Autism Spectrum Disorder (ASD) Treatment in Delhi, India

Autism is a condition in which a person's brain development is impaired. The affected part is responsible for socialising with people and their surroundings and how a person perceives their environment. This leads to issues with interaction and communication. Autistic people tend to show a limited and repetitive type of behaviour. This condition is also known as an autism spectrum disorder, in which spectrum refers to the diversity and severity of symptoms presented by patients.

Autism spectrum disorder is a group of conditions formerly known to be separate. These conditions include autism, Asperger's syndrome, an unspecified form of pervasive development disorder, and disintegrative disorder.

This disorder begins in early childhood and causes problems related to interacting with people, especially in school, work, or elsewhere. Symptoms of autism are often evident in the very first year of life. Some children may develop the disease in early childhood, but the symptoms regress between 18 and 24 months of age when symptoms develop.

Even though autism cannot be cured, early diagnosis and treatment help make a big difference in the lives of autistic children.

Types of Autism

The types of autism were initially thought to be separate conditions, but now, they are known as autism spectrum disorders. These conditions include:

• Asperger's syndrome: Children with this syndrome find it difficult to socialise and have a narrow scope of interests. However, they do not have an issue with language and are often average or above intelligent.
• Autistic disorder: This condition refers to issues with communication, social interaction and play in children younger than three years of age. This is a common term used for people with autism.
• Childhood disintegrative disorder: Children with this disorder have a typical normal development for at least two years of age, and then they begin to lose their social and communication skills.
• Pervasive developmental disorder (PDD or atypical autism): When children display behaviours of delayed communication and social skills but are not apt to fit into other categories, they are considered to have a pervasive developmental disorder.

Symptoms of Autism

Symptoms of autism typically appear before the age of 3. However, some children may develop symptoms from birth. Some common signs and symptoms are:

• Lack of eye contact.
• A narrow range of interests or having an intense interest in specific fields.
• Repetitive actions, speech, or movements, such as doing something repeatedly. For example, repeating words or phrases or rocking back and forth.
• Increased sensitivity to touch, smell, sounds, or sights that are ordinary for others. Talking in a sing-song, flat, or robotic voice.
• Trouble adapting to changes in routine.
• Not looking at or listening to others.
• Avoiding interaction.
• Not wanting to be touched or cuddled.
• Difficulty comprehending or using gestures, speech, facial expressions, or tone of voice.
• Some children may have seizures, while others may not start until adolescence.

Causes of Autism

Autism spectrum disorder has no specific cause. Since the disorder is too complex and differs in symptoms and severity, it may occur due to numerous causes. Most importantly, genetics and environment may both be involved.

Genetics

Autism spectrum disorder may occur due to multiple genetic disorders. In some children, it may occur due to Rett syndrome or fragile X syndrome. While for others, genetic mutations may be responsible. Many other genes may affect the development of the brain and disrupt the communication among brain cells or determine the severity of clinical symptoms. Genetic mutations may occur spontaneously or may be hereditary.

Environmental factors

Factors such as viral infections, complications during pregnancy, medications, or air pollutants may trigger the development of autism spectrum disorder.

Link Between vaccines and an autism spectrum disorder

This statement is highly controversial. Despite extensive research, There is no clear link between vaccines and an autism spectrum disorder. Avoiding childhood vaccinations can threaten the child's life and put them in danger of acquiring severe diseases such as measles, mumps, diphtheria, tetanus, and others. Thus, complete vaccination is advised.

Risk Factors of Autism

It is poorly understood why the cases of autism are rising day by day. It is unclear whether it is because of early diagnosis, a real surge in the cases, or both. This disorder affects individuals of all races and nationalities. However, certain risk factors are associated with the development of the disease. These include:

• Child's gender: Boys are more likely to develop autism than girls.
• Family history: Families with one child of autism carry an increased risk of having more such cases in the house. If parents are autistic, the children, too, may have issues with social interaction or communicating with others.
• Other disorders: Children with certain medical disorders are at higher risk of developing autism spectrum disorder or autistic symptoms. For instance, fragile X syndrome, a hereditary disorder that causes intellectual disabilities; tuberous sclerosis, a condition in which benign tumours form in the brain; and Rett syndrome, which causes delayed head growth, intellectual disabilities and loss of dominant hand function.
• Preterm babies: Babies born before 26 weeks of gestation are at a higher risk of developing autism spectrum disorder.
• Parents' ages: It is suspected that there may be a connection between autism and children born to older parents. However, this requires more evidence.

Diagnosis of Autism

Autism spectrum disorder is often diagnosed at regular visits to the doctor or when parents notice strange behaviour in their children. A referral to a specialist is provided if the doctor finds any positive signs of this disorder. The specialists include psychologists, child psychiatrists, paediatric neurologists or developmental paediatricians for an evaluation.

This disorder has a wide variety of symptoms that differ in severity. It is thus difficult to diagnose it. In general, no specific medical test will help diagnose autism. Instead, a thorough medical history, observation of the child's behaviour during social interactions, communication skills, and usual behaviour will help diagnose the disease.

For diagnosis, children can be given tests covering speech, hearing, developmental level, language, and social and behavioural issues. Structured social and communication interactions can be presented to the child and scored to determine the severity of their symptoms.

Treatment for Autism

The autism spectrum is not treated by medication. Teamwork by a Pediatrician, Occupational therapist and speech therapist can resolve autistic behaviour. The goal of treating autism is to support the child with communication, social interaction and dealing with their surroundings. In addition, it is essential to maximise the child's ability to function in the fast-growing world.

Understanding the child's symptoms and curating the treatment plan accordingly is necessary. Thus, the guardians must understand the child's strengths and weaknesses and work with them as needed. Early intervention, especially during preschool, helps them strengthen their critical social, communication, functional and behavioural skills.

Autistic children have special schools if home-based education seems overwhelming. However, their needs change from time to time. Some common intervention options are:

• Behaviour and communication therapies: Many programs help autistic children address their social, language and behavioural difficulties. Some programs also focus on diminishing problem behaviours and teaching new skills. Other programs help children learn how to behave in social situations or communicate better.
• Educational therapies: Autistic children respond well to highly structured educational programs tailored by a team of specialists. These programs include a variety of activities that help improve social skills, behaviour and communication.
• Family therapies: Parents and other family members must learn to live and interact with their autistic children.
• Other therapies: Depending on the child's needs, different therapies that can help include:
• Speech therapy to improve communication skills.
• Physical therapy to improve movement and balance.
• Occupational therapy to teach daily living activities.
• Psychology counselling to address problem behaviour.
• Medications: No medications can improve the core signs of autism spectrum disorder. However, some medications can help improve the intensity of symptoms, such as medicines for hyperactive children, antipsychotic drugs to treat severe behavioural problems, and antidepressants to control anxiety.

Complications of Autism

Autistic children often find it difficult to interact with others. Some complications that they may face include:

• Problems in school and with successful learning.
• Stress within the family.
• Employment problems.
• Inability to live independently.
• Social isolation.
• Victimisation and being bullied.

Prevention of Autism

There is no specific method to prevent autism spectrum disorder, but treatment options prevail. The essential options are early diagnosis and intervention. In addition, working on the child's behaviour and communication skills, such as language and skills, also helps. Children, however, never outgrow autism. Instead, they simply learn to survive and adapt to their surroundings.

Review

Reviewed by Dr. P. S. Narang, Director, Paediatrics (Ped).