Autism and Assistive Technology for Autistic Children

Autism is a complex neurobehavioral condition that is found in a person from early childhood days where the person faces difficulty in communicating with another person. It is also known as ASD or Autism Spectrum Disorder. It is a spectrum disorder because its effect varies from person to person. This is caused due to some changes that happen during early brain development. It is suggested that it may arise from abnormalities in parts of the brain that interpret sensory input and process language.

Previous disorders that are considered under the umbrella of diagnosis for autism include:

• Autistic Disorder: This is what most people think of when they come across to the term ‘Autism’. It refers to problems with social interactions and communication.
• Asperger’s Syndrome: A person suffering from this syndrome don’t face a problem with language and often score above average in IQ tests. But they face social interaction problems and have limited scope of interests.
• Pervasive Development Disorder (PDD): This disorder causes a delay in performing normal activities that other normal person can perform easily and leads to trouble with socializing and communicating.
• Childhood Disintegrative Disorder: Children having this disorder grow normally till 2 years or so but lose some or all of their communication and social skill while they grow up.

What causes Autism?

There is no single cause for this disorder and research is still on to find what factors cause it. It is because even if one person is exposed to similar circumstances that creates autism in another person, he or she may not get affected or develop autism. A number of known factors that can may cause ASD are:

• One or many faulty genes. 15% of autistic people are suffering from this factor.
• Lack of oxygen during birth
• Rubella in pregnant mother
• Diseases like Tuberous Sclerosis, Fragile X syndrome, Encephalitis
• Environmental causes like exposure to pesticides and heavy metals like mercury
• Advances in the age of the mother or the father

Symptoms of Autism

Autism symptoms appear in early childhood mostly before the age of 3. An autistic child benefits from early diagnosis, preferably within first two years of life which helps in providing early behavioral therapy or other treatment that proves to be most effective at that age. The behaviors or symptoms that an autistic child displays are often seen in a child who is not autistic, so a final diagnosis to confirm if a child is autistic or not should be done by a group of professionals like neurologist, psychologist, psychiatrist and speech pathologist. Some common symptoms are:

• No pointing or babbling by the age of 1
• No words were spoken by the age of 16 months or two-word phrases uttered by age of 2
• No response to name calling
• Poor eye contact
• No smiling or social response
• Loss of language or social skill
• Excessive obsession about a certain pattern or thing
• The difficulty with verbal and nonverbal communication
• Unusual facial expressions, gestures, and tone of voice
• Difficulty in recognizing emotions of one’s own as well as others
• The difficulty with understanding one’s own personal space as well as others
• Repetitive behaviors like repetitive body movements or motions with objects
• Narrow or extreme interests in specific topics
• Need for unvarying routine and resistance to change
• Have unusually developed skills in areas like drawing, music or solving math problems

Levels of Autism

• Level 1: Requiring Support - Problem in the organization of activity, thoughts, and speech. Try to communicate and interact but fail to do so socially. Able to speak full sentences and engage in communication but can’t able to make friends.
• Level 2: Requiring Substantial Support - Problem with coping up with changes, need support to carry out activities like interacting socially. Speaks simple sentences and limited to narrow special interest.
• Level 3: Requiring Very Substantial Support - Severe problem to deal with social interaction and great difficulty to change focus. Speaks few words only and rarely initiate conversation except to express a need.

Autistic incidents rate

In 2018, it is determined that approximately 1 in 59 children is diagnosed with an autism spectrum disorder (ASD). 1 in 37 boys . 1 in 151 girls. Boys are four times more likely to be diagnosed with autism than girls. Most children were still being diagnosed after age 4, though autism can be reliably diagnosed as early as age 2. 31% of children with ASD have an intellectual disability (intelligence quotient [IQ] <70), 25% are in the borderline range (IQ 71–85), and 44% have IQ scores in the average to above average range (i.e., IQ >85). Autism affects all ethnic and socioeconomic groups. Minority groups tend to be diagnosed later and less often. Parents who have a child with ASD have a 2 to 18 percent chance of having a second child who is also affected. Studies have shown that among identical twins if one child has autism, the other will be affected about 36 to 95 percent of the time. In non-identical twins if one child has autism, then the other is affected about 31 percent of the time. An estimated one-third of people with autism are nonverbal. Nearly half of those with autism wander or bolt from safety. Nearly two-thirds of children with autism between the ages of 6 and 15 have been bullied. Nearly 28 percent of 8-year-olds with ASD have self-injurious behaviors. Head banging, arm biting and, skin scratching are among the most common. Drowning remains a leading cause of death for children with autism and accounts for approximately 90 percent of deaths associated with wandering or bolting by those age 14 and younger. Attention Deficient Hyperactivity Disorder (ADHD) affects an estimated 30 to 61 percent of children with autism. Anxiety disorders affect an estimated 11 to 40 percent of children and teens on the autism spectrum. Depression affects an estimated 7% of children and 26% of adults with autism. Children with autism are nearly eight times more likely to suffer from one or more chronic gastrointestinal disorders than are other children. As many as one-third of people with autism have epilepsy. Studies suggest that schizophrenia affects between 4 and 35 percent of adults with autism. By contrast, schizophrenia affects an estimated 1.1 percent of the general population. Autism-associated health problems extend across the lifespan – from young children to senior citizens. Nearly a third (32 percent) of 2 to 5-year-olds with autism are overweight and 16 percent are obese. By contrast, less than a quarter (23 percent) of 2 to 5-year-olds in the general population are overweight and only 10 percent are medically obese.

Many young adults with autism do not receive any healthcare for years after they stop seeing a pediatrician. More than half of young adults with autism remain unemployed and unenrolled in higher education in the two years after high school. This is a lower rate than that of young adults in other disability categories, including learning disabilities, intellectual disability or speech-language impairment. Nearly half of 25-year-olds with autism have never held a paying job.

How can Autism be treated?

• Medications: Medication cure is not present for ADS. There are medications to deal with anxiety, depression etc. Medication should be given after proper examination and suggestions from professional caregivers.
• Education/behavioral therapies and interventions: This is a very helpful way to treat and give care to autistic children. There are skill-oriented sessions for the patient as well as counseling sessions for parents and other family members of the patients. For example, Camouflage is a technique used by Autism individual to cover up his/her disorder when interacting with people socially. This is not considered as good practice since it takes a great deal of effort for camouflaging which increases stress and anxiety. Few camouflaging techniques used include making eye contact during conversation, using prepared phrases or jokes in conversation, mimicking others social behavior and imitating facial expressions or gestures.
• Technology to support Autism: There is no specific cure discovered yet to completely remove ASD in a person but there are technologies that help them.

A lot can change if we focus more on helping the autistic people with technology along with the research work going hand in hand. Most adults and children these days are considered to be “digital natives” or “native speaker” of technology. Children with autism spectrum disorder(ASD) also find themselves more comfortable with devices in their hands.

1. Assisting verbal and communication skills: According to statistics of the center of disease control(CDC), more than 20,000 autistic children born each year, who are diagnosed with ASD still remain functionally non-verbal and unable to communicate their thoughts, wants and needs verbally. In such sort of cases, assistive technologies provide alternatives to communicate. They act as a gateway for self-expression, which significantly improves the child’s overall quality of life.
2. Communication: Tobii Dynavox is a company that specializes in Augmentative and Assistive Communication (AAC) technologies which include touch-based speech generative keyboard and devices and respective software. They provide online training and guides that teach how to tailor these assistive technologies to the unique needs of a child while encouraging skill building over time and development. This helps the children in struggling with verbal and communication skills.
3. Education: when technology is more accessible the audio-visuals and computer graphics attract the children to a great extent and maintain their attention. Rather than sitting in a classroom listening to a teacher, by creating interactive displays of a storybook, lessons etc., helps the children to watch the videos repetitively so that they can understand the things in a much better way. This also assists the children to improve their natural abilities when exposed to a technology-aided classroom as they learn by doing, experiencing and constructing.
4. Stress relief: Apple devices like ipads, offered a range of learning tools that help the child to interact with others and communicate their thoughts eloquently. They not only provide an interactive application they also provide applications that ASD people to self-stimulate in a calm and safe way than by hand flapping, repetitive noises, picking etc. This acts as an outlet for the child to relieve stress. When the child was introduced to these type of applications, eventually the autistic behaviors disappeared. Due to media hype, of this device, many consumers began to purchase iDevice.
5. Security of child: Parents of children with ASD always has the fear that their children may wander off here and there also called elopement which is due to an impaired sense of danger. Usage of GPS tracker with different anchor points provides assurance to parents by locating child location and prevents the occurrence of child wandering episode. Security devices for a home like security cameras, wifi connected locks, doors, and windows alarms provide round the clock protection along with providing additional notifications for smaller issues like shower being left on or door being open. These increase confidence in parents about their child security and also makes the child with ASD independent.

Few technological innovations that improve the way Autistic children communicate are:

1. Synchrony, Communication through music Synchrony is a therapeutic instrument designed to help to reduce the social-emotional gap between autistic children with their parents. It is achieved by letting autistic children literally harmonizing playmates. The device responds to touch by playing soothing music and avoiding “bad notes” which makes Synchrony to be a favorite device for autistic children.
2. Smart Stone, For Non-verbal autistic children Smartstone focuses on non-verbal communication with taps, swipes, and gestures on a digital stone making tactical touch a way of communication. It offers a simplified way of communication by giving autistics children tactical feedback.
3. Leka, Autistic child buddy Leka encourages an autistic child to learn individuality through independent play. It looks adorable and can quickly become a buddy to the children. It responds back by playing sounds, light, and vibration. Leka also available on the iOS marketplace.

Robotic Technologies to help Autism

1. Milo: Milo the robot is designed to be interesting and approachable for learners with ASD. He can walk, talk and even model human facial expressions. Milo never gets frustrated or tired. He consistently delivers lessons in a way that learners with ASD respond to. This recurring positive experience creates an environment in which learners can learn and thrive. Milo delivers lessons verbally. As he speaks, symbols are displayed on his chest screen that will help your learner better understand what he is saying. Throughout the lessons, Milo will ask your learner to watch four to five-second video clips on the student tablet. The videos show learners displaying the skills or behaviors both correctly and incorrectly that Milo is teaching. Your learner will be asked “yes” or “no” questions to determine if the learners in the video are doing the behaviors right or wrong.
2. Cozmo: Cozmo is an interactive robotic character that employs video game character animation in a toy rather than on the screen. Cozmo is beguiling because he interacts with players based on a series of artificial wants and needs rather than a pre-programmed linear story. More than this he can see with a small camera in his head and knows when a particular person is present in the room. The result is surprisingly human behavior.
3. Nao: This two-foot-tall robot goes by the name of Nao, and young kids who had a therapy that included Nao made more progress on their social skills. Nao can walk, talk, dance and engage kids in a number of activities meant to improve their ability to read facial expressions and maintain appropriate eye contact. Upon success, Nao can even offer a child a congratulatory high-five. Human beings can be overwhelming to a kid with autism, displaying a cascade of movements and behaviors. On the other hand, robots are more reserved and reassuring to these children.
4. Kaspar: Kaspar is a child-sized humanoid robot designed as a social companion to improve the lives of children with autism and other communication difficulties. By interacting and behaving in a childlike way, Kaspar helps teachers and parents support children with autism to overcome the challenges they face in socializing and communicating with others. Kaspar has been purposefully designed as an expressive robot offering a more predictable and initially repetitive form of communication, which aims to make the social interaction simpler and more comfortable for the child.

Disadvantages of using technology in treating Autism

1. Devices like iPad, Robots are costly and it may need frequent replacement when given in hands of children. Thus this type of treatment itself becomes a money crunch issue.
2. Many apps are free but many of the apps used for therapy can start at around 99 cents and can go up to as much as $200!
3. Technology cannot replace the skills and knowledge that therapists have to teach children with special needs as somewhere still they lack the full human emotion and touch
4. Games and apps on iPads and smartphones are interactive, but only between the child and the device itself and children need the opportunity to interact with actual people to also learn the language and social skills.
5. Using technology is also not the best or only way to develop a child’s fine motor skills.
6. Young children need to have time to use hands-on toys and real-life activities such as stacking blocks, nesting cups, scribbling with crayons, stirring in pots and dumping sand in order to develop “real life” skills needed for later success.
7. Allowing children to spend a good part of their day using technology, be it computers, iPads, smartphones or TV and video games can be over-stimulating.
8. Kids also need exercise and unless they are playing interactive games using robots. Most handheld devices are contributing to sedentary time for children.
9. Technology can best help when it is balanced with other normal human activities. If not well balanced, it may turn out to be more harmful sometimes.

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