The earlier the therapy starts, the better the result

Autism Spectrum Disorders are a group of neuro-developmental disorders in which children have concerns in the area of communication and social behaviour. The exact cause of Autism is unknown. There are more myths than facts, like the misconception that it has to do with the parent's behavior or vaccination. This is not true at all.

To diagnose it, firstly we need to look at the symptoms such as: delay in non-verbal communication such as difficulties in making eye contact and expressing with gestures; repetitive behaviors like hand-flapping and body rocking; delayed speech or jargon speech (words which have no meaning); lack of appropriate body language, pretend play (like Peek-a-Boo etc); and others. The physical and motor milestones may be spot on but the communication, language and social milestones may be either delayed or deviant. In case of these concerns, parents need to seek the help of a Developmental Pediatrician to help diagnose Autism.

Unfortunately, the average age of diagnosis in India is around four to five years. In India, there are so many myths about a child speaking late- for instance, grandparents would say that the father spoke late so the child will also speak late, which is largely the reason for late diagnosis. Unfortunately, parents who know little about Autism focus only on delayed speech. Autism is not merely a speech problem. Speech is affected in a child with Autism because the child doesn't know how to communicate. Communication is both non-verbal (which develops first, before one year of age) and verbal (which develops after one year of age only after the development of non-verbal communication). Normally, a one year old child has to speak at least one meaningful word. A lot of children with autism have early words but they are not meaningful.

Intervention should begin as early as possible. Research has shown that intervention which starts before two or three years of life yields maximum benefit because these are the years of language development of the brain. Hence, the earlier the therapy starts, the better the result.

Also, it has to be multi-disciplinary therapy. You require a team of experts like a development paediatrician who makes the diagnosis, a clinical psychologist who runs the tests, an occupational therapist who focuses on behaviour, and a speech and language therapist who works on speech and language, a remedial educator for academic development and counselling for parents and families.

It is essential to have a documented plan for therapy. This is called Individual Therapy Plan (ITP) and is the basis of the intervention programme. Parents need to follow this program at home, too, for two to three hours daily.
Every child has to be looked at as an individual and evaluated for his strengths and needs.

A child with Autism can lead a ‘functional life’. The focus of intervention is to enable a child to live a life with dignity and function as independently as possible. Today, we do not have facilities which are friendly towards children with special needs; neither in society nor schools. Society on the whole has to move towards getting friendly towards individuals who are differently-abled. This is a social issue and the question is what you and I can do as individuals to enable a child within our community who has Autism.

Optimism, acceptance and inclusion are the key skills to make us all live and work collaboratively with every individual in society despite his or her differences, whether Autism or others.

Dr.Waheeda Pagarkar is Pediatrician and Pediatric Audiologist, University College London Hospitals, London.