Autism spectrum disorder or Autism is a condition relating to brain development impacting the person’s perception and the ability to socialize with others, causing problems in social interaction and communication. Limited and repetitive patterns of behavior are also noted in this disorder.

Autism spectrum disorder begins in early childhood and problems functioning in society — socially, in school and at work occur in these cases. Often children show symptoms of autism within the first year.

Each child with this disorder has a unique pattern of behavior and level of severity — from low functioning to high functioning.

In low-functioning autism, people may need help with everyday tasks and have a more challenging time with social, learning, or communication abilities.

Others may have less problems communicating and may often do well in school as full as socially.  It is best to use these terms sensitively and keeping in mind to not offend anyone’s feelings.

In India, about 1 in 100 children under the age of 10 has autism, and nearly 1 in 8 has at least one neurodevelopmental condition.

What are the symptoms of Autism?

Autism symptoms may present before a child turns 3 or right from birth. These may be as follows:

• Lack of eye contact
• Narrow range of interests or intense interests only in specific topics
• Repeating one thing over and over, like repeating words or phrases, rocking back and forth, or fidgeting with objects
• High sensitivity to sounds, touches, smells, or sights that seem ordinary to other people
• Not listening to other people
• Not looking at things when someone points it out
• Not wanting to be in contact or to be cuddled
• Problems in understanding speech, gestures, facial expressions, or tone of voice
• Talking in a sing-song, flat, or robotic voice
• Difficulty adapting to changes in routine

What are the causes and risk factors of Autism?

Autism has no known cause and given the complexity of the disorder, there are probably many causes. Both genetics and environment may play a role.

There are several risk factors for autism –

• Sex of the child – Boys are about four times more likely than girls.
• Family history
• Other disorders – certain medical conditions increase risk of autism or autism like symptoms. These are fragile X syndrome, tuberous sclerosis,etc.
• Extremely preterm babies – Especially babies born before 26 weeks of gestation.
• Parents’ ages – There is lesser evidence but there may be a connection between a children born to older parents and autism.

How is Autism diagnosed?

Getting a definite diagnosis for autism is difficult and the diagnosis is focused on behavior and development.

Diagnosis in children is generally taken in 2 steps –

• A developmental screening conducted by the doctor assess if the child is on track with basic skills like learning, speaking, behavior, and moving. Screening during developmental delays during their regular checkups at 9 months, 18 months, and 24 or 30 months of age is pivotal. There are routine checkups specifically for autism at their 18-month and 24-month.
• If the child shows signs during screenings, the doctor does a thorough and complete evaluation including hearing and vision tests or genetic tests. There might referral to specialist such as developmental pediatrician or a child psychologist. Psychologists may also conduct tests called the Autism Diagnostic Observation Schedule (ADOS).

What are the treatment options for Autism and how does a person deal with the condition?

There is no cure for autism, but the goal of treatment is to maximize the child’s ability to function by reducing the symptoms and supporting development and learning. Early intervention may help in learning critical social communication, functional and behavioral skills.

Treatment options for Autism include:

Treatments are tailormade for the person or the child. The main types of treatments are:

Behavioral and communication therapies: Some programs focus on reducing problem behaviors and teaching new skills like acting in social situations or communicating better with others. 

Developmental: Speech therapy improves communication skills, physical therapy improves motor ability, occupational therapy works on life skills like dressing and eating.

Psychological: Treatments like cognitive-behavioral therapy (CBT) helps people deal with anxiety, depression, or other mental health issues.

Educational: Adapts learning processes to the needs of people with autism.

Social-relational: Focuses on bettering social skills and building emotional bonds.

Medications: Work to ease symptoms of ASD, like attention problems, hyperactivity, or anxiety.

Complementary therapies include music, art, or animal-assisted therapy, such as horseback riding may help boost learning and communication skills in some people with autism.

How can a child with Autism be helped?

Communication

Better communication with autism is possible by:

• Using the name of that person
• Speaking slowly and clearly
• Using language clear and simple
• Give that person extra time to comprehend what that person is saying
• Use simple gestures, pictures, or eye contact

Avoid:

• Having a conversation in a noisy or crowded area
• Saying things or phrases with more than one meaning like “break a leg”
• Asking the child a lot of questions

Trouble sleeping

Sometimes it is difficult for a child with autism to fall asleep. Following things may help:

• Keeping a sleep diary
• Following a bedtime routine each night
• Using ear plugs to sleep, if it helps them
• Keeping the bedroom dark and quiet
• Talking to the doctor about sleep issues.

To help a child socialize:

• Ask the child’s school for help.
• Seek help from autism team
• Seek or read information from other parents of children with autism.

Do not:

• Force the child into social settings.
• Put pressure on the child.