Dr. Varsha Manohar

Pediatrician and Pediatric Neurologist, Brains Super Speciality Hospital.

Autism, a term coined by Leo Kanner in 1943, is a neurodevelopmental disorder that affects communication and behaviour. People with autism often have difficulty with social interaction, communication, and repetitive behaviours.

Autism is a spectrum disorder, which means that there is a wide range of symptoms and severity. Some people with autism may have mild symptoms that barely affect their daily lives, while others may have more severe symptoms that make it difficult to function independently.

CLINICAL FEATURES

Some of the common symptoms of autism include difficulty with social interaction, difficulty with communication, repetitive behaviors, sensory sensitivities and restricted interests. Autism can be reliably diagnosed between 2 to 3 years of age if the child has following symptoms

• Poor response to name call by 1 year of age
• No meaningful words by 18 months of age
• Does not play with toys appropriately
• Decreased interaction with peers/friends
• Odd movement patterns and/or very repetitive behaviors
• Hyperactive
• Toe walking

Here is an example that attempts to explain the difficulties faced by a child suffering from Autism:

Imagine that you are in a foreign country where you don't speak the language. You would have difficulty communicating with people, and you might not understand their customs or social cues.

This is similar to what it is like for people with autism. They may have difficulty understanding and responding to social cues, and they may have different ways of communicating. Often they are misunderstood and lead to bullying or being ridiculed.

WHAT IS THE CAUSE OF AUTISM?

There is no one cause of autism, but it is thought to be caused by a combination of genetic and environmental factors. Risk factors for autism include

• A sibling with autism
• Older parents
• Certain genetic conditions, such as Down, fragile X, and Rett syndromes
• Very low birth weight

HOW IS AUTISM DIAGNOSED?

Autism is diagnosed based on a child's behavior and development by a trained doctor who usually relies on DSM V or ICD 11 diagnostic criteria. There is no medical test for autism, however, here are the common investigations performed

• Blood Investigation: Complete blood count and serum lead if we are suspecting exposure to lead.
• Hearing and vision assessments
• Neuroimaging and EEG if there are seizures
• Genetic evaluation to ascertain type of genetic syndromes

Some of the co-occurring conditions with Autism include Intellectual disability, Attention deficit hyperactivity disorder, seizures, obesity, feeding and gastrointestinal problems, anxiety, and temper tantrums.

TREATMENT

There is no cure for autism; however, there are treatments that can help people with autism live full and productive lives. Some of the most common treatments include:

• Applied behavior analysis (ABA) therapy: promotes positive behaviour and discourages negative behaviour.
• Speech therapy: helps in communication
• Occupational therapy: can help in life skills like dressing, eating and relating to people.
• Medication: Methylphenidate and Atomoxetine are used to decrease hyperactivity and increase attention span,Rrisperidone for aggressive behavior, and selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine or sertraline for anxiety and repetitive behaviors. Melatonin may be used for sleep disorders.
• Diet – omega 3 fatty acids, casein-gluten free diet have been tried. The best treatment for autism will vary depending on the individual child's needs. No single therapy has proven to be especially effective. But early treatment can make a big difference in development for a child with autism.