Abstract
In today’s medical world, there are various disabling conditions that afflict individuals and populations. There have been tremendous strides in the techniques used to alleviate these conditions, and one of them encompasses using recreational therapy modalities. The paper purposes to elucidate how these recreational modalities can be used successfully on some of these conditions. Its chief focus is on autism as a disabling condition, and animal therapy as the modality used therapy. The paper begins by offering a brief description of autism including its history, its prevalence, and how it affects individuals. It then delves into the causes of the conditions, the secondary conditions arising from the primary condition and the needs and limitations individuals with the condition experience. The paper then proffers various RT modalities that should be used with the condition before focusing on one of them (animal therapy). It delineates how the modality should be applied, the goals of the therapy, as well as the specific activities to fulfill the purpose of the modality. The paper then offers an in-depth description and analysis of one of these activities as well as how the activity should be adapted for autistic individuals. Lastly, the paper compares the RT conditions and adaptability to the first condition with those for a second condition.
Keywords: Autism Spectrum Disorder, animal therapy, Generalized Anxiety Disorder
Disabilities, Modalities and Activity Adaptations: Autism Spectrum Disorder (ASD)
Autism Spectrum Disorder (ASD) refers to a collection of developmental disorders that lead to fundamental impairments in social interaction and communication and encompasses stereotypical repeated and restrictive patterns of behavior (Tuchman, Cuccaro, & Alessandri, 2010). These disorders are complex in nature, have no well-defined biological markers for diagnosis, change definitions over time, and symptoms usually exhibit themselves before the age of 3 years (CDC, 2012).
Categories
The disease has various cognitive manifestations all of which have various symptoms and include:
- Childhood autism; also referred to as autistic disorder. Childhood autism is the classical case that manifests itself in children who exhibit symptoms such as mental retardation and poor speaking skills (Tuchman, Cuccaro, & Alessandri, 2010).
- Asperger syndrome- Mostly occurs in high-functioning college students with individuals exhibiting above-average IQs (higher than 70), inadequate social skills that are not as severe, and language development that is not delayed (Currenti, 2010).
- Atypical autism- Also referred to as pervasive developmental disorder not otherwise specified (PDD-NOS). This disorder lacks an operational definition, a trait that creates challenges in its classification, study, and the monitoring of prevalence (Tuchman, Cuccaro, & Alessandri, 2010).
Prevalence
There has been an upsurge in the reported incidences of ASD over the past ten years, with some reports suggesting that the condition has quadrupled (Schaefer & Mendelsohn, 2008). In 1990, it affected approximately 3 in 1,000 persons, but today that rate has increased to about 20 in 1,000 persons. Among children, autism is one of the most prevalent developmental disabilities, second only to mental retardation (Currenti, 2010). Autism varies in its prevalence across countries, among genders, and among race. In some nations, the prevalence rates are reducing, in some the cases are reducing. The condition occurs predominantly in males (one in 54 males has it) while one in 254 females has it which gives a male: female ration of 4 to 1 (CDC, 2012). Surprisingly, the condition has a higher prevalence in African-Americans.
Etiology
There is no well-defined cause for ASD to date, but the interplay of genetic and environmental factors remain the most important. The significance of genetic factors supported by the high concordance rates among twins and siblings. Population studies done on the condition indicate that recurrence risks for full siblings are 4% for female children and seven percent of male children (Schaefer & Mendelsohn, 2008). (Kelleher & Bear, 2008) Show how numerous single-gene disorders coincide with increased ASD rates, and how these molecular defects affect the pathways used for synaptic protein synthesis, a phenomenon that causes cognitive and neuronal impairment.
Environmental perturbations have also been shown to play a significant role in the upsurge of ASD due to their hefty influence on universal and localized genetic regulation (Currenti, 2010). Emerging research shows that the environmental changes of the last 30 years have had numerous impacts on people’s genetic makeup, consequently causing increased neurological disorders (Zhang & Wong, 2006). Elucidated how electromagnetic radiation (EMR), as well as infantile exposure to mercury, play an important role in increasing the incidences of mercury. They stated that on average, autistic children have twice the level of mercury that non-autistic children have. There were also higher reported incidences of autism near coal-burning plants that emit higher quantities of mercury and lead into the atmosphere. There has been an upsurge in the awareness and diagnosis of ASD, but more needs to be done regarding elucidating the genetic, epigenetic, nutritional, and environmental etiology of the disease.
Secondary conditions
Autistic children have exhibited a higher risk for mood and anxiety problems, and this impacts negatively on their overall adaptation
Summary of limitations and strengths
Some limitations that autistic individuals exhibit include:Lack or orientation towards social stimuli but hypersensitivity to sensory stimuli, difficulties in mentalizing as well as interpreting verbal and non-verbal cues, inappropriate emotional responses, the lack of empathy for others, and difficulties in sharing an affective experience, deficiencies in cooperation, self-control, and assertion and difficulties in initiating social interactions (Beidel & Murray, 2008).
Individuals with Asperger’s, in particular, exhibit the following strengths:Increased levels of intelligence (higher than average IQs), a fascination with letters and numbers as well as the ability to memorize factual data in their formative years, increased absorbing interest in some specialized topics and over stimulation that leads to them being aware of things that ordinary people screen out.
Recreational Therapy Modalities
There are diverse recreational therapy modalities that can be utilized for ASD and these include:
- Interactive robots- Many autistic individuals prefer gadgets to people in their therapy, and this has led to the development of mobile robots as therapeutic tools. These robots enable autistic children to overcome their social communication challenges by modeling socially appropriate questions and responses (Dautenhahn & Werry, 2005). The robots also encourage these children to interact meaningfully with the therapists as well as other individuals.
- Hydrotherapy- Aquatic experiences provide unique and essential opportunities particularly for autistic children with very low muscle tone. These hydrotherapy sessions are instrumental in promoting the health and wellness of autistic children with difficulties in sitting or walking for long periods (Dewi & Judarwanto, 2009). The benefits derived are useful throughout their lifespans.
- Art therapy- Incorporates object relations, developmental and behavioral approaches, and psychotherapy in the treatment process. The therapy capitalizes on the use of art materials to address specific and difficult treatment objectives (Martin, 2009).
- Dance therapy- Its main objective is to channel communication patterns into ‘dances of relationship’ by utilizing the elements of movement and dance in assessment and intervention (Boris, 2007). It has a unique capacity to work directly with the core deficiencies of ASD such as cognitive challenges and walking disabilities.
- Music therapy- It allows for a ‘connection with life’ for individuals who are otherwise cut off from human communication. It involves practices such as listening or performing music, and by so doing influencing the physical, emotional, social, and cognitive wellness of ASD patients (Davis, Gfeller, & Thaut, 2008).
- Animal therapy- This RT modality is the focus of this paper.
Animal Therapy
It involves the introduction of animals into the immediate surroundings of ASD patients with the objective of offering therapeutic services. The therapy is offered in a variety of institutions including psychiatric, rehabilitation, and acute care centers.
History
Animal therapy has existed for over 12,000 years, with one of the earliest cited findings being a skeletal remain of a human holding a puppy in Northern Israel. In the 1700’s, residents of York, England, used rabbits and hens for therapy involving mentally ill patients (Morrison, 2007). In 1980, a society called the Delta Society was formed to promote the use of animals in aiding individuals improve their health, life quality, and independence. Over the years, animal therapy has grown and is currently one of the widely preferred therapeutic interventions for a range of conditions including ASD.
Purpose and Full Description
Extensive research has shown that animal-assisted therapy can regularly give an approach to achieve results that conventional treatments don’t. For some individuals with Autism, the animals may give a window of relating that then can be deciphered into their different connections and other relationships. Animal-assisted therapy helps kids to feel more contented with treatment and also affect school conduct by expanding certainty and consideration aptitudes and diminishing hyperactivity.
Animal therapy can be as straightforward as bringing a family pet into the family unit, as organized as projects that offer horseback riding or swimming with dolphins or as complex and involving as counseling and training centers. Counseling and training centers that accommodate patients with autism, furnish treatment to them with a band that incorporates a clinician who is reasonably au fait with the disorder as well as the animals. The team works with the family to build up objectives. While beginning phases of treatment include particular animals, at times the group may suggest Filial Pet Therapy, a methodology that includes coordinating the family pet into helpful associations.
Modality Assessment
As this modality is constantly perceived as a reasonable treatment choice, there is a developing requirement for profoundly qualified animals to serve people in different and changed limits. Notwithstanding the species or the specific part, animals are progressively being recruited for parts in human wellbeing administrations. With the utilization of proper appraisal instruments, which have the effect ability to evaluate the attributes that apply to the requests of a specific occupation, animal therapy becomes very effective for patients ailing from autism disorder. Evaluation, therefore, involves a use of appropriate assessment instruments in a regular pattern that helps to determine the effectiveness of the therapy and the overall progress of both the patients and the pets. Most conventional assessments focus on behavioral aspects and acquired skills as opposed to character traits. Evaluation should be aimed at assessing the compatibility between the particular animal and an animal as well as the progress in character traits of the individuals. The underlying factors include controllability, sustainability, predictability, and reliability of the modality thus the need in the mental health field. Multi-dimensional assessment tools such as CARAT (Clothier Animal Response Assessment Tool) could also be used. CARAT employs various primary disposition indexes each including particular individual traits. Psychometric properties and ethical considerations are also a basis for decision making and animal therapy evaluation.
Animal therapy enhances a spontaneous connection between autistic individuals and animals. Subsequently, evaluation of the modality involves assessment of communication and social skills, for instance, how playful one gets, jovialness and level of happiness, and the level of focus around the animals or pets. Progress notes are part of medical records that record status, progress or achievements of the autistic individuals. It is through such records that their attention, ability to hold information longer and learning capabilities can be effectively evaluated.
Behavioral evaluation incorporates a pet’s body language that serves as an important viewpoint resource for counselors. The pet’s conduct mirrors the way in which characters from the species instinctually speak with one another in the pack. Conclusively, information of the animal’s non-verbal communication could be utilized to illuminate the guide about an individual’s available enthusiastic state and or level of anxiety.
A classic example that illustrates the important areas of evaluation is horse riding. Riding a horse is of both mental and physical merits to the autistic individuals. The objectives decrease stereotyped conduct, reduce tactile affectability, and build the craving and capacity to interface socially with others such as the illustration of a perkier mindset, more engaged, and more mindfulness of social surroundings when in the vicinity of a treatment pooch.
Specific activities and Activity adaptation
Activities help to lessen and rectify unsuitable behavioral patterns as well as improve motor coordination. They also provide a platform for autistic people to have fun and release tension that does not heavily rely on language or imagination dependent skills. Physical exercises that don’t include learning amusement standards can be appreciated alone and additionally with others. Those that use rhythmical, tedious developments are extremely well known. Numerous kids with autism disorder appreciate strolling, running, hopping, climbing and swimming. They also appreciate exercises that benefit as much as possible from utilizing their faculties, albeit some don’t. They frequently favor exercises that make utilization of visual aptitudes, for example, shading and shape coordinating and sorting. For tactile seekers, toys and exercises that are outwardly fascinating or have curiosity components such blazing lights, musical sounds come in handy. This develops a comprehension of circumstances and end results and expands on their loving for redundancy
Physical exercises can also incorporate conveying dogs and cats visitations, swimming with dolphins or cavorting with a puppy. Research shows that children with autism spectrum disorders heighten their attention and enhance their thinking by spending time around dolphins. Dolphins and other animals in animal therapy can rouse and inspire individuals to connect with as well as to partake in productive exercises that they would not have something else.
The term hippotherapy alludes to how word related treatment, active recuperation, and discourse dialect pathology experts use confirmation based practice and clinical thinking in the intentional control of equine development to connect with tangible, neuromotor, and intellectual frameworks to accomplish utilitarian results (AHA, 2015). In conjunction with the affordances of the equine environment and other treatment methodologies, hippotherapy is a piece of an understanding’s incorporated arrangement of consideration. In hippotherapy, the horse’s movements involve forward and backward strides and side to side movement of the pelvis that helps the rider to comprehend motion. Essentially, the horse influences the rider rather than the conventional way where the rider influences the horse and ultimately the rider understands how he or she should be moving (Shurtleff, 2011).
A horse is a warm mammal, a characteristic that makes therapeutic horseback riding effectively in achieving goals that improve physical, enthusiastic, social, subjective, behavioral and instructive aptitudes for autistic individuals. The riders develop an emotional bond as they ride due to the feeling of security and safety.
As a matter of first importance, pets such as dogs regularly serve as guardians, keeping a tyke safe and avoiding meandering. Numerous kids with autism disorder are inclined to meander from safe spaces, be it home or school, some of the time with sad results. An extraordinary number of accidents have been accounted for, and folks whose kids are inclined to wander off frequently turned out to be consistently cautious and depleted. The pets could enhance such circumstances. Appended to the influenced kid by a chain and belt framework, yet reacting to charges from a guardian or other grown-up handler, the puts ensure their kid does not leave a protected range and in the unlikely event that the child attempts, the pet can utilize their weight to opposing, allowing guardians to mediate.
Case studies point out that people with autism disorder increase certain attitudes through their cooperation with the pets such as dogs, for instance figuring out how to coordinate their pace to the puppies while out strolling, how to toss a ball, or how to pet the pooch with the right measure of weight. Parents are excited to report diminished nervousness, expanded placidness, and the decrease in the quantity of emergencies or fits of rage, disseminated/defused displeasure, and more sensible sleep time schedules.
The above backdrop lends support to the school of thought that pets interaction and animal therapy, in general, are of great benefits to people with autism spectrum disorder especially children. There arises a need, however, to consider and even adapt to individuals’ sensitivities instead of employing a one size fits all kind of approach (Arbogast, 2014). Such considerations also come to play during pet ownership evaluation process. Pets can play a bigger part in the life of a person with autism spectrum disorder than an animal met amid a brief treatment session, giving each day help and backing as watchmen, aides, and assistants. According to research, approximately two-thirds of the families with people with autism disorder have ended up owning pets. In families without pets, autistic children also enjoy playing and interacting with dogs. Activity adaptation is a progressive process that involves careful considerations.
Generalized Anxiety Disorder
Everybody, irrespective of the age or position has fears in suitable circumstances. In a few environments, the extensive concern can be lifesaving, and the body’s reaction to apprehension is known as the battle or flight response (Torpy, Burke, & Golub, 2011). Whenever uneasiness or trepidation happens over generally basic things or occasions, is troublesome for the person to control, is intemperate, and keeps going no less than six months, this is called generalized anxiety disorder. Alongside alternate sorts of nervousness issue, summed up uneasiness issue is genuinely regular. Not at all like the different scenes of extreme frenzy tension that happen in frenzy issue, the level of nervousness changes progressively in persons who have summed up uneasiness issue. Nervousness issue influence more than 40 million grown-ups in the United States alone, around 18 percent of the populace. Around the world, roughly 20 percent of persons who get essential medicinal services have anxiety disorders.
Symptoms of this disorder include quick or unpredictable pulse that is palpitations or shuddering in the mid-section, sweating or flushing of the skin, muscle pressure, migraines, trouble sleeping, loss or change of appetite, and Nausea. Physical explanations behind a portion of the symptoms of the generalized anxiety disorder incorporate heart issues, thyroid conditions, among other medicinal ailments. Through restorative history and physical examinations, a doctor, may request testing to eliminate these restorative issues. Psychiatrists make inquiries and use particular testing strategies to analyze a singular’s side effects to check whether the patient has one of the uneasiness issue or another psychological issue.
According to a Journal of American Medical Association, treatment of this disorder takes several approaches all combining medication and therapy. A combination of therapy and medication helps to fight the symptoms mentioned above. One of the most effective types of therapy used is the cognitive behavioral therapy abbreviated CBT. CBT offers patients some assistance with finding methods for adapting to their sentiments and learn new strategies to bargain with the circumstances that make them on edge.
Relaxation methods are regularly useful and can incorporate contemplation, yoga, and biofeedback. Physical activity lifts temperament and enhances general well-being. Different sorts of treatment should be offered, contingent upon a singular’s particular needs. Medications may incorporate one or more sorts of antianxiety medicine, a significant number of which are likewise used to treat depression. Treating substance misuse, including tobacco reliance, ought to be considered as a component of the, generally speaking, administration of generalizes anxiety disorder.
Anxiety is a characteristic reaction and an important cautioning adaptation in people. It can turn into a pathologic issue when it is exorbitant and wild, requires no particular outer jolt, and shows with an extensive variety of physical and full of feeling side effects and, also, changes in conduct and discernment. As illustrated in the Diagnostic and Statistical Manual of Mental Disorders (Rowney & Hermida, 2010), tension issue incorporate summed up uneasiness issue, social nervousness issue otherwise called social fear, particular fear, frenzy issue with and without agoraphobia, and substance-actuated tension issue.
Adaptation is key to the diagnosis, treatment and coping of and with individuals with generalized anxiety disorder. Physicians must be cautious while treating certain populaces of anxious patients, incorporating patients with substance reliance, ceaseless obstructive pneumonia ailment or other respiratory ailments, and pregnant or elderly patients. Benzodiazepines are the boss worry in these patients. This class of drugs can diminish the respiratory rate in numerous ailments in which the rate should be as of now bargained and can improve the probability of incoherence in both the elderly and restoratively sick. Benzodiazepines are additionally considered for the most part hazardous for use amid pregnancy and have the potential for misuse in patients with substance reliance. In these populaces, the consolidated treatment of a CBT treatment is favored. If benzodiazepines are fundamental, it is vital to begin at a low dosage, titrate gradually, and arrangement for just transient use.
It is also necessary to instruct the patient and relatives about reasonable treatment desires and console them of the nonappearance of medicinal reasons. In the first place, line treatment is with a specific serotonin reuptake inhibitor, beginning at low measurements with watchful titration so as not to compound tension manifestations. Start intellectual, behavioral treatment alongside pharmaceutical to fundamentally build reaction rates. Consider fleeting benzodiazepines in more extreme cases and use of pharmaceuticals with longer half-lives to minimize withdrawal impacts should also be effective not to forget allusion to an emotional well-being proficient in troublesome cases or for patients with a not exactly anticipated that reaction treatment.
Conclusion
The two classic examples of disabling conditions illustrated above depict the developmental, cognitive and psychological impairments in the society today. Inference can be drawn to mirror all the disabling conditions ailing the present day society from the backdrop above. Adaptation activities analysis give a picture of the needs and strengths of persons with disabling conditions.
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