KOCHI: Autism, a neurobiological disorder, is becoming a common condition in our society with an estimated prevalence of 1 in 54 children. The disorder is characterised by defects in communication, difficulty in imitation and socialisation with stereotypical body movements.
Cause
The exact cause is yet to be identified. However, it is important to note that the condition is not caused due to vaccination or parenting problems. There is no single lab test to identify it. It can only be diagnosed through careful analysis of the child’s developmental history, behaviour and social interactions.
Behaviour patterns
Communication defects are both verbal and non-verbal. The child has poor eye contact and will not use pointing, gestures or facial expressions for communicating.
Speech may be delayed or inappropriate with reduced name-call response. Some children also have reduced emotional reciprocity and can be indifferent to other people’s emotions. For eg, if the mother is sad, the child may be unable to understand it. They also have deficits in developing, maintaining and understanding social relationships.
They might have difficulty making friends or playing with other children. They may have restricted interests and may be hypo or hypersensitive to pain, touch, lights and sounds. Around 40% can have intellectual disability.
All the aforementioned features may not be present in all children. Sometimes the defects may be subtle initially and may be missed. Early diagnosis is very important as it can bring marked and sometimes complete improvement. There are simple questionnaires for parents to identify autism very early.
Questionnaires
If you point at an object (eg: fan), does your child look at it or does your child points at some other object to get it (eg: milk)?
Does your child engage in pretend play like pretending to drink from a cup or does your child copy you when you do something?
Does your child make unusual finger movements near the eyes?
Does your child look at you when you smile or point at something interesting or bring interesting things to show you (eg: flower)?
Does your child look at other children, smile and play with them?
Does your child look you in the eye when you play with him or talk to him?
Does your child understand when you ask him to do something (put a cup on the table)?
Is your child upset by everyday noises?
If the child exhibits any such behaviours, the parents should seek consultation with a developmental paediatrician and get a formal assessment.
Treatment
If there is any delay in the above milestones, early intensive developmental therapy, speech therapy and behaviour therapy should be started.
Individualised education programmes with techniques like applied behavioural analysis, TEACCH and alternative augmentative communication systems are also used. Starting the therapy early is pivotal. A multidisciplinary team including a psychologist, speech and language pathologist, occupational therapist and remedial educator will be able to address the different issues faced by the child.
An effective home programme after training the parents and family members as co-therapists is found to have maximum benefit. A positive attitude focusing on the child’s strengths is very important.
Normal independent life can be made possible with intensive therapy.
Public spaces should be made more inclusive for neurodivergent people.
Specialist employment support needs to be created for autistic adults. Early, personalised and effective support will enable them to have the best chance of a happy, healthy life.
Mind and body
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