In 2010, the Center for Disease Control and Prevention [CDC] (2014) found that the prevalence of autism had increased not only in the US, but also the in the whole world. The surveillance identified that 1 out of 68 children has Autism Spectrum Disorder [ASD] (Dave and Fernandez, 2015). That translated to 1 in 189 girls and 1 in 42 boys having ASD. That means that in every 14.7 of 1000 children of 8 years of age have ASD. On the same line, the estimates of ASD varied between 5.7 and 21.9 in 1000 children of 8 years of age. Figure 1.0 shows the prevalence of ASD. A close analysis of the displayed findings of the CDC indicates that ASD has been increasing from 2000 to 2010. This increase clearly indicates that ASD will continue increasing with time. Sex and race are some of the risk factors since males are more affected compared to the female children(Dave and Fernandez, 2015)According to CDC (2014), ASD affects the intelligence of the affected children to a great deal. As a result of ASD, 25% of children from the non-Hispanic white race and 38% from Hispanic race were found to have intellectual disabilities. The percentage was higher, up to 48% for the non-Hispanic black children. With such an effect, their school performance dwindles with time as the disease progresses.

Ratajczak (2011) defined autism as a condition, which affects the brain and other parts of the nervous system. There are various triggers that bring about autism spectrum disorder. Having knowledge of what triggers this condition is a step forward towards attaining good care of the affected children. Unfortunately, few people know the triggers. Expounding on the triggers will add more understanding to the teachers and parents of children who are suffering from this condition. If they will be knowledgeable as a result of the information achieved from this project, then, avoidance of these triggers will be achieved where necessary. The reason that has led to the choice of this topic is that my son is autistic. He was diagnosed with this condition at the age of 4 years. In the initial years after the diagnosis, my son could develop challenging behaviors that I failed to understand their origin. Later on, I realized that some things could lead to such behavior for my autistic son. From such an experience, I have had the enthusiasm to know more about autism and at the same time inform parents and teachers about the same condition since they may come across children with autism.

Figure 1.0 CDC prevalence of ASD in the US

RESEARCH METHODS

Study Design

The research project was a cross-sectional study that employed quantitative approach to gathering data. The study was an action research.  An action research is one whose major aim is to find and initiate a solution to an already existing problem in the society. According to Denscombe (2010, p. 6), an action research should purpose to solve a given problem in addition to producing guidelines that are essential for practice. In this study, the major problem is ASD, which affects the health of young children and their intelligence, as well as other dimensions of life (Little, Sideris, Ausderau, & Baranek, 2014). It was of great significance not only to address the problem itself, but also to address the solutions to the problem so as to promote the society’s wellbeing.

Data Collection

The gathering of data was by the use of questionnaires filled by the staff and parents who had had the opportunity of taking care children suffering from ASD. Questionnaires were vital in that all the views of the respondents were elicited. Although the questionnaires are just like interviews concerning the nature of data collected, I choose this method because it is comparatively cheaper. This assertion is in line with McLeod (2014) explanation that questionnaires are comparatively cheaper, efficient and quick in obtaining large amounts of information. The collection of data is normally quicker than other methods of data collection because there is no need for the researcher to be present in order for the questionnaires to be filled. McLeod (2014) asserted that the use of questionnaires is a good alternative when interviews are impractical.

Reliability and validity of the questionnaires are important in ensuring that the data obtained is not only valid, but also reliable. Any research tool has its validity and reliability in gathering data (Corbetta, 2003). Reliability is essential for measuring the consistency of a tool used in research. Best and Kahan (2006) defined reliability as the degree to which a particular measurement concept produces same results with the same tool. The questionnaire for this study was same for all the respondents and questions were in the same order. McLeod (2014) asserted that with the way questionnaires are structured, their validity and reliability is substantial. The choice of using the questionnaire was partly because of its increased validity and reliability as well as its economical friendliness. Research has questionnaires are more reliable than some of the research tools, which are often used in the collection of data. Ingalill et al. (2007) found that the Cronbach’s Alpha value is 0.935 on satisfaction. More so, the value was 0.959 on the importance at a confidence level of 95%. In regard to reliability, Ingalill et al. (2007) ascertained that the Alpha (?) value of greater or equal to 0.70 is acceptable.

On the same line, the validity of any tool of research measures the accuracy of the tool. Hinton (2004) and Anthony (2011) defined validity as the degree to which a particular instrument measures what it should measure. Sirkin (2006) confirmed that a structured questionnaire has greater construct validity. With the use of the structured questionnaire in the collection of data in this study, the information that was gathered was valid.

Ethical considerations

This study was conducted in line with the SCCB Code of Ethics Conduct. The research study sought the necessary approval from the Ethics Board before commencement. According to Peart (2000), any research should only happen when there is a body such as an established ethics committee to review and approve it. With such a body in place, all researchers should forward their proposals for review and approval. Most institutions have the ethics committees that are appropriate for regulating research activities. The chief role of the committee is to enhance protection ofthe welfare and rights of the research participants. The committee has to ensure that the research is done in a manner that cannot coerce the research participants to participate in the study.

Kenner, Langerman  and Grey (2004) insisted that pediatric research can only proceed if the children’s welfare is protected.  This study didn’t involve children as the primary participants in the research. In fact, the study recruited only the teachers, parents, and other people who might have taken care of children suffering from ASD. In addition, any adult who might have had an opportunity to observe a child suffering from ASD was eligible to participate in the study. The researcher drew a detailed explanation of the research project for the participants to understand before getting recruited in the study. With this explanation, the researcher ensured that only eligible participants could fill in the questionnaires. That means that the participants understood the purpose of the study, their role in the study and how the information could be used in the process of data collection. It is important to ensure that the participants understand what the research entails before deciding independently without coercion whether to participate in the study or not (Kenner, Langerman  and Grey 2004).involves children as the source of information or participants, then the children themselves and or the parents as well as other people who take care of then should be informed of the research.

On the same line, informed consent was regarded as important in this study. The study obtained informed consent from the research participants before administering them with questionnaires for filling. That happened after the participants demonstrated to have understood the importance of the study, how their information would be used as well as how the information would be held confidential among many other things. According to…..it is ethically right to obtain informed consent from the research participants. That means that the participants make a decision to participate in the study without being forced by the researcher. In addition, they must not be lured by the use of incentives by the researcher so as to be part of the study. Kenner, Langerman  and Grey (2004) and Peart (2000) explained that once the participants have made their informed consent to participate in the study, they should not be coerced to complete the same study against their wish. They should be given an opportunity to either finish the study or withdraw at any stage at their wish. Any withdrawal should not be penalized. This study adopted the same in that all the participants were allowed to withdraw at any stage without a penalty. Furthermore, the research ensured that the information given by the participants was held confidentially. The confidentiality was upheld by the use of numbers instead of names of the participants on the questionnaires. All this was explained to the participants before obtaining the informed consent.

RESEARCH RESULTS

The study recruited 40 research participants who filled in the questionnaires. All the participants completed the study accordingly.

Table 3.1 Behaviors in ASD

Of all the participants, 95% agreed that reduced attention span is one of the behaviors in ASD. 87.5% of the participants agreed that that children with ASD present with upsets with small changes; an equal percentage said that such children prefer playing alone. More so, participants agreed that children who suffer from ASD tend to avoid eye contact. Similarly, 82.5% had agreed that the children present with unusual emotions when suffering from ASD and 37.5% agreed that the children have a delay in language development. The results are presented as shown below.

Figure 3.1 Behaviors in ASD

These findings are in line with previous researches in that children who suffer from ASD can present differently depending on many factors. For instance, Tek and Landa (2012) found that the symptoms or presentation of toddlers varies on the basis of minority or non-minority in the society. GOSH, NHS Trust, (2006) established that some children can present unusual emotions, a reduction in concentration span. More so, some of the children have been found to present with language development delays, unusual upsets with small changes in the environment and inappropriate facial expressions among others (Ratajczak 2011). Tek and Landa (2012) found that some children may only have a few of the signs and symptoms of the disorder while others may have many of them. That can explain why the respondents didn’t notice all the manifestations in the children they were taking care of.

 

 

Table 3.2 Age of children affected by ASD

Age (years)		%	n
0-1	5	2
2 to 3	12.5	5
4 to 6	37.5	15
7 to 10	50	20

Out of the 40 participants, only 5% of them had seen or cared for an autistic child of less than one year. However, 12.5% said that the children were between 2 to 3 years of age. Similarly, 37.5% of the respondents settled at an age of 4 to 6 years. The percentage of the participants increased when it came to the children aged between 7 to 10 years. The results are presented in the Figure 3.2 as shown below.

Figure 3.2 Age of children affected by ASD

The findings of the study are related to the previously done researches. CDC (2014) asserted that children who suffer from ASD can be diagnosed at an early age. However, the disease can be realized at a later age. The most common age that CDC (2014) confirmed to be an age whereby it’s easier to diagnose the disease is eight years. That is in line with what the participants said that the percentage of the responses increased concurrently with an increase in age of the children suffering from ASD.

Factors that trigger ASD

All the participants in the study agreed that there are factors, which trigger autism behavior among children who suffer from ASD.

Table 3.3 Factors that trigger ASD

%	n
Disturbing stimuli	100	40
Drugs used by the mother when pregnant	37.5	15
Scarring emotions and experiences	87.5	35
Diseases from infectious pathogenic microorganisms	60	24
Inheritance of genetic factors	70	28

 

All the participants in the study agree that disturbing stimuli can trigger autism behaviors in children who suffer from ASD. However, only 37.5% of them agreed that the use of drugs by a pregnant woman can cause autism in preborn children. On the same line, 87.5% were in agreement that scarring emotions, as well as experiences, can trigger autistic behavior in children.  Similarly, 60% of the participants ascertained that pathogenic infections can also trigger autism behavior in children. However, 70% of them agreed that genetic factors are behind the trigger of autism in children at an early age. Figure 3.3 below illustrates the same results.

Figure 3.3 Factors that trigger ASD

The findings of GOSH NHS Trust (2006) are similar to the findings in this research study. GOSH, NHS Trust (2006) ascertained that autistic behavior can be triggered by environmental factors such as the presence of stimuli. For instance, expressing something that the child doesn’t want can trigger ASD. The participants agreed that the stimuli can be scarring and disturbing. On the same line, the findings of Matsuzaki,Iwata,Manabe and Mori (2012) show that infections, especially viral ones are likely to trigger autism.Matsuzaki,Iwata,Manabe and Mori (2012) found that there is a strong correlation between ASD and viral infections like cytomegaloviruses, influenza and rubella viruses among many others.

Researches, just like this study, have also found that the use of medications can result in autism.Ratajczak (2011) asserted that the use of thalidomide by pregnant women contributes to autism. However, not all the medications can cause ASD. Finally, genetics plays a major role in the causation of autism. According to Matsuzaki,Iwata,Manabe and Mori (2012), males are the most affected in autism. That illustrates that an X chromosome may be involved. Although this study didn’t address the issue of sex in regard to autism, the participants agreed that genetics contributes to the disorder. Research from monozygotic twins has further proved the same in that if one has autism, then the other one is likely to have the same condition.

Strategies to avoid Autism

Table 3.4 Strategies to avoid triggering autism behavior

%	n
Avoid the use of un-prescribed drugs during pregnancy.	55	22
Get early treatment of diseases for a child or a pregnant mother	82.5	33
Avoid environmental stimuli that trigger autistic behaviors	95	38
Consult a genetic counselor early enough if autism is in the family	32.5	13

In this study, 95% of the participants agreed that avoidance of stimuli in the environment that trigger autism can be a great strategy to avoid the behavior.  Similarly, 82.5% of them said that early treatment of infectious diseases among pregnant women and children can be the best strategy. On the other hand, 55% of the participants agreed that avoidance of drug use among women during the pregnancy period is a good strategy for avoiding autism. However, only 32.5% of them were in agreement that genetic counseling can help in combating the disorder in case it is in the family. The figure below illustrates the same results.

Figure 3.4 Strategies to avoid triggering autism behavior

These findings are related to other researchers’ findings as well. The American Psychiatric Association (2013) asserted that avoidance of the factors that trigger autism can be instrumental in combating the occurrence of autism behavior. In this study, the participants were in agreement with the avoidance of the factors that can lead to autism such as infections and unwanted environmental stimuli among many others.

CONCLUSION AND RECOMMENDATIONS

There are several triggers for autism among children of a younger age. Some of the causes include the presence of disturbing stimuli and scarring emotions and experiences in the environment. On the same line, some drugs, and infectious diseases can trigger autism in children, especially if the mothers use drugs like thalidomide or get infected with viral pathogens. Genetics plays a major role in the triggering of the disorder amongst small children. Despite researchers demonstrating that ASD can be diagnosed at an early age in children, most of then get diagnosed with the disease at a later age. That is why most of the children are seen be having the disease beyond the age of four years.

Children with ASD can present with different manifestations, which can vary from one child to another depending on many factors in the society. Some children can avoid eye contact while others may fail to respond to name at the age of one year. Some of the children prefer playing alone. Others may present with inappropriate facial expressions, delayed language development, reduced attention span or unusual emotions among others. The study found that there are strategies, which can result in the avoidance of the autism behavior in children. Pregnant mothers should avoid the use of un-prescribed drugs as they can predispose the unborn child to the disorder. Similarly, the environmental stimuli can be essential in avoiding autism behavior if such stimuli are known to cause or trigger the behavior in a given child. Since infectious diseases among pregnant women can cause the disease in unborn children, their treatment can prevent the subsequent occurrence of the disease.

The study will be instrumental not only to teachers and parents of children suffering from autism, but also to all people who take care or may take care of such children at some point in time. The findings will inform them of the condition, its causes, and triggers as well as the strategies to avoid it among others. Interviews and observation can be well used to enhance validity and reliability of the study findings.

References

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Association.

Kanner, S., Langerman, S. and Grey, M. (2004). Ethical considerations for a child’s participation in research. Journal for Specialists in Pediatric Nursing,9(1):15-23

Little, L. M., Sideris, J., Ausderau, K., & Baranek, G. T. (2014). Activity participation among children with autism spectrum disorder. The American Journal of Occupational Therapy, 68(2), 177.

Dave, D. M., & Fernandez, J. M. (2015). Rising Autism Prevalence: Real or Displacing Other Mental Disorders? Evidence from Demand for Auxiliary Healthcare Workers in California. Economic Inquiry, 53(1), 448-468.

Center for Disease Control and Prevetion (2014). Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2010, [online]. Accessed on 20^th February, 2015. From: http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6302a1.htm?s_cid=ss6302a1_w

McLeod, S. A. (2014). Questionnaires. Accessed on 20^th February, 2015. From: http://www.simplypsychology.org/questionnaires.html

 Tek, S. and Landa, R. J. (2012). Differences in Autism Symptoms between Minority and Non-Minority Toddlers, Journal of Autism and Developmental Disorders,42(9): 1967–1973.

GOSH, NHS Trust- Great Ormond Street Hospital for Children NHS Trust (2006). Information for Families; Understanding and managing behavior problems for children and young people with autistic spectrum disorders. [i.p. 4].

Matsuzaki, H., Iwata, K. Manabe, T.  and  Mori, N. (2012). Triggers for Autism: Genetic and Environmental Factors. Journal of Central Nervous System Disease, [ i.p. 32].

Ratajczak, H. V. (2011) Theoretical aspects of autism: Causes—A review. Journal of Immunotoxicology, 8(1): [i. p. 68, 75].

Anthony, D. (2011). Statistics for Health, Life and Social Sciences. London Business School, Regent’s Park

Corbett, P. (2003).Social Research:Theories, Methods, and Practices.Thousand Oak,London: Sage Publishers.

Best, W. J.and Kahn, V. J. (2006).Research in Education.New Delhi, India:Prentice-Hall of India

Hinton, R. P.(2004).Statistics Explained (2^ndedition). NewYork: Routledge Taylor andFrancis Group

Ingalill, F., Thomas, L., Mike, T., John, L. and Bondemark. (2007). Reliability of a Questionnaire Assessing Experiences of Adolescents in Orthodontic Treatment.The Angle Orthodontist, 77 (2), 311 – 317

Sirkin, M. R. (2006).Statistics for the Social Sciences.California: Sage Publication

Peart, N. (2000). Health research with children: the New Zealand experience. Current Legal Issues, 3: 421–39.

Denscombe, M. (2010). Good Research Guide: For small-scale social research projects (4th Edition). Open University Press. Berkshire

Appendix:Questionnaire

Answer the following questions appropriately by ticking the boxes as it applies or as appropriate.

1. Have you ever heard of or seen a child suffering from autism?

Yes               No

2. If yes, what were the behaviors  that made you conclude that the child had autism?

Avoiding eye contact

Failure to respond to name at one year of age

Preference to play alone

Inappropriate facial expressions

Delayed language skills development

Frequent repetition of words and phrases

Getting upset by small changes

Reduced attention span

Unusual emotions

Others (specify)…………………………………………………………………………………………………………………

3. What was the approximate age of that child in years?

0-1

2-3

4-6

7-10

Others (specify)……………………………………………………………………………………………………….

4. Are there factors that you think might have triggered the child to have the autism behaviors?

Yes                           No

5. If yes, what were they?

Disturbing stimuli

Drugs used by the mother when pregnant

Scarring emotions and experiences

Diseases from infectious pathogenic microorganisms

Inheritance of genetic factors

Others (specify)………………………………………………………………………………………………………

6. What strategies can you use to avoid or minimize the predisposing and triggering factors of the challenging behaviors in autism?

Avoid the use of un-prescribed drugs during pregnancy.

Get early treatment of diseases for a child or a pregnant mother

Avoid environmental stimuli that trigger autistic behaviors

Consult a genetic counselor early enough if autism is in the family

Others (specify)