Autism Spectrum Disorder
Introduction
The prevalence of autism spectrum disorder (ASD) has been steadily rising, affecting both children and adults. Although it is easy to recognize a child infected with autism spectrum disorders, it is not simple for the medical practitioners to differentiate autism from other forms of spectrum disorders and conditions. In addition, it has become hard for healthcare professionals to identify the causes of autism spectrum disorders, but precious research suggest that ASD is brought by genetic factors based on a complex mode of inheritance (Faras, Al Ateeqi, and Tidmarsh 395). Therefore, with difficulties in identifying outstanding factors causing ASD, its occurrence is increasing worldwide. The autism spectrum disorder is described with a wide range of symptoms that include patients having a hard time to interact with other individuals and unusual repetitive behaviors (Fakhoury 2).
Therefore, the objective of this paper is to investigate the prevalence of ASD, particularly in Middle East countries and the United States. The paper will also look at the factors that cause ASD, its impact, and the importance for patients with ASD to be assigned to diagnostic programs as early as possible. To achieve the aim of this paper, previous research on ASD will be reviewed with the analyses taking into account the available evidence showing the prevalence of ASD. This paper examines the strategies that the healthcare sector is using to prevent and diagnose autism spectrum disorders cases.
Search Method
For this study, the researcher used PubMed search engine to obtain peer-reviewed articles on autism spectrum disorder. The main strength of PubMed is that as a major search engine, PubMed offers a great variety of advanced features and nursing information that consist different fields. For this study, the search process involved carrying out searches using the AND and OR combination with the help of PubMed filters. The researcher typed “Autism Spectrum Disorder OR ASD and AND prevalence OR risk factors OR diagnosis OR impact”. The filters, English, and children birth-18months were used to customize the search. The PubMed search involved articles that were published between 2009 and 2016. The initial search gave 280 articles. However, a review of their titles reduced the articles to 60. Further analysis of the abstract reduced the articles to 25. A further detailed review of the focus of the 25 articles reduced them to 14, which were then used to provide a dipper analysis of the paper.
The researcher started by outlining key findings from the previous review of ASD surveys and incorporated the key points to the current results in this paper. As the purpose of this study was to present the understanding of ASD from the perspective of various authors who had undertaken an intensive review of the same topic from different regions of the world, the researcher grouped the data from various countries into sub-regions and then came up with a final report. Using this strategy, the researcher used previous studies from U.S., Middle East, and Europe, to understand ASD from the perspective of medical practitioners.
To come up with a prolific discussion and findings, the research results were narrowed down to more than 20 results, where the researcher focused on the case autism spectrum disorder in countries such as the United States, Europe, and the Middle East. Most of the searches were narrowed done by date so that the researcher can come up with a reasonable discussion and findings. The search results were then analyzed to determine the prevalence of ASD and why its prevalence is increasing in countries such as Qatar and the United States. As terminologies at PubMed are major factors that affect the retrieval of information that the researcher requires, to search for appropriate information words such as risk factors of ASD, the diagnostic program for ASD, children with autism were used primarily to acquire information on ASD.
Results: Summary of the Literature
Prevalence of Autism Spectrum Disorder
Autism spectrum disorder is a biological condition that has clearly defined phenomenology. Studies on this topic have been rare, and as a result, little is known about the prevalence of ASD, in particular across the Middle East countries. According to Fakhoury, around 20% per 10,000 children in the United States are affected by ASD and the major early symptoms of the disorder are identified between the age of 1 and three years old (2). Along the similar argument, Davidovitch, et al. stated that in a review that was published between 1966 and 2009, it the prevalence of ASD was 0.7% or one child in a sample of 143 children (785). Therefore, ASD is mostly becoming more predominant among children aged between one and three years. Different studies affirm that the occurrence of autism is on the rise in every region across the world where the current estimate of the ASD prevalence is 1 in 68 people (Kelly et al. 1). Despite limited studies concerning ASD in Europe and the Middle East, in the similar study, it is stated that the ASD increase rate is found in Europe and Middle East (Kelly et al. 1).
In the study, “Examining Characteristics of Autism Spectrum Disorder,” Hussein, Taha, and Almanasef reveal that in the Middle East countries such as Saudi Arabia and Jordan, the male children at a high risk of being victims of ASD than the girls. The researchers showed that in the Middle East, boys are exhibited to delinquent behavior problems than the girls (2). Additionally, in the United Arab of Emirates, 58 children per 10,000 children have autistic feature, which is an indication of the increase of ASD conditions within the Middle East region (2). Hansen, Schendel, and Parner posit that the prevalence of autism spectrum disorders (ASDs) has gone up prominently over the years (56). The researchers suggest that the increase of ASD among children within the age of one and three years is caused by non-etiologic factors such as the change in diagnostic practices (Hansen, Schendel, and Parner 56).
Kelly, et al. contend that no comprehensive study that has been completed regarding the occurrence autism spectrum disorder in Qatar (5). However, they quoted that the research by the Qatar Biomedical Research Institute portrays that in Qatar, the prevalence of ASD is increasing among children between 5 and 12 years (5). Comparing the increase of ASD in the U.S. and the Middle East, one can note that in both regions, the prevalence rate of the autism is similar; however, it is higher in the latter. While analyzing the prevalence and incidence of ASD, Davidovitch et al. point out that in the United States and Canada, the autism prevalence is estimated to be 1%, while the prevalence of ASD in South Korea is at 2.6% (785). Notably, the study reflects that in the Middle East countries, the prevalence of autism disorder is at a higher rate than in the Western nations and America.
Risk Factors Leading to the Increase of Autism Spectrum Disorder
The available literature on the factors that cause ASD indicate that autism is a devastating childhood condition that is an increasing social concern. Research by Dietert, Dietert, and DeWitt disseminate that autism spectrum disorder is caused by environmental, genetic, and epigenetic factors (1). In the similar study, Dietert, Dietert, and DeWitt quote that some of the environmental factors that cause ASD include direct exposure of drugs to the environment, chemicals, and medical procedures that involve pregnant mothers and sometimes fathers (5). In support of the findings concerning factors leading to the increase of ASD, Gardener, Spiegelman, and Buka claim that parental factors are among the risky determinants of autism spectrum disorder (7). The study points out that pregnancy-related exposure is a parental factors that stance the risk of a child being infected with ASD at an early age. The study suggested that infection and exposure to intrauterine infections during pregnancy are the leading parental related factors that can increase the prevalence of ASD (9).
Correspondingly, Chaste and Leboyer outline that genetic factors are more likely to cause the increase of ASD than any other factors (282). In the study, the researchers highlight that the prevalence of autism spectrum disorder is caused by factors that relate to the families, especially the shared genes and the variation of autistic traits shared by people who come from the same families (282). A review by Dietert, Dietert, and DeWitt suggested that the increasing occurrence of ASD cases result from the collaboration of different inclined genetic factors (4). In this case, the study presents that genetic factors are major elements that led to the increment of ASD prevalence and mostly affects children between the age of one and five years. To conclude on the subject of factors causing ASD, it is evident that individuals with enhanced exposure to environmental chemicals, genetic inclinations, and parental factors are at increased risks of getting ASD.
Impact of Having a Family Member with ASD to Other Members
Research shows that raising a child with ASD can be a devastating experience for both parents and families (Karst and Van Hecke 247). Karst and Van Hecke outline that ASD leads to a decreased parenting efficacy, increased family stress, and leads to possible financial crisis (247). Similarly, Smith, Greenberg, and Mailick argue that a child with ASD makes their parents live with anxiety, especially when the child is in the adolescence transition (732). In a corresponding research by Weiss, Wingsiong, and Lunsky, they show that parents to children with ASD might get high-level depression, anxiety, and mental health related issues (1). Consequently, ASD not only affects children but further impacts the family of the victims economically, socially, and psychologically.
Significance of Early ASD Diagnosis
Guthrie, Swineford, Nottke, and Wetherby speculate that many health care systems need to ensure the diagnoses of ASD is stable in children at the age of three years (582). Koegel, Robert, Kristen, and Jessica emphasize that early diagnosis of ASD is important because it makes the health care practitioners see ASD as a single disorder that is treated according to its symptoms, individuals’ characteristics, and environmental context (51). Consequentially, the research discusses that when a child with ASD is assigned to early treatment, this makes the healthcare practitioners open to intervention programs (51). Early intervention increases treatment support that greatly benefits the patient to an extent where they no longer seek ASD services. Guthrie, et al. confirm that early diagnosis of ASD brings out a high rate of stability to the health of the children. Therefore, for a child with ASD to have a stable health, they should get their first diagnosis by the age of three and five years.
Further, to ensure that early diagnosis and intervention of ASD conditions is efficient, healthcare organizations should develop a scale-rating instrument that will be used to evaluate the behavioral elements of patients (Fakhoury 4). In this case, Fakhoury writes that for hospitals to improve the aspect of ASD prognosis, they can use observation tools such as autism diagnostic observation schedule (ADOS) and other standardized instruments such as autism diagnostic interview-revised tool (ADI-R) (5). The use of such instruments will help the medical practitioners to observe the behavior of children with ASD, which will allow them to use specific diagnostic criteria at an early age.
Discussion
From the analyses of the previous studies, the rate of ASD prevalence has continued to increase over the years. For instance, Davidovitch et al. noted that in Israel, since 2010, the ASD prevalence rate for children between 1 and 12 years has raised to 0.48%, which is higher than the previously reported prevalence figures in Middle East countries (785). Further, the researchers point out that in 2010, ASD prevalence for children aged eight years in Israel was 0.65%, which was a lower rate that in U.S. where the rate of ASD occurrence was 0.9%. Moreover, in the United States, the rate of autism spectrum disorder is increasing at a rate of 1% and inthe Middle East countries the it is increasing at 0.2% (Davidovitch et al. 789). Therefore, the identified prevalence of ASD has increased significantly in the recent years. On ASD prevalence, the occurrence of ASD is increasing as six children per 1000 children are likely victims (Faras, Al Ateeqi, and Tidmarsh 294).
Moreover, from 1980 to 1991, the prevalence of ASD prevalence increased at a rate of 60%; but with the change of diagnostic criteria, ASD prevalence in Europe decreased in early 1994 (Hansen, Schendel, and Parner 61). The ASD diagnostic criteria that were introduced in countries such as Denmark had a broader effect on ASD prevalence, as the criteria gave the clinicians an opportunity to treat the victims. Dietert, Dietert, and DeWitt showed that early diagnosis is essential to both the children with ASD and the family members (2). Treatment and diagnosis programs for children with ASD should be initiated when they are two years or after normal development (2).
Conclusion
This paper looked at the prevalence of ASD, factors leading to its increase, and the need for early diagnosis. The prevalence of ASD continues to increase, mostly in children between one and eight years. Additionally, medical practitioners are playing a crucial role in the identification and treatment of ASD. Consequently, the health care system and physicians have come up with tools used in detecting ASD and initiated diagnostic programs that facilitate ASD prevention efficiently.
Recommendations
Following the understanding of the prevalence of ASD, factors causing it, and diagnostic procedures that should be applied to its treatment, health care systems should consider the following recommendations.
First, to detect the ASD cases early enough, the health care sector should come up with screening programs for all children between one and eight years. This will develop and create monitoring activities that will ensure that diagnostic process for the children with ASD starts timely.
In addition, to identify ASD, the physicians should carry out a formal evaluation of children’s social behavior, language, and nonverbal communication. This will allow physicians to observe the health of a child and if the observation suggests any symptoms of ASD, the medical practitioner will emphasize on early diagnosis.
For effectiveness in the treatment of ASD, nurses and doctors should work with the health care professional organizations to acquire the support needed in the treatment of ASD condition. The healthcare professional organizations disseminate information that shows the nurses the nature and range of ASD in young children, especially the preschool children.
Works Cited
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