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AUTISM SPECTRUM DISORDER - A BRIEF OVERVIEW

 
  By : , Kochi , India       2.4.2019         Phone:0484 669 9999          Mail Now
  Kuttisahib Road, Near Kothad Bridge, South Chittoor, Cheranalloor, Kochi, Kerala 682027
 
 
 

Dr Susan Mary Zachariah,
Senior Specialist,
Developmental Paediatrics,
Aster Medcity, Kochi

April 2 is celebrated all world over as World Autism Awareness Day and April, the month for autism awareness. This month, programmes and talks are conducted all over the world to educate and enlighten people about Autism Spectrum Disorder - in order to facilitate early diagnosis and early intervention. The theme for this year is Assistive Technologies, Active Participation.

What is Autism Spectrum Disorder?

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that affects communication and socialization. Children with autism may also have repetitive movements, restricted interests and/or sensory issues. Currently, studies say that one in 59 children have autism. That means that nearly every family will either have or know of someone who has autism.

Children with autism are mostly in their own world. They have difficulties with making eye contact with people, with using gestures and actions for communication. Most of them have speech delay, some of them speak, but don’t use speech to communicate with another person – for example, they may be able to narrate rhymes, say A – Z and maybe even read; however they do not know how to ask for what they want, they don’t point out or share things that interest them with others, they don’t approach other children to play with them. Children with autism have a lot of sensory issues – some of them get easily upset with loud noises, or noise of a particular pitch or tone; some like looking at rotating objects; some walk on toes; etc. Many of them have repetitive body movements (like rocking, spinning), talk the same thing repeatedly or repeats what others have said, have difficulty tolerating changes to their routine (like getting upset on taking a different route to school) or have very narrow interests that are difficult to divert from (like cars, dinosaurs, etc).

Some children with autism start to show features as early as 6 months of age, when they don’t look and smile at the mother or other people. They don’t respond to their name being called, despite having normal hearing. They prefer being alone, and play with the same things repeatedly. They may not play with toys the way children usually play with them, instead they might play only with parts of a toy. For example, while a child without autism might roll the toy car, pretend to have accidents, or transform a car into a plane, a ship, a train, etc; a child with autism might just play by spinning the wheels of the car.

As autism is a spectrum disorder, not all children behave the same. Some may have only mild difficulties and some may have a lot. Like how typical children have a varying range of IQ, similarly children with ASD also have varying IQs and abilities. NO TWO CHILDREN WITH AUTISM ARE THE SAME.

Just because children with autism have difficulty expressing themselves, it doesn’t mean that they don’t understand what happens around them. Almost half of the children with ASD have average to above average intelligence. They just have difficulty understanding the social behaviour and norms of society and the world around them.

What Autism Spectrum Disorder is NOT:

1. Autism is a condition, NOT a disease to be feared.
It is present since birth, though symptoms may be obvious only later. Some children also develop relatively normally till 1-2 years of age, after which the symptoms of autism appear.

2. Autism is NOT due to bad parenting – the parents are no way at fault for having a child with autism.

3. Autism is NOT caused be vaccines - there are numerous studies which prove that.

4. Autism DOESN’T mean mentally retarded. Some children with autism are very bright, many have skills in other spheres like music, art, dance, writing, etc.

5. Autism DOESN’T mean that children don’t know and feel empathy - they just have difficulty expressing it.

6. Autism DOESN’T mean that the child doesn’t want to play with others. Majority of children struggle with knowing how to approach other children for play.

7. Having autism DOESN’T mean that the child is going to be completely dependent on his parents lifelong. With early diagnosis and good intensive training, many children can grow up to be almost independent, requiring some support systems in place.

Why do children have autism?

The reasons why a child can have autism are not fully known yet. There is both a genetic component as well as an environmental component, however much more research is needed. What is known is that children with autism have altered wiring in their brains - their neuronal circuitry is different from the typical. Thus they see the world differently.

Many children with autism tend to concentrate on details rather than the whole picture. Their ‘altered wiring’ makes it difficult for them to imitate others and thereby learn by watching others. They have difficulty looking at things from another person’s point of view, and thus can seem to be selfish and lack empathy.

The different neuronal wiring also means that many children with autism have difficulties integrating their senses. For example, a child may have difficulty looking and listening at the same time. Some children get upset with varying pitches and loudness of sounds, some with shadows.

Why do children with autism behave ‘weirdly’?

When a child’s senses get overwhelmed (like in a crowd where there are multiple sounds, too many colours, light and shadows), they tend to shut down (similar to a short-circuit in a house). When they shut down, they withdraw into themselves and either start shouting to drown out the other noises they hear, or start showing bizarre-looking movements like rocking self, mannerisms with fingers and other methods to calm themselves down. These can look very scary and strange to the outsider, but the truth is that many of us do variations of these when we are anxious or stressed - we bite our nails, tap our feet, play with our hair, walk back and forth, grind our teeth, start mumbling prayers, press or squeeze something that we think will bring us luck and so on..

How can we help children with autism?

1. EARLY DIAGNOSIS and EARLY INTERVENTION is very important to help a child with autism to reach his/her potential. If there is any doubt regarding the communication pattern in a child, please consult a professional immediately. The ideal age to start intervention is less than 3 years of age - the earlier the better.

2. INTERVENTION : There are multiple techniques of intervention that help children with autism, and hence each intervention has to be individualized to the child’s difficulties, strengths and interests. He/she will need speech therapy, occupational therapy and behavioural therapy, to mention a few.

3. The role of MEDICINES is very limited and is only for a selected few. Medicines do not help change the core features of autism - difficulties in social communication and restricted repetitive behaviour and interests.

4. Use of complementary and alternative medicine like transcranial magnetic stimulation, hyperbaric oxygen treatment, accupuncture/accupressure, stem cell transplantation, etc are not recommended and can be harmful at times.

5. If you see a child with autism have a meltdown, PLEASE DO NOT STARE. Staring won’t help the child and will only stress the family more. Give them some space so that the family, who knows their child best, can help the child or adult with autism, without feeling the pressure and judged by society.

6. PROMOTE INCLUSION: Children with autism are still children - they deserve to play, to be with other children, to go to school, to visit the mall, etc. In many schools, these children are not given admission, primarily due to parental pressure from the other children studying there. Inclusion helps both children with autism and without - the child with autism learns acceptable behaviour from others, and the typical child learns kindness, compassion and tolerance.

7. If you work in any service industry, and see a family struggling with a child with autism, enquire politely how you may help them - you may need to maybe dim the lights a little, or alter the volume of the music, or maybe facilitate a faster checkout. Just a little bit of effort from your side will make things much more happier for the child and the family, as a whole.

Autism and Technology:

The rapid technological advances have been both a boon and a hindrance for children with autism. Since children with autism have difficulty interacting with others, they prefer the electronic (and primary visual) media over being with people. They thus tend to get more easily addicted to these, and this then hinders social development in these children.

On the other side, the advance in technology means that there are other ways to communicate instead of by speaking. Around 40% of children with autism remain non verbal (they do not speak despite having gotten regular intensive therapy). Though they don’t speak, many of them still communicate by typing, using communication software like Avaaz, Speak For Yourself, Words on Wheels, etc. Using such apps, children with autism who are non verbal can still communicate their thoughts and feelings to those around.

In addition to communication, technology can teach children with autism various skills needed for daily life, as it is possible to give instructions through pictures rather than through words. Many people with autism are visual thinkers - it is easier for them to understand pictures than written or spoken word.

Judicious use of technology with using it only for a particular goal and limited use for entertainment’s sake is one way of helping children with autism become more communicative and helping them to become more independent.

Let’s join hands together to create an inclusive society where people with autism can grow and become independent and do well in their particular field of interest. As Mahatma Gandhi said “The true measure of a society is how it treats its most vulnerable members”.

People with autism have treasures hidden inside them - it remains up to us to help them discover it and to share it with the rest of us.




TAGS: AUTISM SPECTRUM DISORDER,   Autism,   Why do children with autism behave ‘weirdly’?,   Why do children have autism?,   How can we help children with autism?,   Autism and Technology,  




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