Interviews

Autism, they need love and protection

Dr-Rakesh-Jain

Experts estimate that every 2-6 children out of every 1000 have Autism. Out of every 250,1 children or adult is suffering from (figure may vary as many cases are not diagnosed) and currently 10 million people are suffering in India. The government only recognized the data in 2001, till 1980’s, there were reports that Autism didn’t exist in India.

Decades back in India, Autism is considered as the problem attached with mentally retarded condition and often parents afraid of taking their child for experts help. Even if they visit the hospitals, they only want to be reassured that their child is just “slow.” Then to psychologist just to be told that there child is ‘mentally subnormal then to psychiatrist, to be told that their child has attention deficit disorder, and must be put on medication to control hyperactivity but unsatisfactory results. Fortunately, today diagnosis of the autism is improving in major cities; still some of the doctors feel that nothing can be obtained by diagnosis autism unless until there are more services available and more awareness of the disorder spreads. To provide Children with autism a normal life span and supervision after their parent’s death, country requires a proper planning for homes and centres.

Today government of India recognizes autism as disability, and even started funding the schools which are catering the services towards the autistic children. Today lots of NGO’s and government run special schools have come into force  but still there are not enough services to meet the needs of autistic and mentally retarded children and adults in India.

Dr Rakesh Jain, Consultant, Pediatrics Neurologist, Fortis Hospital Gurgaon, in conversation with Ekta Srivastava, Health Technology

What is autism?

Autism spectrum disorder (ASD) is a range of complex neurodevelopment disorders, characterized by social impairments, communication difficulties, and restricted, repetitive, and stereotyped patterns of behaviour.  Autistic disorder is the most severe form of ASD, while other conditions along the spectrum include a milder form known as Asperger syndrome, and childhood disintegrative disorder and pervasive developmental disorder not otherwise specified (usually referred to as PDD-NOS). It is almost four times common in males than females.

What are the Symptoms of Autism?

The most important feature of ASD is impaired social interaction.  As early as infancy, a baby with ASD may be unresponsive to people.  Usually, a child with ASD may appear to develop normally and then withdraw and become indifferent to social engagement.

They usually avoid eye contact with others and may even fail to respond to their names. They do not understand the emotional or social cue in the conversation instead they usually go by the literal interpretation. They are generally monotonous in their action, speech and behaviour.

Many of them would have some kind of stereotypic movements as rocking and twirling, or in self-abusive behavior such as biting or head-banging.

Does it has its effect since childbirth or one can have it in the mid of his life?

It starts in the childhood, however, scientists are not certain about its causes, but it’s likely that both genetics and environment play a role.

Twin and family studies strongly suggest that some people have a genetic predisposition to autism.  In case of identical twins, if one twin is affected, there is up to a 90 percent chance the other twin will be affected. In families with one child with ASD, the risk of having a second child with the disorder is approximately 5 percent, or one in 20.  This is greater than the risk for the general population.  In some cases, parents and other relatives of a child with ASD show mild impairments in social and communicative skills or engage in repetitive behaviors.

Are there any criteria to detect any symptoms before birth?

There are certain genetic conditions which can be associated with autism, but in the absence of any confirmed genetic diagnosis, it is not always possible to detect it antenatally.

Does it have any relevance with the family history or it can happen to anyone?

It can happen to anyone, but a positive family history is risk factors for ASD.

What exactly needed to be done by the parents?

Parents should keep their mind open and try to look for the following symptoms –

Early indicators that require evaluation by an expert include:

  • no babbling or pointing by age 1
  • no single words by 16 months or two-word phrases by age 2
  • no response to name
  • loss of language or social skills
  • poor eye contact
  • excessive lining up of toys or objects
  • No smiling or social responsiveness.

Later indicators include:

  • impaired ability to make friends with peers
  • impaired ability to initiate or sustain a conversation with others
  • absence or impairment of imaginative and social play
  • stereotyped, repetitive, or unusual use of language
  • restricted patterns of interest that are abnormal in intensity or focus
  • preoccupation with certain objects or subjects
  • inflexible adherence to specific routines or rituals.

Is there any possibility that if your first child is autistic then second can also be?

Yes, there is. In case of identical twins, if one twin is affected, there is up to a 90 percent chance the other twin will be affected. In families with one child with ASD, the risk of having a second child with the disorder is approximately 5 percent, or one in 20.  This is greater than the risk for the general population.  In some cases, parents and other relatives of a child with ASD show mild impairments in social and communicative skills or engage in repetitive behaviors.

How it can be treated?

There is no definitive cure for ASDs.  Therapies and behavioral interventions are designed to address specific symptoms and can bring significant improvement.  The ideal treatment plan coordinates therapies and interventions that meet the specific needs of individual children.  Most health care professionals agree that the earlier the intervention, the better.

Educational/behavioural interventions:  Therapists use highly structured and intensive skill-oriented training sessions to help children develop social and language skills, such as Applied Behavioural Analysis.  Family counselling for the parents and siblings of children with an ASD often helps families cope with the particular challenges of living with a child with an ASD.

Medications:  Doctors may prescribe medications for treatment of specific autism-related symptoms, such as anxiety, depression, or obsessive-compulsive disorder.  Antipsychotic medications are used to treat severe behavioural problems.  Seizures can be treated with one or more anticonvulsant drugs.  Medication used to treat people with attention deficit disorder can be used effectively to help decrease impulsivity and hyperactivity.

Children with characteristics of an ASD may have co-morbid conditions, including Fragile X syndrome (which causes mental retardation), tuberous sclerosis, epileptic seizures, Tourette syndrome, learning disabilities, and attention deficit disorder.  Up to one third of children with an ASD develop epilepsy.

Is there any research going on related to communication ?

There are a lot of research projects going on to find out the specific gene locations and their mutations causing different symptoms, nothing curative has come so so far.

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