Autism: A complex disorder that requires early recognition

My son is already 2 yrs but he has not started speaking”, don’t worry my dear he will. Just wait for few more months.but he is not even looking at me when I’m talking to him. No response to any instructions. No playing with other children. May be he is little shy. Just wait. He will overcome this as well. He is hyperactive at home. Always breaking things,my dear all children are naughty. His father was a menace as a child.

This are the excerpts from the conversation of a mother whose child was later diagnosed with autism. Majority of such moms and dads say ‘I had suspicion of something wrong when he was 15-16 months old but people suggested me to wait as many children outgrow these problems.’

Autism is a complex developmental disorder with impairments in Verbal and nonverbal communication Reciprocal social interaction ,associated with stereotypical repetitive behavior. The incidence of autism has been steadily increasing year by year. According to a US study, the incidence was 1 in 150 children in 2000 which increased steadily to 1 in 68 children by 2010. If the incidence increase at this rate than the day is not far when half of our kids will be autistic. So the parents should closely follow the development pattern of their children and look for any red flag signs. Routine neuro developmental assessment by a professional can also be done.

There are certain early signs which parents can notice in pre school children whose presence warrant early consultation with a specialist.

• Delayed or no spoken language
• Repetition of same words or questions(Echolalia)
• Do not respond to other people’s expression and look through them as if they do not exist
• Poor eye contact
• Lack of pretend play
• Do not show interest in peers
• Do not show interest in social or organized play
• Unable to share pleasure with others
• Do not point an object of interest to show it to others
• Extreme reaction to change of routine
• Do not communicate non verbally unusual repetitive hand and finger movements like hand flapping
• Hyperactivity unusual for his age
• Unusually high or low reaction to sensory stimuli like sounds or lights.

5 internationally recognised red flag signs of autism are-

• Doesn’t babble or coo by 12 months.
• Doesn’t gesture(point, wave, grasp) by 12 months.
• Doesn’t say a single word by 16 months
• Doesn’t say 2 word phrase on his or her own(but may have echolalia for        multiple words) by 24 months.
• Has loss of any language or social skills at any age.

1. Other associations of autism-
   • Learning disorders
   • Seizure
   • Sleep disorders
   • Mental ill health and behavioural problems
   • Anxiety or depression
   • ADHD etc 
     Diagnosis- Many behavioral scales may be used for diagnosis like CHAT. M-CHAT, CARS etc. But whenever there is suspicion it is advisable to start treatment immediately and not wait for the confirmation of diagnosis because early intervention always yield good results.
     Treatment
     1- Non pharmacological
     Mainstay of therapy. It includes ABA, NDBI, PECS, SI therapy, Speech therapy, behavioral and psychological interventions. Parents are the best therapists for any child. No body can bring the change what mother can bring. So parents should understand the basics of therapy so that they can apply this in day to day routine of the child and adjust according to the home environment.
     2- Pharmacological
     For hyperactivity, inattention and associated problems.