Many parents who first hear the words “Your child has autism” are shocked and dismayed. While we have all heard about autism, many of us have only vague ideas of what the diagnosis means and what can be done to help children so that they can lead a life as normal as possible.
AUTISM
If you go to the literal meaning of autism it is remaining in once own world. In 1943 Leo Kanner first described 11 cases of what he termed “autistic disorder”. Later on in1978 a landmark in classification occurred in when Michael Rutter proposed a definition of autism based on.
- Social delay and deviance that were not just a function of mental retardation;
- Communication problems, again, not just a function of associated mental retardation;
- Unusual behaviours such as stereotyped movements and mannerisms; and
- Onset before age 30 months
The truth is that autism, being a spectrum disorder, affects different people in different ways and no two autistic children are exactly alike. There are also many different theories about what causes autism and what can be done to treat it. In 70% of cases autism is associated with mental retardation.
The onset of Autism is within 3 years of life. But we can notice few signs and symptoms quite early in childhood. If we study the social mile stones of an infant or beyond infancy we know that child start giving social smile and recognises mother within 1-3 months. child follows objects and person up to 4 months, responds to his name at around 8-10 months. If we study the speech development, babbling starts within 4 to 7 months, monosyllabic starts at 6 to 9 months, disyllables at 9 months, speaks meaningful speech at around 15 to 17 months and speaks full sentence at around 2 or maximum 2 ½ yrs. His language comprehension starts at the same time of meaningful speech. Within 2 yrs he understands simple instruction, understands denials, etc.
All these milestones are delayed significantly or poorly developed in an autistic child. We see that
Social reciprocation is impaired – EARLY SIGNS
- Child looks at one object constantly
- Child does not give an eye contact on calling
- Child does not respond to his name
- Child does not give a social smile
- Child does not recognise family member
- Child is busy in his own world
Later on we can notice
- Poor eye contact
- Failure to develop peer relationships
- Difficulty with social reciprocation, responding to emotional stimuli expressing joy or pain, sharing experiences, pain or joy, appears be in their own world • Poor language comprehension and hence does not follow commands
Speech and communication
At the level of speech we find delayed development of speech or deficient for that age. Like only monosyllables or disyllables, cannot join words or cannot speak sentences.
Qualitatively it can be irrelevant, nonsense, talking to self, talking in foreign language etc.
Echolalia-child repeats the things or repeats the question before answering.
Communication needs interaction with environment as well as speech. As there is problem at the level of speech as well as social skills, this communication is deficient or impaired in autism. There is no response or poor response to name, following commands, answering question, initiating conversation, asking questions, emotional reciprocation etc.
Obsession and rigidity
One thing which is observed is the rigidity of thinking and behaviour and hence we see
- Resistance to change in routine
- Child has obsession about material things
- Presence of stereotype, repetitive activities or interests
- Along with this children have many problems at the level of sensory integration, fine motor coordination and behaviour
Different obsessions can be
Colour, clothes, place, diet, time, sequence obsession, objects like boxes, cards, cars, toys, water, pins, mobile, advertisement sachets, bottles, languages etc. Obsession can also be about sensory gratification like need for pressure, bathing, mouthing, music, smelling everything, etc.
Repetitive behaviour and motor mannerism can be- Putting things in mouth, touching things, touching genitals, touching nose, screaming shrieking, laughing, making noise, playing with urine and stool, playing with hairs, clothes, thread, facial grimaces, frowning, rocking, running, jumping, climbing, stamping, kicking, throwing, striking etc.
These behaviours can be destructive like Destroying clothes, tearing, cutting, pinching, scratching, kicking, throwing, beating, head banging, etc.
Impaired sensory integration
We see impaired sensory integration in these children- like hypo or hypersensitivity to pain noise, smell, taste, colour, light, gravitational fear, etc.
Thus in a nut shell the symptomatology can be grouped as Abnormal or impaired development in
- Social interaction, reciprocation and skill,
- Speech and communication
- Presence of stereotype behaviour, purposeless monotonous hyperactivity, and interest,
- Rigidity of behaviour,
- Impaired sensory integration.
- Onset before three years of age.
- Males are more affected than female.
- In 70% cases, autism is associated with mental retardation
Diagnosis
Diagnosis is usually based on careful observation as well as information provided by parents and other caregivers on the child’s behaviour, communication, social interaction and developmental levels.
There are also a number of psychological screening tests or questionnaires which can be performed, including the CARS rating (Childhood Autism Rating Scale) and CHAT (Checklist for Autism in Toddlers), ATEC(autism treatment evaluation checklist).From these tests we can know the degree of autism like mild, moderate or severe.
Other investigations which have to be done are audiogram or BERA, EEG, serum serotonin and genetic karyotyping to know any pathology at the level of brain or familial tendency.
What causes autism?
It is known that autism is a neuro developmental disorder and that there may be differences in the shape and the structure of the brain of autistic children as opposed to non-autistic children.
There has been lot of research going on in this area, it is said that there might be a genetic predisposition to autism, which may run in families but there are several ‘triggers’ which can precipitate the disorder. They can be problems in pregnancy (like any infections or medical diseases in mother, treatment taken for these disorders, mechanical trauma or emotional trauma), and birth (prolonged labour, O2 deficiency, delayed cry), viral infections, treatment taken, mechanical trauma or emotional factors which may affect the child (fear fright separation) exposure to certain environmental chemicals or pollutants, vaccines, etc.
Holistic Treatment for Autism
Other investigations which have to be done are audiogram or BERA, EEG, serum serotonin and genetic karyotyping to know any pathology at the level of brain or familial tendency.
Research studies have shown that homeopathic medicines can reverse the course of autism. They help to reduce hyperactivity, modify behaviour; correct sensory perception reduces rigidity, helps in speech development, social skill and communication.
Along with that child needs occupational therapy, sensory integration, speech therapy and special education for faster results. All these therapies need Perseverance over a long period of time.
Prognosis of an autistic child will depend upon the degree of autism, degree of associated MR and how early the intervention is started including homoeopathy.
