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'Autism is not a disability, it is a different ability'

-Stuart Duncan

United Nations General Asssembly  declared the observance of The 'World Autism Awarenss Day' on the 2nd of April every year "as a means to affirm and promote the full realization of all human rights and fundamental freedoms for autistic people on an equal basis with others” ; the theme observed in the year 2024 is 'Moving from Surviving to Thriving: Autistic Individuals share regional perspectives'

 

So what is Autism?

Autism is a neurodevelopmental disorder (a disorder which arises due to abnormalities in the way the brain/ central nervous system develops in early childhood) which primarily presents with the afflicted individual having difficulties in communicating and socialising with others along with a number of behavioral disturbances; it can arise due to several genetic or environmental factors. It is clinically diagnosed as 'Autism Spectrum Disorder' (ASD) because it can present very differently, with widely varying symptoms (extensive variation in presentation) in every individual who has been diagnosed. Several studies report that a higher number of boys are diagnosed with ASD (4:1 ratio) though it is also claimed that this apparent lower prevalence in girl children could be due to difference in presentation between the genders. 

Related  What is ADHD in Children? How Can You Treat it?

 

What does Autism look like?

Though some red flag signs can be noted in children as early as 1 year of age, a Autism Spectrum Disorder is diagnosed at around 3 years of age. One of the early signs, in which ASD is suspected, is when the child is seen not to turn when called by his/ her name, despite having intact hearing faculties, and can be seen turning/responding to other sounds or noises (TV/music jingles). It is suspected when the child does not make eye contact when speaking/being spoken to or smile back/ reciprocate the emotions of the family members or when the child has difficulty in playing with other children of their age and prefers to play alone. Some other common symptoms are:

• The child does not indicate his/her needs verbally or through actions/gestures; has delay in attainting age appropriate speech milestones

• Does not look where pointed to
• Has no sense of danger in new environments or no sense of personal space even when interacting with strangers
• Does not understand social conventions
• Has difficulty in sitting in one place

Sensory sensitivities: children on the Autism Spectrum can either be over sensitive to certain sensory stimuli or under sensitive to the same, for example:

• Child does not tolerate loud (closes ears) day to day sounds/noises: loud conversations in crowded environments, sounds of home appliances such as the mixer grinder, cooker, vaccuum cleaner

or

• Child does not react to even very loud sounds (crackers), attempts to only play with toys in a noisy manner (banging toys to create sound)
• Child does not tolerate touching sticky objects (eating food with hands, playing with clay, sand), walk on tiptoe, does not tolerate getting their fingernails or hair cut, avoid certain textures of clothing, being hugged or touched by friends and family

or

• Child enjoys playing with textures by rubbing clothes/objects across their cheeks/skin
• Child is highly sensitive to bright lights
• Child has altered pain sensitivity
• Child is very sensitive to smells (picks up smells very easily)

Sensory overload can overwhelm the child greatly; as they additionally have difficulties in communication, they may find it very difficult to verbalise/explain to others, their difficulties/needs in these situations and sometimes may resort to externalizing their frustration by crying or even physical aggression; while these are problem behaviours that need attention and correction, it is important to note that they arise only because of the sensory vulnerabilities and inability of the child to cope or communicate his/her challenges and are not purposeful acts by the child. Some children engage in self soothing behaviors in such challenging circumstances by rocking back and forth, flapping their hands, jumping or spinning, or exploring textures of objects.

It is important to note that autism spectrum disorder can present very differently in each child and that the above list is indicative and not exhaustive.

Managing Behavioral Challenges: Understanding sensory sensitivities and providing appropriate therapies can greatly improve your child's mental health. Reach out to us for expert care and support at Maarga Mindcare  - Best Hospital for Autism in Bangalore

 

FAQs

I suspect my child may have autism. What should i do?

If one suspects that their child may be on the spectrum, it is imperative to reach out to a mental health professional to get the child clinically assessed. While this option might seem excessive to many, who may have been primed to follow the 'waitful-watching' method by well intentioned family members (as "similar delays were noted in their childhood but they turned out just fine"), it is pertinant to observe that, early identification and initiation of appropriate therapy will significantly improve developmental outcomes and mitigate the childs behavioral problems offering the child and the family an opportunity to avail support and an improved quality of life.

 

What should i expect when i take my child to a mental health professional?

The mental health professional will initially ask the parent/caregiver in detail about the issues concerning the child and other basic information about the child's birth, developmental history and other relevant medical history; they will then proceed to speak to and assess the child separately and on occasion  use standardized instruments (paper/pen tests) to screen, evaluate and confirm the diagnosis. This may occur over one or more sessions depending on the rapport built and information obtained.

 

My child has been diagnosed with Autism. What next?

A child who has been diagnosed with Autism may require one or more therapeutic modalities to address their specific impairments and special needs . A multimodal approach is the gold standard for management of Autism Spectrum Disorders. Children with speech impairments (vocabulary, prosody) will require speech therapy, while children with sensory sensitivities and hyperactivity will require the assistance of an occupational therapist, who will work on social skills, self help and sensory sensitivities of the child. Behavior therapy and parent management training will be imparted to children and families who predominantly encounter difficulties in managing behavioral disturbances. Special/remedial educators may be required if the child is found to have intellectual disability. There is no one size fits all approach instead treatment is tailor made for the child's individual needs.

 

Are there medications to "cure" autism?

There is no "cure" for autism till date. Children on the spectrum are considered 'neurodivergent' or simply as children with different abilities. They simply differ from 'neurotypical' children in the ways they interact and behave; though they may be found lacking in social and communication abilities, many autistic children have outstanding talents and skills in niche domains such as art, music or mathematics. Some autistic children may only have difficulties in the social domain, while interacting with people, making friends and understanding social norms. The childrens individual needs are assessed and improved with therapy.  Medications are considered briefly in autistic children who have severe behavioral abnormalities (physical aggression, self harm behavior) or sleep disturbances along with other modalities of therapy.