Autism

Autism, or autism spectrum disorder (ASD), refers to a broad range of conditions characterized with having difficulty with-

1. Social emotional reciprocity- can’t share joy with parents, have a conversation to and fro, can only have a need based communication.

2. Non verbal communication– paucity of eye contact, gestures, facial expression, can’t point.

3. Relationship- can’t play with peers, no imitation or pretend play.

Children with Autism have concerns related to -

1. Repetitive motor and verbal movements – repeats words heard (immediately or delayed ), flapping of hands.

2. Need for sameness- small changes disturb them.

3. Unusual focus- focus on part of toy rather than the toy.

4. Sensory disturbances- sensitivity to noise, taste, smell, texture, movement.

• Genetics.
• Environmental conditions.
• No single cause.

According to studies 1 in 59 children are said to be autistic in USA. In India it is 1 in 65 aged between 2-9.

• Is done by clinical observation, tools (like M chat, Inclen, ADOS) designed to diagnose above mentioned features.
• Early diagnosis has better outcomes.
• ASD is a lifelong condition.
• Though they grow out of diagnosis, they may still need help social skills.
• Severity is based on the extent of supports needed to function - mild, moderate, severe.
• No two kids are same.

Goal of Therapy

• Address the above areas and make the child as functional as possible. Type of schooling will be based on the functioning, intelligence and understanding of the child.
• Reduce the negative behaviour (problem behaviour) and increase the positive behaviour (communication , functioning).

Scientfically Approved Therapy Methods

• Applied behaviour analysis – Discrete trial training.
• Developmental model – floor method.
• Naturalistic method – Early start Denver model , pivotal response training.

Therapies With Insufficient Scientific Evidence

• Diets.
• Biofeedback.

Many use overlap of techniques, rather than one method. Remember not one size fits all. It is important to maintain records and track progress.

Research says 25-30 hours of therapy needed. Possible when integrated to daily activities and carried out at home as well.

• Constipation.
• Seizures.
• Sleep disturbances.
• Attention deficit hyperactivity.
• Anxiety.
• Eating of inedible substances.

Not all children have all the conditions but awareness is quintessential as they can become barriers to therapy.

Genetic testing may be asked on either the parents or the chid if any other medical findings/ associations are suspected. Recurrence in future pregnancy has to be discussed prior to conception.

• Parents have to accept, be aware and advocate for the child.
• Self care is vital. Any disturbances in your sleep, diet and activity will need medical attention.
• Not wrong to have guilt, anger, fear of future or sad.
• Practice mindfulness ( thankful for all the good ), practice yoga, meditation, have time for yourself, seek medical care when needed - even ten minutes of mindfulness can make a huge difference.
• Support your spouse and your other children. Even they need your attention from time to time.
• Seek help from family and friends.
• Join parent group.
• Seek help from authentic sources, lots of misinformation also around.
• Be aware of state and government provisions available for the child right from therapy to tax rebate. For India please visit the national trust website for more details.
• Autism speaks is also an excellent source of information for US and Canada.