services. In other cases, faith embedded in a religion may limit a specific group of people from accessing heath services (Goddard & Smith 2001, p. 112). A good example if the Islamic faith in Saudi Arabia. In Saudi Arabia, the society in that state is based on Islamic faith and follows the teachings of Sunnah and the Qur’an stated by Prophet Muhammad. Consequently, the cultural values of Saudi society deals with disabilities in accordance with policies in the Sunnah and the Qur’an (Al-Mousa, 1999, p. 29). According to the teachings of these books, disability is sometimes perceived to result from punishment for a person who has disrespected a family with a child with a disability. Also, it may be perceived as a test of patience for those who have been prepared a place in heaven by Allah and who will not go unrewarded for the patience. These perceptions lead people in Saudi Arabia to treat persons with disabilities negatively. Sometimes, such individuals are discriminated against or ignored in public. They are also prevented from practicing their rights like typical individuals do. As a result, some teachers and administrators in public and special education institutions may have such perception of the people with autism. A teacher with such a perception is likely not to provide quality support services for students with autism even when such services are availed by the state (Al-Mousa, 1999, p. 29).
Access to housing, water, food and Income
Access to housing, water and food influences the health of individuals. At the same time, access to income determines the ability of individuals to access basic needs and health services. People with limited access to the key human basic needs have poor health. They are likely to get health problems or diseases that are caused by malnutrition and related problems. In addition, access to contaminated food and water may also lead to poor health. Access to adequate income, on the other hand, leads to ample access to the aforementioned key basic needs. As well, the have access to quality health services since they are able to pay for them (Goddard & Smith 2001, p. 118). The problem of accessing income and the basic needs often faces individuals with disabilities.
Unlike normal individuals, persons with disabilities require additional support to access basic needs. Many of them are unable to acquire basic needs on their own, and they depend on the support of the family members (Matson, 2008, p. 78). In some case, families of persons with disabilities are disadvantaged and do lack ability to provide all the basic needs to the individuals with autism during the lifetime. In cases where the individuals with disabilities lack adequate support for food and housing, for instance, their overall health may be significantly affected. Further, many individuals with disabilities require a lot in terms of financial resources for the purpose of treatment and therapy services (Matson, 2008, p. 78). Parents or guardians of children with disabilities who cannot afford the finances to take their children to special schools and to pay for treatment and therapy services may encounter numerous problems. In such cases, the individuals with may not benefit psychologically, socially and physically. On the other hand, availability of basic needs and financial support may enhance the overall wellbeing of individuals with autism to the extent that they perform just like normal individuals. In this regard, the national governments and other authorities should provide support to individuals with disabilities in cases where family members and guardians are unable to adequately provide such support. As Matson (2008, p. 78) notes, parents and guardians of individuals with disabilities in many countries seek financially and professional assistance from national governments and social welfare organisations to ensure those individuals make a proper and consolidated transition to adulthood, and are able to perform optimally in all dimensions.
Part 3: Capacity of Policy and Practice in Challenging Stigma and Discrimination
In most cases, individuals with disabilities suffer from stigmatism and discrimination. In schools, for instance, typical children hardly understand the condition with the children with disabilities and thus, they perceive them as having odd behaviours. They may find it difficult to accept them, or even interact with them. In some cases, they may openly show rejection to the individuals with disabilities. Adults with disabilities are also likely to face rejection in the society. A significant problem with individuals with disabilities is inability to perform equally to other people. In most cases, individuals with disabilities wonder why they have lower abilities to perform various activities like other individuals. Such thoughts often lead the persons with disabilities to suffer from low esteem and resentment. In other words, such issues affect the emotional well-being of individuals with disabilities. The extent to which the society provides social support to individuals with disabilities influences their ability to cope with emotions. When they are provided with emotional support, their emotional wellbeing is enhanced. Emotional wellbeing of individuals with disabilities can be supported through encouraging the other members of the society to accept and give them any necessary support. In order to do so, all people in the society must be sensitized on the special needs of individuals with disabilities and the need to support them. This calls the need for solid policies to support them. In addition, it is essential to come up with effective social policies that will facilitate enhancing of the wellbeing of disabled persons.
Different countries have different policies that guide their practices on how they deal with disabled persons. In almost all countries, the set policies discourage the stigma and discrimination of disabled persons. In the UK and the US, for instance, have various policies that help to support the inclusion of the persons with disabilities in the society. In the UK, the social policies for disabilities are developed by the Department of Health. As well, practices involving the treatment of the disabled individuals are regulated by the Disability Discrimination Act and the Equity Act (2010). The social policies in the UK require record of all disabled individuals to be kept. According to the policies, the methods used to treat several cases of disability should also be maintained so that, should a similar disorder be diagnosed in another individual, then it will be easier to deal with it. Records should also be kept determine the number of individuals with disabilities in a given region so that plans to deal with the disorder can be put in place (Department of Health, 2010, p. 19).
Secondly, the policies acknowledge that every individual with disabilities has unique and special needs, thus requiring a personal plan because of their unique patterns of learning. Personal planning is based on the principle that any individual can succeed despite a current impairment. The policies stipulated that all parties involved in the intervention programme for individuals with disabilities should have high and realistic expectations on education so as to allow the expectations of the individuals to be realised. The social policies acknowledge that all parties should also understand that the education of individuals with disabilities is completely different from education in a typical education system. The law stipulates that the education system for individuals with autism should consist of seamless social, cognitive and communication transitions which should be closely monitored to ensure effectiveness (Department of Health, 2010, p. 19).
According to the policies, individuals with disabilities, just like typical individuals, should be provided with all necessary supportive services and programmes, especially social and material, and appropriate environments to enable them achieve their potential. For successful and effective educational programmes for individuals with disabilities, parents and teachers need to be provided with the necessary, important information about the disorders so as to devise the best intervention methods to use. Parents and teachers have different roles to play in the intervention programmes though their roles must converge in the end. Teachers must take the entire responsibility for developing the literacy, cognitive and numeracy skills of the individuals while the parents must focus more on social and communication skills (Department