Methodology Chapter3/2016_Dissertation_Pro Chap1_2.docx
How do parents manage the education of their child with Autism Spectrum Disorder?
Submitted by
XXXXXXXXXXX
XXXXXXXXXX University
Any Town USA
May 30, 2016
Dr. XXXX XXXX
Chapter 1: Introduction to the StudyIntroduction
In the recent years, there has been an increase in the prevalence of Autism Spectrum Disorder (ASD). When parents receive an educational determination of autism for their child, both parents have the potential to be asymmetrically influenced. The “opportunity cost” to families of children with autism are defined as the alternatives experiences that foregone in terms of personal, social, and economical stressors (Amendah, Grosse, Peacock, & Mandell, 2011). A child diagnosed with an ASD can exhibit behaviors or actions that are overwhelming for a parent. Children with an autism spectrum disorder (ASD) have many exacerbated behaviors that can increase a parent’s frustration.
A notable collection of research exists that reveals that overexertion can often occur when parenting a child with an ASD (Laxman, McBride, Jeans, Dyer, Santos, Kern, Sugimura, Curtiss, & Weglarz-Ward, 2014). There are a number of studies, on parental stressors in mothers and fathers of children with ASD (Laxman et al., 2014). However, there is very little research on how parents manage the education of their child with an Autism Spectrum Disorder. This qualitative study will employ the use of a set of in-depth case studies, conceptualized within the social theory of symbolic interaction, to generate a solid narrative around familial factors related to parenting a child on the Autism Spectrum (Frieden, Joffe, Cono, Richards, & Iademarco, 2014).
Today’s educators report feeling unprepared to face the demanding task of teaching children with autism spectrum disorder (ASD). It is not unexpected that parents and other stakeholders verbalize low levels of confidence in the capabilities of special education teachers (Tincani, Cucchiarra, Thurman, Snyder, & McCarthy, 2014). Research on the state of education and educator training programs has been going on for the past three decades (Buchanan, 2012; Gujarati, 2012; Gujarati, 2012), and has consistently displayed that teachers feel unready to work with parents. Regrettably, the results of the research have not manifested in substantial improvements in the circumstances.
Discovering methods of dealing with the educational process is dire. As stated, the number of children with ASD is on the rise (Frieden, Joffe, Cono, Richards, & Iademarco, 2014), and school officials and teachers will be challenged to adequately serve this growing population. Since current research does not provide an adequate response to the issue, this study will serve to explore this essential feature. One source of expertise, and also anxiety, may be parental involvement.
Criterion
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Learner Score
Chair Score
Methodologist Score
Content Expert Score
Introduct ...
Methodology Chapter32016_Dissertation_Pro Chap1_2.docxHow do .docx
1. Methodology Chapter3/2016_Dissertation_Pro Chap1_2.docx
How do parents manage the education of their child with Autism
Spectrum Disorder?
Submitted by
XXXXXXXXXXX
XXXXXXXXXX University
Any Town USA
May 30, 2016
Dr. XXXX XXXX
Chapter 1: Introduction to the StudyIntroduction
In the recent years, there has been an increase in the prevalence
of Autism Spectrum Disorder (ASD). When parents receive an
educational determination of autism for their child, both parents
have the potential to be asymmetrically influenced. The
“opportunity cost” to families of children with autism are
defined as the alternatives experiences that foregone in terms of
personal, social, and economical stressors (Amendah, Grosse,
Peacock, & Mandell, 2011). A child diagnosed with an ASD can
exhibit behaviors or actions that are overwhelming for a parent.
Children with an autism spectrum disorder (ASD) have many
exacerbated behaviors that can increase a parent’s frustration.
A notable collection of research exists that reveals that
overexertion can often occur when parenting a child with an
ASD (Laxman, McBride, Jeans, Dyer, Santos, Kern, Sugimura,
Curtiss, & Weglarz-Ward, 2014). There are a number of studies,
on parental stressors in mothers and fathers of children with
ASD (Laxman et al., 2014). However, there is very little
research on how parents manage the education of their child
with an Autism Spectrum Disorder. This qualitative study will
employ the use of a set of in-depth case studies, conceptualized
2. within the social theory of symbolic interaction, to generate a
solid narrative around familial factors related to parenting a
child on the Autism Spectrum (Frieden, Joffe, Cono, Richards,
& Iademarco, 2014).
Today’s educators report feeling unprepared to face the
demanding task of teaching children with autism spectrum
disorder (ASD). It is not unexpected that parents and other
stakeholders verbalize low levels of confidence in the
capabilities of special education teachers (Tincani, Cucchiarra,
Thurman, Snyder, & McCarthy, 2014). Research on the state of
education and educator training programs has been going on for
the past three decades (Buchanan, 2012; Gujarati, 2012;
Gujarati, 2012), and has consistently displayed that teachers
feel unready to work with parents. Regrettably, the results of
the research have not manifested in substantial improvements in
the circumstances.
Discovering methods of dealing with the educational process is
dire. As stated, the number of children with ASD is on the rise
(Frieden, Joffe, Cono, Richards, & Iademarco, 2014), and
school officials and teachers will be challenged to adequately
serve this growing population. Since current research does not
provide an adequate response to the issue, this study will serve
to explore this essential feature. One source of expertise, and
also anxiety, may be parental involvement.
Criterion
*(Score = 0, 1, 2, or 3)
Learner Score
Chair Score
Methodologist Score
Content Expert Score
Introduction
This section provides a brief overview of the research focus or
problem, explains why this study is worth conducting, and
discusses how this study will be completed. (Minimum three to
four paragraphs or approximately one page)
Dissertation topic is introduced and value of conducting the
3. study is discussed.
3
Discussion provides an overview of what is contained in the
chapter.
3
Section is written in a way that is well structured, has a logical
flow, uses correct paragraph structure, uses correct sentence
structure, uses correct punctuation, and uses correct APA
format.
3
*Score each requirement listed in the criteria table using the
following scale:
0 = Item Not Present or Unacceptable. Substantial Revisions are
Required.
1 = Item is Present. Does Not Meet Expectations. Revisions are
Required.
2 = Item is Acceptable. Meets Expectations. Some Revisions
May be Suggested or Required.
3 = Item Exceeds Expectations. No Revisions are Required.
Reviewer Comments:
Background of the Study
Autism spectrum disorder (ASD) is a combination of multiple
neurodevelopmental disorders that is comprised of autism,
Asperger disorder, and pervasive developmental disorder not
otherwise defined (American Psychiatric Association, 2013).
Infants who have ASD exhibit moderate to rigorous impairments
in social synergy and communication along with limited,
4. repetitive behaviors, and defined peculiar kind of behaviors,
activities, and interests typically unfolding before a child
reaches three years old. Diagnoses of ASD should be
precipitated by elaborate behavioral appraisals, making
diagnostic evaluation tedious and time-consuming. This
assemblage of signs characterizes autism from moderate autism
spectrum disorders (ASD) such as Asperger syndrome (Boyle,
Boulet, Schieve, Cohen, Blumberg, & Yeargin-Allsopp, 2011;
Dingfelder, & Mandell, 2011; Delmolino, & Harris, 2012).
Although the heredity of autism is complicated, and it is unclear
if ASD is defined more by multigene reciprocal action or by
occasional mutations (Center for Disease Control, 2012). In
exceptional instances, autism is heavily associated with factors
that produce birth deficiency. Other researchers’ suggest that
circumstances, such as infancy vaccines, may contribute to the
disorder, but these are questionable and the vaccine hypotheses
lacks reliable scientific confirmation (Luckhaupt et al., 2013).
Most current reports approximate a prevalence of one to two
incidents per thousand people for autism, and about six per
thousand for ASD, with ASD averaging a 4.3:1 male-to-female
proportion (Leventhal et al., 2011). The number of people
perceived to have autism has grown astronomically since the
1980s, at minimum partially owing to differences in diagnostic
method; the issue of whether real pervasiveness has risen is
incomplete (Centers for Disease Control, 2012). A new
government survey of parents suggests that 1 in 45 children,
ages 3 through 17, have been diagnosed with autism spectrum
disorder (ASD). This is notably higher than the official
government estimate of 1 in 68 American children with autism,
by the Centers for Disease Control and Prevention (CDC, 2014).
The report is based on based on an analysis of the medical and
school records of 8-year-old children at 11 monitoring sites
across the country. As such, it can miss children who are not
receiving medical or special education services related to
autism. (Centers for Disease Control, 2014).
The current methods of how parents manage the education of
5. their child with ASD is due to the lack of intensity of services,
and training (Dingfelder, & Mandell, 2011; Delmolino, &
Harris, 2012). All individuals diagnosed with ASDs have some
social, communication, and behavioral difficulties, there is
significant variability in the number, severity, and type of
impairments presented. Individuals also exhibit unique strengths
and needs in other areas that can be impacted by ASDs. Because
ASD interventions target specific needs or skills, rather than
treating ASDs in general, whether
an intervention is likely to be effective depends on the specific
strengths and needs of the individual. Research data are
reviewed to identify ASD interventions that have been
demonstrated to be effective in addressing a target need or skill
in individuals with similar characteristics. Individual
characteristics that often are central to intervention selection
include the individual’s age, level of cognitive functioning,
level of functional communication, nature and extent of social
impairment, any intrusive stereotypic preoccupations, and any
co-occurring psychiatric symptoms. (Ingersoll, & Berger, 2015).
These are many factors that contribute to the educational
malfunctioning that exists, but altering these features would
enhance the potential aliments for parents in the academic
realm. The past measures to nurture ASD children have yielded
minimal results in this field and have perpetuated the stressful
nature of parent and child interaction. The development of ASD
harbors considerable insight into the issue.
Criterion
*(Score = 0, 1, 2, or 3)
Learner Score
Chair Score
Methodologist Score
Content Expert Score
Background of the Study
The background section explains both the history of and the
present state of the problem and research focus. It identifies the
"gap" or "need" based on a summary of the current literature
6. and discusses how the study will address that "gap" or "need."
(Minimum two to three paragraphs or approximately one page)
Provides a summary of results from the prior empirical research
on the topic and identifies the need as defined by the prior
research which this current study will address.
3
Section is written in a way that is well structured, has a logical
flow, uses correct paragraph structure, uses correct sentence
structure, uses correct punctuation, and uses correct APA
format.
3
*Score each requirement listed in the criteria table using the
following scale:
0 = Item Not Present or Unacceptable. Substantial Revisions are
Required.
1 = Item is Present. Does Not Meet Expectations. Revisions are
Required.
2 = Item is Acceptable. Meets Expectations. Some Revisions
May be Suggested or Required.
3 = Item Exceeds Expectations. No Revisions are Required.
Reviewer Comments:
Problem Statement
It is not known how parents manage the education of their
children with an autism spectrum disorder. Children with ASD
have extraordinary demanding task in socialization and
interaction with others (Alquraini, & Gut, 2012) due to gross
neurological dysfunction which impairs the functioning of their
brains. It is not known how parents manage the education of
their children with an autism spectrum disorder. Corresponding
to American Psychiatric Association (2013), Autism Spectrum
7. Disorders (ASD) or Pervasive Developmental Disorders (PDD)
is described as uncompromising and pervasive impairment in
manifold domains of development: communication skills,
reciprocal social interaction skills, or the habitual stereotyped
way of life, activities and interests.
It is not known how parents manage the education of their
children with an autism spectrum disorder. As a result an in-
depth case study, conceptualized within the idiographic
approach will be used. Case study is an in-depth investigations
of a single person, group, event or community. Typically, data
are gathered from a variety of sources and by using several
different methods (e.g. observations & interviews). Case studies
allow a researcher to investigate a topic in far more detail than
might be possible if they were trying to deal with a large
number of research participants (nomothetic approach) with the
aim of ‘averaging’.
The purpose of this qualitative case study is to explore and
define how parents manage the education of their children with
an autism spectrum disorder in North West region of
ProjectAutism.org in Houston Texas. The case study approach is
useful to this research because there is a need to obtain an in-
depth appreciation of the issue, event or phenomenon of
interest, in its natural real-life context in “how parents manage
the education of their child with ASD” over time (Yin, 2013).
In order to achieve the intended purpose of this research, the
researcher will be guided by the following questions:
Phenomenon. Curricula decisions made by parents.
R1: How do parents mange the education of their child with
Autism Spectrum Disorder?
R2: How does parental participation support the education of
their child with Autism Spectrum? The research will guide the
interpretation and understanding of the circumstances
encountered by parents striving to teach, help, and inform
parents, guide children or both on better ways to handle their
special needs’ children.
8. Parental Stress
The behavioral components of ASD that significantly correlate
to parental stress levels involve temperament, child
responsiveness, repetitious behaviors, and supplementary care
needs (Cappe, Wolff, Bobet, & Adrien, 2011). The everyday
demanding task of raising a child with additional variables can
produce stress in fathers, mothers, and other caregivers when
parenting a child with ASD. Coming to terms with the disability
can be a challenge in and of itself; nevertheless, other
circumstances can create pressure and anxiety in parents. The
elements that contribute to lofty stress levels in parents with a
child on the autism spectrum are oftentimes mentioned as lack
of sufficient professional assistance, adverse social reactions
towards persons with ASD, and certain behaviors of the child
(Pisula, 2011).
Since many children with autism exhibit behavior that is seen as
”unusual,” at times even “creepy,” parents may agonize about
social criticism from other parents. Social reactions to the
disorder can leave parents feeling agitated or worrisome. With a
lack of knowledge of ASDs, there is imperceptible approval of
people with this disability than many others. With this broad
lack of awareness of the dysfunction, parents may also anguish
over their child being teased or bullied at school (Foody, James,
& Leader, 2014).
Ultimately, stress is similarly connected with the child’s
capacity to communicate or regulate in social circumstances.
Communication deficiencies are seen across a spectrum of
nonverbal and verbal skills such as rhythm, gestures, melody,
demeanor, facial appearances. Self-injury and aggression are
also prevalent in children with ASD. Aggressive and contrarily
disruptive behavior are the greatest predictors of parental stress.
Not surprisingly, these stress constituents can lead to reduced
health consequences for parents. These brand of provocations
are normally the fundamental reason parents solicit professional
guidance.
Child behavioral difficulties, in particular, and not the severity
9. of the disorder, have been observed to contribute to parental
depressive symptoms. According to Rezendes & Scarpa (2011),
a child's lack of prosocial behaviors donates greatly to parental
stress.
Concurring to a study administered by Foody, James, & Leader,
(2014), 74 mothers parenting children on the autism spectrum
put on an ambulatory blood pressure monitor that obtained
diastolic and systolic blood pressure and heart movement over a
24-hour span. The study recorded high levels of anxiety and
parenting stress, and fairly high levels of depression in
participants (Foody, James, & Leader, 2014).
The amount of stress in parents of children with developmental
disabilities emerges strongly correlated with increases in their
depressive manifestations and reductions in their emotional
well-being (Cappe et al., 2011; Neece, Green, & Baker, 2012)
Parenting Self-Efficacy
Prior study implies that parental constituents may affect the
relationship between child behavior problems and parenting
depression and stress, adding the role of parenting self-efficacy
within the parenting experience. Giallo, Wood, Jellett, and
Porter, (2013) studies found that self-efficacy is negatively
correlated with parental psychopathology. Rezendes and Scarpa,
(2011) investigated the relationship between parental
cognitionsperceptions and maternal self-efficacy and found that
parental depression, guilt, and stress all accounted for
unprecedented variance in self-efficacy. Mothers who recorded
higher levels of self-efficacy were similarly more efficient in
supporting the growth of their children, implying that self-
efficacy may also play a role in parenting behaviors.
Karst, and Van Hecke, (2012) observed that self-efficacy
arbitrated the effects of child behavior problems on the mother's
anxiety and depression. Parents of children with autism report
both increases in parenting stress and decreases in parental
competency (Rezendes, & Scarpa, 2011). Also, mothers who
reported feeling more guilt about their child's state of health
were found to have profound parental self-efficacy (Gardiner, &
10. Iarocci, 2012). Prevailing research hints that parenting self-
efficacy may underlie the association between child behavior
problems and maternal anxiety/depression.
This research will guide the interpretation and understanding of
the circumstances encountered by parents striving to teach,
help, and inform, and guide parents on better ways to manage
their special needs’ children. The delving into the matter will
provide more insight into the situation and provide potential
avenues to venture that could aid in the familial temperament.
Criterion
*(Score = 0, 1, 2, or 3)
Learner Score
Chair Score
Methodologist Score
Content Expert Score
Problem Statement
This section includes the problem statement, the population
affected, and how the study will contribute to solving the
problem. This section is summarized in Chapter 3. This section
of Chapter 1 should be a minimum of three to four paragraphs
with citations from empirical research articles to support
statements. (Minimum three or four paragraphs or
approximately one page)
States the specific problem proposed for research by presenting
a clear declarative statement that begins with “It is not known if
and to what degree/extent...” (quantitative) ~or~ or “It is not
known how/why and…” (qualitative)
3
Identifies the general population affected by the problem.
3
11. Suggests how the study may contribute to solving the problem.
3
Section is written in a way that is well structured, has a logical
flow, uses correct paragraph structure, uses correct sentence
structure, uses correct punctuation, and uses correct APA
format.
3
*Score each requirement listed in the criteria table using the
following scale:
0 = Item Not Present or Unacceptable. Substantial Revisions are
Required.
1 = Item is Present. Does Not Meet Expectations. Revisions are
Required.
2 = Item is Acceptable. Meets Expectations. Some Revisions
May be Suggested or Required.
3 = Item Exceeds Expectations. No Revisions are Required.
Reviewer Comments:
Purpose of the Study
The purpose of this study is to develop substantive theory about
how parents manage the education of their child diagnosed with
an Autism Spectrum Disorder. An in-depth case study,
conceptualized within the social theory of symbolic interaction,
will use to generate thick description and explanation. Case
study in psychology refers to the use of a descriptive
research approach to obtain an in-depth analysis of a person,
group, or phenomenon. A variety of techniques may be
employed including personal interviews, direct-
observation, psychometric tests, and archival records. The
distinctive topics for applying the case study method arise from
12. at least two situations. First and most important (e.g., Yin,
2013), the case study method is pertinent when your research
addresses either a descriptive question (what happened?) or an
explanatory question (how or why did something happen?); in
contrast, a well-designed experiment is needed to begin
inferring causal relationships (e.g., whether a new IEP
curriculum had improved the student performance), and a
survey may be better at telling you how often something has
happened. Second, you may want to illuminate a particular
situation, to get a close (i.e., in-depth and first-hand)
understanding of it. The case study method helps you to make
direct observations and collect data in natural settings,
compared to relying on “derived” data (Yin, 2013) such as test
results. Case studies are generally a single-case design, but can
also be a multiple-case design, where replication instead
of sampling is the criterion for inclusion. Like other research
methodologies within psychology, the case study must
produce valid and reliable results in order to be useful for the
development of future research.
Symbolic Interactionism focus on the subjective aspects of
social life, rather than on objective, macro-structural aspects of
social systems. One reason for this focus is that interactionists
base their theoretical perspective on their image of humans,
rather than on their image of society. Segalman, (2014)
contends humans are pragmatic actors who continually must
adjust their behavior to the actions of other actors. We can
adjust to these actions only because we are able to interpret
them, i.e., to denote them symbolically and treat the actions and
those who perform them as symbolic objects. This process of
adjustment is aided by our ability to imaginatively rehearse
alternative lines of action before we act. Social Interactionism
lens may shed light on interventions to improve ASD
communication Symbolic Interactionism.
Highly structured, intensive early intervention may lead to
significant developmental gains for many children with autism.
However, a clear understanding of early intervention effects
13. may currently be hampered by a lack of precision in outcome
measurement. To improve the precision and sensitivity of
outcome assessment it may be useful to integrate research on
the nature of the social disturbance of autism with how parents
manage the education of their child diagnosed with ASD
(Thiemann-Bourque, Brady, and Fleming, (2012) at
ProjectAutism.org in North West region of Houston Texas.
Criterion
*(Score = 0, 1, 2, or 3)
Learner Score
Chair Score
Methodologist Score
Content Expert Score
PURPOSE OF THE STUDY
The purpose statement section expands on the problem
statement and identifies how the study will be accomplished. It
explains how the proposed study will contribute to the field.
This section is summarized in Chapter 3. (Minimum two to
three paragraphs)
Presents a declarative statement: “The purpose of this study
is….” that identifies the research methodology and design,
population, variables (quantitative) or phenomena (qualitative)
to be studied and geographic location.
3
Identifies research methodology as qualitative, quantitative, or
mixed, and identifies the specific research design.
3
Describes the target population and geographic location for the
study.
14. 3
Quantitative: Defines the variables, relationship of variables, or
comparison of groups.
Qualitative: Describes the nature of the phenomena to be
explored.
3
Section is written in a way that is well structured, has a logical
flow, uses correct paragraph structure, uses correct sentence
structure, uses correct punctuation, and uses correct APA
format.
3
*Score each requirement listed in the criteria table using the
following scale:
0 = Item Not Present or Unacceptable. Substantial Revisions are
Required.
1 = Item is Present. Does Not Meet Expectations. Revisions are
Required.
2 = Item is Acceptable. Meets Expectations. Some Revisions
May be Suggested or Required.
3 = Item Exceeds Expectations. No Revisions are Required.
Reviewer Comments:
Research Question(s) and Hypotheses
The purpose of this case study is to understand, describe,
develop, and discover the central phenomenon of the study for
the participants at ProjectAutism.org in Houston Texas. The
researcher will ask two central questions as stated below R1 and
R2 followed by no more than ten sub questions. A few sub
15. questions succeed each general central question; the sub
questions narrow the focal point of the research but leave open
the questioning. This method is well within the limits set by
Miles, Huberman and Saldana (2014), who recommended that
investigators write no more than a dozen qualitative research
questions in all (central and sub questions).
In order to achieve the intended purpose of this research, the
researcher will be guided by the following questions:
Phenomenon. Curricula decisions made by parents
R1: How do parents mange the education of their child with
Autism Spectrum Disorder?
R2: How does parental participation support the education of
their child with Autism Spectrum?
Phenomenon to be studied.
The research will study how parents manage the education of
their child with autism spectrum disorder. An empirical inquiry
that investigates the phenomenon within its real-life context. In
the human sphere this normally translates into gathering ‘deep’
information and perceptions through inductive interviews,
discussions and participant observation, and representing it
from the perspective of the research participant(s).
Alignment:
Alignment is an important issue in this research project because
how parents manage the education of their child with autism
spectrum disorder questions are derived from the research
purpose. R1: How do parents mange the education of their child
with Autism Spectrum Disorder further distill the purpose by
more clearly focusing the research purpose, and the purpose
provides clues to the type of research design (Miles, Huberman
& Saldana 2014). The research questions, will be further
narrowed as the project moves forward, to be clearly related to
the research design. R1 and R2, are clearly aligned to sustain
the research.
Criterion
*(Score = 0, 1, 2, or 3)
Learner Score
16. Chair Score
Methodologist Score
Content Expert Score
Research Question(s) and/or Hypotheses
This section narrows the focus of the study by specifying the
research questions to address the problem statement. Based on
the research questions, it describes the variables and/or groups
and their hypothesized relationship (quantitative study) or the
phenomena under investigation (qualitative study). It describes
how the research questions are related to the problem statement
and how the research questions will facilitate collection of the
data needed to answer the research questions. (Minimum two to
three paragraphs or approximately one page)
Qualitative Designs: States the research question(s) the study
will answer and describes the phenomenon to be studied.
Quantitative Designs: States the research questions the study
will answer, identifies the variables, and states the hypotheses
(predictive statements) using the format appropriate for the
specific design.
3
This section includes a discussion of the research questions,
relating them to the problem statement.
3
Section is written in a way that is well structured, has a logical
flow, uses correct paragraph structure, uses correct sentence
structure, uses correct punctuation, and uses correct APA
format.
3
17. *Score each requirement listed in the criteria table using the
following scale:
0 = Item Not Present or Unacceptable. Substantial Revisions are
Required.
1 = Item is Present. Does Not Meet Expectations. Revisions are
Required.
2 = Item is Acceptable. Meets Expectations. Some Revisions
May be Suggested or Required.
3 = Item Exceeds Expectations. No Revisions are Required.
Reviewer Comments:
Advancing Scientific Knowledge
The current knowledge on this topic recognizes the various
issues that exist, but fail to harbor comprehension on all
matters. Considerable research has been employed in order to
discover the factors and features of the spectrum. Further
detailed research investigates the varied aspects of familial
incidents that occur when a child is on the Autism Disorder
Spectrum. A study in 2012 investigated perspectives of parents
whose children have received outpatient therapy in community
mental health clinics (Brookman-Frazee, Baker-Ericzén, Nicole
Stadnick, & Taylor, 2012). This type of examination has been
the focus of the research, which does not serve to explore the
facets of this issue. Participation of parents of children with
autism is commonplace in most comprehensive intervention
programs, yet, there is limited research relating to the best
practices in this area (Steiner, Koegel, Koegel, & Ence, 2012).
The varied evaluations into children with autism do extend into
interactive measures with parents, but does not acquiesce the
maintenance features for parents in order to limit stress.
The research that has been executed thus far serves to engage an
initialization into the issue, but is limited in its angled
comprehensive framework. Due to increasing prevalence rates
of Autism Spectrum Disorders in recent years, there is a strong
18. need for efficient, cost-effective, and Empirically Supported
Treatments for this population” (Steiner, Koegel, Koegel, &
Ence, 2012). The conception of parental anxiety and stress in
relation to a child with an ASD is well documented, but the
most effective means of thwarting the frustration have not
emerged. This research will aid in delving into the topic and
obtaining insight into the potential paths to enter in order to
gain some relief from the stress. The contribution will provide
vision for educational features of ASD children and allow for
parents of these children to gain recognition into methods of
application.
The proposed study will make several substantial and original
contributions to knowledge. This study will develop
substantive theory in an area where no such theory presently
exists. The theory will lead to an understanding and explanation
of the situation faced by parents trying to educate their child or
children with an ASD. The theory will be relevant to the
development of policies concerning parents trying to educate
their child with an ASD in United States of America. This
study will provide a unique exploratory analysis, in-depth
perspective of the situation faced when trying to educate a child
with ASD in United States of America.
Criterion
*(Score = 0, 1, 2, or 3)
Learner Score
Chair Score
Methodologist Score
Content Expert Score
ADVANCING SCIENTIFIC KNOWLEDGE
This section specifically describes how the research will
advance the body of knowledge on the topic. The study can
yield a small step forward in a line of current research, but it
must add to the current body of knowledge in the literature in
the learner’s program of study. It identifies the “gap” or “need”
based on the current literature and discusses how the study will
address that “gap” or “need.” This section also identifies the
19. theory(ies) or model(s) that provide the theoretical foundation
for the study and how the study will contribute to the research
on the theory(ies) or model(s). This section summarizes part of
the Background (focused on identifying the “gap” or “need”
from the literature) and Theoretical Foundations sections
(expanded in Chapter 2). (Minimum two to three paragraphs)
Clearly identifies the “gap” or “need” in the literature that was
used to define the problem statement and develop the research
questions.
3
Describes how the study will address the “gap” or “identified
need” defined in the literature and contribute to the body of
literature.
3
Identifies the theory(ies) or model(s) that provide the
theoretical foundations or conceptual frameworks for the study.
3
Connects the study directly to the theory and describes how the
study will add or extend the theory or model.
3
Section is written in a way that is well structured, has a logical
flow, uses correct paragraph structure, uses correct sentence
structure, uses correct punctuation, and uses correct APA
format.
20. 3
*Score each requirement listed in the criteria table using the
following scale:
0 = Item Not Present or Unacceptable. Substantial Revisions are
Required.
1 = Item is Present. Does Not Meet Expectations. Revisions are
Required.
2 = Item is Acceptable. Meets Expectations. Some Revisions
May be Suggested or Required.
3 = Item Exceeds Expectations. No Revisions are Required.
Reviewer Comments:
Significance of the Study
Case studies can provide very detailed information about a
particular subject that would not be possible to acquire through
another type of experimentation to investigate cases in-depth
and to apply multiple sources of evidence making them a
beneficial tool for descriptive research studies where the focal
point is on a specific situation (Yin, 2013). Case studies provide
very specific information about a distinct case that would not be
feasible to procure through some other type of experimentation
to examine cases in-depth and to employ multiple sources of
evidence making them a useful vehicle for descriptive research
studies where the focal point is in a particular circumstance
(Yin, 2013).
This research will contribute to a better understanding of how
parents manage the education of their child with Autism
Spectrum Disorders (ASD. An in-depth case study,
conceptualized within the idiographic approach will contribute
to the literature by utilizing an in-depth investigations into the
parent’s educational management of their child through data
collection from a variety of sources and by using several
different methods (e.g. observations & interviews).
How parents manage the education of their child with Autism
21. Spectrum Disorders (ASD) relates to other studies in the
background and problem statement because the recent public
debate has focused on relatively few questions - almost
exclusively on the hypothesized links between the combined
measles, mumps and rubella (MMR) vaccination of bowel
disorders and autism. Because of the important public health
implications of any such link, several expert groups and reports
have considered these particular issues in detail (Jain, Marshall,
Buikema, Bancroft, Kelly, & Craig, 2015). While they
acknowledge that there are interesting findings, they have found
no persuasive evidence for such links. The broader question
“What are the causes of autism?” therefore remains, as does of
the question of how parents manage the education of their child
with ASD? It was in the light of these uncertainties’ that the
Department of Health asked the Medical Research Council
(MRC) to review research on the causes and epidemiology of
autism (American Psychiatric Association 2013).
Parents need specific training in autism education, so that
children on the spectrum are able get the best help out of his or
her classroom experiences (Todd, Beamer, & Goodreau, 2014).
The research will contribute to the conceptual framework in the
context of the strengths, concerns, values, and preferences of
the child with an ASD and his or her support network. This
network includes the family, the professional team, and
available community resources. The project will play an
important role in summarizing and synthesizing the knowledge
base on ASD interventions providing parents with the most
current evidence to guide intervention planning and
implementation. A parent needs to become familiar with what
will work best with that particular child. As Pajareya, and
Nopmaneejumruslers, (2011) suggests, every child is going to
be different and parents have to be able to adjust with every one
of them.
The proposed research will offer information on different
effective mechanism that can be useful to parents managing the
education of their autistic children. It will offer an in-depth
22. perspective and understanding of the circumstances encountered
by parents attempting to manage the education their children
with ASD. The outcome of this research will be very relevant to
the advancement of policies concerning parents trying to
educate their child with ASD in United States of America.
Criterion
*(Score = 0, 1, 2, or 3)
Learner Score
Chair Score
Methodologist Score
Content Expert Score
Significance of the Study
This section identifies and describes the significance of the
study and the implications of the potential results based on the
research questions, the problem statement, and the hypotheses
or the investigated phenomena. It describes how the research
fits within and will contribute to the current literature or body
of research. It describes potential practical applications from
the research. (Minimum three to four paragraphs)
Describes how the proposed research fits within the prior
research and how the study will make an academic research
contribution in the field of study.
3
Describes how the study will make a practical contribution in
the field of study.
3
Describes how addressing the problem will add value to the
population, community, or society.
3
23. Section is written in a way that is well structured, has a logical
flow, uses correct paragraph structure, uses correct sentence
structure, uses correct punctuation, and uses correct APA
format.
3
*Score each requirement listed in the criteria table using the
following scale:
0 = Item Not Present or Unacceptable. Substantial Revisions are
Required.
1 = Item is Present. Does Not Meet Expectations. Revisions are
Required.
2 = Item is Acceptable. Meets Expectations. Some Revisions
May be Suggested or Required.
3 = Item Exceeds Expectations. No Revisions are Required.
Reviewer Comments:
Rationale for Methodology
The central goal of the qualitative methodology for this research
is to gather an in-depth understanding of human behavior and
the reasons that govern such behavior. Qualitative methods
examine the why and how of decision making, not just what,
where, when, or "who" (Saladana, 2012). A popular method of
qualitative research is the case study (Yin, 2013) which
examines in-depth purposive samples to better understand a
phenomenon (e.g., family well-being and children with
intellectual disability; Glidden, (2012) hence, smaller but
focused samples are more often used than large samples which
may also be conducted by the same or related researchers.
On the other hand quantitative research is the systematic
empirical investigation of observable phenomena via statistical,
24. mathematical or computational techniques (Salkind, 2013). The
objective of quantitative research is to develop and employ
mathematical models, theories and/or hypotheses pertaining to
phenomena. Salkind, (2013) contends the process of
measurement is central to quantitative research because it
provides the fundamental connection between empirical
observation and mathematical expression of quantitative
relationships.
Qualitative research gathers information that is not in numerical
form. For example, diary accounts, open-ended questionnaires,
unstructured interviews and unstructured observations.
Qualitative data is typically descriptive data and as such is
harder to analyze than quantitative data. Qualitative research is
useful for studies at the individual level, and to find out, in
depth, the ways in which people think or feel (e.g. case studies
Yin, 2013). Case studies are in-depth investigations of a single
person, group, event or community. Typically, data are gathered
from a variety of sources and by using several different methods
(e.g. observations & interviews). This method assists you to
make immediate data collection and observations in natural
environments, matched to relying on acquired data (Denzin &
Lincoln, 2011)—e.g., school, test results and other statistics
supported by government agencies, and responses to
questionnaires.
Criterion*
(Score = 0, 1, 2, or 3)
Learner Score
Chair Score
Methodologist Score
Content Expert Score
Rationale for Methodology
This section clearly justifies the methodology the researcher
plans to use for conducting the study. It argues why the
methodological framework is the best approach to answer the
research questions and how it will address the problem
statement. It uses citations from textbooks and articles on
25. research methodology and/or articles on related studies to
justify the methodology. (Minimum two to three paragraphs)
Identifies the specific research methodology for the study.
3
Justifies the methodology to be used for the study by discussing
why it is the best approach for answering the research
question(s) and addressing the problem statement.
3
Uses citations from seminal (authoritative) sources (textbooks
and/or empirical research literature) to justify the selected
methodology. Note:Introductory or survey research textbooks
(such as Creswell) are not considered seminal sources.
3
Section is written in a way that is well structured, has a logical
flow, uses correct paragraph structure, uses correct sentence
structure, uses correct punctuation, and uses correct APA
format.
3
*Score each requirement listed in the criteria table using the
following scale:
0 = Item Not Present or Unacceptable. Substantial Revisions are
Required.
1 = Item is Present. Does Not Meet Expectations. Revisions are
Required.
26. 2 = Item is Acceptable. Meets Expectations. Some Revisions
May be Suggested or Required.
3 = Item Exceeds Expectations. No Revisions are Required.
Reviewer Comments:
Nature of the Research Design for the Study
This qualitative study will use a case study research design.
This is an approach to research that facilitates exploration of a
phenomenon within its context using a variety of data sources.
This ensures that the issue is not explored through one lens, but
rather a variety of lenses which allows for multiple facets of the
phenomenon to be revealed and understood. When the approach
is applied correctly, it becomes a valuable method for health
science research to develop theory, evaluate programs, and
develop interventions (Hancock, & Algozzine, 2011).
Good, rigorous case studies require a strong methodological
justification (Yazan, B. 2015) and a logical and coherent
argument that defines paradigm, methodological position, and
selection of study methods (Denzin & Lincoln, 2011). Case
study research empowers the researcher to investigate relevant
topics not readily covered by other designs. Conversely, other
designs cover many issues better than does case study research.
The overall concept is that several research approaches serve
equivalent functions. The study might even utilize multiple
methods that involve the case study (Yin, 2013). Denzin and
Lincoln, (2011) argue that human learning is best researched by
using qualitative data. In selecting a case study research
methodology, (Yin, 2013) suggests that it is proper to select
that paradigm whose assumptions are best met by phenomenon
being investigated. This study is about human learning in its
natural environment and the effective use of emerging
technology in facilitating it. Qualitative case study is concerned
with processes rather than simply the outcomes or products.
When the understanding of an event is a function of personal
interaction and perception of those in that event, and the
description of the processes that characterize the event,
qualitative approaches are more appropriate than quantitative
27. designs to provide the insight necessary to understand the
participants’ role in the event, and their perceptions of the
experience.
The ethnographic method is not appropriate for this study
because it is different from other ways of conducting case study
approach due to the following reasons. Ethnography means
trying to understand behavior and culture by going out and
talking to and observing people wherever they are, while
they’re doing whatever it is they do (Weber, & Cheng, 2013). It
means entering someone’s world for a while, be it a couple of
hours or a couple of days, or a couple of years. A major
difference between ethnography and case study research is the
depth and intimacy of the work. Getting up close and personal
with the research participants. By spending time with
participants as they go about their daily lives, and develop a
better understanding of the cultural significance of various
products, services, or medical conditions and treatments, and
get a first-hand look at how people respond to, and are affected
by, their social surroundings (Weber, & Cheng, 2013).
Grounded theory is also not conducive for this research on the
ground of its misunderstood status as theory (is what is
produced really 'theory'?). Thornberg, and Charmaz, (2012)
suggest that it is impossible to free oneself of preconceptions in
the collection and analysis of data in the way that Glaser and
Strauss say is necessary. They also point to the formulaic nature
of grounded theory method and the lack of congruence of this
with open and creative interpretation – which ought to be the
hallmark of qualitative inquiry. They suggest that the one
element of grounded theory worth keeping is constant
comparative method. In grounded theory, researchers engage in
excessive conceptualization and defend this as "sensitivity to
context." Because of this, convergent conceptualization
becomes impossible (Thornberg, & Charmaz, 2012).
Criterion
*(Score = 0, 1, 2, or 3)
Learner Score
28. Chair Score
Methodologist Score
Content Expert Score
Nature of the Research Design for the Study
This section describes the specific research design to answer the
research questions and affirms why this approach was selected.
It describes the research sample being studied as well as the
process that will be used to collect the data on the sample. It
identifies the instruments or sources of data needed to answer
the research questions. It provides citations from seminal
sources such as research textbooks, research articles, and
articles on similar studies.(Minimum three to four paragraphs or
approximately one page)
Describes the selected design for the study.
3
Discusses why the selected design is the best design to address
the problem statement and research questions as compared to
other designs.
3
Briefly describes the target population, and the sample for the
study, the data collection procedures to collect data on the
sample, and the instruments or sources of data needed to answer
the research questions.
3
Section is written in a way that is well structured, has a logical
flow, uses correct paragraph structure, uses correct sentence
structure, uses correct punctuation, and uses correct APA
29. format.
3
*Score each requirement listed in the criteria table using the
following scale:
0 = Item Not Present or Unacceptable. Substantial Revisions are
Required.
1 = Item is Present. Does Not Meet Expectations. Revisions are
Required.
2 = Item is Acceptable. Meets Expectations. Some Revisions
May be Suggested or Required.
3 = Item Exceeds Expectations. No Revisions are Required.
Reviewer Comments:
Definition of Terms
The following are the operational definitions of terms used in
this research:
Autism
As defined by American Psychiatric Association, (2013), autism
is a broad term for a collection of heterogeneous disorders of
brain development. These disorders are portrayed, at varying
levels, by challenges in social interaction, verbal and nonverbal
communication and repetitive behaviors.
Prevalence
Center for Disease Control, (2012). Refers to prevalence as the
cumulative amount of cases of a disease in a given population at
a particular time which includes autistic disorder, Asperger's
disorder, childhood disintegrative disorder, and Pervasive
Developmental Disorder-Not Otherwise Specified. (PDD-NOS)
Etiology
As defined by Yu, T.W., Chahrour, M.H., et al. (2013), etiology
means the set of causes, cause, or manner of causation of a
disease or condition.
Antisocial disruptive behaviors
As defined by Minshawi, Hurwitz, Fodstad, Biebl, Morriss, &
30. McDougle, (2014), antisocial disruptive behaviors refer to
disruptive acts characterized by covert and overt hostility and
intentional aggression toward others.
Intervention
Charman, (2011), defines intervention: as the act of intervening,
interfering or interceding with the intent of modifying the
outcome.
An inclusionary Classroom
As defined by Ruggs, and Hebl, (2012), an inclusionary
Classroom is the act of placing children with disabilities sitting
next to ones who have been deemed "gifted and talented." The
mixing is performed quietly, and carefully. Students do not
fundamentally know who is working at what level.
Criterion*
(Score = 0, 1, 2, or 3)
Learner Score
Chair Score
Methodologist Score
Content Expert Score
Definitions of Terms
This section defines the study constructs and provides a
common understanding of the technical terms, exclusive jargon,
variables, phenomena, concepts, and sundry terminology used
within the scope of the study. Terms are defined in lay language
and in the context in which they are used within the study.
(Each definition may be a few sentences to a paragraph.)
Defines any words that may be unknown to a lay person (words
with unusual or ambiguous meanings or technical terms) from
the research or literature.
3
Defines the variables for a quantitative study or the phenomena
for a qualitative study from the research or literature.
3
31. Definitions are supported with citations from scholarly sources.
3
Section is written in a way that is well structured, has a logical
flow, uses correct paragraph structure, uses correct sentence
structure, uses correct punctuation, and uses correct APA
format.
3
*Score each requirement listed in the criteria table using the
following scale:
0 = Item Not Present or Unacceptable. Substantial Revisions are
Required.
1 = Item is Present. Does Not Meet Expectations. Revisions are
Required.
2 = Item is Acceptable. Meets Expectations. Some Revisions
May be Suggested or Required.
3 = Item Exceeds Expectations. No Revisions are Required.
Reviewer Comments:
Assumptions, Limitations, Delimitations
There are several limitations to the current study that should be
mentioned and taken into account when interpreting and
disseminating the findings.
1. This study represents findings from a relatively small
sample.
2. Given the sampling efforts, this could potentially represent a
selection bias, meaning that those who participated are more
32. likely than others to participate in research more generally.
3. Families whose children are more severely affected by ASD
were unable to participate given their time and energy
limitations.
4. This study uses data from intact couples and findings may not
be applicable for single parents or separated or divorced
parents.
The following are assumptions to this study:
1. Parents provide accurate information regarding their child‘s
specific diagnosis.
2. There was a wide range of ages among children with Autism
used in the study.
Criterion
*(Score = 0, 1, 2, or 3)
Learner Score
Chair Score
Methodologist Score
Content Expert Score
Assumptions, Limitations and Delimitations
This section identifies the assumptions and specifies the
limitations, as well as the delimitations, of the study. (Minimum
three to four paragraphs)
States the assumptions being accepted for the study
(methodological, theoretical, and topic-specific).
3
Provides rationale for each assumption, incorporating multiple
perspectives, when appropriate.
3
33. Identifies limitations of the research design.
3
Identifies delimitations of the research design.
3
The Section is written in a way that is well structured, has a
logical flow, uses correct paragraph structure, uses correct
sentence structure, uses correct punctuation, and uses correct
APA format.
3
*Score each requirement listed in the criteria table using the
following scale:
0 = Item Not Present or Unacceptable. Substantial Revisions are
Required.
1 = Item is Present. Does Not Meet Expectations. Revisions are
Required.
2 = Item is Acceptable. Meets Expectations. Some Revisions
May be Suggested or Required.
3 = Item Exceeds Expectations. No Revisions are Required.
Reviewer Comments:
Summary
The number of epidemiological studies of autism has increased
in recent years, one of the most controversial topics with
respect to this population is the prevalence of this spectrum of
disorders. The number of cases has risen dramatically,
(Amendah, Grosse, Peacock, and Mandell, 2011) and various
hypotheses have been put forward to explain this phenomenon.
Among the most frequently addressed possibilities are expanded
34. diagnostic criteria, more awareness of the disorder, diagnosis at
earlier ages, and the recognition that ASD is a lifelong
condition.
Infants who have ASD exhibit moderate to rigorous impairments
in social synergy and communication along with limited,
repetitive behaviors, and defined peculiar kind of behaviors,
activities, and interests typically unfolding before a child
reaches three years old. Diagnoses of ASD should be
precipitated by elaborate behavioral appraisals, making
diagnostic evaluation tedious and time-consuming. This
assemblage of signs characterizes autism from moderate autism
spectrum disorders (ASD) such as Asperger syndrome (Boyle,
Boulet, Schieve, Cohen, Blumberg, & Yeargin-Allsopp, 2011;
Dingfelder, & Mandell, 2011; Delmolino, & Harris, 2012).
The current methods of how parents manage the education of
their child with ASD is due to the lack of intensity of services,
and training (Dingfelder, & Mandell, 2011; Delmolino, &
Harris, 2012). Individuals also exhibit unique strengths and
needs in other areas that can be impacted by ASDs. Because
ASD interventions target specific needs or skills, rather than
treating ASDs in general, whether an intervention is likely to be
effective depends on the specific strengths and needs of the
individual.
It is not known how parents manage the education of their
children with an autism spectrum disorder. Children with ASD
have extraordinary demanding task in socialization and
interaction with others (Alquraini, & Gut, 2012) due to gross
neurological dysfunction which impairs the functioning of their
brains. The purpose of this qualitative case study is to explore
and define how parents manage the education of their children
with an autism spectrum disorder in North West region of
ProjectAutism.org in Houston Texas. The behavioral
components of ASD that significantly correlate to parental
stress levels involve temperament, child responsiveness,
repetitious behaviors, and supplementary care needs (Cappe,
Wolff, Bobet, & Adrien, 2011). The amount of stress in parents
35. of children with developmental disabilities emerges strongly
correlated with increases in their depressive manifestations and
reductions in their emotional well-being (Cappe et al., 2011;
Neece, Green, & Baker, 2012)
The purpose of this study is to develop substantive theory about
how parents manage the education of their child diagnosed with
an Autism Spectrum Disorder. An in-depth case study,
conceptualized within the social theory of symbolic interaction,
will use to generate thick description and explanation. The case
study method is pertinent when your research addresses either a
descriptive question (what happened?) or an explanatory
question (how or why did something happen?); in contrast, a
well-designed experiment is needed to begin inferring causal
relationships (e.g., whether a new IEP curriculum had improved
the student performance), and a survey may be better at telling
you how often something has happened (Yin, 2013).
The researcher will ask two central questions as stated below
R1 and R2 followed by no more than ten sub questions. A few
sub questions succeed each general central question; the sub
questions narrow the focal point of the research but leave open
the questioning. This method is well within the limits set by
Miles, Huberman and Saldana (2014), who recommended that
investigators write no more than a dozen qualitative research
questions in all (central and sub questions). Considerable
research has been employed in order to discover the factors and
features of the spectrum. Further detailed research investigates
the varied aspects of familial incidents that occur when a child
is on the Autism Disorder Spectrum. A study in 2012
investigated perspectives of parents whose children have
received outpatient therapy in community mental health clinics
(Brookman-Frazee, Baker-Ericzén, Nicole Stadnick, & Taylor,
2012). This type of examination has been the focus of the
research, which does not serve to explore the facets of this
issue. This study will provide a unique exploratory analysis, in-
depth perspective of the situation faced when trying to educate
a child with ASD in United States of America.
36. Case studies can provide very detailed information about a
particular subject that would not be possible to acquire through
another type of experimentation to investigate cases in-depth
and to apply multiple sources of evidence making them a
beneficial tool for descriptive research studies where the focal
point is on a specific situation (Yin, 2013). An in-depth case
study, conceptualized within the idiographic approach will
contribute to the literature by utilizing an in-depth
investigations into the parent’s educational management of their
child through data collection from a variety of sources and by
using several different methods (e.g. observations &
interviews).
The central goal of the qualitative methodology for this research
is to gather an in-depth understanding of human behavior and
the reasons that govern such behavior. Qualitative methods
examine the why and how of decision making, not just what,
where, when, or "who" (Saladana, 2012). This qualitative study
will use a case study research design. This is an approach to
research that facilitates exploration of a phenomenon within its
context using a variety of data sources. This ensures that the
issue is not explored through one lens, but rather a variety of
lenses which allows for multiple facets of the phenomenon to be
revealed and understood. When the approach is applied
correctly, it becomes a valuable method for health science
research to develop theory, evaluate programs, and develop
interventions (Hancock, & Algozzine, 2011).
There are several limitations to the current study that should be
mentioned and taken into account when interpreting and
disseminating the findings. (a) One cannot generalize from a
single case; (b) the case study is most useful for generating
hypotheses, whereas other methods are more suitable for
hypotheses testing and theory building; (c) the case study
contains a bias toward verification; and (d) This study uses data
from intact couples and findings may not be applicable for
single parents or separated or divorced parents. The following
are assumptions to this study: (1) Parents provide accurate
37. information regarding their child‘s specific diagnosis. (2)
There was a wide range of ages among children with
Autism used in the study.
Organization of the Remainder of the Study
This case study will present a concrete narrative detail of
actual, or at least realistic events of how parents manage the
education of their child with ASD, it will have a plot,
exposition, characters, and sometimes even dialogue" (Yin,
2013). The reports will be extensively descriptive, the right
combination of description and analysis" (2013). The researcher
will address each step of the research process, and attempt to
give the reader as much context as possible for the decisions
made in the research design and for the conclusions drawn.
This contextualization will include a detailed explanation of the
researchers' theoretical positions, of how those theories drove
the inquiry or led to the guiding research questions, of the
participants' backgrounds, of the processes of data collection, of
the training and limitations of the coders, along with a strong
attempt to make connections between the data and the
conclusions evident.
The researcher will identify significant variables that emerged
during the research and suggest studies related to these, and
will suggest further general questions that the case study
generated ending with implications for further study.
TEACCH program as well as semi-structured interviews and
approved data aggregation technique will be collected (Andres,
2012). Chapter 2 contains a review of literature. Chapter 3
contains the description of the research design, sampling
procedures, and the statistical methods that will be used. The
following chapter contains the review of literature for the study.
Criterion*
(Score = 0, 1, 2, or 3)
Learner Score
Chair Score
Methodologist Score
Content Expert Score
38. Chapter 1 Summary and Organization of the remainder of the
study
This section summarizes the key points of Chapter 1 and
provides supporting citations for those key points. It then
provides a transition discussion to Chapter 2 followed by a
description of the remaining chapters. The Proposal, but not the
Dissertation, provides a timeline for completing the research
and dissertation. (Minimum one to two pages)
Summarizes key points presented in Chapter 1.
3
Provides citations from scholarly sources to support key points.
3
Describes the remaining Chapters and provides a transition
discussion to Chapter 2. For proposal only, a timeline for
completing the research and dissertation is provided.
3
The Chapter is correctly formatted to dissertation template
using the Word Style Tool and APA standards. Writing is free
of mechanical errors.
3
All research presented in the Chapter is scholarly, topic-related,
and obtained from highly respected academic, professional,
original sources. In-text citations are accurate, correctly cited,
and included in the reference page according to APA standards.
39. 3
Section is written in a way that is well structured, has a logical
flow, uses correct paragraph structure, uses correct sentence
structure, uses correct punctuation, and uses correct APA
format.
3
*Score each requirement listed in the criteria table using the
following scale:
0 = Item Not Present or Unacceptable. Substantial Revisions are
Required.
1 = Item is Present. Does Not Meet Expectations. Revisions are
Required.
2 = Item is Acceptable. Meets Expectations. Some Revisions
May be Suggested or Required.
3 = Item Exceeds Expectations. No Revisions are Required.
Reviewer Comments:
Chapter 2: Literature Review
Introduction to the Chapter and Background to the Problem
This chapter will review the pertinent literature in harmony with
the relative to the research questions defined in the first
chapter. The research questions will act as guiding tools for
conducting the literature review. This meta-analytical method
will offer insight into the issue and allow for an in depth
investigation into all crevices of the disorder. To better
understand the problem and its context, it is appropriate to
provide a theoretical framework for the study and an overview
of how parents deal with the education of their child with an
Autism Spectrum Disorder. Gathering evidence and research
will provide a background of information that will serve to
reveal the gaps in the understanding of the issue. There is
40. growing evidence that efficacious interventions for autism are
rarely adopted or successfully implemented in public mental
health and educational systems; as a result there is a growing
need for parental intervention of how parents deal with the
education of their child with ASD due to lack of intensity of
services and training of staff (Dingfelder, & Mandell, 2011).
The literature review will reveal the necessary direction that
needs to be pursued in order to gain a better comprehension of
ASD.
Autism spectrum disorder (ASD) is a combination of multiple
neurodevelopment disorders that is comprised of autism,
Asperger disorder, and pervasive developmental disorder not
otherwise defined (American Psychiatric Association, 2013).
These varied disorders have in recent years been incorporated
into ASD due to the connectivity of the symptoms involved in
the behavior of people afflicted with the disorder. The
inclusion was highly debated due to the expansive scope that
would then exist for people diagnosed with ASD. Infants who
have ASD exhibit moderate to rigorous impairments in social
synergy and communication along with limited, repetitive, and
defined models of comportments, activities and interests all
springing developing before a child is three years old. Due to
the age of diagnosis, children may begin intervention at a young
age and best practices suggest that parent involvement is
essential both for more rapid gains and for consistency across
the child’s waking hours (Steiner, Koegel, Koegel, & Ence,
2012). The focused method of acquiring a diagnosis of ASD
depending on very specific features that is among a long list of
potential factors. Diagnosis of ASD should be precipitated on
elaborate behavioral appraisals, making diagnostic evaluation
tedious and time-consuming. This assemblage of signs
characterizes autism from moderate autism spectrum disorders
(ASD) such as Asperger syndrome (Boyle, Boulet, Schieve,
Cohen, Blumberg, & Yeargin-Allsopp, 2011).
Autism has a solid generative foundation, although the heredity
of autism is complicated, and it is unclear if ASD is defined
41. more by multi-gene reciprocal action or by occasional mutations
(Center for Disease Control, 2012). In exceptional instances,
autism is heavily associated with factors that produce birth
deficiency. Other researchers suggested circumstances, such as
infancy vaccines, are questionable and the vaccine hypotheses
needs reliable scientific confirmation (Luckhaupt et al., 2013).
Most current reports approximate a prevalence of one to two
incidents per thousand people for autism, and about six per
thousand for ASD, with ASD averaging a 4.3:1 male-to-female
proportion (Blumberg, Bramlett, Kogan, et al. (2013; Coo,
Ouellette-Kuntz, Lam et al., 2012). The number of people
perceived to have autism has grown astronomically since the
1980s, at minimal partially owing to differences in diagnostic
method; the issue of whether real pervasiveness has risen is
incomplete (Centers for Disease Control, 2012).
Impact of ASD on Parents and Families
The effects of begetting a child with an ASD on parents and
families are, like the disorder itself, multifaceted and pervasive.
Nearly 85 % of individuals with ASD present with cognitive
and/or adaptive constraints that restrict their capacity to live
autonomously, leading to the likelihood that they will need
some degree of assistance or care from their parents and
families through life span (Beer, Ward, and Moar, 2013). In
Seltzer et al. (2001) longitudinal study of parents of children
with developmental disabilities, over 50 % of parents aged 50 or
older showed that they still reside with their child, compared
with a rate of 17 % for typically developing children. The
permanent weary load often placed on parents and siblings of
children with ASD probably exacerbates the challenges faced by
families of children with ASD, may change caregivers’
understanding of parenting, and possibly decreases enthusiasm
about their own fate, as well as the prospect of their afflicted
child. In summation, the perception and conceptualization of
ASD are quickly and continuously evolving (Rutter, 2011;
42. Ritzema, & Sladeczek 2011). In consequence, families of
children with ASD are confronted with a disorder for which
etiology is unclear and optimal treatment is disputed. These
families are therefore usually left navigating a heterogeneous
and ever-changing direction, all the while grasping that
impediments in accessing services could lead to worse treatment
outcomes.
Family and caregiver distress linked to ASD typically occurs
long before an official diagnosis is given. Parents of children
later diagnosed with an ASD rumor early concerns regarding
variations in communication, social behavior, play, and motor
abilities within the first 6 months of life, with most parents
recounting specific anxiety about ASD at around 18 months
(Bolton, Golding, Emond, & Steer, 2012). Nonetheless, the real
time parents are notified of an Autistic Disorder diagnosis for
their child usually comes much later, when the child is roughly
3.1 years of age, with an average of 7.2 years of age for a
determination of Asperger Syndrome (Center for Disease
Control, 2012).
Parents of children with ASD frequently show relief following
the diagnosis, which can assist them better comprehend their
child’s challenges (Midence and O’neill 1999). Nonetheless,
Chamak et al. (2011) stated that roughly 63 % of parents
revealed discontent with the way the diagnosis was reported.
The experience of the diagnosis itself probably contributes to
the way in which parents make sense of their child’s disability,
and Shyu et al. (2010) observed that the way in which parents
described their child’s deficiencies affected their personal well-
being, their child’s functioning, and the treatment programs
chosen by the family. Parental knowledge and analysis of
deficiencies is probably correlated profoundly with the way
ASD is told to them by treatment professionals (e.g.,
Psychologists or Pediatricians). Nevertheless, no study to date
has investigated how specific explanatory techniques or
processes at the time of diagnosis affected parent and family
functioning or coping from that point onward. Assessing these
43. measures appears expressly important given the extensive and
ever-changing views within the scientific community on the
etiology of ASD and optimal treatment methods for children
with ASD (Kim et al., 2011).
Supporting and raising a child with an ASD seems to have
adverse effects on parents and families regardless of the rigor of
symptomatology or the time since diagnosis of the disorder
(Rezendes & Scarpa (2011). Ekas et al. (2010) remarked that
core manifestations, correlated symptoms, and behavior
difficulties linked with ASD all added significantly to negative
parental well-being, with roughly 12 % of the fluctuations in
well-being explained by children’s ASD deficiencies. Presented
the variability in ASD exhibition, it is necessary to traverse
specific areas affected by having a child with ASD to gain
broader knowledge of what behaviors/deficits add to each
particular domain of impact.
Effects of ASD on Parents
Parental Self-Efficacy
It seems important to understand caregivers’ mental conviction
in their ability to parent effectively their child, or parenting
self-efficacy (PSE), notwithstanding of the appearance of a
disability. In part, this construct may affect actual parenting
behaviors, as a study of PSE in parents of typically developing
children by Karst, and Van Hecke, (2012) proposed that PSE
predicts the level of parenting proficiency. These authors
further stated that parents with higher PSE tend subsequently to
demonstrate more efficient parenting even in the face of
challenging child behavior (Karst, and Van Hecke, (2012). The
importance of PSE discussed in Karst, and Van Hecke review
warrants consideration of how this construct is affected by
having a child with an ASD. If adverse effects exist, it is crucial
to understand how they impact children with ASD and the
services they receive, as well as how they contribute to further
difficulties for parents, as PSE has been associated with
increased levels of parenting stress in parents of children with
44. disabilities (Giallo, Wood, Jellett, & Porter, 2011). Parenting
self-efficacy may be uniquely influenced by having a child with
ASD for various reasons. Parents with larger autism phenotype
(BAP) or sub-threshold components of autism often seen in
parents of children with ASD (Sasson, Lam, Parlier, Daniels,
and Piven, 2013) may require self-confidence in assisting their
child address challenges that they too encounter (e.g., social
anxiety or distress with nonverbal communication). Besides, the
discussion over ASD etiology and description, in combination
with the plethora of mediations available for ASD, usually
leaves parents feeling confused and unsure about the optimal
direction of treatment for their child (Mackintosh et al. 2012).
In addition, Sofronoff and Farbotko (2002) remarked that the
delay in diagnosis (which, with Asperger syndrome, can
continue into the teenage years) oftentimes means parents of
children with ASD have been utilizing ineffective parenting
strategies for long periods, leaving themselves frustrated and
unsure of their parenting capabilities. Ultimately, PSE may be
uniquely affected by parents of children with ASD due to the
child’s deprivation of mutual social communication, a
trademark deficiency of autism. Parents may feel less equipped
to meet the passionate needs and wants of their children with
ASD, who are usually incapable of expressing amply such needs
due to impairments in both verbal and nonverbal
communication.
Sofronoff and Farbotko (2002) underscored the significance of
targeting PSE in parents of children with ASD in their study of
a parent management training program intended to enhance
parents’ self-efficacy. They observed that parents in a 1-day
seminar and parents attending individual treatment sessions
both recount improved self-efficacy compared with control
groups, with significantly elevated improvement detected in
maternal caregivers (Sofronoff and Farbotko 2002). Besides,
Keen et al. (2010) stated that a parent-focused intervention led
to higher growth in PSE pertinent to a self-directed
intervention. These conclusions imply that PSE in parents of
45. children with ASD is flexible and responsive to brief, targeted
intervention. Sofronoff and Farbotko (2002) also discovered
that parents reported less child behavior problems post
intervention, implying that improvements in PSE in parents of
children with ASD can have an immediate impact on the
diagnosed child. Hastings and Brown 2002) proposed that
parents of children with developmental delays displayed
increased parenting competence comparison with parents of
typically developing children, but did not relate competence to
perception of efficacy.
In a research of mothers of children with ASD, Kuhn and Carter
(2006) observed that diminished sense of agency and heightened
feelings of guilt in parents were both correlated with profound
PSE. Parental agency was imagined as the degree to which a
mother assumes an active role in her child’s development,
engages in communications with her child, and continues in
recognizing strategies that reduce maladaptive child behaviors
and maximize adaptive behaviors (Kuhn and Carter 2006). Kuhn
and Carter noted that agency and guilt donated significantly
diminished PSE beyond other circumstances such as parenting
stress, depression, the amount of time since the child’s
diagnosis, and whether another child in the family had a
disability. It also seems that there are discrepancies between
parental and maternal caregivers of children with ASD with
regard to parenting ability. Hastings and Brown (2002) observed
that PSE served as a medium for mothers between child
misconduct and maternal distress and despair, while for fathers,
PSE was observed to reduce the relationship between child
behavior difficulties and maternal anxiety. The association
between parental awareness about ASD and PSE seems
significant given the complexity of the disorder, but a study in
this area has been limited. Kuhn and Carter (2006) detected that
autism-related knowledge was not significantly associated with
maternal self-efficacy, although they showed that limitations in
their measure of autism knowledge, along with a homogenous
representation, provided inadequate variance to confirm the lack
46. of a correlation between these constructs. These researchers saw
a positive relationship between autism-related knowledge and
time since diagnosis, suggesting that parents continued to
enhance their own knowledge about ASD after diagnosis.
Mackintosh et al. (2012) noted that parents continue relying
massively on the internet for information about their child’s
disorder. Nevertheless, it is unclear what impact, if any,
enrollment in any kind intervention had parent's knowledge of
ASD. Taken in aggregate, there are several reasons to believe
that parents of children with ASD suffer from diminished PSE
though no longitudinal studies to date have validated this
hypothesis. Nevertheless, given that increases in PSE through
interventions such as that by Sofronoff and Farbotko (2002)
seem to impact positively parents and their children with ASD,
it seems important to take this variable into account in
understanding the overall effect of having a child with ASD on
parents and families.
One of the most extensively researched areas of impact
considering parents of children with ASD is parenting stress,
broadly imagined as pressure, strain, and tension revolving
particularly around the task of rearing (Rao & Beidel 2009).
Parents of children with ASD encounter higher levels of
parenting stress than parents of normally developing children as
well as parents of children with other kinds of developmental
delay or special health care demands (Schieve et al. 2011).
Circumstances donating to parenting stress in caregivers of
children with ASD include the child’s cognitive impairment,
externalizing behavior difficulties and internalized mental
agony, depressed mood or anger, functional dependency,
hyperactivity, dissent, lack of self-care facilities and profound
adaptive functioning, language deficiencies, learning disability,
inflicted limits on family opportunities, demand for care across
the lifespan, improper eating, toileting, and sexual expression,
comprehensive social difficulties, and great likelihood of living
in the house (Brown et al. 2011; Hall & Graff 2011). Although
cognitive impairment was once recognized as one of the biggest
47. patrons to lofty parenting stress (Ingersoll & Hambrick 2011).
Davis & Carter (2008) observed that cognitive deficits did not
add uniquely to variation in parenting stress when evaluated
along with other child characteristics. Further, Rao and Beidel
(2009) noted that higher intellectual functioning in high-
functioning children with ASD did not ameliorate high levels of
stress in parents. Davis and Carter (2008) suggested that neither
deficits in language and communication nor stereotyped
behavior contributed significantly to parenting stress, despite
these two categories representing two of the core deficits of
ASD. These verdicts grant support to the idea that the novel
combination of emotional, functional, and behavioral
difficulties common in children with ASD, in conjunction with
the pervasive and usually critical impact of the disorder, affect
parents more than the ‘‘core symptoms of autism, per se.
Therefore, the objectives of ASD interventions (i.e., functional
difficulties vs. symptoms) may be vital to consider when
evaluating how treatments influence parenting stress.
With reverence to parent gender, mothers of children with ASD
seem to suffer from heightened levels of parenting stress
correlated with fathers (Davis and Carter 2008; Cappe, Wolff,
Bobet, & Adrien, 2011) were found to perceive greater levels of
stress for other specific family members and for their family as
a whole (Little 2002). Intercommunication influences between
parent gender and child age, with mothers of older siblings with
ASD manifesting lower stress levels while father’s stress stayed
constant throughout childhood (Bebko et al. 1987). These
researchers recommended that this reduction in stress might
depict a relationship between parenting stress and the
acceptance of ASD deficits, at minimum in parental caregivers.
Hastings (2003) showed that parental stress was linked not only
to child challenges but also paternal mental well-being (i.e., the
mental health of the other caregiver), while fathers’ stress did
not seem to be immediately affected by parental mental health.
However, Tehee, Honan, & Hevey, (2009).observed that
mothers of children with ASD exhibited heightened levels of
48. parental engagement compared with fathers. The amount of
parental engagement displayed by caregivers was associated
with parenting stress, and it has been suggested that parenting
engagement may somewhat or wholly reconcile the relationship
between parent gender and stress (Tehee et al. 2009). These
conclusions imply a demand for more comprehensive
understanding of how parents divide care obligations for their
children with ASD and how this division of caregiver
assignments influences parent mental health. Fathers and
mothers may also vary in terms what child features donated
most to their parenting stress, with regard to both etiology and
rigor (Davis & Carter 2008). Davis and Carter (2008) observed
that emotional child dysregulation donates significantly to
parental stress, whereas fathers were affected by their child’s
maladaptive externalizing behaviors. Deficits in social
relatedness added significantly to both maternal and paternal
stress (Davis & Carter 2008).
The findings suggest that for problems that are ongoing and
difficult to address, such as ASDs, psychological acceptance
may be an important factor in coping for parents. A study on the
well-being of parents of children with autism by Baer, Lykins,
and Peters, (2012) found that parents who received more social
support, had lower scores of depression, anxiety and anger.
Also parents with older children, females and larger families
reported lower scores of anger.
Criterion
*(Score = 0, 1, 2, or 3)
Learner Score
Chair Score
Methodologist Score
Content Expert Score
CHAPTER 2 INTRODUCTION (TO THE CHAPTER) AND
BACKGROUND (TO THE PROBLEM)
This section describes the overall topic to be investigated,
outlines the approach taken for the literature review, and argues
49. the evolution of the problem based on the "gap" or "need"
defined in the literature from its origination to its current form.
(Minimum two to three pages)
Introduction: Provides an orienting paragraph so the reader
knows what the literature review will address.
3
Introduction: Describes how the chapter will be organized
(including the specific sections and subsections).
3
Introduction: Describes how the literature was surveyed so the
reader can evaluate thoroughness of the review. This includes
search terms and databases used.
3
Background: Discusses how the problem has evolved
historically into its current form.
3
Background: Describes the “gap” or “need” defined in the
current literature and how it leads to the creation of the topic
and problem statement for the study.
3
Section is written in a way that is well structured, has a logical
50. flow, uses correct paragraph structure, uses correct sentence
structure, uses correct punctuation, and uses correct APA
format.
3
*Score each requirement listed in the criteria table using the
following scale:
0 = Item Not Present or Unacceptable. Substantial Revisions are
Required.
1 = Item is Present. Does Not Meet Expectations. Revisions are
Required.
2 = Item is Acceptable. Meets Expectations. Some Revisions
May be Suggested or Required.
3 = Item Exceeds Expectations. No Revisions are Required.
Reviewer Comments:
Theoretical Foundations and/or Conceptual Framework
Autism Spectrum Disorders such as autism and Asperger's
syndrome cause issues in crucial areas of development: Verbal
and nonverbal communication, Social interaction, Imaginative
or creative play, and Sensory processing (Taddei & Contena,
2013). Children on the autism spectrum may have trouble
understanding or communicating their needs to teachers and
fellow students. They can have difficulty understanding some
classroom directions and instruction, along with subtle vocal
and facial cues of teachers. Inappropriate social interaction can
lead to challenging behaviors, bullying, and ostracizing (Center
for Disease Control, 2014). Difficulties with imaginative or
creative play hamper interactions with other children and mean
that many teaching strategies will not be effective. Sensory
issues mean a student may not cope with noisy environments,
being touched by others, or maintaining eye contact. This
inability to fully decipher the world around them often makes
education stressful for the child, and teachers often report that
they find it difficult to meet the needs of students on the autism
51. spectrum. Parents and teachers, ideally should have specific
training in autism education, so that they are able to help the
student get the best out of his or her classroom experiences
(Center for Disease Control, 2014).
Why do challenging behaviors occur?
Every child is born perceiving themselves at the center of their
universe. As they grow, they realize that other people exist
separately to themselves. In turn, they realize these other people
have needs and wants that may conflict with their own, you
can’t always get what you wanted.
In a sense, the process of becoming an adult is learning to
respect other people’s needs and balancing them with your own.
Children with autism have great difficulties in this area, as the
disorders involve problems with seeing the world from another
person’s perspective (Hutchins, Prelock, & Bonazinga, 2012). A
child with autism is not willfully engaging in challenging
behavior more than any other child would. They simply have
much more trouble in developing this awareness of others that
modifies and refines our behavior.
The parent as 'behavior detective'
A common principle in behavior management is looking for
what the child is communicating through their behavior. The
young boy screaming in the supermarket trolley may have
wanted that yogurt, may be overcome by all the noise, or finds
the hard seat in the trolley uncomfortable. The parent of an
autistic child need to be a 'behavior detective' - investigating
the cause of a behavior and forming appropriate responses,
particularly if it occurs regularly.
Parental Involvement
An important issue in identifying points of leverage in
improving students’ academic achievement is determining how
and to what degree parental involvement (PI) affects their child
with ASD achievement. Such knowledge might inform parenting
practices as well as school-based policies, practices, and
interventions that involve working with parents. For example,
such research might help in the design and development of
52. interventions that maximize parental involvement, where it has
been shown to have the most positive and powerful effect.
Shute, Hansen, Underwood, and Razzouk, (2011) found that the
literature on PI is quite complex and sometimes contradictory.
The idea that parental involvement engenders students’
academic achievement is intuitively appealing to the point that
society in general, and educators in particular, have considered
PI an important ingredient for the remedy of many ills in special
education today. Legislation was enacted, such as the Goals
2000 (Report of the Ready for School Goal Team (2000).
Educate America Act and the reauthorized Elementary and
Secondary Education Act (ESEA) in the United States, which
has made parents’ involvement in their children’s education a
national priority (Baker, & Soden, 1998; Beyer, & Johnson,
2014). Schools have been encouraged to reexamine their
parental involvement policies and programs and to demonstrate
innovative approaches in order to obtain PI. For example,
eligibility for Title I funding is now contingent on the
development of agreements where families and schools assume
mutual responsibility for children's learning.
A collaborative parent-school relationship is based on parents
and teachers understanding each other’s perspectives and
realities. It is important for parents to have a clear
understanding of their child’s school program, the roles of staff
members and how individual classrooms meet the diverse needs
of all the students. It is equally important for teachers and
school staff to have an understanding of the experiences
families go through in living with children with ASD, the
interventions they access and the important role that schools
play in families’ lives. With these understandings and a
commitment to collaboration, parents and teachers can work
together to create positive and effective educational programs
for students. Each family is unique and has different
experiences obtaining a diagnosis, and planning for and
adapting to meet the needs of a child with ASD.
There is no particular best satisfied efficacious educational
53. method for all children with an ASD. The Models of Best
Practice is based on common strengths and core deficits among
individuals with ASD. Despite some similarities, there will be
much variation among students’ abilities and needs. Study has
determined that the best programs are those that consolidate a
mixture of accurately verified methods and are intended to
address and promote the requirements of individual students and
the experts and families with whom they are connected (Wong,
C., Odom, S. L., Hume, Cox, Fettig, Kucharczyk, & Schultz,
(2014). This places relatives, and primarily parents, in very
severe conditions regarding the selection of suitable and
effective educational methods regarding their individual child
with an ASD. Consequently, there is a long-standing attitude by
parents of children with an ASD of receiving instructional
strategies and methods that lack effectiveness and proven
efficacy (Bergen, 2013). The challenge then is how parents deal
with the education of their child with an Autism Spectrum
Disorder.
Criterion
*(Score = 0, 1, 2, or 3)
Learner Score
Chair Score
Methodologist Score
Content Expert Score
theoretical foundations and/or conceptual framework
This section identifies the theory(ies) or model(s) that provide
the foundation for the research. This section should present the
theory(ies) or models(s) and explain how the problem under
investigation relates to the theory(ies) or model(s). The
theory(ies) or models(s) guide the research questions and justify
what is being measured (variables) as well as how those
variables are related (quantitative) or the phenomena being
investigated (qualitative). (Minimum two to three pages)
Identifies a model(s) or theory(ies) from seminal source(s) that
provide a reasonable conceptual framework or theoretical
54. foundation to use in developing the research questions,
identifying variables/phenomena, and selecting data collection
instruments.
3
Accurately cites the appropriate seminal source(s) for each
theory or model.
3
Includes a cogent discussion/synthesis of the theory or model
and justifies the theoretical foundation/framework as relevant to
the study. Connects the study directly to the theory and
describes how the study will add or extend the theory or model.
3
Builds a logical argument of how the research questions directly
align to the theoretical foundation for the study.
3
Reflects a deep understanding of the foundational, historical,
research relevant to the theoretical foundation/framework.
3
Section is written in a way that is well structured, has a logical
flow, uses correct paragraph structure, uses correct sentence
structure, uses correct punctuation, and uses correct APA
55. format.
3
*Score each requirement listed in the criteria table using the
following scale:
0 = Item Not Present or Unacceptable. Substantial Revisions are
Required.
1 = Item is Present. Does Not Meet Expectations. Revisions are
Required.
2 = Item is Acceptable. Meets Expectations. Some Revisions
May be Suggested or Required.
3 = Item Exceeds Expectations. No Revisions are Required.
Reviewer Comments:
Review of the Literature
Defining Autism Spectrum Disorders
Autism spectrum disorders (ASDs) are a group of
neurodevelopmental disabilities defined by significant
impairments in social interaction, deficits in communication,
and the presence of rigid behaviors and restricted interests.
Persistent deficits in social communication and social
interaction across context, not accounted for by general
developmental delays, and manifested by social-emotional
reciprocity, nonverbal communicative behaviors, and
developing and maintaining relationships (Lohr & Le, 2012;
Maenner, Schieve, Rice, et al. 2013).
The thinking and learning abilities of people with ASDs can
vary – from gifted to severely limited. ASD typically begins
before the age of 3 and can create challenges throughout a
person's life. Additionally, people with ASD will have
restricted, repetitive patterns of behavior, interests, or activities
as manifested by stereotyped or repetitive speech, excessive
adherence to routines or ritualized patters, highly restricted or
fixated interests, and hyper- or hyperactivity to sensory input or
unusual interest in sensory aspects of environment (Lohr & Le,
56. 2012; Maenner, Schieve, Rice, et al. 2013). ASD occurs in all
racial, ethnic, and socioeconomic groups and is at least four
times more likely to occur in males than females.
The primary ASDs are Autistic Disorder (or “autism”),
Asperger’s Disorder, and Pervasive Developmental Disorder -
Not Otherwise Specified (PDD-NOS). These conditions share
many of the same behaviors, but they differ in terms of when
the behaviors start, how severe they are, and the precise pattern
of problems. Other disorders often listed as a PDD include
Rett’s Disorder and Childhood Disintegrative Disorder,
although these disorders may no longer be included on the
“spectrum” as new diagnostic criteria for ASD are developed.
Autistic Disorder
Autistic Disorder or “autism” is defined by qualitative
impairments in three areas of function: (1) social interaction,
(2) communication, and (3) restricted repetitive and stereotyped
patterns of behavior, interests, and activities. Common
symptoms include poor eye contact, poor “reading” of social
cues, failure to develop peer relationships, lack of social or
emotional reciprocity, delayed speech development, difficulty
sustaining conversation, lack of make-believe play, repetitive
motor mannerisms, and rigid adherence to routines (National
Institute of Mental Health. 2010). Symptoms are present before
3 years of age. As many as 60- 75% of children with Autistic
Disorder also have intellectual disabilities, but some children
with Autistic Disorder can develop average or even superior
intellectual abilities. Even in children with intellectual
disabilities, there may be isolated skills that are highly
developed such as in music, math, or memory (Center for
Disease Control, 2014).
A revision to autism spectrum disorder (ASD) was submitted in
the Diagnostic and Statistical Manual of Mental Disorders
version 5 (DSM-5), (American Psychiatric Association. 2013).
The new diagnosis encircles previous diagnoses of autistic
disorder, Asperger's disorder, childhood disintegrative disorder,
and PDD-NOS. In preference to categorizing these diagnoses,
57. the DSM-5 embraced a dimensional method to diagnosing
disorders that fall underneath the autism spectrum umbrella. It
is contemplated that persons with ASDs are best portrayed as a
single diagnostic category because they manifest similar types
of symptoms and are best differentiated by clinical specifiers
(i.e., dimensions of severity) and associated salient qualities
(i.e., known genetic disorders, epilepsy and intellectual
disability). An additional change to the DSM involves
communication and collapsing social deficits into one domain.
Thus, a person with an ASD diagnosis will be described in
terms of severity of social communication symptoms, severity
of fixated or restricted behaviors or interests and associated
features. The restriction of onset age has also been loosened
from 3 years old to early developmental period, with a note that
symptoms may manifest later when demands exceed
capabilities.
Autism forms the core of the autism spectrum disorders.
Asperger syndrome is closest to autism in signs and likely
causes (Meyer-Lindenberg, 2012) unlike autism, people with
Asperger syndrome have no significant delay in language
development (American Psychiatric Association. 2013). PDD-
NOS is diagnosed when the criteria are not met for a more
specific disorder. Some sources also include Rett syndrome and
childhood disintegrative disorder, which share several signs
with autism but may have unrelated causes; other sources
differentiate them from ASD, but group all of the above
conditions into the pervasive developmental disorders (Lohr &
Le, 2012; Maenner, Schieve, Rice, et al. 2013). Autism,
Asperger syndrome, and PDD-NOS are sometimes called the
autistic disorders instead of ASD (Lohr & Le, 2012) whereas
autism itself is often called autistic disorder, childhood autism,
or infantile autism (Helverschou, Bakken, Martinsen, 2011).
Although the older term pervasive developmental disorder and
the newer term autism spectrum disorder largely or entirely
overlap, (National Institute of Mental Health. 2010) the former
was intended to describe a particular set of diagnostic labels,
58. whereas the latter refers to a postulated spectrum disorder
linking various conditions (American Psychiatric Association.
2013). ASD, in turn, is a subset of the broader autism phenotype
(BAP), which describes individuals who may not have ASD but
do have autistic-like traits, such as avoiding eye contact
(American Psychiatric Association. 2013).
Asperger’s Disorder
Asperger’s Disorder or Asperger Syndrome is defined by
impairments in social interaction combined with restricted or
repetitive patterns of behavior, interests, and activities.
Common symptoms include poor “reading” of social cues,
failure to develop typical peer relationships, lack of emotional
reciprocity, intense interests or preoccupations, and rigid
adherence to routines. Children with Asperger Syndrome do not
show general impairments in language or overall cognitive
development, although impairments in visual-motor skills and
pragmatic (social) language are common. Children with
Asperger’s syndrome have better fluid reasoning abilities even
than children with typical development and better visual
attention than children with an autistic disorder (Taddei &
Contena, 2013).
This aspect serves to reveal the levels involved in the spectrum.
Asperger’s syndrome provides a separation in the spectrum and
the differences aid in the development of effective approaches
to treatment. Consistently with what has been shown by some
authors, results of different studies are not homogeneous,
perhaps because of a difference between the instruments used,
theoretical frames, definitions and research methodologies;
many different theories to explain autistic disorder have been
proposed but delineation of the areas and processes of the brain
involved is a topic of much debate (Taddei & Contena, 2013).
The image of Asperger’s disorder, however, is much less
offensive to family and friends than that of Autism. In a
current study the finding that the condition of autism has a
greater impact on the child and family than that of Asperger’s
disorder is consistent with the concerns raised about the autism