What is Autism Spectrum Disorder?
Autism spectrum disorder (ASD) is a disorder of brain development. Children with this disorder have persistent trouble communicating with others. In addition they have repetitive behaviours and a restricted interests and activities. These symptoms can occur in combinations and the degrees of intensity vary in each individual.
ASD can be associated with intellectual disability, difficulties in motor co-ordination, attention and health issues such as sleep. Some persons with ASD excel in Visual skills, music, math and art.
How common is Autism Spectrum Disorder?
ASD has a prevalence of about 1 %. However the prevalence is rising and recent US figures from CDC identified around 1:68 children have been identified with ASD. This increase is only partly explained by improved diagnosis and awareness. Environmental influences also seem to have a role. Studies also show that Autism is 4 to 5 times more common among boys than girls.
What causes Autism Spectrum disorder?
There is no one particular cause of autism as there is no one type of autism. A number of rare mutations or gene changes are identified by scientists to be associated with ASD. However most of the cases of autism appear to be caused by combination of genes and environmental factors influencing early brain development.
What are the signs of Autism Spectrum Disorder?
Children affected by ASD often exhibit early signs by 12-24 months of age.
A child may demonstrate only a few of these signs
• Poor eye contact
• Does not point and look
• Doesn’t smile
• Trouble making meaningful gestures by 1 year
• Does not respond to their name
• Begins to develop language and then loses it or doesn’t acquire language at all
• Cannot speak 1 word by 16 months or combine 2 words by 2 years
• Does not exhibit bonding (example does not initiate cuddles)
• Not interested in interacting or playing with other children
• Does not engage in adequate imaginative play
• Has problems with, or is not interested in playing with toys
• Strongly resists change in routines
• Has difficulty sleeping/ wakes at night
• Self-restricted/ selected diet
If you see any signs of ASD in a family member, talk to your health care professional.
How is ASD diagnosed?
A team of professionals will use various standardised tests to make a diagnosis.
Timely screening and diagnosis is very important. Early intervention with proven behavioural therapies can improve outcome in a child’s development and daily functioning. Most of the times receiving a diagnosis can be very helpful, as it enables parents, as well as others to understand and support the child better. Diagnostic assessment also helps to clarify if the child needs any extra support and appropriate help can then be sought.
What does it mean to be on the “Autism spectrum”?
Each individual with Autism is unique.
Many have exceptional abilities in visual skills, music, math , academics and art. About 40 % have average or above average intellectual abilities. Others have significant disability and are unable to live independently.
About 25 % are nonverbal but can learn to communicate with other means.
Is there a treatment?
There is no known “cure” for this condition. However there are many useful programmes and interventions to develop the child with specific difficulties, which, may impact them and their families quality of life.
It is also important to note that ASD affects every child in a different way. An intervention that helps one child might not be suitable for another.
Parents are strongly adviced to seek professional guidance.
It is important to help children in their areas of difficulties, but it is equally important to support them in their areas of strengths. It is often their strengths that increase their quality of life, help them to achieve their potential and contribute to society.
It is important to be aware that children with ASD are at increased risk of developing other difficulties like sleep difficulties, anxiety, depression, or behavioural problems. These are often treatable and it is important to seek medical help if concerns arise.
The medications have significant side effects and should be prescribed by a doctor who specialises in the condition being treated. If medication is offered, your child will have regular check-ups to assess if the medication is working.
Is there any role for Dietary Restriction?
Dietary restrictions (example Gluten free and casein Free diet) are widely practiced. However there is not enough scientific evidence to recommend this routinely.
Some children with ASD already have a self-restricted diet. In addition if a dietary restriction is imposed, it can be detrimental, as some of the essential nutrient needs of the growing child might not be met.
If the parents are concerned, please discuss the diet needs with the medical doctor. The child might need an evaluation by a qualified medical professional for any underlying medical conditions, which might benefit from the diet restriction.
Parents should be cautious about any treatment that claims to be a ’cure’ for autism.
Dr. Pranathi Gutta MBBS ; MRCPCH(UK)
Apollo Health City, Jubilee Hills, Hyderabad