Towards a Better Understanding of Autism

Autism is a neurological disorder that hinders cognitive development in children and impairs their social, learning and communication skills. It is a lifelong condition of development that affects how they make sense of the world around them and relate to other people. Autism can manifest in a broad range of symptoms and covers many levels of behavioral disabilities. Hence the condition is formally called Autism Spectrum Disorder (ASD). ASD can range in severity from a single behavioral handicap that somewhat interferes with normal life to a debilitating condition, due to which institutional therapy may become necessary.

Autism is believed to be present from birth. The cause of the condition is not known but experts attribute it to genetics, high levels of testosterone in the womb, environmental pollution and even vaccination. There is no cure for ASD but the disorder can be managed with early therapy and high levels of empathy. Medicines for autism are limited to alleviating the symptoms of the condition like hyperactivity, sensory problems, and anxiety, etc.

Features of Autism

Autistic individuals are impaired in three behaviors:

• Social Interaction: People with autism have low social skills. They make poor eye contact and have difficulty in understanding body language and facial expressions. They also have trouble with day to day relationships and making friends.
• Communication: Autistic individuals have a learning disability, especially language. They struggle to start and keep up conversations. They are also characterized by repetitive speech and a lack of imagination.
• Narrow Range of Interests: Paucity of knowledge limits an autistic person’s range of interests. However, they may develop a deep interest in a particular subject, activity or object. This may be accompanied by repetitive hand or body movements.

Sometimes, autistic individuals are also afflicted with other developmental conditions such as intellectual disability and Attention Deficit/Hyperactivity Disorder (ADHD). This is called co-morbidity and it can be as high as percent.

Boys are four times more likely to be afflicted with autism than girls. Autism has no ethnic, racial, or social preferences; income levels, social status, and the educational environment have no impact on a child’s likelihood of being autistic.

Differences between Intellectual Disability and Autism

• Autistic individuals have varying degrees of intelligence. It can range from low to average and can even be superior to normal people. People with intellectual disability are considered to be mentally retarded, usually with an IQ lower than 75.
• Development of skills and various abilities is at a uniform pace in children suffering from an intellectual disability. However, in autistic children, these developments are uneven with some skills developing faster than other abilities.
• Children with autism have an impaired understanding of social situations and emotions, whereas children with intellectual disability do not have any difficulty with understanding emotions and are socially adept.
• Autistic children may have a severe verbal handicap. They can have trouble communicating and having conversations. Intellectual disability needs to be characterized by these disabilities.

Signs and Symptoms of Autism

Symptoms of autism generally appear during the first three years of a child’s life, though some babies may exhibit them from birth. Some children grow normally in the first year but begin to show signs between 18 and 36 months of age. In some children, the communication disorder may not show any signs until they grow much older, when their capacity cannot cope with the needs of the environment.

Parents, especially mothers, have a predominant role to play in identifying any issued with their child’s normal development. Anything strange about the child should be immediately brought to the notice of pediatrician.

According to the American Centre for Disease Control (CDC), the child may be autistic if it:

• Does not respond to his or her name by 12 months
• Does not show interest in an object by 14 months
• Does not play imaginary games by 18 months
• Does not make eye contact
• Has trouble with understanding or expressing emotions
• Has unduly delayed speech and language development
• Constantly repeats words and phrases
• Gets upset by sudden changes
• Has obsessive interests
• Flaps hands spin or rock its body
• Has an unusual reaction to certain sounds, smells or touch

If a child is presented to a pediatrician for any of the symptoms mentioned, the doctor will generally subject him or her to four types of assessments:

• Assessments to Confirm Autism: Autism can be identified with a number of checks (CARS), the Indian Scale for Assessment of Autism (ISAA) and the Modified Checklist for Autism in Toddlers (M-CHAT).
• Psycho-Educational Evaluation: This consists of a combination of tests to evaluate the skills level of the child and any particular skill the child may have. The most commonly used tool is the Psycho-Educational Profile (PEP).
• Informal Assessments: This is done with the help of tests to evaluate learning disabilities such as dyslexia or reading difficulties. The test can be a basic classroom skills assessment, the Brigance test for learning disabilities or with a checklist for normal development.
• Psychological Evaluation: Psychological evaluation involves tests for Intelligence Quotient (IQ). These are Binet-Kamat Test of Intelligence, Bhatia’s performance tests of intelligence or the Seguin Form Board test.

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