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Home / AUTISM SPECTRUM DISORDERS

Autism and Autism spectrum disorders are a group of complex disorders of the brain developmental characterized by impaired reciprocal social interaction, verbal and non verbal communication and restricted stereotyped behaviours that is manifest before the age of 3 years.

What to do if you are worried about your child’s development?
Step one: Discuss with your paediatrician and schedule an autism screening. The American Academy of Paediatrics recommends that all children receive routine developmental screening as well as specific screenings at 9 months, 18 months and 30 months of age.
Step Two: Schedule a detailed assessment for Persistent Development disorders and Autism.
Step three: Seek early intervention service. Even in the absence of a definitive diagnosis early intervention can be started.

WHY EARLY IDENTIFICATION IS IMPORTANT

An early identification and diagnosis of autism spectrum disorders usually before the age of 18 months followed by intensive therapy makes a huge difference in the outcome of treatment for autistic children. Early intervention methods take advantage of the brain’s plasticity and can reverse the symptoms of autism.  However no matter what the child’s age, intensive intervention has very good results.

As a parent, closely monitor your child’s early development with your paediatrician during well baby visits. Any delay in social, emotional and cognitive milestones should be discussed with your doctor. Although a slight variation in achieving milestones is normal, DO NOT ACCEPT the “ don’t worry” , “ wait and see” “ she will catch up after joining school”  or “ he will grow out of it” approach.

Early signs of autism in babies and toddlers:

  • Does not make eye contact while doing routines like feeding, playing
  • Does not smile back when smiled at
  • Does not respond to his/her name or to the sound of a familiar voice
  • Does not follow objects visually
  • Does not point to objects or wave goodbye or use other gestures to indicate needs
  • Does not follow the gesture when parent points things out
  • Does not make noise to get parent’s attention
  • Does not initiate or respond to cuddling
  • Does not imitate your movements or facial expressions
  • Does not reach out to be picked up
  • Does not play with other people or share interest or enjoyment
  • Does not ask for help to ask for basic requests

Red signals

6 months: Lack of reciprocal smile, joyful expressions
9 months: Lack of cooing, smiles and other gestures in to and fro communication with parent
12 months: Lack of response to name, or baby talk , no pointing, no showing, no reaching out for objects, no waving
18 months: Lack of spoken words
24 months: Lack of meaningful sentences

Signs of Autism in older children

Social interaction difficulties

  • Self absorbed, disinterested in other people around him
  • Unable to connect and play with peers
  • Cannot do imaginative pretend games, cannot create innovative use of toys
  • Does not share interests and achievements with others
  • Does not enjoy being touched, cuddled etc
  • Does not seem tp listen when talked to

Speech and Language difficulties

  • Speech delay
  • Abnormal tone of voice
  • Repeats same words again and again beyond meaning
  • Refers to themselves in 3rd person
  • Has difficulty communicating needs and desires
  • Does not understand simple instructions

Communication difficulties

  • Poor eye contact
  • Inappropriate facial expressions
  • Lack of pointing to objects
  • Reacts unusually to sights, sounds, smells and textures
  • Abnormal postures, clumsiness or eccentric ways of moving
  • Restrictive stereotyped behaviours
  • Keep rigid inflexible routines and has difficulty adapting to changes in schedules
  • Unusaual attachment to toys or objects
  • Lines up things or arranges them in a certain order
  • Preoccupation with a narrow topics of interest
  • Focusing on one object for long period like a ceiling fan
  • Repeats same actions like flapping of hands, rocking, twirling.
  • Self stimulatory behaviours

ASD WORK UP (PDD AND AUTISM SPECTRUM DISORDERS AND ASPERGERS DISORDER)

The usual process for an Autism assessment is:

The first session is generally booked for the parents to attend, without the child to discuss background and developmental information and to plan what specific assessment items are needed to meet the needs of your child. This will depend on your concerns, and what your doctor or paediatrician have requested be assessed.

Assessment for ASD includes review of developmental history, observation of child in structured and semi-structured situations, nursery/school report, assessment of cognitive level and problem behaviors with standardized tests, speech and language and adaptive skills. If indicated referrals are made for audiology, visual tests and physical investigations.

OUR APPROACH

Our aim is to identify children at risk at early ages younger than 5 years. We apply the ESDM program. ESDM is a comprehensive early intervention program for toddlers and preschoolers WITH Autism Spectrum Disorders. The program uses developmental and behavioural approaches focusing on social learning and social- cognitive development to increase communication, imitation, sharing, joint attention, and play. Parent is trained to carry on one to one program with the child at home.

OUR APPROACH
Our aim is to identify children at risk at early ages younger than 5 years. We apply the ESDM program. ESDM is a comprehensive early intervention program for toddlers and preschoolers WITH Autism Spectrum Disorders. The program uses developmental and behavioural approaches focusing on social learning and social- cognitive development to increase communication, imitation, sharing, joint attention, and play. Parent is trained to carry on one to one program with the child at home.

Prognosis

While there is no cure for autism the outcome of treatment depends on the child’s cognitive abilities, age at starting treatment, quality of treatment, intensity of treatment and consistency of treatment. Children with favourable prognostic factors may have “ Best Outcomes” and no longer carry the diagnosis when independently assessed by a developmental diagnostician. They might go on to pursue education, careers and marriage with just very minor deficits that are not observable by normal layman.

Assessment

A typical diagnostic evaluation should involve an interdisciplinary team of psychiatrist/ psychologist, paediatrician, speech and language therapist, occupational therapist. Several diagnostic instruments are used to measure specific developmental areas. Direct observation and interaction with the child and parent helps in formulating treatment plans.

Treatment

The aim of treatment is to minimize core abnormalities in communication, social skills, functional adaptive skills, academic and cognitive skills and reduce maladaptive behaviours. Several well researched treatment modalities are available such as ESDM, TEACCH, ABA, DTT, DIR, RDI.


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