Dr Aditi Bakshi
United Nations General Assembly(UNGA)unanimously declared 2nd April as World Autism Awareness Day(WAAD)to highlight the need to help improve the quality of life of those affected with autism and to recognize their rights so that they could lead a full filling and meaningful life as an integral part of society.
History
The Word autism is derived from the word “Auto” which means children are locked within themselves .Word Autism was first used by a psychiatrist Leo camer in 1943 who described it as “Early Infantile autism”
Today it is considered to be a severe form of a broader group of disorders referred to as pervasive developmental disorders.
ASD has been the focus of debate in recent years largely as a result of multinational reports of increase in its prevalence from past 40 years, which can be attributed to greater public awareness.
What it means to be on Autism spectrum?
Autism spectrum disorder is a neuro development disorder characterized by impairment in several areas of development (apparent before age of 3 years)typically verbal and nonverbal communication ,social interaction ,sensory experience, affected individuals exhibit repetitive and stereotypic movements/actions, difficulties in adapting to changes, lack of imaginative play, display anger tantrums and characteristics that appear in wide variety of combinations ranging from mild to severe hence referred it is referred to as “SPECTRUM”.
Early signs of autism
* Avoids eye contact
* No response to name by 9 months
* Does not show different facial expressions by 9 months .
* No interactive play by 12months.
* No pointing by 18 months.
* Does not show interest in joining other children in play by 36 months. No pretend play by 48 months of age
* Lines up toys
* Obsessive interest. Fixity to routines
* Gets upset by minor changes
* Rocks body, flap hands ,spins in circles, self hitting {in anger or excitement }
*Not all or any of these symptoms may be present in same individual or affected individual. Some symptoms show up within 12 months of life while others make take 24 months to show up when they stop gaining new skills or lose previously acquired skills { termed as regression}. Also some people without ASD might also have some of these symptoms
Is there a cure for autism ?
There is no known cure for autism. Children are either born with the disorder or with a potential to develop the ASD symptoms. It does not mean that nothing can be done to help the child with autism. Early diagnosis and Early intervention lead to significantly improved long term outcomes.
How is autism diagnosed ?
There are no definitive medical tests. Medical examination does helps to rule out other problems unrelated to autism for example :Hearing impairment, lead poisoning ,development or behavior disorders, mental retardation, eccentric habits.
The diagnosis is usually carried out by a team comprising of psychologist, neurologist , Development pediatrician, Speech and language therapist, Occupational therapist and others.
The team uses observation ,interviews ,specific checklist/screening tool developed for autism screening purpose.
What is Early intervention
Early intervention (EI) is defined as the services delivered to children in infancy to about the age of 6 years. Research shows that EI makes a dramatic impact on reducing the symptoms of autism as young brains are most most flexible .
It begins with knowing and observing the development milestones and tailoring a comprehensive treatment program for the child.
Several treatment approaches are being used to cater to different difficulties and conditions associated with spectrum and sometimes a combination of different treatment approaches may be planned for improved results .
Behavioral Approaches
Focus on changing behaviors by understanding what happens before and after the behaviour. Includes:
Applied behavior analysis (ABA){based upon Reinforcing positive behaviours and gradually decreasing negative or unacceptable behaviours}
Discrete Trial Training (step by step instructions to teach desired behaviour ) and Pivotal Response Training (takes place in natural setting rather than clinical setting )
* Another approach is known as FLOORTIME involves social and emotional skills
* The TEACCH program: uses picture cards and other visual cues
* Play Therapy {learning via play ,child directed methodology}
* Other behavioural approaches :Modeling ,video modeling ,peer mediated intervention ,social stories ,behavior momentum{increases motivation when a challenging task is required}
Developmental Approaches :Includes
a) Occupational therapy :involves teaching skills for independent living for instance dressing bathing eating relating to people .Includes :
* Sensory Integration Therapy: improves response to both restrictive and overwhelming sensory input
PhysicalTherapy : improves physical skills
* Brain Gym Exercises : includes specific exercises to activate certain specific areas of brain and hence improve the overall all results generated with occupational therapy
b)Speech and language therapy: helps improve understanding and use of speech language and overall communication .
SCHOOL READINESS PROGRAM: includes : Facilitated peer interaction, Group therapy program .
Others therapies in use:
Art therapy ,Music therapy ,Dance therapy ,yoga therapy ,primitive reflex therapy ,Reiki healing ,play therapy ,Neuro linguistic planning (NLP) ,RDI and so on…..
*Earlier the child receive early intervention(EI) more likely will it be possible for them to reach there full potential.
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