2
Autism Awareness in Lahore
Muhammad Ghazi Abid
Raja Ramz Ullah
Syed Saad Bin Sami
Tamiah Nasir
Mr. Humair Hashmi
Psychology
Lahore School of Economics
2
AUTISM AWARENESS IN LAHORE
Abstract
The paper aims to explore and seek out the issues primarily attached to the questions of autism
awareness in Pakistan. The research has been done through a critical analysis of the primary and
secondary information collected, this includes a review of the literature of five research articles
based on autism, an interview and questions asked through questionnaires which has enabled us
to predict the progress regarding the awareness of autism, in the recent years. The literature
review summarizes the articles on autism which has initiated this research on autism awareness.
The paper demonstrates five distinct variables having an effect on autism awareness including
media, organizations working for autistics, education, and confusion of autism with other
ailments and social attitudes. The paper shows the relationship these variables have with
awareness of autism.
AUTISM AWARENESS IN LAHORE
Acknowledgments
We bow our head in gratitude before Almighty Allah for His blessings and for giving us the
strength to accomplish this task.
We are honored and deem it a source of pleasure to express our profound and heartiest
gratitude to Mr. Humair Hashmi for giving us valuable guidance. His keen interest in our work,
helpful criticism and timely suggestions throughout the term paper work whenever we required
made our work possible. Without his vital instruction and kind behavior, it would not have been
possible for us to complete this term paper. We are also thankful to the people who helped us
directly and indirectly in completing the project.
AUTISM AWARENESS IN LAHORE
Autism Awareness in Lahore
Autism is one of the top most ailments/disorders around the globe. Autism is one of those
ailments that tears down the personality, it being a developmental disorder that appears in the
early stages of childhood such as the first 3 years. Generally it tends to move on a stable routine
without diminution, with impinge on the brain's normal development of social and
communication skills. Autism as a form of the physical condition coupled to the abnormal
biology and chemistry present in the brain has its causes still unknown and disguised. It is
eminent not only through a distinct indication, but by a characteristic triad of symptoms that take
in impairments in social interaction, impairments in communication, and restricted interests and
repetitive behavior. Other aspects, such as typical eating, are also common but are not essential
for the analysis. Autism's individual symptoms occur in the general population and appear not to
associate highly, without a sharp line separating pathologically severe from common traits.
Autism results in pestering with the information that has to go through the course of action in
the brain, by altering the connection and organization of nerve cells and their synapses. But how
this occurs is still a matter of discovery as still its roots are unknown. It is one of the three
recognized disorders in the autism spectrum (ASDs), the other two being Asperger syndrome,
which lacks delays in cognitive development and language, and Pervasive Developmental
Disorder, which is diagnosed when the full set of criteria for autism or Asperger syndrome are
not met. It is exceptional for some cases in autism to have this disorder strongly associated
with agents that cause birth defects.
Controversies surround other proposed environmental causes, such as heavy
metals, pesticides or childhood vaccines. The vaccine hypotheses are biologically improbable
and lack convincing scientific evidence. The symptoms are usually seen in early age because the
AUTISM AWARENESS IN LAHORE
child tends to act in a way that is repetitive and not in a normal routine which makes it
prominent. These indications appear gradually but in most of the children they have a propensity
to develop normally but then lose ground.
Lack of social characteristics tells between autism and the related autism spectrum
disorders from other developmental disorders. People with autism show social impairments and
often are deficient in the intuition about others that many people take for granted. Unusual social
development becomes apparent early in childhood years. Autistic infants show less attention to
social stimuli, smile and look at others less often and respond less to their own name. Autistic
toddlers differ more strikingly from social norms, for example, they have less eye contact and
turn taking, and do not have the ability to use simple movements to express them such as the
deficiency to point at things.
About a third to a half of individuals with autism do not develop enough natural speech to
meet their daily communication needs. The disability of communication may start to appear from
the very first year of life diminishing the communication ability and this may also include
deferred inception of babbling, unusual gestures, weakened responsiveness and vocal patterns
that are not synchronized with the caregiver. In the second and third years, autistic children have
less frequent and less diverse babbling, consonants, words and word combinations. Their
gestures are less often integrated with words. In a pair of studies, high-functioning autistic
children aged 8–15 performed equally well as, and adults better than, individually matched
controls at basic language tasks involving vocabulary and spelling. As people are often sized up
initially from their basic language skills, some studies suggest that people speaking to autistic
individuals are more likely to overestimate what their audience comprehends.
AUTISM AWARENESS IN LAHORE
Current Situation of Autism awareness
By culture you refer to stereotype, the “majority” of people among the population.
Speaking about Pakistan, it is one of the under developed countries till date while being
augmented with widespread poverty, illiteracy, bad governance, corruption and abuse of human
rights more than other parts of the world. Pakistan being a conservative country at large shows a
wide variety of customs and beliefs that go back to the old ages. While Autism is being
discussed, it is pertinent to mention that due to the cultural prevalence of cousin marriages for
materialistic reasons or any other may be one of the major causes for the autistic disorder present
in the patients in our country. Though the roots are not known for this disorder but genetics cause
seems to be one of them.
Due to lack of awareness and illiteracy, non existence of proper forums for the
information of this disorder and other multiple factors, majority of the families with these
patients do not know exactly about this infirmity and are unable to differentiate with other
disorders and syndromes. As a result they treat the children no differently as they should respond
to the special needs of these children. Even if the people here are aware of this ailment, they are
not able to give proper treatment due to lack of availability of technology and medical education
as well as facilities for these autistic children.
Yet the situation is not as bleak as it used to be as in the present era a lot of study has
been done in the universities and hospitals and respective institutes regarding such illnesses. A
couple of non-profit organizations have been established too, to help and nurture such patients.
All this is still not enough as with the increasing population greater steps ought to be taken to try
to eliminate and eradicate this issue which is present in the society.
AUTISM AWARENESS IN LAHORE
A positive step forward is through the role of the media. Talk shows, interviews, research
papers and news paper articles have thrown light on this syndrome and have discussed it at
length. Thus autism awareness is growing among those who are literate. Another step forward is
the setting up of clinics with trained personnel at government hospitals recently, from which the
masses will benefit immensely. However, the situation is not at all ideal and still a lot of effort
and working is required for any kind of government or private funded campaign to increase more
and more awareness.
This paper proposes to find out the major variables and reasons that affect the awareness
of autism and its patients. Also, it aims to analyze the reasons and thus suggest how these
patients struck by autism could be taken out from the darkness of isolation. It also highlights the
related problems present in the society.
The significance of this research is that it aims to get first hand experiential information
about the conditions relating to autism in Pakistan, mainly in Lahore due to limited resources and
time. . It will include an objective analysis of the available resources and how well or how badly
these resources are put to use.
Literature Review
Two students of elementary school with ADHD (attention deficit hyperactivity disorder)
and PDD-NOS (pervasive developmental disorder – not otherwise specified) were chosen for the
implementation of Social StoryTM alone as well as along with DRO (differential reinforcement of
zero behavior). Results demonstrated that both the school boys responded to the procedures
differently; however there was a decrease in response to both procedures in both the participants
(Iskander & Rosales, 2012). The teachers of these participants confirmed that both the students
AUTISM AWARENESS IN LAHORE
demonstrated decrease in their target behaviors when DRO was added to Social Story
Intervention. This was the first case study that indicated the effectiveness of pairing DRO with
Social Story intervention in order to decrease the problematic behavior of students during the
classroom routine. Since the target behaviors had to be maintained by attention coming from
adults, positive feedback had to be provided by the teachers during the assessment of these two
participants.
During pediatric visits, early school years children are screened with ASD screening
measures to check whether or not they are on the developmental track (Briegel, Schimek, &
Kamp-Becker, 2010; Fernell & Gillberg, 2010; Leung, Mak, Lau, Cheung, & Lam, 2010; Lung,
Chiang, Lin, & Shu, 2011). However, this test cannot be relied on because it has shown a high
incidence of false positives. According to a study, out of 243 toddlers (who were labeled as ASD
positive on the basis of screening), only 141 actually had ADS. Meanwhile, screening does help
on identifying the characteristics of those who have ADS and those who do not (Kozlowski,
Matson, Worley, Sipes & Horovitz, 2011). When the ASD group was compared with a non-ASD
group, it was found out that the toddlers in the ASD group showed greater cognitive and adaptive
functioning impairment. The specific areas where the two groups differed were communication
abilities, personal-social skills, cognitive capacities and motor functioning domains.
Another study showed that there is a relationship between social attribution abilities and
age, after control is achieved in verbal and language skills in children who are diagnosed with
ASDs (Bal, Yerys, Sokoloff, Celano, Kenworthy, Giedd & Wallace, 2012). The children with
ASD, in this particular study, provided not very appropriate responses to the moving pictures of
geometric shapes. Also, these children demonstrated a decreased tendency to point out towards
these animations.
AUTISM AWARENESS IN LAHORE
Another study suggests that the presence of interface of verbal communication skills and
challenging behaviors made ASD diagnosed children’s social skills better. The analyses affirmed
the fact that moderation of relationship between social and communication skills in ASD
diagnosed children can be attributed to challenging behaviors (Matson, Hess & Mahan, 2010).
The best social skills were of the participants who had low rates of challenging behaviors along
with improved social skills in ASD diagnosed children. Nonetheless, the most important factor
for the determination of children’s social skills was the rate of challenging behaviors. This
implies that irrespective of the communication skills, the children with decreased rates of
challenging behaviors had a somewhat same level of social skills. Moreover, the children with
improved communication skills and who demonstrated increased rates of challenging behaviors
had poorer social skills as compared to the children with worse communication skills who
demonstrated increased rates of challenging behaviors. Nevertheless, all the children who were
exhibiting decreased rates of challenging behaviors exhibited improved social skills. The bottom
line is that the amount of communication may not play a role in the development of social skills
as compared to the effect of challenging behaviors.
The aforementioned results of this study are suggestive of the kind of treatment that
should be given to children who are diagnosed with ASD. As a result, the treatment regimen for
these children should stream their attention on behavioral strategies so as to enhance functional
alternative behaviors and at the same time decrease challenging behaviors.
There are many methods through which we can diagnose school going children as well as
toddlers with ADS. On the other hand, it is also important for us to make sure that we eliminate
the false negative as well as the false positive tests, especially when we screen toddlers and
children for ASD. Meanwhile, the treatment should focus on the factors that help develop these
AUTISM AWARENESS IN LAHORE
children the appropriate social skills along with the appropriate cognitive behavior (Matson,
Kozlowski, Fitzgerald & Sipes, 2012).
Research Questions
1. How is media responsible for creating autism awareness?
2. What is the relationship between education and awareness regarding autism?
3. What role do social attitudes play when considering awareness on autism?
4. Does confusion of autism with other ailments result in lower awareness of autism itself?
5. Do the organizations working for the autistic create awareness about autism?
6. What forces are to be blamed for the reasons of unawareness of Autism?
Method
The research has been conducted using both primary and secondary research methods.
Five research studies have been taken from, ScienceDirect, an academic search engine and were
reviewed in order to write a literature review. The primary research comprises of an interview
and a questionnaire. The questionnaire was constructed using 5 variables. The primary research
also included an interview with a renowned psychiatrist Dr. Saad Basheer Malik. Dr Saad whose
help cannot be thanked enough also helped us consult with a child psychologist currently doing a
P.H.D in Autism Sajjad Ahmed.
Research Design
The questionnaires comprised of 3 demographic questions relating to age, sex and
educational background. It also included 19 separate questions on 5 variables. We kept the
independent variable as Awareness on which we constructed 3 questions. Rest of the 4 variables
AUTISM AWARENESS IN LAHORE
had 3-4 questions each. These dependent variables were, Media, Organizations supporting
Autism, Social Attitudes, Confusion with other ailments and Education. We sent these
questionnaires out to 30 people in total which was our sample size.
Measures and Procedure
The questionnaires comprised of statements to which respondents were asked to reply
with a number from the Likert scale. A score of 1 denoted a strong disagreement, a score of 5
denoted neutrality and a score of 10 denoted strong agreements. After receiving the responses we
transferred the answers to an Excel sheet which helped us to get the average marks for each
respondent of every variable in the questionnaire. Excel helped us construct pie charts for the
demographic questions. We constructed three pie charts for the three demographics question on
Age, Sex and Education. After compiling all the results in the Excel sheet we exported this data
to statistical software known as Statgraphics to help with running the simple regression,
correlation analysis and multiple-regression analysis between the variables. This further led to
constructing an equation relating our independent variable awareness to the dependent variable.
Next we ran a correlation matrix using all the variables to see what relations they had with each
other.
Results
Simple Regression - Awareness vs. Confusion with other Ailments
Dependent variable: Awareness
Independent variable: Confusion with other Ailments
Linear model: Y = a + b*X
Coefficients
AUTISM AWARENESS IN LAHORE
Least Squares Standard T
Parameter Estimate
Error
Statistic
P-Value
Intercept
8.69035
0.795287 10.9273
Slope
-0.187825
0.116275 -1.61535 0.1174
0.0000
Analysis of Variance
Source
Sum of Squares Df Mean Square F-Ratio P-Value
Model
2.94259
1
Residual
31.5759
28 1.12771
Total (Corr.) 34.5185
2.94259
2.61
0.1174
29
Correlation Coefficient = -0.29197
R-squared = 8.52466 percent
R-squared (adjusted for d.f.) = 5.25769 percent
Standard Error of Est. = 1.06194
Mean absolute error = 0.860511
Durbin-Watson statistic = 2.28024 (P=0.7759)
Lag 1 residual autocorrelation = -0.177311
Interpretation
The output shows the results of fitting a linear model to describe the relationship between
Awareness and Confusion with other Ailments. The equation of the fitted model is
Awareness = 8.69035 - 0.187825*Confusion with other Ailments
AUTISM AWARENESS IN LAHORE
Since the P-value in the ANOVA table is greater or equal to 0.05, there is not a
statistically significant relationship between Awareness and Confusion with other Ailments at
the 95.0% or higher confidence level.
The R-Squared statistic indicates that the model as fitted explains 8.52466% of the
variability in Awareness. The correlation coefficient equals -0.29197, indicating a relatively
weak relationship between the variables. The standard error of the estimate shows the standard
deviation of the residuals to be 1.06194. This value can be used to construct prediction limits for
new observations by selecting the Forecasts option from the text menu.
The mean absolute error (MAE) of 0.860511 is the average value of the residuals. The
Durbin-Watson (DW) statistic tests the residuals to determine if there is any significant
correlation based on the order in which they occur in your data file. Since the P-value is greater
than 0.05, there is no indication of serial autocorrelation in the residuals at the 95.0% confidence
level.
Simple Regression - Awareness vs. Education
Dependent variable: Awareness
Independent variable: Education
Linear model: Y = a + b*X
Coefficients
Least Squares Standard T
Parameter Estimate
Error
Statistic
P-Value
Intercept
7.52836
1.08812
6.91866
0.0000
Slope
-0.0113917
0.145124 -0.0784963 0.9380
AUTISM AWARENESS IN LAHORE
Analysis of Variance
Source
Sum of Squares Df Mean Square F-Ratio P-Value
Model
0.00759446
1
Residual
34.5109
28 1.23253
Total (Corr.) 34.5185
0.00759446
0.01
0.9380
29
Correlation Coefficient = -0.0148328
R-squared = 0.0220011 percent
R-squared (adjusted for d.f.) = -3.54864 percent
Standard Error of Est. = 1.1102
Mean absolute error = 0.862221
Durbin-Watson statistic = 2.02728 (P=0.5176)
Lag 1 residual autocorrelation = -0.066506
Interpretation
The output shows the results of fitting a linear model to describe the relationship between
Awareness and Education. The equation of the fitted model is
Awareness = 7.52836 - 0.0113917*Education
Since the P-value in the ANOVA table is greater or equal to 0.05, there is not a
statistically significant relationship between Awareness and Education at the 95.0% or higher
confidence level.
The R-Squared statistic indicates that the model as fitted explains 0.0220011% of the
variability in Awareness. The correlation coefficient equals -0.0148328, indicating a relatively
weak relationship between the variables. The standard error of the estimate shows the standard
AUTISM AWARENESS IN LAHORE
deviation of the residuals to be 1.1102. This value can be used to construct prediction limits for
new observations by selecting the Forecasts option from the text menu.
The mean absolute error (MAE) of 0.862221 is the average value of the residuals. The
Durbin-Watson (DW) statistic tests the residuals to determine if there is any significant
correlation based on the order in which they occur in your data file. Since the P-value is greater
than 0.05, there is no indication of serial autocorrelation in the residuals at the 95.0% confidence
level.
Simple Regression - Awareness vs. Media
Dependent variable: Awareness
Independent variable: Media
Linear model: Y = a + b*X
Coefficients
Least Squares Standard T
Parameter Estimate
Error
Statistic
P-Value
Intercept
8.82887
0.933768 9.4551
Slope
-0.195296
0.128822 -1.51601 0.1407
0.0000
Analysis of Variance
Source
Sum of Squares Df Mean Square F-Ratio P-Value
Model
2.61841
1
Residual
31.9001
28 1.13929
Total (Corr.) 34.5185
29
2.61841
2.30
0.1407
AUTISM AWARENESS IN LAHORE
Correlation Coefficient = -0.275418
R-squared = 7.58552 percent
R-squared (adjusted for d.f.) = 4.285 percent
Standard Error of Est. = 1.06738
Mean absolute error = 0.834897
Durbin-Watson statistic = 2.11571 (P=0.6017)
Lag 1 residual autocorrelation = -0.113588
Interpretation
The output shows the results of fitting a linear model to describe the relationship between
Awareness and Media. The equation of the fitted model is
Awareness = 8.82887 - 0.195296*Media
Since the P-value in the ANOVA table is greater or equal to 0.05, there is not a
statistically significant relationship between Awareness and Media at the 95.0% or higher
confidence level.
The R-Squared statistic indicates that the model as fitted explains 7.58552% of the
variability in Awareness. The correlation coefficient equals -0.275418, indicating a relatively
weak relationship between the variables. The standard error of the estimate shows the standard
deviation of the residuals to be 1.06738. This value can be used to construct prediction limits for
new observations by selecting the Forecasts option from the text menu.
The mean absolute error (MAE) of 0.834897 is the average value of the residuals. The
Durbin-Watson (DW) statistic tests the residuals to determine if there is any significant
correlation based on the order in which they occur in your data file. Since the P-value is greater
AUTISM AWARENESS IN LAHORE
than 0.05, there is no indication of serial autocorrelation in the residuals at the 95.0% confidence
level.
Simple Regression - Awareness vs. Organizations Working for the Autistic
Dependent variable: Awareness
Independent variable: Organizations Working for the Autistic
Linear model: Y = a + b*X
Coefficients
Least Squares Standard T
Parameter Estimate
Error
Statistic
P-Value
Intercept
7.47415
1.21601
6.14647
0.0000
Slope
-0.00389148
0.157073 -0.024775 0.9804
Analysis of Variance
Source
Sum of Squares Df Mean Square F-Ratio P-Value
Model
0.000756677
1
Residual
34.5178
28 1.23278
Total (Corr.) 34.5185
0.000756677 0.00
29
Correlation Coefficient = -0.00468198
R-squared = 0.00219209 percent
R-squared (adjusted for d.f.) = -3.56916 percent
Standard Error of Est. = 1.11031
Mean absolute error = 0.860172
0.9804
AUTISM AWARENESS IN LAHORE
Durbin-Watson statistic = 2.01712 (P=0.5206)
Lag 1 residual autocorrelation = -0.0612564
Interpretation
The output shows the results of fitting a linear model to describe the relationship between
Awareness and Organizations Working for the Autistic. The equation of the fitted model is
Awareness = 7.47415 - 0.00389148*Organizations Working for the Autistic
Since the P-value in the ANOVA table is greater or equal to 0.05, there is not a
statistically significant relationship between Awareness and Organizations Working for the
Autistic at the 95.0% or higher confidence level.
The R-Squared statistic indicates that the model as fitted explains 0.00219209% of the
variability in Awareness. The correlation coefficient equals -0.00468198, indicating a relatively
weak relationship between the variables. The standard error of the estimate shows the standard
deviation of the residuals to be 1.11031. This value can be used to construct prediction limits for
new observations by selecting the Forecasts option from the text menu.
The mean absolute error (MAE) of 0.860172 is the average value of the residuals. The
Durbin-Watson (DW) statistic tests the residuals to determine if there is any significant
correlation based on the order in which they occur in your data file. Since the P-value is greater
than 0.05, there is no indication of serial autocorrelation in the residuals at the 95.0% confidence
level.
Simple Regression - Awareness vs. Social Attitudes
Dependent variable: Awareness
Independent variable: Social Attitudes
Linear model: Y = a + b*X
AUTISM AWARENESS IN LAHORE
Coefficients
Least Squares Standard T
Parameter Estimate
Error
Statistic
P-Value
Intercept
7.765
0.80251
9.6759
0.0000
Slope
-0.0477655
0.115725 -0.41275 0.6829
Analysis of Variance
Source
Sum of Squares Df Mean Square F-Ratio P-Value
Model
0.208753
1
Residual
34.3098
28 1.22535
Total (Corr.) 34.5185
0.208753
0.17
0.6829
29
Correlation Coefficient = -0.0777661
R-squared = 0.604757 percent
R-squared (adjusted for d.f.) = -2.94507 percent
Standard Error of Est. = 1.10695
Mean absolute error = 0.862727
Durbin-Watson statistic = 2.02503 (P=0.5102)
Lag 1 residual autocorrelation = -0.066602
Interpretation
The output shows the results of fitting a linear model to describe the relationship between
Awareness and Social Attitudes. The equation of the fitted model is
Awareness = 7.765 - 0.0477655*Social Attitudes
AUTISM AWARENESS IN LAHORE
Since the P-value in the ANOVA table is greater or equal to 0.05, there is not a
statistically significant relationship between Awareness and Social Attitudes at the 95.0% or
higher confidence level.
The R-Squared statistic indicates that the model as fitted explains 0.604757% of the
variability in Awareness. The correlation coefficient equals -0.0777661, indicating a relatively
weak relationship between the variables. The standard error of the estimate shows the standard
deviation of the residuals to be 1.10695. This value can be used to construct prediction limits for
new observations by selecting the Forecasts option from the text menu.
The mean absolute error (MAE) of 0.862727 is the average value of the residuals. The
Durbin-Watson (DW) statistic tests the residuals to determine if there is any significant
correlation based on the order in which they occur in your data file. Since the P-value is greater
than 0.05, there is no indication of serial autocorrelation in the residuals at the 95.0% confidence
level.
The first row denotes the linear relationship or more specifically shows us the strength of
the linear relationship between the variables. It is the Pearson Product Moment Correlation
which has a range from negative one to positive one. The value in parenthesis is the number of
pairs of data used to calculate these coefficients which as you can clearly see is 30 for all the
variables. The 3rd entry is the P-Value which tests the statistical significance of the estimated
correlations. A P-Value of below 0.05 denotes a statistically significant correlation. As is given
up the strongest correlation is between Education and Organizations working for the Autistic. It
has a corresponding P-Value of 0.000 which means that this correlation is significant. The
second strongest linear relation or correlation is between Media and Social Attitudes with 0.7373
and correspondingly the P-Value is again 0.000 confirming the significance of this correlation.
AUTISM AWARENESS IN LAHORE
The least strong correlation is between Awareness and Organizations working for the autistic at 0.0047. To sum it all up the following variables have a statistically significant correlation.
The next statistical tool we used on the data was the multiple regression analysis. We
took the average values of the three questions on Awareness for all 30 respondents and ran a
regression with the rest of the five variables. This gave us an equation which told us how the
relations held and how each variable contributed to our independent variable i.e. Awareness and
whether or not the dependent variables were influential in determining the independent variable.
The multiple regressions which we ran yielded the following results.
The equation is given as Awareness= 7.43891+0.246459*Social Attitudes0.529067*Confusion with other Ailments+0.374665*Education+0.312152*Organizations
working for Autistic-0.462949*Media. Since the P-Value in the ANOVA table is less than 0.05
there is a significant relationship between the variables. One variable however which stands out
is the Organizations working for the Autistic which has the highest P-Value of 0.1920 and it is
required that it should not be included in the model which is also a nod to our previous
correlation analysis in which the lowest correlation value came out to be for the Organizations
for the Autistic with Awareness.
Discussion
The results given below reflect a true picture of our expected findings. As the correlation
matrix suggests the strongest correlation was between Media and Social Attitudes which we
expected to find. It is even evident by our interview that media and social attitudes have a big
role to play. Secondly another strong correlation was found between education and organizations
working for the autistic. The least strong relation however was between Autism and
AUTISM AWARENESS IN LAHORE
Organizations working for the Autistic which is also consistent with our multiple regression
model which stated that we might as well remove the dependent variable Organizations working
for Autism out of our model. It also goes on to further show that people do believe that the
organizations are not doing enough or that their role in spreading awareness about Autism
restricted. The results were also well in line with our interview in which Dr. Saad Basheer Malik
clearly stated the importance of the role of media for creating Awareness. All in all we do accept
certain limitations of our model and research. We believe that a larger sample size may have
yielded much more accurate and consistent results. The problem with this type of research was
that it was qualitative in nature and converting this into a quantitative research had some
drawbacks. Certain things are clear for e.g. that for awareness media and education have a
special role to play. In Pakistan the education system is in shambles and the media, however free
and liberal, stilly shies away from giving light to the truly important matters at hand.
References
Iskander, Jeannette M. & Rosales, Rocio. 2012.“An evaluation of the components of a Social
StoriesTM intervention Package”. Youngstown StateUniversity,United
States.Elsvier Publications.
Kozlowski, Alison M.; Matson, Johnny L.; Worley, Julie A.; Sipes, Megan; Horovitz, Max.
2011. “Defining characteristics for young children meeting cutoff on the modified
checklist for autism in toddlers”. Louisiana State University, Baton Rouge, LA
70803, United States. Elsvier Publications.
Bal, Elgiz; Yerys, Benjamin E.; Sokoloff, Jennifer L. & Kenworthy, Lauren. 2012. “Do social
attribution skills improve with age in children with high functioning autism
AUTISM AWARENESS IN LAHORE
spectrum disorders?” a Children’s NationalMedicalCenter,Washington,DC,USA.
Elsvier Publications.
Celano, Mark J.; Giedd, Jay N.; Wallace, Gregory L. 2012. “Do social attribution skills improve
with age in children with high functioning autism spectrum disorders?” National
Institute of Mental Health, Bethesda, MD, USA. Elsvier Publications.
Matson, Johnny L.; Mahan, Sara & Hess, Julie A. 2010. “Moderating effects of challenging
behaviors and communication deficits on social skills in children diagnosed with
an autism spectrum disorder.” Louisiana StateUniversity,United States. Elsvier
Publications.
Matson, Johnny L.; Kozlowski, Alison M.; Fitzgerald, Mary E. & Sipes, Megan. 2012. “True
versus false positives and negatives on the Modified Checklist For Autism in
Toddlers”. Louisiana StateUniversity,United States.Elsvier Publications.
AUTISM AWARENESS IN LAHORE
Appendix: A
Questionnaire
This research is being carried out to gauge the societal approach and awareness towards Autism.
You are requested to place an appropriate number to show the level of your opinion against each
statement. Your cooperation will be highly appreciated.
Age: -
- 15 - 24
- 25 - 34
- 35 - 44
- 45 - 54
- 55 - 64
- 65 and above
Gender: - (i) Male
(ii) Female
AUTISM AWARENESS IN LAHORE
What is the highest level of education you have completed?
-
O-Levels / Matric
A-Levels / F.S.c.
Undergraduate
Graduate
Post-Graduate
Please answer the following questions with respect to the scale given below.
1
2
3
4
5
6
7
8
9
10
Strongly Disagree
Sr.#
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
Neutral
Strongly Agree
17
Statements
Rating
Media has provided a platform for Autistic awareness.
Talk shows can create reflective awareness of Autism.
Interest in Autism can be generated through movies and documentaries.
Education creates better understanding of Autism.
Education aids in positive response towards the Autistic.
Education generates research based knowledge of Autism.
Autistic people are subject to social segregation.
Negativity to Autistic results in their lower social interaction.
Response to Autism differs according to the social class.
Education has helped differentiate between Autism and abnormality.
Autism is sometimes confused with lunacy.
Autistic people are thought to be victims of superstitious charms.
Organizations projecting potentials of Autistic influence our opinions.
Initiatives by organizations to help Autistic lead a normal life has contributed to awareness.
Organizations through special trainings of Autistic have lessened negativity towards it.
Organizations have helped generate Autistic awareness through positive skill learning of
the affected.
Awareness is the first step to treatment
18
People in our society are not as aware as in developed countries
19
Greater awareness leads to greater tolerance
AUTISM AWARENESS IN LAHORE
Appendix: B
Interview Transcript
Dr. Saad Basheer Malik: “It’s a psychiatric disorder that affects children and in it there are
different questions as to how and why children are born with it. In this disorder there are some
organic, brain related problems, some are structural problems. What happens to kids in this
disorder is that their normal skills for e.g. speech, developing eye contact and developing
relations aren’t developed. These children become solitary. They live in their own world. They
insist on playing with one specific toy for e.g. and have a fixed daily routine and they get upset
when that routine is not followed. Their I.Q. is variable, from very low to average. They have
speech problems. In some children there is a quality which is very outstanding like computers or
mathematical calculations. Their treatment does not involve a drug rather they have training
sessions which include one to one speech training and rehabilitation. These symptoms continue.
AUTISM AWARENESS IN LAHORE
It is debatable that many of them develop psychiatric disorders when they grow up but generally
due to their speech related problems they really can’t live normally.”
Interviewer: “Ok, and do receive autistic people for treatment or diagnosis?”
Dr Saad: “This basically is the domain of a child psychiatrist. In Pakistan we don’t have many
child psychiatrists. There are only one or two in some centers who can treat these patients.”
Interviewer: “So, I think it’s safe to say that not much is being done?”
Dr Saad: “Yes”
Interviewer: “Why do you think that Autism and other such disorders are considered taboo in our
society? Why do people refrain from talking about them and even taking their children who have
these disorders to doctors and psychiatrists?”
Dr Saad: “In our society the stigma about mental disorders is a very big issue. Whenever
somebody has such a problem they don’t discuss about it and they don’t let other people know
about it for the fear of their image. They don’t want people to know about such problems
because they will automatically shy away from them. When there is such a disorder in children
they think that maybe people will not marry their children and therefore due to similar reasons
refrain from talking about such problems.”
Interviewer: “So the communication disorder is why Autism and such other disorders go
undiagnosed.”
Dr Saad: “Sorry what’s the problem?”
Interviewer: “I mean that people don’t talk about it and there is no communication”
AUTISM AWARENESS IN LAHORE
Dr Saad: “Ok now what happens is that it’s difficult to diagnose. Families don’t even realize that
their children are suffering from such a disorder… ”
Interviewer: “And why is that?”
Dr. Saad: “Because there is no awareness. What happens is that these children are sent to normal
schools. There they fail to do well. They don’t have make friendships and they fail to develop
relationships with peers. Their I.Q. is low and the teacher thinks that they are dumb. They hit
these children. There isn’t any awareness amongst teachers or parents.”
Interviwer: “Are you aware of any such organizations which are trying to bring about this
awareness, some schools or NGOs or even the media?”
Dr. Saad: “There are some private institutions which are working on the private level and there
are one or two NGOs who look after such patients.”
Interviewer: “So obviously two or three are not enough?”
Dr Saad: “No.”
Interviewer: “Would you agree that media has a strong role to play?”
Dr Saad: “Media has a very strong role to play because they can create awareness. They can
show and tell what the signs and symptoms are and what are the procedures for early detection
and media can help train teachers and parents.”
Interviewer: “And this is also lacking…”
Dr Saad: “Absolutely”
AUTISM AWARENESS IN LAHORE
Interviewer: “… because if you see there has been an influx of these channels but there is no
education about such disorders.”
Dr. Saad: “The education is equivalent to not being present at all.”
Interviewer: “Why do you think that, when we talk about tolerance; tolerance for people with
Autism and tolerance for people with mental disorders why is there an overall low level of
tolerance among people for e.g. like you said earlier that people don’t even take their children to
doctors and specialists.”
Dr. Saad: “The problem is that our society is constructed on faulty values. We take pride in our
children. We want to live for them. We want to present them and be proud of them. Children
pressurized to do well so if the children is a slow learner he is no longer a pride for the family
and so the parents think that the child is an embarrassment for them and a shame for them which
is wrong and so they don’t really care about their treatment as such”
Interviewer: “Is it safe to say that they are victims of segregation. They are segregated a lot.”
Dr Saad: “What happens here in both Autistic children and mentally handicapped children is that
instead of people letting them mingle with society they handicap them more by minimizing their
interaction with the world so they develop secondary symptoms of speech and social
communication. They already have the primary defects but by keeping them away from the
world they develop a secondary type of handicap.”
Interviewer: “There was another thing that we saw was that, especially in Pakistan, and I think
that is because of the awareness deficit that autistic children are sometimes extraordinarily gifted
like you mentioned earlier, but people have a stigma and they confuse autistic people with
AUTISM AWARENESS IN LAHORE
mentally retarded people whereas their main symptom is the communication disorder. They
confuse autism with other disorders.”
Dr Saad: “It’s the same thing. It’s difficult to diagnose.”
Interviewer: “Is there a degree to the symptoms of Autism?”
Dr Saad: “Oh yes. It is known as Autism Spectrum. It is a spectrum. You can have very mild
cases in which their I.Q. is a little low and speech problems are also not very extreme. In severe
cases speech is poor, I.Q. is poor and they are completely handicapped therefore the spectrum.”
Interviewer: “And the extreme cases? Are they beyond any treatment?”
Dr Saad: “There isn’t any special treatment except for rehabilitation in clinics.”
Interviewer: “Which we have talked about that such clinics are not present”
Dr Saad: “There are only one or two private institutions which only the rich can afford to send
because they are very expensive.”
Interviewer: “Are you aware of what happens in these institutions?”
Dr Saad: “There is intensive teaching one a one-to-one basis. It takes a lot of time. There are
grooming sessions.”
Interviewer: “And to what extent are they successful?”
Dr Saad: “It’s, I think it’s not more than 40 percent”
Interviewer: “One question that we are trying to answer in our research is that should autistic
people with less extreme symptoms be integrated in schools with normal students?”
AUTISM AWARENESS IN LAHORE
Dr Saad: “In the West, they have specialists. The severe cases they cannot cope but the mild case
might survive but you have to see that if you integrate a person with mild symptoms with normal
students there will be a lot of stress on them and also the normal students won’t accept them”
Interviewer: “So would you say that it is more dependent on the type of society?”
Dr Saad: “For mild children you will have to determine what is best for the child but for the rest
of the cases it isn’t possible.”
Interviewer: “When we talk about Awareness, do you think that there is a difference between
how people of different social classes treat patients of Autism or other disorders?”
Dr Saad: “Oh yes. The lower middle and low income classes don’t even know what the condition
is. They just give up on the child. They don’t bother about what kind of problem they have.
There is no assessment and no diagnosis. The rich however, will go to a pediatrician and get a
diagnosis.”
Dr Saad: “In our society there is such a dismal state of affairs that a poor person who has 9 or 10
daughters is willing to and odes marry them off to autistic patients who come from rich families.
You can explain to them a million times but they don’t listen. An autistic person cannot stand
under the institution of marriage. He or she cannot live that life.”
AUTISM AWARENESS IN LAHORE
Appendix: C
Demographic Details
Gender
Female
47%
Male
53%
AUTISM AWARENESS IN LAHORE
Age
35-44
0%
45-54
0% 55-64
0%
25-34
10%
15-24
90%
Post-Graduate
3%
Graduate
4%
Education
O-Levels/Matric
0%
Undergraduate
20%
A-levels/F.S.c
73%