What is

AUTISM SPECTRUM DISORDER ?

Autism is a developmental condition that affects neurotypical development of the brain. It hampers the child’s communication, social interaction, cognition, and behaviour.  In most cases it manifests in the first three years of life. A W.H.O. study estimated that 1 in 160 children worldwide suffer from autism. The problem seems to be more acute in developed countries, for example, according to the US Centers for Disease Control and Prevention (CDC) 1 in 59 people are on the autism spectrum, a number that used to be lower than 1 in 600 just 40 years ago.  It has also come to light that autism is 4 times more prevalent amongst boys than girls.

Autism Spectrum Disorder (ASD) is termed a spectrum because its symptoms manifest in multiple combinations that affect different children in different ways. It is often said that “If you’ve met one person with autism, you’ve met one person with autism”. The Spectrum covers children who possess extremely rich vocabulary at one end and some that are hardly vocal or are non vocal at the other, socially withdrawn children at one end and socially active at the other. This spectrum now covers conditions which were previously independently diagnosed and treated including Pervasive developmental disorder not otherwise specified (PDD-NOS), Asperger syndrome and Autistic disorder.

Autism Spectrum Disorder is marked by problems in the following three areas :

1. Undeveloped or Underdeveloped Speech and Language

2. Sensory Processing Disorders

3. Social Skills

A large number of children on the spectrum also suffer from associated issues such as ADHD (Attention Deficit/Hyperactive Disorder), Learning disability, motor difficulties etc. Occasionally, some children may also suffer from Intellectual Disability, Seizures and Regression.

The warning signs of autism can be identified by the time a child turns three, In rare cases autism can be detected as early as 18 months. These symptoms may be mild, moderate or severe and differ for each child. However, in most cases the following common traits present themselves:

  • Difficulty with social interaction. This may include problems with eye contact, name response, talking/listening or playing with others. Often the child seems unusually shy.
  • Unusual way of playing with toys and objects, i.e. looking at the wheels of a toy car, staring at fingers etc.
  • Does not point or look in the direction that you point to.
  • The need for sameness. Changes in their surroundings, routines etc. may be very disconcerting.
  • Under or over reaction to the senses: sight, touch, taste, smell, or hearing, e.g. some children may be very disturbed by loud noises while some others may seek auditory inputs.
  • Child does not babble till the age of One year or acquires speech then loses it.
  • Repetitive movements. They may do this to calm themselves in a stressful environment or to engage themselves.
  • Unusual responses/reactions or body movements. They may seem prone to tantrums, unaware of their surroundings etc.
  • Sudden mood swings.
 
Autism can further be classified into the following conditions :
  • Autistic disorder (classic autism).
  • Asperger’s disorder (Asperger syndrome).
  • Pervasive developmental disorder not otherwise specified (PDD-NOS).
  • Childhood disintegrative disorder (CDD)

It is necessary to mention here that an early diagnosis of Autism can lead to very positive changes and with the right course of treatment Autistic children can lead fulfilling lives. However, the fact that there is very low awareness about autism delays parents’ ability to identify the early symptoms. Although there is no cure for autism, early intervention therapies have helped a lot of children on the spectrum overcome their problems and lead fulfilling lives. Click here to learn more about the success stories of those who have overcome Autism.

We also need to remember that just like every other child, children with autism have strengths and talents. Parents, caregivers and educators should nurture these positive aspects and encourage the child at every opportunity. Labels such as mild, moderate or severe do not paint a complete picture, each individual is differently abled in different areas. Parents should not lose hope and opt for the best course of treatment for their child.

An autistic child may possess one or more of these skills:

  • Good visual and spatial memory
  • Methodical and organized way of doing things
  • Ability to understand abstract concepts
  • Excellence in the area of their interest
  • Attention to detail
  • Interest in languages (among children who can speak well)

Guided with the right treatment and education, an autistic child can develop several of the above skills. It may not come easy and it may not come quick, but with enough time and effort many autistic children can lead an independent life.

WHAT CAUSES AUTISM

The exact cause for autism is still not known but research indicates that it may occur due to a combination of genetic and environmental factors. The environmental factors could be a variety of conditions affecting brain development, which can occur before, during or soon after birth. It is also observed that any damage to the central nervous system during infancy can cause autism. 

As we researched Autism, we realized just much has been discovered about autism spectrum disorder from research in a wide variety of fields, including genetics, neuroscience, and cognitive psychology.

We also quickly realized just how many questions remain unanswered. We still don’t know exactly what causes autism; we haven’t yet been able to identify specific subtypes of autism; and we still have very few proven treatments for autism. Answers to these important questions will only come through research, research which requires data in which we seek your co-operation. If you would like to join us in this endeavor kindly get in touch with us.

Important note to parentsAs a precaution, parents should request pediatricians to conduct routine developmental tests to check if the child has met developmental and language milestones. 

Screening at home for

aUTISM

No parent wants to believe that there is something wrong with their precious child, but they are the first ones to notice when something is wrong, they can spot warning signs that a Pediatrician may miss in a ten minute visit. An early diagnosis of Autism combined with the right therapies can substantially help the child overcome Autism, in some cases children have completely lost the diagnosis. 

However, early diagnosis is only possible if parents are made aware of the warning signs of Autism, if caught in infancy treatments can take advantage of the remarkable plasticity of the young brain and reverse a lot of the issues that arise. Parents should bear in mind the following developmental red flags:

  1. By 6 months: No facial expressions of joy such as smiles.
  2. By 9 months: No interaction with sounds and smiles.
  3. By 12 months:  No name response or baby talk, no pointing or reaching out for people and objects
  4. By 18 months: No spoken words.
 

Parents of infants and toddlers should also be on the look out for the following warning signs:

  • The child begins to develop language then loses it, or doesn’t acquire language at all
  • The child appears deaf, responds unevenly or not at all to sounds
  • The child has difficulty in transitioning from one activity to another (tantrums)
  • The child has difficulty sleeping / wakes at night
  • The child does not point with his fingers
  • The child does not bond with or is indifferent to parents’ presence/absence
  • The child has a restricted/selected diet
  • The child has no or limited imaginative play
  • The child shows no interest in playing with other children
  • The child suffers from chronic gastrointestinal problems/ repeated infection.
 
 

Older children may exhibit more diverse symptoms of autism related to social skills, speech, language and non verbal communication difficulties and rigidity in behaviour, some of which are provided below: 

Problems in Social skills :
 1. Shows little interest in people near him/her or is uninterested.
2. Is unable to connect with his peer group.
3. Prefers not to be touched, not even to show affection.
4. Does not play pretend games or use toys as intended
5. Has difficulty expressing emotions
 
Problems in Speech & Language :
1. Speaks in an abnormal voice or pitch.
2. Repeats the same phrase without meaning it.
3. Repeats questions rather than answering them.
4. Makes grammatical errors or refers to himself in the third person.
5. Is unable to understand irony or sarcasm.
 
Problems in non verbal communication :
1. Is unable to understand gestures and facial expressions.
2. Makes very few if any, gestures.
3. Odd movements such as walking on tip toes or moving fingers around eyes.
4. Unusual reactions to sounds, smells, textures.
5. Avoids eye contact.
 
Problems with Flexibility:
1. Demands a rigid routine/fixed pattern.
2. Difficulty in adapting to change.
3. Obsessively lines things.
4. Fixates on keys, light switches etc.

5. Repetitive movements such as rocking, hand flapping etc.

Please do not panic if your child shows one or more of these warning signs, we are providing links to two assessments below that can help you decide if your child is afflicted with or  is at risk of autism.

 1. The 3 Minute Child Autism Test at https://www.psycom.net/child-autism-test
2. The M-CHAT-R available at https://www.autismspeaks.org/screen-your-child

If the screening tests linked above indicate that your child is at risk, do not waste any time. Remember, early intervention is the key to recovery. Contact your Pediatrician and have them refer you to a specialist that can conduct a formal assessment. After the doctor has conducted a formal assessment they will provide you with a comprehensive treatment plan. Bear in mind that children do not simply grow out of autism but with the right treatment can overcome most, if not all, challenges posed by it.

GETTING A FORMAL DIAGNOSIS

Child Psychologist

Diagnosing Autism Spectrum Disorder is a complicated process as there are no medical tests, such as blood tests, which can be used to diagnose it. It can ony be diagnosed through direct observation by the right medical personnel.

Specialist Medical personnel that diagnose Autism include Child Psychologists/Psychiatrists, Child Neurologists and Developmental Pediatricians.

Pediatrician

There are several diagnostic tools employed by professionals to diagnose Autism. These tools may be area specific (speech, cognitive development etc.) or comprehensive tools encompassing multiple areas of concern. These tools rely on two sources of information, Parents description of their child’s behaviour/issues and the professionals direct observation of the child during the assessment. Some examples of diagnostic tools are :

  1. Childhood Autism Rating Scale (CARS) : Suitable for any child over 2 years of age, CARS is made up of  components of five important systems for diagnosing autism, each component covering an important area of development.
  2. Autism Diagnosis Interview -Revised (ADI-R) : The ADI-R focuses on behavior in three main areas: reciprocal social interaction; communication and language; and restricted and repetitive, stereotyped interests and behaviors, it is designed for children and adults with mental ages about 18 months and above.
  3. Diagnostic and Statistical Manual, 5th Edition (DSM-5): Prescribed by the American Psychiatric Association, DSM-5 provides standardized criteria to help diagnose ASD.
  4. Indian Scale for Assessment of Autism (ISAA) : Based on CARS, ISAA was designed with the Indian Child in mind which covers the six domains, namely, social relationships and reciprocity; emotional responsiveness; speech, language and communication; behavior patterns; sensory aspects and cognitive component.

TREATING AUTISM

Autism spectrum disorder is not a disease and thus is not treated as such.  Individuals with autism have varying symptoms and needs and can benefit greatly from the right kind of therapy. There have even been instances where a child diagnosed with autism has benefited from timely intervention and completely lost the diagnosis and recovered. However, it should be borne in mind that if there are any underlying medical conditions such as Epilepsy, Insomnia and ADHD, those should be treated medically by a licensed medical professional as a high priority because they can be a real stumbling block for the child.

Every child or adult with autism has unique strengths and challenges and so each autism intervention or treatment plan should be tailored to address their specific needs. A person’s treatment plan can include behavioral interventions, speech therapy, sensory integration, other therapies, medicines or a combination of all of these. Early diagnosis of ASD, coupled with swift and effective intervention, is paramount to achieving the best possible prognosis. These therapies can broadly be classified into the following four groups

Special Education
Special
Education
Occupational Therapy
Occupational
Therapy
ABA based Behavioural Therapy
Speech Therapy
Speech
Therapy

WE CAN HELP

We, at EduPlay Therapy offer a supportive and interactive environment for young minds to learn and grow. We offer Special Education, Occupational Therapy, ABA Based Behaviour Therapy and Speech Therapy for specially abled children with conditions such as ADHD, Autism Spectrum Disorder, Down syndrome and Cerebral Palsy. We also provide parent training sessions to ensure that every parent can be an active participant in their child’s recovery. To know more about our services click here.

AUTISM MYTHS

Most people with Autism struggle with Social skills which makes them seem  shy or unfriendly. They do want to socialise, but  find it difficult to communicate this desire.

People on the spectrum have just as many feelings as a neurotypical person does. They just to tend to express them differently. They can sometimes struggle to understand the emotions of others through sarcasm or body language, but when directly communicated to them, people on the spectrum are more empathetic than their neurotypical counterparts.

Autism brings with it some unique abilities. The trick is to teach people on the spectrum to turn their need for perfection/ repetition/ single minded pursuit into their strength in talents which require practice such as music, arts and sports. Remember what Einstein said “Everybody is a genius. But if you judge a fish by its ability to climb a tree, it will live its whole life believing that it is stupid.”

Absolute rubbish. Although parents often tend to blame themselves, nothing could be further from the truth. The “refrigerator mother hypothesis” has been debunked time and again.

More than half a dozen studies have failed to find a link between Vaccines and Autism. The doctor that proposed the link between vaccines and autism has since lost his license to practice medicine.