Autism Spectrum Disorder


Introduction:

Even though everyone develops at varied paces, all of us achieve similar developmental milestones at about a similar time. These developmental skills include important abilities like language and communication, socializing, problem-solving and even some physical skills like rolling, crawling, walking and other fine motor skills. If some of these skills do not develop as per the appropriate timeline, depending upon the severity, it can cause varied problems in the child’s life. These are known as neurodevelopmental disorders. If the skills of socialization, language and communication remain un/underdeveloped, it can lead to isolation and multiple behavioural problems. This lack of development came to be known as Autism. Autism is a spectrum of disorders i.e it ranges from varied abilities and severity.


Autism Spectrum Disorder (ASD), is a neurodevelopmental disorder that can cause several problems in the person’s social, behavioural and communication problems. Some individuals with ASD can live and function well but some require moderate to complete support with daily activities.


“My 3-year-old spends most of her time playing with a specific toy. She throws it up and watched it fall. She scratched herself and stares at the redness of her skin as she scratches it. She hasn’t started speaking yet and doesn’t know how to eat on her own. She screams suddenly in the day and continuously shakes her hands and doesn’t even look at me when I call her name”


This experience of a mother is just one case of autism. There is no single representation of the neurodevelopmental disorder. Two major major characteristics of ASD include

1) Impairment in social communication and interaction

2) Repetitive, restricted patterns of behaviour, interest or activities.


Diagnosis of ASD can range from a young Javed who is a 10-year old boy who can’t speak and requires pictures to point out what he wants to communicate and once he gets upset or angry, starts to hit anyone around him which can cause serious injuries. This same diagnosis was given to young Akshat who has an entirely different set of challenges. He is extremely gifted in playing the piano and also very good at Math. But when it comes to conversations, he shuts down. He runs to a quiet place with urgency and gets extremely overwhelmed. He cannot maintain eye contact or start a conversation.


Individuals with ASD have problems with social, behavioural and communication skills. They fail to develop age-appropriate social relations. Difficulties concerning communication can range from inability to maintain a conversation, inability to maintain a conversation and even to a lack of verbal communication. Another characteristic feature is the inability of a child to engage in joint attention. If a child without ASD, sees a toy that he likes, he may look at his mother, smile, look at the toy, again and again, and want to give it to his mother. This shows an interest in the toy and also a desire to share this interest with someone else. But individuals with ASD (especially those who were previously diagnosed with Asperger’s disorder) lack in this area of reciprocation and may appear disinterested and self-focused. Individuals with ASD, depending upon the severity, may even show no or inappropriate expressions or tone of voice which is known as prosody. They may repeat the same things as the others say. So if one says “My name is Ankita, what is your name?” they may repeat some parts of the sentence or the exact same sentence sometimes, even with the same intonation “Ankita, what is your name?”. Another striking characteristic is the restricted, repetitive patterns of behaviour, interests or activities. They may have an obsessive interest in some specific objects like aeroplanes, animals etc. They tend to have a preference for maintaining a status quo and even spend countless time doing the exact same activity and stereotyped behaviour. Such as, waving their hands, spinning around in circles, wringing their hands etc. Some general symptoms may include:

  • Not looking at an object or another person while showing interest in them or when someone is talking to them.

  • Not looking at objects when another person points at them

  • Lack of interest in other people or relating to others

  • Avoiding eye contact and want to be alone

  • Inability to understand the feelings of others or talking about their own feelings

  • Do not respond when their name has been called

  • Repetitive words/phrases or words/phrases said to them, noises or actions

  • have trouble expressing their needs using typical words or motions

  • Not playing “pretend” games

  • Are unable to adapt to change and maintain a status quo and pattern/routine

  • Having unusual reactions to the way things smell, taste, look, feel, or sound

  • Forget skills that they have acquired easily

  • Being unusually sensitive to light, sound but is unaffected by pain or temperature

  • Engage in self-harming activities like headbanging, aggressive scratching

  • Fixation with a particular object or activity

  • Has problems with coordination and movements, clumsiness, walking on toes or stiff body movements

Causes of Autism are on a spectrum, similar to the disorder itself. One of the associations that have been found by research is increasing paternal age at the time of conception. Another important risk could be any trauma during pregnancy. If there is any injury to the mother during pregnancy, any infection or conception of drugs could put the child at an increased risk of ASD. Genes also play an important role in the causality of ASD. Between identical twins, the prevalence of ASD was found to be 77%, suggesting a high genetic root for the disorder. But, a specific gene responsible has not to be identified by research, it could be a combination or even genetic mutation. This explains why there is a spectrum of the disorder. Research is being carried out about any environmental factors that may increase the risk of the disorder.


Currently, no cure has been found for ASD. Early intervention for young children is essential for better treatment and to manage symptoms efficiently using medications, education-based aid and psychotherapy. Special attention is given to psychological problems with communication and socialization. Parents of a child with ASD also require assistance and even psychological help to manage the specific demands and stress that may be caused as a result of being a caregiver to a child with ASD. As autism is a spectrum disorder, multiple individuals show a multitude of strengths and challenges. Hence treatment also tends to be multi-disciplinary. Some individuals with autism may require occupational therapy, speech therapy or some may require aid in communication. There are no specific medicines for ASD but pharmacological treatment can be used to manage specific symptoms such as to reduce hyperactivity, increase attention, manage anxiety etc.


Current statistics of ASD suggest that the prevalence ratio of ASD between males and females is 4.4:1. Approximately 1 in 160 children have ASD, according to WHO. It can also have comorbidity with other intellectual disabilities. Individuals with ASD are often subjected to stigma and discrimination wherein they are treated badly by society, are also deprived of appropriate treatment. They too, have similar health concerns as individuals without ASD. They have specific concerns related to ASD and other comorbid issues. They are more prone to face humiliation by society, even in health care facilities which is mainly due to a lack of knowledge and misconceptions. One such misconception that has been debunked by research is that vaccines cause ASD. The truth is that ASD is a global phenomenon without any barriers of race, ethnicity, socio-economic class etc. It can be extremely difficult to manage the symptoms of those with autism and hence if a parent is concerned that their child may have autism, they must approach either a paediatrician, neuropsychologist, psychiatrist or a neurologist. Early intervention is important in cases of autism.


Scientists have not been able to find a specific cause for autism. Yet, one thing we do understand is that it affects not just the individual but also those around them. Although one does not out-grow the disorder, with timely intervention, treatment can be given to manage specific symptoms and depending upon the severity, even function well. Family members have reported that being patient and persistent with the child has helped them deal with the symptoms better. At times, ignoring some attention-grabbing behaviour could be better to prevent this behaviour from recurring. It is also essential to show your love to the child. Children with ASD knowing that they are loved is also very essential. The disorder does not define them but is a part of them. Hence, regardless of them having ASD, showing affection, love and being respectful to them is always a good choice. As the parents or carers of individuals with ASD, seeking help for yourself is also very important. The symptoms of the child can be very difficult to handle and seeking help for yourself will be beneficial for you and also the child.


Conclusion

ASD is a global phenomenon. It is a neurodevelopmental disorder that affects the socialization, communication and language skills of individuals. It differs in severity and has different symptoms for each individual who’s suffering from it. As a society, we need to educate ourselves about the disorder and grow increasingly compassionate towards those suffering. We need individuals, NGOs to spread awareness about the disorder. Influential platforms like media, popular culture, celebrities need to speak out about the disorders. In India, movies like Barfi, Koi mil Gaya, TV series like Atypical (Netflix), The Good Doctor (NBC) have portrayed characters who suffer from ASD and have successfully made the society aware about some aspects about ASD. We need more depiction of ASD like in these movies. ASD does not mean that individual is incapable of being loved, is bizarre or unworthy. As Sam in Atypical said , "Sometimes to be accepted, you need to stand out."

This article on 'Autism Spectrum Disorder' has been contributed by Smruti Pusalkar, who is a graduate Psychology student from Fergusson College. She is part of the Global Internship Research Program (GIRP), which is under the leadership and guidance of Anil Thomas. GIRP is an Umang Foundation Trust initiative to encourage young adults across our globe to showcase their research skills in psychology and to present it in creative content expression.


Smruti wishes to develop herself to be a more patient listener and a sharp observer to understand the happenings of the world and grow increasingly empathetic. She is passionate about mental health and well being and plans to pursue a career in this field. She is extremely curious about psychology and wants to spread awareness about mental health problems to help those in need.


Anil is an internationally certified NLP Master Practitioner and Gestalt Therapist. He has conducted NLP Training in Mumbai, and across 6 other countries. The NLP practitioner course is conducted twice every year. To get your NLP certification

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