Autism: We are all unique

Sameer (name changed) is six years old. He often makes a high-pitched screeching noise, prefers to sit away from the other children and spends much of the day with his hands over his ears and is un-responsive to teacher's instructions. Ruhi (name changed) is also six years old. Unlike Sameer, who does not use speech, Ruhi is very vocal. She likes 'talking to' the teachers about Hindi songs and does well in studies, however she cannot make friends and is often bullied at school. Chandan (name changed), is a manager in a bank. He is well dressed and slightly old fashioned and rigid in his ways. He is married with two sons. His wife sees him as eccentric but a good man, a good father, and a good provider.

Sameer, Ruhi and Chandan are all very different and they all have autism or Autism Spectrum Dis-order (ASD). Autism affects people in strikingly different ways despite the similarities in the core impairments. However, in each individual who has autism, the symptoms of autism vary, in severity and expression. It is estimated that 1 in every 44 (2.3%) 8-year-old children have ASD (2018). Aut-ism is a complex neurodevelopmental disorder which is characterized by deficits in social interac-tion and communication, with unusual and repeti-tive behaviour.

The exact reason why ASD occurs is unknown but many risk factors have been identified like age of the parents, poor ovulation, infections or exposures to harmful chemicals or radiation during pregnan-cy, thyroid, diabetes, birth injuries and infections in childhood etc.

ASD displays a myriad of symptoms but some of the common symptoms of ASD are limited or lack of speech and in some children speech that was developed before may regress. Many of them don't prefer to mingle with children of their age group. Repetitive action, physical restlessness,inability to understand emotions, mood swings like sudden bouts of excitement, crying without any reason are few symptoms displayed by many autistic children. Aggressive behaviours like self harming, head banging, biting/pushing others, destructiveness are displayed by few. Inability to understand com-mands and maintaining sustained eye contact are some of the common symptoms exhibited by many.

There is no way to prevent autism spectrum dis-order, hence early diagnosis and intervention can improve behaviour skills and language develop-ment. Older children and adolescents can also be evaluated for ASD too. In adults, symptoms can overlap with other mental health disorders. How-ever, intervention at any age is always helpful to manage the symptoms.

There is no 'one-size-fit-all' when it comes to management of ASD. Therapies and interventions are necessary to remedy specific symptoms. The ideal management plan is a combination of thera-pies and interventions that meet the specific needs of the individual. Some of them will include beha-vioral management, speech therapy, educational and school-based therapies, nutritional therapy, sensory integration therapy and occupational ther-apy. Hence it is important for a team of experts to manage all the different areas of intervention and to provide holistic care to the child/ person with ASD.

Dr Nitishna Dutta

Physiotherapist and Occupation Therapist

Consultant, MIND India

Ask Dr Sangeeta Goswami

Question: My child is 8 years old and he has ASD and I am unable to teach him. How can I help him to learn better?

Each child is unique and has his/her own strengths and capabilities. Try to notice what he is good at and encourage the same. Children with ASD need structure and routine to manage their symptoms. Some of the teaching strategies that parents/ caregivers can try are

• Stick to routines. Most children with autism are sensitive to abrupt changes in routine and will learn best in routine situations.

• Remove too many physical distractions from the room, like TV, furniture etc.

• Give fewer choices

• Use more visual cues like flash cards, chart papers etc

• Incorporate sensory tools like sensory mats, sand, slime, or putty etc.

• Keep your voice low and clear when teaching

• Make them learn social cues to enhance so-cial skills but limit physical contact

Most importantly, give yourself some quality time, self care and appreciate yourself for your efforts as it takes a lot of energy and patience from the parents or caregivers to manage a child with ASD.

Rejoinder- On the 4th September issue of Melange (on page 6) we had carried an article by MIND India titled- Let's Talk About Suicide. We apologize to our readers for the inappropriate picture selection to support that article. The content was provided by MIND India but the picture selection was solely the feature editor's discretion. However, we also take this opportunity to state that our intention was never to hurt anyone's sensibilities.

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