Autism (autism spectrum disorder or ASD) is a neurodevelopmental disorder characterised by impaired communication and interaction abilities of a child. These can be difficulties in social interaction, verbal and nonverbal communication, repetitive behaviour, delayed intellectual development, difficulty in motor coordination, lack of attention and physical issues such as disturbed sleep and gastrointestinal issues.
The symptoms present themselves in the early developmental stages, usually when the child is between 2 to 3 years of age. The degree of the symptoms and the developmental disorders differ from child to child, where some children may have mild autism, while others may be severely affected.
In India, more than 10 million children have been diagnosed with autism with an incidence rate of 1 out of 66. This disorder affects boys more than the girls. Autism is categorised into four types:
- Autistic disorder (Kanner’s syndrome or early infantile autism) is characterised by impaired development that manifests before age three in the form of social interaction disability, stereotyped and repetitive behaviour, temper tantrums, sleeping and eating disorders, etc.
- Asperger syndrome – This disorder is generally marked by clumsiness. However, there is no general delay in language or cognitive development.
- Childhood Disintegrative Disorder (Heller’s syndrome) is characterised by normal development until the age of 2, after which the child tends to lose the skills such as the ability to walk or talk. There is a general loss of interest in the environment, repetitive behavioural tendencies, lack of social interaction, etc.
- Pervasive Developmental Disorder – This disorder generally does not fit the diagnostic criteria for autism. The onset is usually after three years of age and mostly arises in individuals with severe specific developmental disorders of receptive language.
Causes and risk factors
Autism cannot be attributed to any particular cause but there are several factors involved in its causation such as genetic, metabolic, and neurological factors, certain infections and other problems at birth.
Symptoms and signs
Following are the clinical features of autism:
- Problems with verbal communication, understanding and using language.
- Preoccupation with unusual objects.
- Repetitive behavioural tendencies such as head banging, hand flapping, etc.
- Impaired social interaction and inability to relate to people or surroundings.
- Difficulty with gestures and facial expressions.
- Obsession with playing with toys in a particular manner
- Difficulty in coping with change in routines or familiar surroundings.
If your physician suspects that your child has autism symptoms, he or she will seek complete family medical history and perform a thorough physical and neurological examination.
There may be some blood tests and x-rays to evaluate the genetic or metabolic causes of autism.
If all these tests do not identify any physical reasons, then the psychological route is taken to determine the level of cognitive, speech, and behavioural development. After seeking inputs from the parents, teachers, etc., the psychologist arrives at the degree of autism.
Treatment and prevention
There are no permanent medical cures for autism. However, focused and persistent therapies may help in the relatively normal development of the child. The treatment plan for the autism include:
- Special education – An autistic child has unique educational needs.
- Behaviour modification – By providing a structured and routine environment to the child, it would help reduce the behavioural fluctuations.
- Speech, physical, and occupational therapies – Help the child to improve the functional abilities.
- Medication – Medicines may be used to treat the associated symptoms such as anxiety, hyperactivity, sleep disturbances, etc.
Depending on the severity of autism, the age when it was diagnosed and treatment started and the emotional and therapeutic support available, a lot of improvement can be expected in an autistic child.
Autism cannot be cured or prevented. However, timely diagnosis and intervention can help to improve the child’s mental, physical and functional abilities.
Sensitising people around the child, providing moral and emotional support to the parents, educating the teachers about the unique needs of an autistic child, etc. can help the child cope better with this condition.
If you suspect any symptoms of autism in your child, consult your physician immediately who would refer you to a specialist psychologist.
If a child is demonstrating any of the following warning signs, then one should get evaluation for autism immediately:
- The child does not babble or coo by 12 months of age (cooing typically starts when a child is two months old).
- The child does not gesture, such as point or wave by 12 months of age.
- There is speech delay until the age of 16 months.
- The child is not able to form short sentences by the age of 24 months.
- If the child seems to be losing some skills that may have been normal so far such as speech, walking, etc.
- The child is avoiding eye contact or any other form of social interaction.
- The child has no facial expression or does not react to facial expressions.
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- Research on autism spectrum disorders in India – National Institute of Mental Health and Neurological Sciences (NIMHANS) – Accessed on February 24, 2016 – http://medind.nic.in/aag/t11/i2/aagt11i2p69.pdf
- Autism Spectrum Disorder. National Institute of Mental Health – Accessed on February 24, 2016 – http://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd/index.shtml
- The National Autistic Society – Accessed on February 24, 2016 – www.autism.org.uk/autism
- Centers for Disease Control and Prevention – Accessed on February 24, 2016 – http://www.cdc.gov/ncbddd/autism/index.html
- Autism Spectrum Disorder – Accessed on February 24, 2016 – http://www.nichd.nih.gov/health/topics/autism/Pages/default.aspx.