Autism is a disorder of brain development, where the child has difficulty in social interaction and communication. Each child with autism is different and presents slightly differently.
Since speech is one of the most important forms of communication, these children often have delayed speech and language. This must never be ignored or passed off casually. Aware and alert parents may notice impaired speech development in children less than even 2 years of age and get the child assessed early.
Many children may able to repeat things like alphabets or full rhymes which they have heard, instead of speaking to communicate or interact with people around, and this may be mistaken for normal speech development. However, they have poor eye contact, may not respond to their name when called, may not wave bye – bye, or play with other children in an interactive way. This does not mean that they have no feelings, or love and affection; they can be very attached to caregivers and siblings, and may just show it in different ways.
Children with autism may also have associated difficulties in chewing food, constipation, sleep disturbances. They may have certain repetitive behaviours. They may often be hyperactive and have behaviour issues like temper tantrums.
Occasionally, some of the children have very advanced skills and abilities – eg music, maths, spelling, reading or writing. They are said to have a savant ability.
What causes autism is as yet unknown, but genetic factors are most likely involved. Increased use of screens in young children less than 2 years of age may result in features of autism, in children who are predisposed to this developing this condition. During Covid times and in the subsequent period, there has been a marked increase in number of cases of autism, because the children were isolated socially.
There is no cure, but the early diagnosis and appropriate therapy are important for best results.
Autism can be diagnosed by the history and examination of the child. Assessment tools which evaluate different areas of development that are affected in autism can confirm, and also give information about, the severity of the condition. All children must undergo evaluation for hearing and vision. MRI brain, EEG and genetic testing may be ordered in certain cases.
No single person can manage autism. A Pediatric Neurologist, Developmental Pediatrician, Clinical psychologist and a team of therapists (occupational therapists, behaviour therapists, speech therapist) must work as team for best results. There is as yet no proven role of drugs and nutraceuticals, or stem cell therapy.
Dr. (Col) Rekha Mittal
Dr. (Col) Rekha Mittal , Additional Director - Pediatric Neurology
Madhukar Rainbow Children’s Hospital, New Delhi
All parents should be aware that autism has been declared as a disability in the Rights of Persons with Disabilites Act of 2016. This entitles the child to a disability certificate or a UDID card. Parents can also avail of Income Tax rebate on expenses occurred in management under Section 80 DD. The Government Insurance scheme , Niramaya can cover some cost of treatment as well, as none of the Insurance companies cover children with autism.
Most of the children are able to attend schools with other children, as awareness and empathy increases amongst the public, and more and more schools are gearing up to educate children with special needs. All in all, children with autism can succeed in school and in life, with the help of doctors and therapists.
