by Muskaan Mehta | 02 APR 2018
Mainstream theory for Autism is quite regarding autistic strengths and abilities. A common misconception about autism is that it is an intellectual disability. However, many of world thinkers and innovators exhibit autistic characters. And more over autistic people seek the right to be valued as equal as normal people. So, we should give up the idea to put term disease to autism. Dr Lalitha Pidaparthi, consultant neurologist at Care Hospitals Hyderabad explains in detail:
There are different types of autistic conditions and what are they - please explain.
Autistic spectrum disorder also called as pervasive developmental disorder. As per Diagnostic and Statistical Manual of Mental Disorders (DSM), autistic spectrum disorder includes
Pervasive developmental disorder not otherwise specified (PDD- NOS).
Autism is the most common type of ASD. Children with autism have problems in thinking, language, bahavior and social skills. PDD-NOS also called as mild autism. Children with PDD-NOS have problems in some of the same areas as in autism. People with Asperger syndrome have normal intelligence and language development but have some autistic like traits. They may have problem with social skills.
Is autism hereditary? Does it mean that it can pass on generations or skip generations?
Some studies showed that the recurrence risk of autism in siblings of children with autism is around 2% to 8%. Scientists have identified more than 100 autism risk genes, however in around 15% of cases a specific cause of autism can be identified. Commonly autism caused by genetic risk and environmental factors such as extreme low birth weight, parents age at the time of conception, and mother exposed to high level of pesticides /air pollution. We should keep in mind that environmental factors alone can’t cause autism. Combination with genetical risk factors increase the risk of causing autism.
What are the signs and symptoms that parents must look for?
According to onset of symptoms traditionally autism described as occurring in one of two patterns. In early onset type, children show abnormalities in social and communicative development in the first year of life. Parents should suspect autism when there is no/limited eye contact, no social smile by 6 months of age. Other early signs are lack of sharing of vocal sounds, lack of non verbal communication by gestures, no response to name by 12 months.
But these early signs are non-specific and do not differentiate children with developmental delays from those with autism. In the second type, regressive autism, children appear to be developing typically for the first year or two. In the second year of life, they lose skills that they had previously acquired, accompanied by the onset of autistic symptoms. The developmental areas most affected by regression are communication and social abilities.
The autistic symptoms includes repetition of words or phrases over and over (echolalia), having highly restricted interests, performing repetitive behaviours such as flapping, rocking or spinning, and unusual and often intense reactions to sounds, smells, tastes, textures, lights and/or colours.
What is the support that the parents require to deal with an autistic child in a society like India? many of them are found to label families and discern it too. Hence how and in what manner is support sort?
ASD symptoms often first recognized by parents and may talk with doctor about their child’s behaviour. Parents’ fundamental concerns throughout their journey were: learning to meet new and unfamiliar challenges as parents, caring for their child’s basic needs, and finding an engaging niche with a sense of belonging for their child in the everyday milieu. Parents are integrated part of the child’s education programme and children’s intervention programmes includes parents as therapists. Training parents as therapists increases the amount of support for children who require intensive, individualised intervention and also provides a cost-effective model of service delivery. Parent education includes training the parents in specific procedures to work directly with their children, to teach them specific skills, reduce problem behaviours, pivotal response training, improve non-verbal communication skills, verbal communication skills and increase appropriate play skills.
Severely autistic children are in special schools as they have problems in learning and also moving ability. Often it is found that the parents of which the mother is with the child all the time. How does it affect both of them? Often mothers are found to bear the burden of the autistic child?
It is not easy to be the parent of an autistic child. The parents of autistic children have feeling of guilt, chronic daily stress, anxiety and depression as they are having worry about the future of their children and also struggle to obtain appropriate services. Although there are many other developmental disorders, which can cause parent stress, autism is unique in several ways. Lack of diagnostic biological test makes it extremely difficult for parents to accept the child’s diagnosis. Because of problems of social interaction, such as forming attachments and showing affection, parents of children with autism are often denied some of the fundamental rewards of parenthood. Almost all parents with autistic children have felt stigmatised in public situations and they have. Yes, more often mothers bear the burden of autistic child. The relatively less impact of the child’s autism on most of the fathers appeared to be at least partially due to the gender roles connected to work and child rearing. Studies showed that high levels of distress have been found in up to 70% of mothers and 40% of fathers of severely disabled children. Mothers of children with high levels of behavioural problems, low functional capabilities used to have negative psychological effects. Parental distress adversely affect child’s development.
What are the therapies that are available and are they cost effective?
There is no cure for autism, but there are educational programs and pharmacological treatments that can address some of the challenges associated with the condition. Treatment for ASD should be as soon as possible after diagnosis and also there is no single best treatment for ASD. Working closely with doctor is an important part of finding the right treatment program. There are behavioural therapy and medications to treat autism. Special educational programs and behavioural therapy early in life can help the children with ASD to acquire self-care, social, and job skills, and often can improve functioning. Intensive Applied Behavior Analysis (ABA) treatment has demonstrated effectiveness in enhancing global functioning in preschool children and is well established for improving intellectual performance of young children. Many medications are used to treat problems associated with ASD, they are psychoactive drugs, anti-depressants, and stimulants.
What about these cases in rural areas and do they get identified on time or are quacks dealing with these cases?
Rural community face significant challenges regarding availability of diagnosis, treatment, and support therapies for ASD. They have low trust on health care professionals and their services. Together these factors lead to risks for delayed ASD diagnosis and treatment. We need to identify specific research and support services that address the specific barriers of rural settings.
Is there an estimated number of the people with this disorder?
In India, currently around 10 million people are suffering from autism spectrum disorder (ASD). According to statistics by the Centers for Disease Control and Prevention (CDC), one in every 88 children today is born with autism spectrum disorder (ASD). ASD is about 4.5 times more common among boys than girls. Indian government recognized the disorder in 2001.
What is their lifespan and how and in what manner is it possible for the society to allow them a fair chance to quality life?
Autism itself does not affect life expectancy, however research has shown that the mortality risk among individuals with autism is twice as high as the general population, in large part due to drowning and other accidents. Autistic adults can be divided into two types based on their functional capabilities which are low functioning and high functioning. Low functioning autistic adults need constant support for daily activities by their parents or in residential facilities. On the other hand, high functioning autistic adults can lead successful and relatively normal lives. With properly taught social responses, need-based education and accepted behaviors, autistic adults can function as contributing members of society.
For Appointments : Dr Lalitha Pidaparthi, consultant neurologist at Care Hospitals Hyderabad
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