Autism or Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that manifests in early childhood or infancy. The first signs of autism can be diagnosed as early as 12-18 months in certain cases. Autism is a spectrum disorder, meaning, that its symptoms occur in varying degrees of severity in different individuals. No two individuals will have the exact same symptoms. Each person on the spectrum has a distinct set of challenges, strengths and needs. While some may require intense support in their daily lives, others may require very little support, and may be able to live independently. ASD refers to a whole range of conditions characterized by difficulties with social skills, repetitive behaviors, restricted interests, delayed development in language and speech learning, difficulties in performing tasks that require analytical and cognitive skills, impaired communication and social interactions, poor motor skills and lack of sensory sensitivities. It has been found that boys are 4 times more likely to be diagnosed with autism than girl. According to a World Health Organization report, 1 in 68 children across the world have ASD today. At least 70 million individuals worldwide have autism, out of which 10 million are from India itself.
A proper diagnosis of autism can only be done by a trained and experienced doctor/clinician who will carefully observe the individual, interview the parents regarding the development of the child, and then follow international standardized criteria and test to come to a final diagnosis. It is important to note that there are no medical or genetic tests to check for autism in an individual. These can rule out other conditions, but will not be able to provide a definitive diagnosis for autism. Moreover, ASD may occur alongside other disorders, such as ADHD, dyslexia, etc. but it is the autistic traits that require attention.
The signs of autism appear at early childhood and can be visible from 12-18 months. However, since autism is a spectrum disorder, and has varying degrees of symptoms, it may be challenging to identify autism as the root cause.
Assessment of children with suspected ASD should be evaluated within a developmental framework, include multiple informants (eg- parents, teachers, etc.) from different contexts, and must include a multidisciplinary field of professionals, such as- clinical psychologists, neuropsychologists, psychiatrists, etc.
There are several screening tools for diagnosing ASD in toddlers and individuals. The Modified Checklist for Autism In Toddlers, Revised with Follow Up (M-CHAT-R/F) is a set of 20 questions to assess ASD in children that their parents can answer during the screening process. The Autism Diagnostic Observation Schedule is a tool for assessing ASD and other pervasive developmental disorders (PDDs) across all age groups, languages skills and developmental levels.
Children on the autism spectrum start showing certain tell-tale signs from as early as 6 months of age. While it may be possible that these signs are simply due to delayed development or non-ASD related causes, it is best to keep an eye out for them, in case you suspect something. Here are some of the signs that you should look out for-
Between 6-10 months:
Between 12-18 months:
Apart from these signs, it is also important to look for any signs of Regression. Children with ASD sometimes start to develop communication and other skills, and then suddenly stop using language completely. For example, a child may suddenly stop playing social games like waving, peek-a-boo, etc that they had previously enjoyed. Any loss of speech or language skills, social skills and gestures should be taken very seriously by parents, as regression is a massive red flag that might indicate ASD.
Once you have cleared the initial stage of diagnosis and screening, it is time to choose an intervention method that works best for your child. This can be even more daunting than the first step because there is an overload of information that makes no sense. When choosing an intervention for your child, always consult an experienced clinician to help you in the process.
In order to get started, you have to first understand your child’s needs. Go for those interventions that directly address your child’s needs. Do not go for ones that make arbitrary, baseless claims about “curing” your child or “quick improvement methods”. This is a long and difficult journey, and the sooner you can accept that, the easier it is to move forward.
Before choosing any intervention, it is best to see what evidence there is of the intervention’s success and effectiveness. Check if the intervention has been tried and tested before. Go through what the research says- sometimes, certain interventions can help only some specific problems or needs. Look up other researchers who have tried this intervention and come up with similar results.
When choosing an intervention for your child, do your own background reading on it.
Was the research published in a well-established science journal?
Has it been tried before with children who have similar needs?
Were there any other factors that may have influenced the test results?
These are some of the questions that you must ask yourself.
Apart from these, here are some other questions that you should also consider before applying for an intervention-
Autism In India:
It is estimated that about 2-10 million individuals in India belong to the autism spectrum. Due to the lack of research and studies around autism in India, it is difficult to ascertain the actual number, or how many of them are children and how many are adults. It is stated that 1 in 68 children in India belong to the autism spectrum. (Source: The Hans India)
A study published by the US National Center for Biotechnology Information showed that in India, out of the 28,070 children who were part of the study, 43 children from rural, urban and tribal areas (between the age group of 1-10), were found to have ASD. The prevalence of ASD was found to be highest in children from rural areas. The study also showed that male sex had a 28% higher chance of being diagnosed with ASD than female sex. Till date, there is no reason to explain this predilection; although, one possible explanation can be that many parents tend to pay more attention to the developmental abilities of their male child than the females.
A report by the World Economic Forum stated that India currently needs 11,000 psychiatrists and 54,000 mental health professionals, whereas in reality there are only 3,500 psychiatrists and roughly 7,000 people in the mental health workforce, comprising clinical psychiatrists, psychologists, psychiatric social workers, and psychiatric nurses.
Legislations Around Autism In India-
Following is an overview of the rights and laws that protect the rights of individuals having Autism Spectrum Disorder-
Apart from these, the fundamental rights in the Indian Constitution also safeguard the rights and privileges enjoyed by persons belonging to the autism spectrum.