Understanding Autism Spectrum Disorder
Autism spectrum disorder (ASD) is a complex neurodevelopmental condition that affects social interaction, communication, and behaviour. Although autism can be diagnosed at any age, it is described as a “developmental disorder” because symptoms generally appear in the first two years of life.
It has a profound impact on individuals and their families, highlighting the need for early recognition and intervention. This condition is often characterized by difficulties in social communication and interaction, coupled with repetitive and restrictive behaviours. Early signs such as poor eye contact or delayed speech may appear by six months of age but frequently go unnoticed. This is often due to ignorance and societal stigma surrounding developmental and behavioral problems. Parents typically become aware of potential issues when their child fails to meet developmental milestones, stressing the importance of broader education about ASD.
In many cases, the diagnosis of ASD is delayed because of inconsistent screening protocols and a lack of awareness among parents and clinicians. Symptoms such as poor eye contact can be identified as early as two years old, allowing for timely interventions that make a significant difference. Screening tools like the Modified Checklist for Autism in Toddlers (M-CHAT) and the Trivandrum Autism Behavioural Checklist (TABC) have proven effective in early identification of the condition.
The prevalence of ASD in India is approximately one in 68 children, with boys being three times more likely to receive a diagnosis than girls. Although the exact cause remains unclear, research points to chromosomal and genetic conditions such as tuberous sclerosis and fragile X syndrome as contributing factors. Additional risks are associated with delivery complications, perinatal issues, and advanced maternal age.
Managing ASD requires a multidisciplinary approach involving Developmental Paediatricians, Psychiatrists, Psychologists, Occupational Therapists, Speech Therapists, Special Educators, and Social Workers. Applied Behavior Analysis (ABA), an evidence-based therapy, focuses on modifying behaviors, teaching essential skills, and minimizing harmful behaviors like self-injury. Naturalistic Developmental Behavioral Interventions (NDBIs) use ABA principles in everyday social settings, providing therapy in a natural context. Parent-mediated treatments, which train parents to deliver targeted therapies, have also been effective, particularly in areas where specialized facilities are limited. These approaches are often combined with tailored educational programs, such as the Treatment and Education of Autism and Related Communication Handicapped Children (TEACCH) curriculum, which is customized to the goals of the Individualized Education Program (IEP).
Speech-language therapy, which employs tools like the Picture Exchange Communication System (PECS) and Augmentative and Alternative Communication (AAC), supports children with limited verbal abilities. For those struggling with motor coordination and sensory processing, occupational therapy and sensory integration techniques can enhance their response to stimuli. In some cases, medical interventions, including medication, are used alongside behavioral therapies to address co-occurring conditions like ADHD and anxiety.
Awareness and systematic screening are critical for early intervention and effective management of ASD. Society must also shift its attitudes to better include and support individuals with autism. Early diagnosis and targeted therapies improve outcomes for affected children while reducing the societal burden of untreated ASD.
Autism is not a limitation but a spectrum of unique abilities and challenges. With timely interventions and supportive environments, individuals with ASD can lead fulfilling lives. Parents, educators, and policymakers must work together to ensure no child is left behind on their journey to realizing their full potential.
Dr Sami Hassan is a PG Resident, Dept. of Community Medicine, GMC Srinagar
