Volume 7 Issue 4 April, 2017
Introduction: Autism is a pervasive developmental disorder characterized by defects in social interaction, verbal and nonverbal communication and repetitive behaviors and interests. In addition they have unusual responses to certain sensory experiences. Many children with autism have mental retardation. This disorder is seen in 3-4 per thousand children and is 4 times more common in males. Autism is commonly diagnosed before 30 months of age. In fact, absence of abnormalities before the first 30 months rules out autistic disorder. The exact cause of this disorder is not known.
Presentation: The commonest presenting complaint in autism is delayed language and social milestones. These include children who do not coo or babble by 1 yr, speak single words by 16m or utter two word phrases by 2 yrs. of age. These children are recognized by parents as being “different” since birth. They have poor eye contact, poor interaction with parents (despite good hearing) and an abnormal preoccupation with certain objects or activities. The child does not use gestures like pointing with their index finger to indicate the thing they need, or involve in pretend play (ex: feeding doll, cooking food using utensils etc.) Some children are apparently normal till 2 years and then become silent, withdrawn, self-abusive and indifferent to social overtures.
Managing a child with autism
Early identification is the key to treat children with autism effectively. Special education is begun as soon as autism is identified and the therapist works along with parents to identify the behaviors to be changed and skills to be taught. During the initial few years emphasis is on speech therapy and occupational therapy. This helps in improving communication and overcome sensory disturbances respectively. Motor coordination and body awareness is improved with special activities (string beads, piece puzzles, paint etc.). Behavior modification is attempted using positive
reinforcement. Children are encouraged to learn social skills like communication with others, making friends, how to behave in social situations, use of public transportation etc. vocational training is also begun from high school onwards. Attempts should be made to incorporate the child into regular classes at least for 1-2 hours a day.
Autism cannot be cured by medications. Drugs are prescribed by a psychiatrist to treat such behavior problems as aggression, self-injurious behaviors and severe temper tantrums. Children with autism may have depression, anxiety, seizures or attention deficit hyperactivity disorder which may warrant medications. One has to remember that autistic children may be very sensitive to medications and may develop serious adverse effects to some. Wholesome diet and regular exercise benefits autistic children.
Dr. Raghavendra, Developmental Paediatrician & Professor, Dept. of Paediatrics, Basaveshwara Medical College & Research Center, Chitrdurga
