31 MARCH 2016
Dr. Priyanka Kalra
Autism is a general term used to describe a group of developmental disorders known as Pervasive Developmental Disorders (PDD) or Autism Spectrum Disorders (ASD). It includes Autistic Disorder, Pervasive Developmental Disorder, Not Otherwise Specified (PDD-NOS) and Asperger Disorder.
People with autism have symptoms or difficulty in these areas:
1. Social interaction and language as used for social communication
2. Repetitive interests or behaviors
While all children with autism have problems in the main areas, the presentation and severity of symptoms are different for each child;
No two children with autism are exactly alike
What is the cause of autism?
The exact cause of autism is not known. Some children have autism as part of a genetic disorder such as Fragile X, Tuberous Sclerosis or Angelman’s syndrome. Being exposed to certain diseases or chemicals during pregnancy has also been linked to autism. For most children the cause is not known. Scientists think that there are many factors. Important factors include genetics, either on their own or when combined with exposure to environmental factors.
How common is Autism?
Centre for Disease control has recently reported the prevalence to be 1 in 68 children.
There is an increase in the prevalence of Autism. It is debated whether the increase in autism is because of a true increase in prevalence or because of an increase in awareness of autism.
What are the signs of autism?
- Poor eye contact
- Child does not smile or show any joyful expressions by six months or later
- Child does not engage in back-and-forth sharing of sounds by nine months
- Child does not babble by 12 months
- There is no pointing, showing, reaching or waving by 12 months
- No words by 16 months
- No meaningful, two-word phrases (not including imitating or repeating) by 24 months
- Any loss of speech, babbling or social skills at any age
- Poor eye contact
How can Autism be diagnosed ?
Parents are the first to pick up the odd behaviour of their child. Teachers and family members may also point out odd behaviour of the child. Some signs can be picked at 12-18 months of age.
For proper diagnosis, the child has to undergo detailed evaluation from a professional like Psychiatrist, paediatrician or psychologist.
The diagnosis involves assessment of
- thinking skills
- play behaviour observation
- assessment of child’s behaviour in daily activities
There is no specific medical test for autism.
Some additional tests may be needed for assessment of Intellect (I.Q) or EEG if there is the history of seizures.Testing may be done reliably at 2 years of age. However, some tests may also be done 18 months of age.
What are the benefits of diagnosing autism?
- Early diagnosis means early intervention
- It can help to reduce the severity of the disorder
- It can also help to prevent the disability
- May help in early and better functioning of the child
- It may also help in integrating the child into society.
Can a child with Autism lead a normal life?
When the child is provided with a treatment that targets specific problems and helps in increasing productivity, it will enable the child to utilize his strengths and lead to a productive and meaningful life.
Can the autistic child go to a regular school?
Children with high functioning autism can attend a normal school. The environment of a normal school gives more opportunities to interact with typically developing children and hence is more stimulating. However, there need to be proper inputs for the special needs such as special educator, therapy for communication. A child with moderate to severe autism needs more attention and one on one therapy work. Hence, a special school is beneficial for a child with moderate to severe autism.
What medical problems can a child with autism have?
child with autism may have
Seizures : they may be in the form of abnormal body movements. When suspected, seizures need to be evaluated. EEG is required, however, it must be interpreted with caution, as in some cases in patients with autism abnormal EEG may be seen even without seizures
Anxiety and/or Depression: Children with autism may have co-morbid anxiety and/or depression or other mood disorders.
Sleep problems : Children with autism may have a difficulty in going to sleep, staying asleep or they are light sleepers who tend to get disturbed by sounds.
Gastrointestinal problems: Children with autism may have frequent digestion problems, stomach pain, frequent diarrhoea or constipation. Children with autism may tend to be very fussy about the food that they eat hence they may be prone to nutritional deficiencies.They may also have food allergies.
Tic Disorders and high rates of accidents and injuries are also found more commonly in children with ASD.
Is Autism Treatable?
Yes. Though there is no single medicine to cure all symptoms of autism, treatment of autism means getting a full evaluation and then making treatment plan. One child with autism may have a different set of problems as compared to the other child. So there is no single therapy that will suit every child with autism. A careful understanding of the child’s problems is needed. After understanding these problems, a management plan needs to be decided to target these problems. There is a need for a complete, holistic approach, hence:
- Speech therapy
- Behaviour therapy
- Occupational therapy
- Special Education
are all tailor made to each child’s needs. Medication is required for the co-morbid medical problems that the child may have.