Doctor in the House: How to understand if your child has Autism Spectrum Disorders

– Autistic disorder

– Pervasive Developmental Disorder-not otherwise specified

– Asperger syndrome

People with ASD have trouble with social interactions and with interpreting and using nonverbal and verbal communication in social context:

– Inflexible interests

-They insist on routine and sameness of environment

-Repetitive motor and sensory behaviours like flapping arms or rocking

– Increased or decreased reactions to sensory stimuli

Since there is such a huge spectrum of symptoms, how a person with ASD functions in daily life depends on the severity of symptoms.

Usually, the behavioural signs surface between age 1.5 years and 3 years. Occasionally, children may appear to develop normally in the first year of life but then start to show signs of regression between 18 months and 2 years of age.

Causes

Currently, there is no known cause for Autism, though some studies point to genetic and environmental factors. Other risk factors include parental age, low birth weight, prematurity and maternal use of drugs such as thalidomide or valproic acid.

There was an initial report linking vaccines like MMR to ASD but many further studies have not found any correlation between vaccination and ASD. (Pic source: Pixabay)

When one child has been diagnosed with ASD, the next child has a 20 per cent chance of developing ASD. If the first two children have ASD, the third child has a higher chance of developing ASD (32 %).

There was an initial report linking vaccines like MMR to ASD but many further studies have not found any correlation between vaccination and ASD.

Signs of ASD

There are a diffuse spectrum of signs ranging from mild to severe. Following are some of the signs that could indicate your child falling into the spectrum for autism.

– Your child does not respond to his name when he or she is called or responds inconsistently.

– The baby at six months does not smile widely or gurgle or has a joyous expression when interacting with mother.

– Baby does not smile or make faces with you or strangers, nor does he or she make eye contact.

– Does not babble by the time he or she is a year old.

– No pointing or waving or back and forth gestures by one year of age.

– No meaningful words or simple phrases by two years of age. Repeats words and phrases verbatim, but does not understand how to use them.

– Any loss of speech or social skills at any age.

– Does not express emotions or feelings and appears unaware of others’ feelings

– In a social interaction, has inappropriate responses like being passive or aggressive .

– Has difficulty recognising nonverbal clues, such as interpreting other people’s facial expressions, body postures or tone of voice.

Most of these children have certain repeated patterns of behaviour or activities. These include:

– Repetitive movements like spinning, flapping and rocking

– Performs activities that could cause self-harm like head banging

– Develops specific routines and gets disturbed when there is a change

– Is fascinated by details of an object like wheels of a car

– Unusually sensitive to light, sound or touch, yet may be indifferent to pain

– Fixates on an object or activity with abnormal intensity.

– Specific food preferences, such as eating only a few food, and refusing foods with certain textures.

How to make the diagnosis?

Unfortunately, there are no tests to diagnose ASD. If you suspect that your baby may have a few of the above signs then speak to your paediatrician. He or she may refer to a child development specialist or child psychologist who has been specially trained to diagnose ASD. The child will need a lengthy examination to come to a conclusion.

Treatment

Once a diagnosis is made, this is usually a life-long condition. Most of the children will benefit from therapies that will teach the child new skills and address the core deficits and thereby reduce the core symptoms of autism. The treatment should be tailored to each child as the symptoms will vary with each child. The earlier the diagnosis is made the better as the therapies can be started early. Sometimes these interventions are needed lifelong.

Some children may have other problems which may be in the form of seizures or gastrointestinal problems which will need attention too. The treatment of these conditions can go on side by side.

Initially, the treatments may be intensive and may involve many professionals like occupational therapists and speech therapists but as they get older it can be more tailored and less frequent to tackle day-to-day problems.

As they get older, therapies and interventions should be aimed at acquiring life skills and possible employment in the future.

For many children, the symptoms get less severe as the child gets older. The treatment will need adjustment as they get older. Most children have a normal life span but may need some form of therapy and the needs depend on the severity of symptoms.

Dr Saroja Balan is consultant neonatologist and paediatrician at the Indraprastha Apollo Hospital, New Delhi. Her column appears every fortnight