UNDERSTANDING AUTISM SPECTRUM DISORDER: HELPING GUIDE FOR PARENTS

Autism, a complex neurodevelopmental disorder, is characterized by challenges in social interaction, communication, and repetitive behaviors. Its spectrum ranges from mild to severe, impacting each individual differently. Despite its prevalence, autism remains widely misunderstood, leading to pervasive unawareness and misconceptions. Many people lack awareness of the diverse range of characteristics and challenges associated with autism spectrum disorder (ASD). This ignorance can lead to stigmatization, discrimination, and barriers to access essential support and services for individuals with autism. Furthermore, societal misconceptions often perpetuate stereotypes, hindering acceptance and inclusion. Increased education and advocacy efforts are vital to raising awareness, fostering understanding, and promoting acceptance of individuals with autism within communities worldwide.

Early diagnosis and intervention can significantly improve outcomes, helping individuals with autism thrive and reach their full potential. Supportive therapies, such as behavioral interventions and educational programs, aim to address core symptoms and enhance social skills. Increased awareness and acceptance are crucial for fostering understanding and inclusion within society for individuals living with autism. We spoke to Dr Natasha Tipnis, Consultant, Neurologist & Epilepsy Specialist- Jaslok Hospital & Research Centre, Mumbai about autism spectrum disorder, what causes it and relevant guidelines for parents.

What is Autism Spectrum Disorder (ASD)?Autism Spectrum disorder (ASD) is a neurological and developmental disorder that affects how people interact with others, communicate, learn and behave. Autism is more common in boys than girls.

How is ASD diagnosed?i) ASD is diagnosed using the DSM-V criteria in which require symptoms in both categories: (a) Social communication deficits (all 3 required) (b) Restricted interests or repetitive behaviour ( 2/4 required )

What causes ASD?Despite continuous ongoing research, we are still unsure about what causes ASD. Vaccines DO NOT cause ASD.

Here are some risk factors associated with ASD :

• Older maternal/ paternal age at birth
• Mother being on antiseizure medications esp. sodium valprotate
• IUGR( Intrauterine growth retardation) and low birth weight
• Certain chromosomal or structural brain abnormalities
• Difficult labour or birth

What is the earliest age at which ASD can be diagnosed?ASD can be diagnosed as early as 6 months of age. But it is important to note that children may often go undiagnosed until they attend school.

What are the signs of ASD that I can recognize in my child as a parent?a. For children <2 years of age:

• Lack of social smile
• No response when child’s name is called out
• No eye contact when you talk to the child
• Use of index finger to point item of interest instead of naming it
• Child not taking any interest in games
• Child not imitating gestures or actions done by others
• Child doing stereotypical actions – rocking, spinning, finger movements

• Not interested in interacting at home/ school
• Not maintaining eye contact when having a conversation
• Doing stereotypical actions
• Having abnormal interests for age ( for eg. A 5 year old being interested in geology and metallurgy)
• Having an unusual attatchment to objects
• Having sensory issues eg. Not wanting to wear certain material, unable to tolerate tags of clothing
• Insistence on routine eg. Taking the same road to school, having particular breakfast daily and the inability to adjust to anything other than routine

Do all children with ASD have intellectual disabilities?Upto 75 % of children with ASD have some level of intellectual disability. However, patients with ASD and high IQ also exist( they were earlier referred to as Asperger’s syndrome)

Is it possible for a child with ASD to have any other neurological condition/illness?Upto 20-30% of children with ASD have epilepsy. Others have movement disorders- chorea, athetosis, vocal stereotypies. Some even engage in self- injuring behaviour.

What are the treatment options available ?The mainstay of treatment for ASD is therapy for both the child and the parent.

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Do we have any pharmacological treatment available?

2 medications approved by FDA for ASD are risperidone and aripiprazole, both atypical antipsychotics. SSRI ( Selective serotonin reuptake inhibitors ) are used to treat symptoms of OCD, anxiety, irritability.

If I have a child with ASD, does this mean all my other children are at risk?Having one child with ASD, increases the risk of ASD in the next child to 20% and if the first 2 children are diagnosed with ASD, there is a 32% risk for the next child. Boys are 4 times more likely than girls to be diagnosed with ASD.

Can children with ASD go to a regular school?Most children with ASD need to go to a special school where teaching methods can be altered to suit their special requirements.