Ann X. Huang

Children with Autism in the People’s Republic of China: Diagnosis, Legal Issues, and Educational Services

Since the late 1970s, special education in the People’s Republic of China has experienced significant reform and fast development. However, education for children with severe developmental disabilities, especially autism spectrum disorders (ASDs), is still the greatest challenge in the field. This paper aims to give readers an overview of what is happening to children with ASDs in China. We first address the issue of prevalence of ASDs, and then offer an introduction to the diagnostic process. After that, a review of disability-related legislation is provided, followed by a description of current treatment options and available educational services. Finally we introduce all extent service providers and their roles.

Including Children with Autism in General Education in China.

I n the People’s Republic of China, a greater social attention to the education of children with special needs began to occur in the late 1970s, when President Deng Xiaoping introduced the Reform and Open Door policy. Since then, special education in China has experienced significant reform and fast development, as well as profound political, economic, and social changes. However, education for children with severe developmental disabilities, especially autism, has long been the greatest challenge in special education. Since the occurrence of autism is not subject to such factors as race, ethnicity, or social backgrounds, the prevalence of autism used by Western countries is also applicable in China. If we use the current conservative prevalence of autism (i.e., 15 per 10,000 births) to calculate, it can be estimated that China, with a population of 1.3 billion, has approximately 1.95 million individuals with autism at various levels of functioning. Considering that 75 to 80 percent of the Chinese population resides in remote, rural areas and might experience financial and technical constraints related to identification of autism (e.g., lack of expertise and unavailability of systematic framework for identification and diagnosis), it is reasonable to estimate that approximately 75 to 80 percent of the 1.95 million individuals with autism have not yet been identified or diagnosed properly. In reality, many individuals with both autism and cognitive impairments have been simply diagnosed with cognitive disabilities (e.g., mental retardation), due to psychiatrists’ lack of knowledge about autism (Tao, 1987). In China, so far, no official data have been released regarding the number of individuals with a diagnosis of autism. According to experts from the Institute of Mental Health, Beijing University, it is estimated that China has approximately 400,000 to 500,000 children (between ages 3 to 18) with autism at various levels of functioning (M.X. Jia, personal communication, November 26, 2005). However, due to the lack of knowledge and awareness, autism has been misunderstood in Mainland China for years and often has been thought of as a rare illness that is contracted by relatively few individuals. Therefore, it has not been officially specified under the category of mental disorders until recently. Currently, the official diagnostic criteria for autism in China are listed in the Chinese Classification and Diagnostic Criteria of Mental Disorders, Version 3 (CCMD-3rd, Chinese Psychiatry Association, 2001). Due t o the lack o f

Maltreatment and depression in adolescent sexual offenders with an autism spectrum disorder

This study examined the self-reported presence and severity of abuse, neglect, and depressive symptoms for 43 adolescents adjudicated delinquent due to a sexual offense. Twenty-seven of the adolescent sexual offenders were also diagnosed with an autism spectrum disorder, and 16 did not carry an autism spectrum disorder diagnosis. Both groups reported moderate to high levels of abuse and neglect. Adolescent sexual offenders with an autism spectrum disorder reported significantly higher depressive symptoms than those without an autism spectrum disorder. Furthermore, of the group with an autism spectrum disorder, those reporting severe levels of emotional abuse and/or emotional neglect were more likely to also have depressive symptoms. Results suggest a need to tailor treatment programs to match the unique needs of sexual offenders.

Identifying individuals with autism in a state facility for adolescents adjudicated as sexual offenders: a pilot study

Using the criteria established by the Commonwealth of Pennsylvania, the assessment procedures for establishing an autism spectrum disorder (ASD) in a previously undiagnosed adjudicated group is detailed. We examined 37 male adolescents adjudicated delinquent for sexual offenses who were sentenced to treatment. Ultimately, 22 (60%) were found to meet the diagnostic criteria for an ASD. All had intelligence quotients in the average range. For the offenders with ASD, we recommend modifying traditional treatment protocols (i.e., relying on individual and group talk therapy) to match their learning styles (e.g., visual learning, modeling with practice, and feedback) and restricting contact with neurotypical sexual offenders to improve therapeutic outcomes. Deterrent programming aimed at bridging the gap between social deficits, Theory of Mind deficits, and sexual knowledge acquisition is discussed.

Understanding the Self in Individuals with Autism Spectrum Disorders (ASD): A Review of Literature

When the system of self is explored in individuals with Autism Spectrum Disorders (ASDs), it is important to measure it via both their own perceptions of the self and their understanding of others’ perceptions on themselves at a multidimensional level. This paper reviews existing research in this area using a three-dimension approach. Researchers have found that impairments in the self-system are usually correlated with these individuals’ social and cognitive functioning levels: high functioning individuals with ASD who have higher IQ are found to have better awareness of their limitations in social and communication domains than those with lower IQ. Many researchers believe that there are impairments in the psychological (but not physical) self in individuals with ASD, such as theory of mind deficits due to social and communicative impairments. On the other hand, some researchers argue that individuals with ASD have selective rather than global impairments in the self. In other words, the impairment usually lies in a specific aspect of functioning in individuals with ASD. Insights from the review of existing literature on this topic may be able to shed some lights on the development of effective intervention programs to improve social communication deficits in this population.