A Glimpse into the Enigmatic World of Autism

Autism Spectrum Disorder is a neuro developmental condition whereby children have difficulty making sense of the world around them due to difficulties with communication and social interaction. They also have repetitive, restricted patterns of behavior and interests; as well as sensory hypersensitivities or hyposensitivities.

The incidence of Autism Spectrum Disorder is increasing the world over. The Center for Disease Control, USA has estimated that currently one in every 68 children have autism spectrum disorder.
 
What is autism spectrum disorder?

Autism Spectrum Disorder is not a psychiatric illness or ‘bad behaviour’. Autism Spectrum Disorder is a neurodevelopmental condition. This means that there is some alteration in the normal development of the brain. There is altered connectivity in the brain when compared to children without autism spectrum disorder.

This altered connectivity can be understood in simple terms comparing it to faulty wiring in a house. When there is faulty wiring in the house, some switches may work, some won’t, in some places the switch of the fan will turn on the light and in some cases, there will be short circuit. Many of the symptoms of autism can actually be explained using this simple imagery. Sometimes children with autism do not respond to name call, but respond to certain other sounds. Sometimes they may have sensory overload similar to a short circuit. Children with autism spectrum disorder are trapped in their own world, unable to interact and communicate with those around them; not because they don’t want to, but because they lack the skills that come so easily to the rest of us.

There are multiple causes of autism spectrum disorder. Genetic, metabolic, structural damage to the brain, toxins and pollutants and environmental related are the most common causes associated with autism spectrum disorder.

What are the symptoms of Autism Spectrum Disorder?

Children with autism spectrum disorder have symptoms relating to their difficulty with communication, social interaction as well as repetitive and restricted patterns of behavior. The early warning signs of autism spectrum disorder are:

-No eye contact by 6 months of age
-Not responding to name call by 12 months of age
-Does not point at objects at 14 months of age
-No ‘pretend play’ by 16 months of age
-Prefers to be alone, doesn’t initiate interaction with others
-No social smile; does not seem to enjoy being with people.
-Delay or regression in speech and language skills
-Can recite numbers/alphabets/sing rhymes but unable to express basic needs vocally.
-Lacks motivation to communicate
-Exhibits difficulty in imitating actions or words
-Repeats words and phrases heard over and over again
-Gets upset by minor changes
-Has obsessive interests
-Repetitive movements like flapping, spinning, rocking etc
-Unusual reactions to sounds, lights, smells, etc
-Lack of social and emotional reciprocity, no turn taking during play
-Difficulty identifying and expressing emotions

Autism spectrum disorder can be identified as early as 6 months of age. The earlier the diagnosis, the earlier the intervention and the better the outcome for children with autism spectrum disorder.

Common myths and misconceptions about autism spectrum disorder:

1. Children with autism spectrum disorder are mad, willfully bad or just being stubborn
Autism Spectrum Disorder is a developmental disorder. They do not act that way because they purposely want to. What such children need are acceptance and regular training

2. Autism is only a speech disorder
Children with autism spectrum disorder have a social communication disorder - both verbal as well as non verbal communication like eye contact, pointing, using gestures, etc. They have limited understanding of emotions, social interaction and social rules. Initially, the child may have more repetitive than meaningful speech, but later continues to have difficulties using language for social purposes.

3. Autism Spectrum Disorder is caused by vaccines or bad parenting
Though at one point in time, bad parenting or ‘refrigerator mother’ was thought to be a cause of autism, it has been proven conclusively to be not so. Also multiple studies have proven time and time again that there is no association between vaccination and autism spectrum disorder.

4. Children with autism spectrum disorder are dependent on their parents for life.
Though autism spectrum disorder is a lifelong condition, with early intervention and consistent training, many children can go on to lead independent and successful lives.

5. Children with autism spectrum disorder are mentally retarded.
More than 45% of children with autism spectrum disorder have average or above average intelligence. Only around one third of children with autism have actual intellectual disability. Most children with autism do very well once their talent and field of interest is identified and they are encouraged to grow in it.

What are the treatment modalities for children with autism?

Treatment for autism spectrum disorder needs to be done early. It consists of behavioural therapy (to help them regulate their behavior as well as to promote learning), occupational therapy (to work on skills, activities of daily living and sensory integration), speech language intervention (to work on joint attention, verbal and nonverbal communication skills to enhance social interaction), special education (for a more practical based learning). There is currently no evidence for treatments using transcranial magnetic stimulation, acupressure / acupuncture, hyperbaric oxygen therapy, stem cell therapy. Medication is used in only a very selected group of children with autism spectrum disorder when behavioral management strategies have failed to help them control their excessive aggression, motor stereotypies and self injurious behavior.