Being a parent is a blessing which comes with its own set of worries and queries. At every stage of our baby’s life we are wondering,
Is she growing well?
Is he eating enough?
Am I doing everything right for my baby?
Is his speech and development normal?
Why is she not interacting yet?
We get answers to most of these questions on your routine visits to doctor, ryt?
However, in today’s world, its very common to get caught up in the daily life. And then suddenly one fine day we find that something is amiss. We head to google and find all the possible diagnoses. We start worrying about the worst ones….
This is a common scenario with “childhood autism”. Firstly because, cases of autism are on the rise world over. Secondly, our elders have not seen much of this disorder. Hence, they are not able to guide us from their experience.
Childhood autism is a developmental disorder leading to problems with social interaction, communication and behavior. These issues if detected early can improve with early intervention.
Currently, 1 in 100 children in India has autism. This doesn’t mean that all these children can not speak, cuddle and interact with the society. Autism is not just one symptom. Rather, it is a spectrum – its symptoms vary from child to child. That is why, the term used is “Autistic spectrum disorder”. Just as the rainbow has multiple colors, this disorder has multiple sets of signs and symptoms occurring variably and with variable severity in different children.
Autistic spectrum varies from simply avoiding “eye contact” to severe forms with “no communication” and “repetitive, aggressive behaviors”.
Read on to get explanation to top ten queries that lead parents to think and search about childhood autism:
- What are the symptoms of childhood autism?
We hear this word “autism” so often but exact info about this disorder looks like a medical jargon. Lets simplify it today.
Three main symptoms of autism are:
a. Poor social skills
b. Poor communication
3. Repetitive behaviors
Now, let’s get to these signs and symptoms of autism spectrum one by one.
a. Poor social skills: These kids have difficulty interacting with others. They seem to be “busy in their own world.”
As parents come back home after an entire day’s work, child seems to be unaffected by their arrival. He will keep busy with whatever he is doing. He doesn’t show any happiness when you cuddle up to him or plant a kiss on his cheek. The child almost never asks to be picked up in the lap. He might not even look at you (poor eye contact) as you are talking to him.
This raises the question “Do autistic kids feel love at all?”
They do feel love but they don’t know how to show it.
b. Poor Communication: Autism babies have poor verbal as well as non-verbal communication.
Many autistic children might not talk at all. Some learn this skill later than babies of their age. Even if they speak, they tend to have a flat robotic voice. They cant point to objects and do not seem to understand gestures.
They have difficulty in using pronouns like “I”, “you”.
An important feature of their speech is “echolalia”. They will keep on repeating a word or a phrase while being busy with themselves.
c. Repetitive behaviors: An autistic child usually has some “fixed”, “atypical” or “unusual” patterns of behavior, like head banging, flapping or ringing of hands, jumping, rocking etc. They keep on repeating these behaviors anywhere and everywhere.
They tend to have fixation on certain rituals and get insanely angry if they are disturbed. For example, if an autistic child is playing by banging a car and you try to stop him – he will get extremely frustrated or will have a meltdown.
They get upset if there is even a slightest change in their daily routine. It might be a small thing like their seat on the dining table or the color of their bathing soap.
These kids might have have extreme sensitivity to bright light or loud sound.
They tend to look “fussy”, “clumsy”, “impulsive” or “hyperactive”.
2. What causes autism?
Exact cause of autism is not known. However, there is a definite role of both genetic and environmental factors.
Some of the factors which increase the “risk of autism” in a baby are,
- Presence of autism in an immediate family member. So if you ask “does autism run in families?” – the answer is yes. But exact pattern of inheritance is not known. Thus, at present we don’t know for sure “whether autism comes from mother or father”. Some genetic studies linked it to mother’s DNA while a few latest ones have found changes in father’s DNA affecting the child.
- If the baby was born premature or had a low birth weight
- Certain genetic conditions like Fragile X Syndrome
- Exposure to certain drugs during fetal life. This means that if a mother is taking certain medicines like valproic acid (a type of anti epileptic/anti-seizure medicine) during pregnancy, there are higher chances of developing autism in the baby later on. Hence, it is advised that expecting mothers should discuss their medication with the obstetrician or their treating doctor.
3. My three year old is not yet speaking. Is he autistic?
Speech delay is an important sign of autism. And, this is usually the first issue which draws attention to this condition.
Today, most of the households have nuclear families with working parents. Child usually stays back in creche or at home with a maid. As a result, he is exposed to multiple languages, he gets confused and his speech is delayed.
Good news is that these kids have good “non-verbal communication”. They can indicate all their needs by pointing. They wait eagerly for their parents and hug you tight as soon as you are back from work. And hence, they just have speech delay…….not autism!!
Also, if a child has hearing impairment, she might not learn to speak unless she gets a hearing aid.
Click here to know in detail about isolated speech delay in kids.
4. How to diagnose autism:
There is no blood test or brain scan to diagnose childhood autism. It is basically diagnosed by a child psychiatrist , pediatrician or a development specialist based on the kid’s speech, communication and behavior.
Usually, your pediatrician evaluates your child for development every time you visit the clinic for vaccination. Questions like “does she smile”, “does he say mama, dada”, is he walking yet, does she point towards objects of her interest , etc. are meant to have a rough estimate of your baby’s development.
Click here to know about important milestones in first year of life.
If the doctor has a doubt about a baby’s development, he will refer her to a developmental pediatrician. There, the child will have a detailed developmental screening. Parents have to answer a questionnaire regarding the child’s routine behavior. For older children (mild cases might be diagnosed later), even school teachers may be asked to fill a questionnaire.
Based on the parents’ and teachers’ responses and child’s assessment, diagnosis of autism is made. There are strict criteria for labelling a child as having ASD or Autistic Spectrum Disorder.
Sometimes, doctor will recommend a hearing test before referring you for a detailed developmental evaluation.
5. What are the early signs of autism:
Although childhood autism has to be diagnosed by a specialist doctor, here are a few early signs in first two years of life which might point towards this disorder.
a. Poor eye contact
b. Not pointing to objects
c. No or little facial expressions
d. Not saying even one word by 15-18months of age
e. Loss of previously acquired language milestones by 2years of age
f. No response to parental affection
g. No response when his name is called out, even at one year of age. But otherwise, child might appear hypersensitive to even slightest noise.
h. Mixing up pronouns like referring to self as “you”
i. Playing with parts of a toy rather than toy as a whole.
j. A strict fixation with routines
k No role play like pretending to be dad/mum
l No interest in playing with other kids
6. Milder forms of autism:
Earlier, milder cases of autism were labelled as “Asperger syndrome”. But now they are categorized as ASD only. These people have problems with social interaction and some unusual behaviors. However, their language and intellectual capabilities are normal.
These children are usually diagnosed in their school years or teenage.
If you remember the lead character in Shahrukh Khan movie “My name is Khan”, he was suffering from Asperger syndrome.
7. Vaccines and childhood autism:
In the past there was a lot of hue and cry about certain vaccines causing autism. Particularly, MMR (MEASLES, MUMPS, RUBELLA) vaccine was said to be the culprit. A chemical called thiomersal , which was being used as a preservative in vaccines was being blamed for this condition.
However, studies conducted in nine different countries found these claims to be baseless. There is no association between any vaccination and occurrence of childhood autism. Vaccines are essential to protect children from infections and there is no role, whatsoever in causation of ASD.
So far as thiomersal is concerned, almost all the vaccines now are thiomersal free. Moreover, CDC(center for disease control) has found no change in incidence of autism after eliminating this chemical from vaccines.
8. Treatment for autism:
There is no cure for autism. Neither do any medicines treat this condition.
These children need support of a developmental pediatrician, child psychologist and a speech therapist who work as a team with parents to make them productive members of the society. They are best managed in “child development clinics” where all these services are available under one roof.
9. Managing an autistic child:
It takes a lot of support to manage autistic children and integrate them into mainstream schooling. Many cities now allow mildly autistic children to be enrolled with regular schools. A child psychologist is usually available to provide additional support to the child.
Severely affected children might need to attend special schools for autistic children in the beginning, wherein their talents are nurtured.
Many organisations provide rehabilitation for severely autistic children helping them become self dependent.
Following are a few strategies that might help parents in managing these kids at home
a. Efficient time management: These children sometimes don’t know “how much time it takes to finish a task”. You can use timers and give them targets to finish small tasks within a stipulated time.
b. Offer rewards: Children should be rewarded for positive behaviors. Let them know that you love them and are proud of their good behavior.
c. Choice time: They should be allowed some control over minor situations like choosing a game or a toy, preferring a food item over other. Try to narrow the choices as much as possible. For instance, “would you like to have an apple or a guava?” “Shall we play with car or truck?”
d. Managing autism meltdowns: Autistic children get overwhelmed in crowded areas. Asking them to behave properly wont help. Instead, enact good behavior. And, reward them for copying you. If this is not helping, take him to a quiet corner to pacify him. You can take their favorite toy along so that they have something familiar to cling on to. This helps to calm them.
10. What are autistic children good at:
Childhood autism comes with many hurdles and challenges in learning. But these kids may have their own set of strengths like
- Music and art. The famous poet “Emily Dickinson”, movie director “Tim Burton”, singer “Susan Boyle” have all aced their autism spectrum symptoms and emerged as legends.
- Some of them excel in mathematics or science. Albert Einstein had autism. If he could overcome in those days, why not now?
- They tend to learn better from visual and auditory resources hence, videos and audiobooks are a good choice for them.
- Few of them might learn things in greater details and remember them for a longer period of time.
Dear friends, childhood autism is difficult to manage but with right guidance these children can reach their full potential. Early recognition of this condition is the key to right management. Let these stars shine too!
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