Does your child not looking you directly in the eyes when you are talking to him/her or playing with him/her? Does your child not pointing with one finger to ask for something or to get help? Does your child not responding to name calls or is unable to understand properly whatever is spoken? Have trouble in interacting with children of his/her age group and appear to be lost in a daydream most of the time? Does he/she line up toys and other objects or hold objects to the side/corner of his/her eyes? Does your child spin, flap his/her hands or play with own’s finger, scream in public places, walk on tiptoes, have aggressiveness, excessively sensitive to certain sensations like touch, movement etc.? It might indicate, he/she may have Autism Spectrum Disorder (ASD). If you find these types of difficulties/behaviour; don’t wait. Please consult a professional as early as possible so that you can ensure your child gets the right help to overcome many challenges and succeed in life.
What is autism spectrum disorder (ASD)?
Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder that begins early in childhood, the incidence of which has increased steadily in the recent past. It affects how a child acts, learns and interacts with others and communicates along with unusual sensitivity to different sensations. Thus it is difficult for children to express themselves either with words or through gestures, facial expressions, touch, etc. Besides they have trouble understanding what other people think, feel and are always engaged on their own with repetition of the same activities/behaviour.
It is called a spectrum disorder as children with ASD can have a series of symptoms with different ranges varied from mild to severe. This is due to irregular development and function of the brain during the developmental period.
Many times co-morbid with learning disabilities, epilepsy, attention deficit hyperactivity disorder, anxiety disorder, tic disorder, etc.
How common is ASD?
Once considered rare, the current understanding of ASD is that it is in fact one of the more common developmental disabilities. About one in every 68 children have an ASD (CDC). It is about 4 times more common in boys than girls. It can affect children of all races & social classes.
What are the causes?
Current thinking is that these disorders arise from a combination of genetic and environmental factors, resulting in alterations in several body systems, including the central nervous system, gastrointestinal system, immunological systems, etc. Common environmental triggers may include; food allergies, toxic heavy metals, polluted environment, excessive exposure to electronic gadgets (e.g. TV, Mobile, etc.), social interaction deprivation, less exposure to play, etc.
How is ASD diagnosed?
There is no medical test for diagnosing ASD. But when parents become concerned about the developmental delay or deviated behaviour or any regression of skills, they should consult professionals skilled in diagnosing and treating ASD. The diagnostic tools for the identification of ASD most commonly used in India at present are INCLEN tools, ISAA( Indian Scale of Assessment of Autism), DSM-5(Diagnostic and Statistical Manual), CARS(Childhood Autism Rating Scale), etc.
Mainly diagnosis based on the basis of observable impairments and behaviours in 3 core areas: a) Social Interaction, b) Communication, c) Presence of repetitive behaviour.
Besides some indicators below can be used as guidelines to establish whether a child falls in the spectrum. Any of these may signal early detection of ASD.
By6 months: No big smiles or joyful expression
9 months: No communication through sounds or facial expressions.
12 months: no babbling, no back-and-forth gestures like pointing/waving.
16 months: No words
24 months: no meaningful two-word phrases
At any age: Any loss of Social and language skills with repetition of behaviour.
What are the common treatment methods?
The main goal of treatment is to lessen the deficits and problem behaviours associated with ASD to increase the quality of life and functional independence.
ASD can best be treated at an early age of child(0-3 years is important) which is called Early Intervention(EI) and is crucial as this is the time the brain is growing rapidly in children. So it is possible to make connections in the brain easily.
Multiple therapies yield better results.
Occupational therapy with sensory integration approach, ADL training, brain gym, craniosacral therapy, dietary intervention, behavioural therapy, communication therapy, remedial and special education services, functional academics, cognitive therapy, floortime pivotal response training, social skills intervention applied behavioural analysis(ABA), etc. all help people with autism. Besides medication is used to treat problems associated with ASD.
Most important is parental involvement. Parents and other family members should be involved in their child’s treatment program. They should be aware of the 3A(Aware, Accept, Action) of ASD and how to be the main facilitators to bring about more functional communication, interaction & play skills in their children. So that the child will benefit holistically.
Some quick facts about ASD:
• Study indicate that 1 in 68 children will be diagnosed with ASD.
• Boys are 5 times more likely to be diagnosed than girls.
• There is no known single cause of ASD.
• Associated with co-morbidities like anxiety, sensory processing disorder, ADHD, DCD, OCD, learning disorder, convulsion, etc.
• ASD effects each person differently. Some people with autism are non-verbal while others are highly gifted in some areas.
• Autism is treatable.
• Early Intervention is critical.
Take Home Message:
If you are worried, don’t wait. If you suspect that your child’s difficulties may require special assistance, please don’t delay in finding support. The sooner you move forward, the better your child’s chances of reaching his/her full potential.
(by Dr. Durga Prasad Mishra, Principal, DRIEMS College of Occupational and Physiotherapy)
(DISCLAIMER: This is an opinion piece. The views expressed are the author’s own and have nothing to do with OTV’s charter or views. OTV does not assume any responsibility or liability for the same.)