Few illnesses have been as mysterious and fewer still as poorly understood, as ‘Autism’. Autistic individuals have a defect in normal social interactive and communicative skills and find difficulties in relating and communicating to external world. It is as if they are living in their own world oblivious to what is going outside.
Why a social animal like a human being ends up in this condition as an aloof alien apparently enveloped in an invisible, impenetrable socio-emotional cocoon is a baffling phenomenon. Although this illness was first described by Leo Kanner as early as in 1943, only in the last one and a half decades, it has started receiving increasing attention of medical world. Western world, particularly USA, has already begun tackling this issue in the right earnest but general public awareness about it elsewhere is almost negligible. What is Autism?
Autism is a complex developmental disability that makes its presence felt typically during the first three years of life. According to Center of Disease Control statistics, about 500,000 diagnosed cases exist in USA alone. Its reported incidence is as high as 1 in 500 individuals. Boys have four times more chance of having this condition as compared to girls. No social, racial, ethnic or economic boundaries exist and it can affect almost anyone. Why does it occur?
No one knows how and why this abnormality occurs. What we know is that the brain of affected individuals is biologically and neurologically different than normal. Genetic influence, biochemical imbalance and immunological abnormalities are all implicated in the causation of this ‘difference’. Food allergies, adverse reactions to some vaccines like rubella and pertussis, excessive amounts of a fungus Candida albicans in gastrointestinal tract and environmental toxins have received their share of blame for causing autism. Let me make some things clear: Autism is not a psychological or mental illness but rather a case where one is dealing with a different kind of a mind. Parenting errors don’t cause autism. Autism is not some play-acting by the kid but a real disability.
Autism is a ‘spectrum disorder’ meaning the disabilities in various social and communicative areas differ in severity and can occur in various combinations in different individuals. Half of such children have slowed development from before but the rest develop pretty much normally until 18 – 24 months of age and then the parents start realising that something is amiss. What are the signs and symptoms of autism?
There is impaired social interaction. The child spends more time alone showing minimal interest in people. He cannot develop peer-relationships and doesn’t reciprocate socially or emotionally. He withdraws on cuddling. There is poor eye contact, lack of facial expressions (including smiling) and other communicative gestures. Speech is delayed or even totally lacking. When present, it is limited to few repeated or echoed words (Echolalia) without any meaning. Even in autistic individuals with adequate speech ability, there is inability to initiate or sustain conversation with others. Ability for imitative or imaginative play is severely impaired. Stereotypic repetitive motor activities like hand flapping, rocking, head banging, teeth grinding, twisting or complex whole body movements are common. Overactive or over-passive behaviour, temper tantrums, self-inflicted injuries, unusual sensory responses especially to sudden, loud, high pitched sounds and abnormal fixation for predictable and often insignificant rituals are some other notable features.
How is it diagnosed?
There are no blood tests, no x-rays and no scans to diagnose autism. It cannot be detected before birth by any type of screening. Formal IQ testing is difficult in most cases and where it is possible, often it indicates functional retardation. One interesting feature is that some autistic individuals may have remarkable isolated abilities where they might even outperform their normal peers. The only way to diagnose autism is by observing the individual’s behaviour, speech and development over a period of time. Ideally such a child should be evaluated by a multi-disciplinary team including developmental paediatrician, paediatric neurologist, psychologist, speech/language therapist and if possible by an expert with specific experience in dealing with autism. While evaluating one should rule out similarly presenting disorders like mental retardation, childhood schizophrenia, hearing impairment, genetic and metabolic disorders, developmental speech delay and result of prolonged isolation and neglect. Chromosomal analysis and DNA testing for disorders like Fragile X syndrome should be considered. How do we treat autism?
Unfortunately autism cannot be cured but with the better understanding of illness, effective strategies can be planned to cope up with it and improve the functionality of affected individuals. - Early intervention is associated with best results.
- There is no single treatment which can be termed as best or ideal. Medicines like fenfluramine have been tried but haven’t been too successful. Hormone secretin is being touted as the latest breakthrough but these claims are yet to be proved.
- Individualised multi-dimensional treatment plan consisting of physical therapy, occupational therapy, speech/ language therapy, early childhood education techniques and sensory stimulation is the preferred plan of action.
- These programmes are highly structured and aim to promote social and communicative skills and positive behaviour.
- Life skills like street-crossing, shopping, cooking and asking for assistance are specifically incorporated and emphasised in such programme to promote independence.
Parents also need special counseling to deal with such children. For them it is like ‘losing’ a living child who is unable to comprehend or reciprocate their love. To further complicate the issue, there is no definite remedy to rectify the situation. So ‘Parent support groups’ play an important role in offering guidance and emotional support to affected families. Long- term outlook for this condition remains unpredictable. Some children grow to lead relatively normal, productive adult lives while others need supported living and working environments throughout. Continuous, compassionate community-care for autistic children and their parents still remains quite a distant goal and only increasing awareness can change this picture. |
Parenting
Spice 'N Sugar
About Us
Autism - In a world of their own
