Introduction

Autism is considered one of the most debilitating developmental disorders in psychology. Due to the changes in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (2000), practitioners have been able to successfully diagnose between 10 to 22 per 10,000 births (Bryson, 1996; Costello, 1996). Since the 1980s, the frequencies of autistic diagnoses have increased due to diagnostic improvements. While autism’s prevalence has been increasing, so have autistic spectrum disorders (ASD), which are characterized by psychological abnormalities involving the need for highly repetitive behaviours, social and communication deficits, as well as highly limited interests. For an unknown reason, autism occurs three to four times more in males than in females and usually among people with higher IQs rather than lower (Lord & Schopler, 1987). Autism possess a significant challenge to parents, especially the way they respond to their child’s autistic complications. In order to contextualize this pervasive developmental disorder, it will be critical to review the characteristics of autism according to the DSM-IV (2000). Following that, discussing the developmental milestones of an autistic child (birth, school-age years, adolescence and adulthood) will provide more detailed information necessary to understand the autistic child’s social developments as well as the hardships parents endure. In addition, assessing the early social development of autistic children (motivation, imitation, and attachment) will provide insight into their ability to socialize and communicate. Lastly, reviewing the hardships and concerns raised by parents regarding their stress in dealing with an autistic child will illustrate the complexity of this developmental disorder. The purpose of this essay is to contextualize family life and the dynamics of family involvement regarding autistic individuals.

DSM-IV Criteria Used for Diagnosing Autism

The diagnostic customary used to identify autism is called the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association (2000). There are twelve diagnostic criteria isolated into three categories: social interaction, communication, and activities and interests. Individuals affected with autism will not necessarily have all of the signs and symptoms associated with the disorder. Although they may exhibit similar symptoms, no two children with autism are alike. In order to be diagnosed with autism, a child must exhibit two criteria from the first category, two criteria from the second category, and one from the third. Here is a closer look at each diagnostic criterion according to DSM-IV (2000).

Social Interaction

This category is characterized by children who are unable to understand nonverbal behaviors and do not know how to use them appropriately. They also do not engage in age-appropriate social interaction. Autistic children 1) make little, if any, eye contact; 2) are unable to read facial expressions and respond to social cues; 3) hardly interact and fail to develop adequate peer relations; 4) pursue isolation and appear uninterested in people; 5) hardly enjoy playing and do not initiate play. In their infancy, they react negatively to being held or picked up and in their toddler stage will be marked with little or extreme attachment to people, even strangers.

Communication

Autistic children also have significant communication deficits. These deficits include: 1) echolalia (repetition of vocalizations); 2) monotonous tone lacking intonation or pitch; 3) hardly any social imitative play and variation as well as spontaneity in situations; 4) reverse pronoun usage. According to autism research, approximately forty percent of children with autism do not develop language at all, nor are they willing/able to use alternative means of communication—they will not even mime.  In the child’s infant stage, he/she will rarely cry or coo appropriately. As a toddler, the child may lose the words he/she had previously learned.

Activities and Interests

A child with autism develops repetitive motor behavior as well as stereotyped patterns of behavior that can manifest in varieties of ways. An autistic child may: 1) repeat motor behavior such as eye-gazing, body-rocking, hand-flapping, tapping as well as vocalizations; 2) abnormally focus on one pattern of behavior, or routine and may desperately seek absolute sameness in their surroundings; 3) have an abnormal relationship/interaction with toys, particularly focusing on specific parts of objects; 4) reactions to sound may be extreme because he/she may not be able to filter the noises in the background and may also overreact to auditory stimulation.

In their infancy, an autistic child may be preoccupied with the textures of his/her food and its taste. A child may stare into space and engage in self-stimulation. Also, some children may be fascinated by the texture of fabrics. Children with autism are similar in many ways, exhibiting deficits more in one category than others; however, each symptom is a part of autism and if enough are present, the child will be diagnosed.

Development of Autistic Children

The developmental process is highly complicated and filled with uncertainties. According to Harris (1984), there exists a family life cycle that involves changes in an infant’s development, from birth to adolescence that is perpetuated across normal families. During birth, the autistic child rarely returns positive affect towards the parent/caregiver and parents are immediately confronted with maintaining a healthy outlook despite their handicapped child. Research has shown that families with handicapped children, particularly Down Syndrome babies, reveal little differences in the amount of care-giving provided to them compared to the amount of care provided to a normal infant (Gath, 1978); however, autistic babies do showcase different, and perhaps exhausting behavioral problems for parents.

Once they have matured enough to enter school, parents encounter a whole new set of problems. These problems include immediately sending their child to special needs facilities or classes. The autistic child’s physical demands do not change, as they grow older, for they still require physical and emotional guidance that may become troubling for parents (Grossman, 1972). The parent’s school-aged autistic child often has siblings, which pressures siblings to adapt to the needs of their autistic sibling. According to Grossman (1972), siblings may find it rewarding to take care of their autistic sibling, however, others may find it a damaging experience. In this stage of development, parents are confronted with resolving tensions that may exist between siblings and may even shift complex roles and initiatives towards their normal sibling (DeMyer, 1979). Siblings may be an excellent resource that would assist parents in the development of their autistic children, but more siblings may be damaging and counterproductive simply because parents must divide their attention equally to ensure that their normal child is not neglected (DeMyer, 1979). As the school-aged autistic child grows, the mother’s freedom is severely limited because of the time and effort devoted to the physical care and needs of her autistic child (Birenbaum, 1971). Essentially, the mother deals with the most significant stress and prolonged mental and physical pressure (DeMyer, 1979).

Beyond their school-age stage, autistic adolescents pose more emotionally complicated and financially complex scenarios for parents. At this stage, parents of autistic adolescents are confronted with scenario of what would happen to them if they died, who would take care of them in the long-term, and how they would be able to live independently. Beyond this stage comes adulthood–when parents are less able to physically care for their autistic adolescent, responsibilities are shifted to their siblings or next of kin.

Early Social Development of Autistic Children

As a pervasive developmental disorder, social deficits may very well be the most impacting and handicapping aspects of autism. While social deficits are central to the autism syndrome, the complicated natures of these difficulties have always resulted in confusion among both parents and non-expert professionals. The reason for this is simply that the autistic child’s current mental state may not be represented in their random smiles or avoidance behaviors. According to Cohen, Paul and Volkmar (1987) social deficits fall into two categories: sociability and attachments. While the subject of early social development is perhaps an overwhelming subtopic, realizing the issues encountered by autistic children in their early development will contextualize the overall complication of this pervasive developmental disorder.

Sociability

Sociability refers to a person’s interest and ability to easily interact and be around other people. While there are several ways to analyze an autistic child’s sociability, it will be important to consider motivation and imitation.

Motivation

According to the American Psychiatric Association (2000), autistic children have a pervasive lack of social awareness. Many studies have shown that very young and school aged autistic children look at people as frequently as their mental age-matched non-autistic peers—in laboratory settings (Dawson et al., 1990; Sigman & Mundy, 1989; Wetherby & Prutting, 1984). Three factors impede the development of an autistic child’s motivation. These factors make it appear that autistic children lack any motivation for social inclusion/participation. These include: 1) avoiding direct eye gazing or auditory input; 2) infrequency with which autistic children try to attract other people’s attention (Dawson & Galpert, 1986); 3) deficits in sharing attention, or participating in following other people’s gaze (Kasari et al., 1990; Loveland & Landry, 1986). Essentially, autistic children are less likely to point or share attention, or pay attention to things that others are gazing at. Baron-Cohen (1989) state that sharing attention is not an accurate representation of an autistic child’s motivation simply because looking at the direction that many individuals are does not necessarily reflect an interest in viewing that object, or that perspective. Therefore, the frequency (or infrequency) of an autistic child’s gaze or attention does not adequately reflect the motivation of the autistic child.

Imitation

An autistic child’s imitative abilities have been correlated with other social skills as well as language development (Dawson & Adams, 1984; DeMyer et al., 1972). As discussed above, autistic children tend to reveal spontaneous motor imitation of others and with less frequency (DeMyer et al., 1972). However, autistic children appear less able to imitate gestures (elicited imitation) or familiar actions with objects (Rutter et al., 1975; Curcio, 1978). Recent research reveals that elicited imitation is the prime indicator of the level of mental handicap and whether or not social skills may be developed through rigorous imitation training and understanding (Stone et al., 1990).

Attachment

Studies show that pre-school autistic children are capable of strong attachments with their parents and even show differences in their behavior once reunited with their parents (Shapiro et al., 1987; Sigman & Mundy, 1989; Sigman & Ungerer, 1984). However, these differences in behavioral changes are very slight simply because autistic children are less likely to respond to a parent’s return with an elicit gesture and therefore parents most often report concerns about their autistic child’s attachment to them (Le Couteur et al., 1989; Ohta et al., 1987). Therein lies a contradiction: parents indicating concern about their autistic child’s attachment to them while simultaneously believing that their child is attached to them. This contradiction is an important one simply because of issues concerning attachment and interpreting aspects of social behavior. Unfortunately, little is known regarding the attachments autistic children form with their siblings. In their schooling, autistic children become increasingly attached to their teachers—they show distress when their teacher is away and show positive affect when they return. According to Rogers & Lewis (1989), a pre-school autistic child’s relationship with their teacher is an important factor in their social and language development. Similar to the issue of attachment with siblings, this is another area that must be engaged with more rigorous research.

The Impact of the Autistic Child on the Family

According to McAdoo and DeMyer (1978), the autistic child is a consistent and chronic source of stress on the family. DeMyer’s (1979) clinical experiences reveal that the failures of a family’s autistic child has a debilitating impact on the structure and cohesion of the family altogether. Furthermore, these failures impede the development of the parent himself/herself to the point where their relations with their autistic child may be questioned. DeMyer (1979) found that one-third of the mothers of autistic children suffered from depressive symptoms. In addition, DeMyer (1979) documented that one-third of siblings expressed feelings of neglect because most of the attention was given to their autistic sibling. Furthermore, parents with older autistic children report difficulties concerning the uncertain changes in behavior and the unstable mental condition, or perhaps worsening conditions of their autistic child. As the complications of their autistic child grows, DeMyer (1979) stated that parents feel like perpetual caretakers, constantly worrying about the state of their autistic child while expressing their inability to financially take care of them through the uses of public services, psychological resources, and institutions that have the experience to deal with autism. Through the use of a 285-item questionnaire given to 29 families, Holroyd et al (1975) studied the levels of stress in families with autistic children. Their study found that families with non-institutionalized autistic children suffered from profound stress as their autistic child aged.

Marcus (1977) clinical experience with parents of autistic children shows that parents were detrimentally affected by their children’s disabilities with persistent fear, worry, and apprehension as the parent’s general mindset. One of the most central issues for parents, according to Marcus (1977) was their inability to cope with their autistic child’s linguistic, auditory, and perceptual handicaps. Furthermore, parents with autistic children have an extreme inability to cope with their autistic child’s human relatedness—parents are putting themselves in tremendous stress while the autistic child gives them nothing in return. Throughout Marcus’s (1977) experience in dealing with parents of autistic children, he concluded that there is an urgent need for research concerning factors that may add to more progressive coping strategies, access to social activities as well as development of appropriate expectations because a parent’s developmental expectations may exceed that of their autistic child’s ability to perform.

Leighton (1969) reported different experiences in dealing with parents who have an autistic child. Her clinical experiences included parents with difficult and perhaps even compromising circumstances that require immediate consultation: 1) issues of high parental expectations for their child; 2) guilt associated with keeping an autistic child, perhaps even blame-shifting concerns; 3) appropriate placement for their children; 4) family assistance and practical solutions; 5) reducing their emotional stress.

The impact on family life is a significant developmental issue concerning autistic children because of their incredible sensitivity to physical and emotional attachment.

Conclusion

The importance of autism research is inestimable, for they aid the significantly growing population of autistic individuals today. This essay was primarily focused on the developmental perspective of caring for autistic individuals and the stresses they create among their surroundings, but more rigorous research needs to be done in order to make conclusive inquiries. In order to characterize the difficulties families with autistic children have, this essay outlined the extent of mental retardation as documented by psychiatrists and psychologists in the Diagnostic and Statistical Manual-IV (DSM-IV). The DSM-IV reveals complex and highly interconnected social and cognitive deficits ranging from their social interaction, communication and their activities and interests. While autistic children do recognize their parents and miss them when their parents are away, they experience positive affect when their parents return; however, they show very little elicit emotive gestures, which complicates the relationship between the autistic child and their care-giver. Secondly, this essay explained the autistic child’s developmental stages. Beginning from childhood and onwards to adulthood, parents and siblings are burdened with immense responsibilities that begin to grow with each passing stage. Following that analysis, issues of early social development were examined. Early social development in autistic children is a critical aspect of an autistic child’s development because issues of motivation, imitation (if imitative ability is good, it is used as an indicator of possible social and linguistic development), and attachment were analyzed as factors concerning the overall social well being of autistic individuals. Lastly, a significant aspect of this essay included a thorough analysis of the impact of living with an autistic child. While the developmental perspective regarding autistic individuals would surely have been exhausting, the main issues discussed in this essay were primarily the ability of the family to cope with the problems of associated with autism.

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