A New Outlook on Autism Spectrum Disorders: 1 Research Statement For my Capstone Project, I will synthesize an argument in the developmental field of psychology. I will base my research off of Developmental Dynamics, a theory that proposes that genetics are not solely responsible for the development of phenotypic (anything that is not biological, as in our behaviors) characteristics. Rather, both genetics and the environment in which we are raised are responsible for our phenotypic development. I will apply the concepts learned from Developmental Dynamics to provide insight on why people with autism develop the way they do. I will attempt to identify the reasons to why they attain this disorder, why they develop the specific behaviors they portray, and acknowledge some methods that could lead people with autism to live a more normal life. I will include a general description of autism in the paper, for it will provide the readers with some information on what the typical behaviors of autistics are. I will then explain what the influence that prenatal factors have on the development of autism in children. I will then study reports of older children with autism, from a range of 8 or so years to around 18 years of age, and see what influence their environments have taken on their behaviors. Then, I will examine what the typical lifestyle of adults with autism is like, and see what their early lives have transformed into, whilst analyzing the effects their genetic and environmental developmental factors have taken on them. Then, using Developmental Dynamics as a point of reference, I will discuss what the current procedures are for helping people with autism. I will build on these techniques using the information learned from Developmental Dynamics, as to provide certain methods that could help people with autism live better lives. I also use information from past psychological experiments, medical experiments, and other popular arguments made for the nature versus nurture debate, as it seems to me that the results of these experiments and arguments are of use in supporting Developmental Dynamics. These include the works of B.F. Skinner, Sigmund A New Outlook on Autism Spectrum Disorders: 2 Freud, and Harry Harlow. I will also use topics discussed in the Sociology class taught at Doral College, for I feel that many of its concepts, such as social isolation, pertains to Developmental Dynamics (especially the environmental portion of the theory). I then use this information, along with Developmental Dynamics, to formulate a coherent thesis for explain the causality of autism spectrum disorders. A New Outlook on Autism Spectrum Disorders: 3 A New Outlook on Autism Spectrum Disorders: Analyzing Autism Spectrum Disorders from a Developmental Dynamics Point of View Doral College A New Outlook on Autism Spectrum Disorders: 4 Abstract Developmental psychology has for centuries roamed around the nature versus nurture debate, in which each side of the debate attempts to prove what human development is caused by. Instead, a new perspective on the subject named Developmental Dynamics proposes that genetics are not solely responsible for the development of phenotypic (anything that is not biological, as in our behaviors) characteristics. Rather, both genetics and the environment in which we are raised are responsible for our phenotypic development. First, a general description of what classifies as being in the autism spectrum is provided in order to get a clear view of what the typical behaviors of autistic people are. With Developmental Dynamics as a reference point, the causes of the onset of autism is explained vis-a-vis research on the inheritance of chromosomes, prenatal factors, Sigmund Freud’s psychosexual theory of development, and Harry Harlow’s experimentation on affection with rhesus monkeys.Then, a follow-up analysis of the influence of autism on adolescents and adults is conducted, with regards to Developmental Dynamics and reports by private organizations with information on the lifestyles of adults with autism. Afterward, a close investigation on the current treatment options for people with autism is done, and consequently, an analysis of these treatment options was constructed in order to devise better procedures for the current treatment options. Keywords: autism, autism spectrum, autism causes, development, treatment A New Outlook on Autism Spectrum Disorders: 5 Nature versus Nurture, or Developmental Dynamics?
For as long as mankind has dug deep into Psychology, the most disputed debate in the field is probably what has been termed the “nature versus nurture” debate. In a nutshell, the nature versus nurture debate is a two-sided point of interest in developmental psychology, that point of interest being the quest for discovering what the factors are in the development of a human being, both physically and mentally. One side, the nature argument postulates that the factors for human development lie in the human genome. For instance, in human intelligence there is a strong correlation between the intelligence of a person’s parents and that person’s intelligence (according to professor George Boeree of Shippensburg University (2003), intelligence is defined as one’s cognitive ability to understand concepts and apply that knowledge in real-world situations) (University of Manchester, 2011). Proponents of the other side, the nurture argument, theorize that human development is essentially driven by certain factors in the environments in which people are raised in. Notably, human personality traits are said to be determined by factors in the environment (“Personality is the result,” 2013). These factors include the prenatal living environment, the parenting style of the individual’s parents, or the social-economic situation in which the person is raised in (“The role of the environmental,” n.d.). While the nature versus nurture debate has been highly disputed, each side of the debate having a plethora of research, several psychologists are starting to reject the entire debate. These psychologists believe that there is no nature versus nurture debate, since many explanations based off of one side of the debate do not make sense (Gopnik, 2014). For example, given that twins share the exact set of genes with the other twin, it is unclear why each twin has a different level of intelligence and a different A New Outlook on Autism Spectrum Disorders: 6 batch of personality traits (Hamilton, 2013). However, developmental psychologists still wish to know what factors contribute to human development. In the last ten to fifteen years, researchers in developmental psychology have developed a new theory for this, called the “Developmental Dynamics” theory. Essentially, what Developmental Dynamics proposes is that genetics are not solely responsible for human development, and neither are the environments in which people are raised in. Rather, Developmental Dynamics claims that the factors of human development are both nature and nurture, where nurture is dependent on nature. That is to say, our genetic information is the “code” for human development, and this code is ran by environmental inputs. Furthermore, in Developmental Dynamics, genetic information includes inherited genes and phenotypic instructions from previous generations (Lickliter & Honeycutt, 2003). This means that not only are genes passed down from generation to generation, but so are the characteristics for the development of behavior, physiological traits, and mental traits. Using the information from Developmental Dynamics, it may be easier to determine why one in every 68 children are affected by an autism spectrum disorder (“Facts about autism,” n.d.). What classifies as autism (or rather, Autism Spectrum Disorder)? To start with, let us define what autism is. Autism is a spectrum disorder (ASD), meaning that the onset of the disorder is capable of impairing a person physically and mentally (Herrington, n.d.). The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), uses the following criteria to determine if a person falls under an autism spectrum disorder: failure to engage in social interactions, deficits in speaking, failure to recognize relationships and the emotions of others, repetitive behavior, and high reactivity to external inputs (“DSM-5 diagnostic criteria,” n.d.). For example, a child A New Outlook on Autism Spectrum Disorders: 7 that is seen to refrain from interacting with other children, has a fixation for stacking his or her toys on top of each other, and has a speech delay may be diagnosed as having an ASD. Furthermore, these symptoms must begin in childhood and must not be caused by intelligence deficits. Although ASDs once included asperger’s syndrome and a variety of other disorders, the DSM-5 currently classifies all children that fall under the criteria previously listed as having an autism spectrum disorder (“Answers to frequently asked,” n.d.). The severity of the disorder is based off of the level of social interaction impairments and the intensity of the repetitive behaviors the person commits (“DSM-5 diagnostic criteria,” n.d.). There is still no known cure for ASDs, seeing that what causes the onset of these disorders is still a speculation. Can Developmental Dynamics explain the causes of ASDs? Despite the fact that the causes for autism spectrum disorders are unknown, there is an increasing amount of research being done to discover what this cause really is (Happe & Plomin, 2006). It was previously believed by many psychologists that ASDs were solely entirely caused by genetic factors (Freitag, 2006). However, further research indicates that genetics, environmental inputs, and cognitive factors are all responsible for the onset of an ASD (Happe & Plomin, 2006). Developmental Dynamics can be used to explain this very well, given that what the theory proposes correlates strongly with what further research in autism shows. What research recently has showed is that chromosomes 7 and 15 are highly associated with ASDs, since inheritance of these chromosomes in families with a speech and language deficit has been found abundantly across linkage studies (Freitag, 2006). In 2002, the Autism Genome Project (AGP) was launched in order to sequence the genetic information from over 1,200 families. The initial results from the AGP revealed that chromosome 11 and neurexin 1 (a A New Outlook on Autism Spectrum Disorders: 8 protein that helps neurons bind to each other) are partially accountable for autism spectrum disorders (“Autism speaks and the world’s,” 2007). Furthermore, brain scans of individuals with autism spectrum disorders consistently show weak neural connections in the brains of these people, increasing the likelihood that genetics do play a role in ASDs (University of Alabama at Birmingham, 2013). With regards to Developmental Dynamics, the inheritance of genes is not fully responsible for the onset of an ASD. Rather, there must be an environmental “trigger” that causes these genes to express themselves in the form of an ASD. Although current results from research on this are ambiguous, there is growing evidence that the prenatal risks are present for the onset of ASDs. It is believed that the greatest prenatal risk for having a child with an autism spectrum disorder is being a pregnant woman over 30 years of age, with increased risks ranging from 27% to 106%. A pregnant mother with diabetes also increases the risks of having a child with an ASD by 81% (Gardener & Buka, 2009). Studies have shown that autistic children at the prenatal stage of their lives have anomalies in their amygdalae (responsible for emotional and social behaviors) and cerebella(responsible for motion and coordination), providing further evidence that autism spectrum disorders begin before birth (Watson, 2007). This may well be the environmental aspect of Developmental Dynamics, given that the mother is the child’s first environment in which the child develops. Tie this genetic model of prenatal development in with any inherited genes that play a role in the onset of an ASD, it is plausible that a child’s prenatal environment serves as the “trigger” to excite this genotypic information. According to Developmental Dynamics, these genetic factors must at some point be provoked when an external stimulant is present near an individual. Thus, it is critical for us to understand what these environmental factors are. For one, Sigmund Freud’s psychosexual theory of human development provides for a strong case for what these environmental factors may be. According to Dino Felluga A New Outlook on Autism Spectrum Disorders: 9 (n.d.) from Purdue University, Freud claimed that humans go through 5 stages of development: oral, anal, phallic, latent, and genital. Of the five stages, the first two stages (oral and anal) are presumably the most coherent stages for explaining the onset of ASDs. During the oral stage (ages 0 to 2), the child becomes fixated with their mouth and lips, since children of this age are breastfed regularly. As reported by Felluga, Freud saw this as the person’s first sexual desires, since the possessive nature of the child over the mother for breast milk causes the child to become more fond of the mother and more ignorant towards the father. Holding Freud’s claim to be true, there is a possibility for which a child may develop behaviors that retract them from social interaction, since the relationship formed with the mother during the oral stage is seen to be crucial for the development of relationship-building. As stated by Felluga, the anal stage (ages 2 to 4) is marked by a high fixation to defecation. Freud believed that the child’s pleasure for defecating symbolized the child’s capacity to become independent. Autistic children might develop into adults that are heavily dependent of their caretakers, since a failure to receive pleasure from the anal stage would not render them independent. The fact that people with ASDs suffer from gastrointestinal problems gives high suspicion that they are failing to enjoy defecation during the anal stage (Herrington, n.d.). Additionally, psychologist Harry Harlow spent several years researching to see if human development was affected by attachment to the mother. Using rhesus monkeys, a “mother” made up of wires with no covering, and a “mother” with wires covered in a soft fabric, Harlow observed how the rhesus monkeys behaved around the uncovered mother and the covered mother. Harlow found that the rhesus monkeys tended to use the covered mother as a form of shelter and security from external stimuli that he would use to frighten the monkeys (such as loud noises), while the monkeys did not tend to interact with the uncovered mother very much (Herman, n.d.). From this, Harlow concluded that motherly attachment is crucial to human development, noting that the lack of the A New Outlook on Autism Spectrum Disorders: 10 attachment could lead to a deterioration in mental health, seeing how the monkeys would remain frightened and hopeless when the uncovered mother was used, and vice-versa (Herman, n.d.). Therefore, a lack of affection from a person’s caretakers may contribute to the onset of ASDs, since the individual would not be able to develop an affection for a caretaker, thus inhibiting the person from being able to form future relationships (Fraley, 2010). Nevertheless, this can only explain the onset of an ASD, or the earliest that signs of an ASD can occur. Autism Spectrum Disorders in adolescence and adulthood Knowing that there is a good chance that ASDs develop at an early age, it is necessary understand why children with an ASD tend to refrain from social interactions, develop speech deficits, and routine behaviors as teenagers and adults. Autistics that go into their teenage years tend to develop a comorbid disorder, often depression and anxiety (Watson, 2007). This may well be due to the fact that autistic teenagers are faced with newer tasks which they have never been accustomed to, such as increased school work, an increase in independence from their parents, and negligence received from others in their social environments which may not approve of their disorder. This can alienate autistics from their social environments, causing them to feel lonesome, which is a key ingredient for depression. Many teens also have difficulties in social interactions since the tend to avoid eye contact with people whom they are communicating with (“Autism,” n.d.). Back to Developmental Dynamics, this could be the expressed form of a gene (seeing how the amygdalae in autistics tends to have irregularities, which can be considered as part of the genetic side) that has been triggered by years of social interactions. However, there are a growing amount of reports suggesting that autism spectrum disorders almost always gets less severe during adulthood, now more than ever due to the increase in A New Outlook on Autism Spectrum Disorders: 11 treatments for these disorders (DeNoon, 2007). Of course, the disorder does not go completely away, but many autistics tend to live a more stable life in adulthood. Some researchers go as far as saying that a small percentage of autistics (under 25%) end up “losing” their autism (Pearson, 2013). However, those that do not recover substantially are usually at the “low functioning” end of the autism spectrum. Of course, it is more difficult in treating people with severe autism, for their communication skills are very limited, therefore complicating the treatment method. The reason that there are so many variations in the outcome of children with ASDs is the fact that every human develops differently; as Professor Robert Lickliter puts it in “Developmental Dynamics: Toward a Biologically Plausible Evolutionary Psychology”: [T]he development of any individual organism is the consequence of a unique web of interactions among the genes it carries; the complex, multidetermined molecular interactions within and across individual cells; and the nature and sequence of the physical, biological, and social environments through which it passes during development. (p. 820). What Lickliter is proposing is that human development is affected by a complicated system made up of our genes and environments in which we live in. Thus, it is inevitable that every single case of an ASD will be unique, since each person has a completely different genome than any other autistic person, and each person is raised in a distinct environment. Therefore, each case of a person with an ASD can end up on a different level of functioning in the spectrum. Nonetheless, elderly people with an ASD do end up living tougher lives than those without an ASD, due to the fact that on top of all of the complications that come with ageing (deterioration of health, exhausted abilities in the workforce, decreasing cognitive capacity), people with ASDs often require more needs due to their disorder (Autism Europe, 2003). In younger generations with ASDs, the propensity for them to retract from social environments greatly A New Outlook on Autism Spectrum Disorders: 12 inhibits their development, seeing how Developmental Dynamics specifically explains that social development is essential for the developmental systems in humans. Consequently, as these young generations turn into older generations, they tend to fall into social isolation, due to the fact that it is more challenging for them to express their ideas and emotions. Furthermore, numerous reports have found that many people with ASDs end up either living with their families, homeless, or at health institutions, which undeniably disconnects them from society even more (Autism Europe, 2003; DeNoon, 2007; The National Autistic Society, 2013). Studies in human ecology (a main area of sociology that deals with the behaviors of populations and individuals) have shown that social isolation can cause people to have higher risks in dying at a young age and debilitates the immune system, which can lead to a vast amount of comorbid diseases, including heart disease and depression (Olien, n.d.). Misdiagnosed people with ASDs struggle even greater in adulthood, for they receive inaccurate disability benefits that may not even help them at all (“Adults with autism,” n.d.). This is so prevalent across the world, Scottish people are starting to recognize a group in their population known as the “invisible generation” (“Older people with autism,” 2013). Thus, this population of autistic people tend to gain little attention in general, leaving them with an inadequacy of help, which they greatly need (Autism Europe, 2003). A New Outlook on Autism Spectrum Disorders: 13 Implementing Developmental Dynamics into treatment options for ASDs Although no cure for any of the autism spectrum disorders has been discovered as of this date, there are several treatment options that can lessen the severity of the effects of the disorders. The typical treatment options for people with ASDs are behavioral therapy, speech therapy, and medication (“Autism spectrum disorder,” n.d.). On few occasions, special school programs are private foundations also provide care for people with ASDs. However, a common flaw in all of these treatments is the fact that no two human beings with an ASD have the exact same medical condition. The prime example of behavioral therapy is Applied Behavioral Analysis (ABA), which uses a method of positive reinforcement to reward good behaviors (“Applied behavior analysis,” n.d.). This method of treatment is based off of B.F. Skinner’s work on reinforcement, which, basically, states that the consequences of a behavior can cause the behavior to be repeated more often. Reinforcement can be either the presence of a positive stimulant or the removal of an unpleasant stimulant. Speech therapy, or more generally communication therapy, is the use of small activities that require children with ASDs to communicate with a therapist, either vocally, visually, or both. Additionally, various types of medications are prescribed to people with an ASD, most commonly antipsychotics (to lessen aggression), antidepressants(to reduce repetitive behaviors, depression, and anxiety), and stimulants (to decrease hyperactivity) (“Autism spectrum disorder,” n.d.). The use of all of behavioral therapy, speech therapy, and medication as treatment has shown some sign of improvement in the functioning of people with ASDs, yet there is no substantial evidence that shows that behavioral therapy can be used as a cure for ASDs (“Applied behavior analysis,” n.d.). Developmental Dynamics provides a great reason for this lack of evidence. Since therapeutic practices and the prescription of medicine requires certain standards or protocol (such as common A New Outlook on Autism Spectrum Disorders: 14 forms of practice or accepted dosages of certain medications as approved by the Food and Drug Administration), it is virtually impossible to give someone with an autism spectrum disorder the perfect treatment for their specific condition, in view of the fact that human development is a complex, interactive network between the human genome and the environmental inputs we experience daily. In itself, human development, as now undoubtedly seen, is greatly outside our grasp of knowledge. Even more so, the development of people with ASDs is truly a convoluted process to which researchers are even more perplexed about. Therefore, it is crucial that researchers on ASDs start focusing on a person’s genetic information and “environmental history.” This would of course take an extensive amount of research, given that genetic mapping is still in its early stages and the funds required for recording a person’s environmental factors would be considerably large. Nevertheless, Developmental Dynamics is a great step forward in the field of developmental psychology, since it has the potential to pinpoint the factors (or network of factors) behind human development, which would undeniably improve the treatments for people with ASDs. For instance, if physicians were to acquire all of this knowledge, children and teenagers with ASDs would be more accurately prescribed drugs. A low functioning autistic person with many repetitive behaviors, adequate speech impairments, and low cognitive capabilities would receive the exact dosage of antidepressants and stimulants to reduce the effects of their disorder. The person would also have the potential to receive regular updates on their medication, depending on how much their functioning has increased from the last prescription. A New Outlook on Autism Spectrum Disorders: 15 Final Thoughts Now that a new perspective of autism spectrum disorders has been presented, it is important to remember that Developmental Dynamics is a relatively “raw” theory when compared to the nature versus nurture debate. Both sides of the nature versus nurture debate have been continuously supported by a growing amount of work, while Developmental Dynamics is still a work in progress. Lickliter and Honeycutt provided a substantial amount of evidence in their journal article “Developmental Dynamics: Toward a Biologically Plausible Evolutionary Psychology,” which was convincing enough to be the basis of this paper. With time, Developmental Dynamics will become more accepted simply for the fact that it explains very well why human development requires both genetic and environmental factors to work with each other. In the context of Developmental Dynamics, the explanations for the onset of the disorder, the development, and the improvement of treatment options for people with autism spectrum disorders is rather feasible. No longer is the causality of an ASD a mystery, since Developmental Dynamics provides evidence that suggests that ASDs are most likely to be caused by genetic, prenatal, and environmental factors, and that treatment options could be of better quality if researchers begin to focus on both genetic and environmental “histories”. 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