Autism and Autism Spectrum Disorder (ASD) are general terms for a group of complex disorders of brain development. Autism can be described as a neuro-developmental disorder that is characterised by difficulties in social interaction, verbal and non-verbal communication, and repetitive behaviour.
ASD can be associated with intellectual disability, motor coordination difficulties, attention deficit, and health problems such as sleeping problems, epilepsy, and gastrointestinal disturbances.
Autism affects each individual differently and at varying degrees—this shows the importance of early diagnosis. Although autism is characterised by a set of behaviours, children and adults with this developmental disorder can exhibit any combination of these behaviours in any degree of severity.
The most obvious signs and symptoms of autism tend to emerge between 12 and 18 months of age. The onset of autism—mostly characterised by delayed communication and repetitive behaviour—becomes apparent within three years of age, or even later.
Parents can detect autistic tendencies in their children by observing their behaviour. Autistic children, in general, do not talk like other children or listen to the the words spoken to them.
In autism, behaviour problems range from very severe to mild. Severe behaviour problems take the form of highly unusual, aggressive, and in some cases, even self-injurious behaviour. These behaviors may persist and are difficult to change.
In its milder form, autism is a learning disability as the affected persons are usually handicapped by deficits in the areas of communication.
The exact cause of autism is not known. Some combinations of genetic, biological, and environmental factors are believed to cause autism. Scientists are working on several genes which are believed to be responsible for the development of such disorders. They are also exploring some regions of the brain that have been linked to the disorders.
In the presence of a predisposition to autism, a number of non-genetic, environmental influences are also deemed to be responsible. Maternal health—both physical and mental—has been identified as an important determinant of autism in children. However, it must be mentioned that these factors, on their own, do not cause autism. They, in combination with genetic risk factors, only appear to modestly increase the risk of autism.
About one in 88 children has been identified with an Autism Specturm Disorder (ASD). The number of reported cases of autism increased dramatically during the last two decades. This increase can largely be attributed to changes in diagnostic practices, referral patterns, availability of services, and general awareness over the time.
 Although we do not have medical tests to detect autism, specialists usually conduct autism-specific behavioral evaluations. Also, no antenatal tests are available to detect autism.
From birth to at least 36 months of age, every child should be routinely screened for developmental milestones.
If there is any concern about a child’s developmental process, physicians ought to refer to the child to a specialist for developmental evaluation and early intervention.
A typical diagnostic evaluation may involve a multi-disciplinary team of doctors. Genetic testing may be recommended, as well as screening for related medical issues such as sleeping difficulties. Sometimes autism is diagnosed later in life. As with young children, diagnosis of adolescents and adults involves personal observation as well as experts’ evaluation.
Each autism intervention plan should be tailored to address specific needs, as each child or adult with autism is unique. The management of autism may include behaviour-modification treatments, medicines, or both. Many persons with autism have additional medical conditions. Addressing such conditions may improve attention, learning, and related communication.
However, there are no medicines to treat the core symptoms of autism. Medicines are given only for target behaviours, such as hyper-activity and self-injury, among others.
Early intensive behavioral intervention requires that the family of an autistic child should work with a team of professionals. Parent training, or parents leading therapy sessions under the supervision of a therapist at home are an option. Other programmes deliver therapy in specialised centres or classrooms.
Different intervention techniques and support programmes are needed as a child develops and acquires social and learning skills. As children with autism get admitted to school, they may benefit from particular social skill trainings and specialised approach to teaching. Adolescents with autism may also derive benefit from transition services promoting a successful maturation to adulthood.
Several studies have demonstrated that early intensive behavioral intervention improves learning, communication, and social skills in young children with autism. However, the outcomes of early intervention vary from one child to another. Although early intervention models vary in details, most of them share some common features.
Young children with autism usually receive structured therapeutic activities for at least 25 hours a week. The therapy is usually guided by specific and well-defined learning objectives, and a child’s progress in meeting these targets is evaluated and documented on a regular basis.
Significant improvement in autism symptoms is most often reported in connection with intensive early intervention. However, at present, we cannot identify the children who will be showing such responses to therapy.
Autism may occur in conjunction with mental retardation. Intellectual disability with autism has been found among 65 per cent to 75 per cent of autistic children; in fact, the figure varies from time to time. Individuals with only mental retardation show relatively even skill development, while persons afflicted with autism typically display uneven skill development with deficits in certain areas.
Many children with autism grow up to live independent and fulfilling lives. They deserve the opportunity to work productively, develop meaningful relationships, and enjoy life.
A change in social attitude towards autistic kids is of paramount importance. They need our empathy, more than our sympathy. Also, greater awareness and understanding of this developmental disorder is needed. With proper interventions and behavior modification programmers, those afflicted with autism may have better outcomes in all spheres of life.