Research Paper: Students must research a disease or condition that impacts communication in some way. Students must explain 1) the disease; 2) its impacton communication; barriers to communication the disease or condition presents; 3) accommodations that must be and/or might be made; 4) ethical and/or legal obligation
Autism, also known as Autism Spectrum Disorder (ASD), is a neurodevelopmental disorder that affects the social, behavioral, and communication patterns of individuals. According to the World Health Organization (WHO), this condition affects one in every 160 children across the world. The prevalence of the health problem over the years and persistence during adulthood creates the need for an adequate understanding of ASD, notably in the communication context, to help enhance the wellbeing of people with the condition. Therefore, this research explores the condition in terms of its impact on communication, accommodations that must be made, ethical and legal obligations associated with the disorder, and treatment modifications for ASD.
The findings suggest that some of the barriers of communication linked to the condition include the inability to communicate effectively, listen to others and inadequate intent to speak. The findings also reveal that informed consent before the implementation of a treatment plan, respect, and dignity for patients are among the legal and ethical obligations associated with the condition. Furthermore, the study shows that the disorder can be modified through pharmacological treatment and psychosocial therapies.
According to a 2019 report by the World Health Organization (WHO), one in every 160 children has an autism spectrum disorder (ASD). This statistic ascertains that ASD is an issue of concern, mainly because of its detrimental effect on the wellbeing of its victims. While there exists significant research on the condition, its core and associated symptoms and impact on patients, there is still scant information on the barriers to communication that the disorder presents. Therefore, this research explores ASD in the communication context and establishes that the communication obstacles associated with the condition include the inability to communicate effectively, listen to others, and inadequate intent to speak to others; and that the disorder can be managed through psychosocial therapies and pharmacological treatment.
Description of Autism
ASD is a neurodevelopmental disorder that affects the social, behavioral, and communication patterns of an individual. As the literature suggests, people born with autism often exhibit distinctive social and behavioral behaviors such as avoidance of eye contact, issues with emotional control, inability to understand the emotions of others, and restricted involvement in social activities and interests (Park et al., 2016). These social behaviors differ significantly from those of verbal persons who tend to have control over their emotions and considerably involve themselves in social activities such as sports and other recreational tasks. Furthermore, research reveals that the disorder affects a person’s communication patterns, both verbal and nonverbal, in the first three years of life (Park et al., 2016). Overall, ASD is a neurodevelopmental disorder whose signs are exhibited in an individual’s behavior and social patterns.
One of the most visible hallmarks of ASD, especially in children and adolescents, is challenges in communication. As opined by Tager-Flusberg, Lord, and Paul (2013), children diagnosed with ASD are often nonverbal beyond childhood compared to their counterparts. While the root cause of non-verbal autism is still unclear, the aspect could be a result of inhibited development of language skills, which creates challenges in communication. Nevertheless, Halle and Meadan contend that some children born with the condition can still develop communication skills, although messages conveyed by such individuals are difficult to comprehend and may eventually result in communication breakdowns (cited by Krupa, Boominathan, Sebastian & Ramanan, 2019). Mostly, the inability to convey understandable messages is caused by challenges in the use of language in a functional way. For example, such persons may not have the skills to use deixis appropriately in a sentence to convey a message. For these reasons, ASD significantly inhibits communication between individuals with autism and those that are verbal.
Barriers to Communication Presented by the Condition
The existing research reveals that ASD poses numerous barriers to communication, among them, the inability to communicate effectively, which can lead to a communication breakdown between the patient and healthcare practitioner. Studies conducted by Nicolaidis et al. show that individuals with ASD often have restricted communication literacy, which affects their ability to undertake typical communication, literal interpretation, and make appointments with caregivers (cited by Mason et al., 2019). As noted, a majority of patients with ASD are non-verbal, whereas those that are verbal have challenges in the functional use of language. Reports by the National Institute on Deafness and Other Communication Disorders (NIDCD) also reveal that children with ASD exhibit poor nonverbal conversation skills such as the use of gestures to give meaning to their speech (“Autism Spectrum Disorder”, n.d.). Therefore, it may be problematic for such individuals to indulge in productive conversations in a healthcare context, such as setting appointments and interpreting written speech because of the inhibited or delayed development of their communication skills.
Additionally, studies conducted among individuals with autism suggest that the inability to listen to others is a significant barrier to communication presented by the condition. According to NIDCD, persons with autism often exhibit narrow interests in social activities and even conversation with others (“Autism Spectrum Disorder”, n.d.). Landa et al. also add that a considerable number of children with ASD have shorter joint engagement and inadequate intent to communicate (cited by Krupa et al., 2019). The probable cause of the inability to listen among individuals with autism is the prevalence of distinctive behavioral patterns such as avoidance of eye contact, which likely triggers a quick loss of attentiveness during conversations. This barrier to communication can have adverse effects in a healthcare setting as patients with ASD may not be attentive enough to understand instructions given by health practitioners. Besides, practitioners that lack adequate knowledge about the condition may interpret the patient’s behavior as rudeness and lack of interest in information relayed during the practitioner-patient interaction.
Furthermore, the growing body of research suggests that inability and inadequate intent to speak is a significant barrier to communication linked to ASD. As noted by scholars, verbal individuals with autism are sometimes unwilling to communicate with others (Krupa et al., 2019). A probable cause for this behavior could be the fact that individuals with the condition often lack the skills to use language functionally. Therefore, failure of first attempts to speak effectively is likely to cause frustrations and minimal intentions to indulge in a subsequent conversation with others. Regrettably, this condition can lead to challenges with a person’s bodily awareness in a healthcare context, such as difficulty describing pain and other symptoms, as observed by Nicolaidis et al. (cited by Mason et al., 2019). The outcomes of these challenges can, in some instances, be vocal outbursts and aggressive behavior as the patient tries to express themselves to the health practitioner.
Accommodations that must be Made
Unfortunately, ASD has been proven to be a lifelong condition, whose patient needs tend to fluctuate periodically. For example, during the early stages, the symptoms of ASD may be mild, and the patient may not have many needs as compared to scenarios when the disorder worsens. Therefore, accommodations must be made appropriately to meet the growing needs of people with autism to help them fit in society while respecting their diversity.
Scholars suggest that one of the accommodations that must be made concerning people with ASD is restructuring language during conversations. Most notably, the National Disability Authority (NDA) aver that verbal people, regardless of the context, should use clear language that is easy to understand (“Reasonable accommodations”, 2015). As noted, people with autism have restricted language skills, which may constrain their ability to comprehend vocabularies during conversations. In his book “It’s Raining Cats and Dogs: Autism Spectrum Guide to the Confusing World of Idioms, Metaphors, and Everyday Expressions”, Michael Barton (2011) also asserts that individuals with autism may interpret expressions in a literal manner. For example, the phrase “hit the nail on the head” may be interpreted literally, leading to confusion during a conversation. Therefore, the use of precise language should be mandatory accommodation to avoid misunderstandings during interaction with people with autism.
Furthermore, the literature suggests that support networks are critical accommodations that should be made when dealing with people with autism. As observed by NDA, friendships can be significant support networks to help meet the needs of this category of individuals (“Reasonable accommodations”, 2015). As noted, people with autism have a distinctive pattern of behavior characterized by restricted social interests (Park et al., 2016). This behavior can lead to isolation due to the struggles associated with developing ties with their peers. Building friendship support networks for this population, such as associating them with people who understand their disorder, can enhance their social life and, to some extent, help strengthen their communication skills.
Ethical and Legal Obligations Associated with the Condition
As the literature suggests, caregivers have an ethical and legal obligation towards patients, especially when implementing treatment plans for people with autism. Most notably, it is argued that physicians are legally obliged to obtain informed consent from patients with autism before implementing assessment or subsequent treatment options (“Legal and Ethical Consideration”, n.d.). However, if patients lack the mental capacity to issue the consent, their legal representative may be required to grant permission on the former’s behalf. Additionally, McDonald and Then (2019) add that nurses have an ethical obligation to treat patients diagnosed with the condition with dignity and respect. Most notably, dehumanizing language and infringement of privacy should be avoided during medical procedures to help promote the overall wellbeing of the patient.
Importance of Awareness among Healthcare Practitioners
Healthcare practitioners must be aware of the legal and ethical issues associated with people with autism to avoid unwanted legal repercussions. This aspect is exemplified in a scenario in the United Kingdom where a patient with autism and significant behavioral problems was agitated when attending a day center, and was subsequently admitted to hospital as a voluntary patient (McDonald &Then, 2019). However, the court ruled that the patient’s treatment was an unlawful deprivation of liberty due to the failure of the nurses to seek the patient’s informed consent (McDonald & Then, 2019). This case scenario illustrates the need for healthcare practitioners to be aware of the ethical ad legal issues associated with autism to avoid similar legal repercussions, which may amount to revocation of a practicing license.
Studies show that ASD can be modified to enhance the wellbeing of an individual through methods such as psychosocial therapies and pharmacological treatment. According to scholars, psychosocial therapies such as Applied Behavior Analysis (ABA) is a treatment based on theories of learning and operant conditioning (DeFilippis & Wagner, 2016). For example, children can be subjected to behavioral modifications while receiving rewards to encourage behavior gains. Also, healthcare practitioners can deal with the situation through pharmacological treatment such as administration of Risperidone and Aripiprazole in low doses and slow titration (DeFilippis & Wagner, 2016). Most notably, studies have proven medication to be appropriate for the management of symptoms associated with ASD, such as irritability.
Findings from this research ascertain that ASD is a lifelong condition that affects communication among its victims, leading to communication barriers. Therefore, specific accommodations must be established to help people with autism to fit into society. Also, the research reveals that the condition is associated with ethical and legal obligations such as informed consent, respect, and dignity, which must be upheld to avoid legal repercussions among healthcare practitioners. Furthermore, considerable evidence shows that ASD can be modified through pharmacological treatment and psychosocial therapies. While this paper provides significant evidence on ASD and its associated core symptoms, further qualitative studies may be required to test the effectiveness of the established accommodations in enhancing the wellbeing of people with autism.
“Autism spectrum disorder: Communication problems in children” (n.d.). National Institute on Deafness and Other Communication Disorders. Retrieved from https://www.nidcd.nih.gov/health/autism-spectrum-disorder-communication-problems-children
“Autism spectrum disorders” (2019, November 7). World Health Organization. Retrieved from https://www.who.int/news-room/fact-sheets/detail/autism-spectrum-disorders
“Legal and ethical considerations” (n.d.). AASPIRE. Retrieved from https://autismandhealth.org/?a=pv&p=main&theme=none&size=small&s=con_con&t=pv_con
“Reasonable accommodations for people with autism spectrum disorder” (2015). National Disability Authority. Retrieved from http://nda.ie/nda-files/Reasonable-Accommodation-for-People-with-Autism-Spectrum-Disorder-updated-20151.pdf
Barton, M. (2011). It’s raining cats and dogs: An autism spectrum guide to the confusing world of idioms, metaphors and everyday expressions. London, UK: Jessica Kingsley Publishers.
DeFilippis, M., & Wagner, K.D. (2016). Treatment of autism spectrum disorder in children and adolescents. Psychopharmacology Bulletin, 15(46), 18-41. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5044466/
Krupa, M., Boominathan, P., Sebastian, S., & Ramanan, P.V. (2019). Assessment of communication in children with Autism Spectrum Disorder in South India: Influence of environment. Communication Disorders Quarterly, 41(1), 34-41. doi: 10.1177/1525740118793978
Mason, D., Ingham, B., Urbanowicz, A., Michael, C., Birtles, H., … & Parr, J. (2019). A systematic review of what barriers and facilitators prevent and enable physical healthcare services access for autistic adults. Journal of Autism and Developmental Disorders, 49(8), 3387-3400. doi: 10.1007/s10803-019-04049-2
McDonald, F., & Then, S. (2019). Ethics, law and health care: A guide for nurses and midwives. London, UK: Macmillan International Higher Education
Park, H.R., Lee, J.M., Moon, H.E., Lee, D.S., Kim, B., … & Paek, S.H. (2016). A short review on the current understanding of autism spectrum disorders. Experimental Neurobiology, 25(1), 1-13. doi: 10.5607/en.2016.25.1.1
Tager-Flusberg, H., Lord, C., & Paul, R. (2013). Language and communication in autism. In F. R. Volkmar, R. Paul, A. Klin & D. Cohen (Eds.), Handbook of autism and pervasive development disorders. New York, NY: John Wiley. doi:10.1002/9780470939345.ch12