A baby with Autistic Spectrum Disorder (ASD) may be unresponsive to people, or can be noticed focusing intently on one item for long periods of time even as an infant. Over the years, a child with ASD gradually withdraws and becomes indifferent to social engagement, known as regression of milestones, which is seen in nearly one fourth of autistic children, says Dr Rakesh Kumar, senior consultant, Pediatrics Neurology, Fortis Memorial Research Institute, Gurugram.
ASD is a spectrum characterised by social impairments, communication difficulties, and restricted, repetitive, and stereotyped patterns of behaviour.
Further elaborating on how such children tend to have poor social interaction and may fail to respond to their names and often avoid eye contact, Dr Kumar says, “They have difficulty interpreting what others are thinking or feeling because they can’t understand social cues, such as tone of voice or facial expressions, and don’t watch other people’s faces for clues for appropriate behaviour. They lack empathy. So, children with above symptoms should be assessed for autism.”
Observed every year on April 2, World Autism Awareness Day is meant to raise awareness about autism and educate people about it. To help, Dr Kumar suggests a few signs to look out for in children, and ways to manage the condition.
How is autism diagnosed?
Autism is clinical diagnosis in which clinician usually assesses the child using many scales like CARS (Childhood Autism Rating Scale), ADI-R (Autism Diagnostic Interview), etc. There isn’t any objective blood test or a scan to diagnose it. Following are the early indicators that require evaluation by an expert and include:
*No babbling or pointing by age 1
*No words by 16 months
*No response to name
*Loss of language or social skills
*Poor eye contact
*Excessive lining up of toys or objects
*No smiling or social responsiveness.
*Stereotypic behaviour or movements like hand flapping, etc.
*Sound hypersensitive, like ear plugging or crying upon mixer noise or pressure cooker whistle. Some children may have hyposensitivity as well.
*Chewing problems or inappropriate mouthing.
*Lost in his/her own world, plays on his own, no sharing, etc.
How is autism managed?
There is no cure for ASDs. However, it is important to diagnose it early and look for associated conditions like ADHD (Attention deficit hyperactive disorder), epilepsy, sleep disorders, etc. Early intervention yields better outcome.
Therapists use highly structured and intensive skill-oriented training sessions to help children develop social and language skills, such as Applied Behavioural Analysis. Individualised Education Plan (IEP) is prepared for every child and followed to track monthly progress.
There is no specific medicine to cure autism. However, your doctors may prescribe medications for autism-related symptoms such as anxiety, depression, or obsessive-compulsive disorder, behavioural problems and seizures, etc.
There are a number of controversial therapies or interventions available, but few, if any, are supported by scientific studies. Parents should use caution before adopting any unproven treatments. Although dietary interventions like gluten and casein free (GFCF diet) have been helpful in very selective cohort of children decided by treating paediatric neurologist by appropriate evaluation, it is not recommended for all.
Tips for working with children with autism
*Give step-by-step instructions verbally and visually.
*Individuals with autism often have trouble interpreting facial expressions, body language, and tone of voice. So be as concrete and explicit in your instructions.
*Have consistent routines and schedules. If you know of change in routine, inform the child in advance to prepare him for the change.
*Parents must look after themselves well first to be able to support the child throughout life.
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