How Serious IS Autism Spectrum Disorder?

There are 70 million people in the world with Autism and 85% of them live in the developing countries. Earlier it was called to be a Pervasive Developmental Disorder now it is said to be a neuro-developmental  condition. It includes deficits in social communication, deficits in language development and restricted range of activities of interest.

Characteristics of people with Autism Spectrum Disorder are: – 

• Child has inability to relate to themselves as well as others, right from infancy.
• Child has problems in language development.
• Child has an obsessive desire for an organised routine.
• Child is hyperactive or passive.
• Child has difficulty in making an eye contact.
• Child shows inappropriate laughing or crying fits.
• Child is usually oversensitive or under-sensitive to sounds.
• They have difficulty in dealing with change.
• Child lacks awareness of danger.
• Child shows unusual behaviour or body movements.
• The child has fascination with objects, their use of objects is stereotypical.

Rimland(1964), was the first person to call this a neuro-developmental condition earlier it was thought  to be a result of parental rejection or neglect.

PREVELANCE AND INCIDENCE :- 

• More prevalent in males than females.
• Females having Autism have comorbidity with Intellectual Disability and ADHD, symptom severity is also high in females than males.
• It tends to go unreported in lower socio-economic strata because of lack of awareness & resources.

CAUSAL FACTORS:-

Genetic Factors

• It has high concordance rate in Monozygotic than dizygotic twins, i.e. – (60%-96%) and (0%-23%).
• Autism runs in families, but the significant others can have symptoms of any other neuro-developmental condition and not necessarily Autism. ( Mash and Barkley,2013)
• It is noted that multiple genetic mutation results in Autism Spectrum Disorder and no single genetic mutation can be considered to be the cause of Autism.

Environmental Factors

• Factors such as maternal infections, maternal medical condition, birth complications, drug exposure can all become contributing factors for Autism.
• Hypertension and Diabetes also pose a risk to developmental delays.
• Incompatibility in the Rh factor between the child and mother due to any complications or chromosomal imbalance increases the risk of Autism.(Mash and Barkley,2013)
• High paternal age at the time of conception poses 2 times more risk of having children with Autism Spectrum Disorder.
• Exposure to teratogens, environment pollutants also increases the risk if Autism.

Neuroanatomical Factors

• MRI studies of 2-4 years old with Autism revealed a larger cerebrum volume as compared to normal children.
• The brain shows abnormal neural connectivity and synaptic pruning during brain development in case of Autism Spectrum Disorder.
• Slower functioning and enlarged size of brain and cerebellum revealed by FMRI studies.(Carper,2000)
• PET Scans revealed lower activation of medial Pre-frontal cortex in children with Autism.
• Somatosensory Dysfunction also contributes to Autism.

ASSESSMENT

Assessment Scales include :-

• WISC 5
• Bayley’s Infant Index Scale
• Peabody Picture Vocabulary Test
• Behavioural Assessment Scale for Children
• Child Behavioural Checklist
• Autism Screening Instrument for Educational Planning

INTERVENTIONS

We should never let a Disability define a person. There is more to the individual with disability than you might think or see.  Don’t think about what one can’t do but about all that’s possible. They do have special needs but the needs that matter to them the most are similar to ours- they also need to be accepted, need friends to make them smile, need a chance to learn and grow. They surely need some extra help but inside they are just like us!!

Some Intervention strategies that can be used are as follows:-

• Practising Time-Out, removing the child from stimulating environment for some time.
• Differential Reinforcement, involves reinforcing appropriate behaviour eg- Maintaining eye contact.
• Ignoring harmless self-stimulating behaviours like- Finger Flapping.
• Identifying and modifying the triggers.
• Teaching attention and compliance to the child.
• Using Sensory Integration strategies- Podcasts, visuals, sensory modalities to teach them language.
• Teaching them how to initiate a conversation by using primary and social reinforcers.
• Motivating the child.
• Helping the child respond to multiple cues.
• Never labelling the child.
• Medications can be used only in case of comorbidity with severe symptoms including self-harm or harming others.

All kids need a little hope, a little help and someone who believes in them. It takes someone special to guide someone special. In a world where you can be anything, BE KIND. Whether you colour the world or light it up blue, you are making a difference, so keep being you!! Always remember that when a flower does not bloom you fix the environment not the flower. Try and see the able, not the label. The only true disability is the inability to accept and respect differences. Always remember that everyone has something of value to contribute and has a right to belong. Autism did not stop Einstein, Newton, Mozart or Temple Grandin, neither will it stop any child.

As Albert Einstein rightly said- “Everybody is a genius. If you judge a fish by its ability to climb a tree, it will live its whole life believing that it’s stupid.”