The intent of this blog is to educate people around Autism or Autism spectrum disorder (ASD) and discuss all the available treatment of Autism in India 2020.
Autism in India has been associated with a lot of stereotypes, What an average person understands about autism, and what Autism spectrum disorder actually are is quite different.
Let’s Start by Defining Autism
What is Autism?
Unlike popular belief, autism is not a single disorder and Autism covers a wide spectrum of developmental disorders and is therefore referred to as Autism spectrum disorder (ASD)
ASD is a broad term used for describing a broad range of neurodevelopmental disorders.
People with ASD are characterized by problems with social interactions and communications.
They find it really difficult to understand how other people feel and think which makes it more difficult for them to express themselves.
Many times they can demonstrate restricted and repetitive patterns of behavior.
People with ASD are normal people who find difficulty in dealing with things an average person can.
According to a WHO report worldwide, one in 160 children has ASD,
In India, the exact percentage ratio is not known but India has more than 2 million people affected with ASD.
According to the Centers for Disease Control and Prevention (CDC) boys have reported 4 times more cases of ASD than girls
We will be talking in detail about symptoms of ASD in detail further in this blog but before that
Let’s take a quick fact check to understand more about people with ASD
- ASD can occur with or without intellectual disability
It’s is not necessary for a person with Autism Spectrum disorder to be intellectually challenged.
- ASD can occur with or without language disablement
It’s not necessary for a person with Autism Spectrum disorder to have trouble with learning or speaking a language.
What are the symptoms of autism?
In general, the symptoms of Autism include
- Problems with communication and social interaction like difficulties in sharing emotions or having a back-and-forth conversation.
People with ASD often have trouble maintaining eye contact with people and developing relationships with others
- Restricted or repetitive patterns of behavior like unusual or repetitive speech patterns
People with ASD face difficulties adhering to certain routines and have a decreased or increased sensitivity towards certain sensor inputs like a specific color or sound.
Early Symptoms of Autism (Age 1-3 Year)
- murmuring and pointing absent till by the age of 1
- Absence of speaking single words by 1.5 years or absence of 2-word phrases by the age of 2
- kids display poor eye contact
- Many kids with ASD don’t respond to their names
- Lack of social responsiveness like smiling.
- Unusual responsiveness to sensory inputs like touch, smell, noise, and taste
To diagnosed autism, the symptoms must be present before the age of 3 years, But many children display mild symptoms hence their diagnosis happens later.
In such cases, There can be certain indicators like
Symptoms of Autism (Post Age 3)
- Kids can have trouble making friends or talking to peers
- Repetitive or unusual use of language
- Restricted interest patterns that are unusual in focus intensity
- Inability to follow certain routines and rituals
If a child does not show any symptoms prior to the age 3 and the symptoms listed above are show post 3 years of age then it is not diagnosed as ASD.
The child would then require a different psychiatric or developmental diagnosis.
Symptoms Boys Vs Girls (Early Age)
Boys and girls can show different symptoms of Autism
Read the detailed research paper on sex differences in the evaluation and diagnosis of autism spectrum disorders among children
Boys tend to show clear symptoms of Autism like self-stimulating behaviors of flicking fingers or rocking movements,
Boys can be loud, hyperactive, get upset or angry easily when they are made to do activities out of their comfort zone,
Girls with Autism tend to be quiet or introverted. They prefer staying alone and disengaging.
In most cultures, girls are expected to be quite a shy therefore diagnosis of Autism for girls many times becomes difficult.
What are the types of Autism?
There are three types of Autism spectrum disorder (ASD)
- Asperger Syndrome:
Asperger’s Syndrome is a disorder that falls under ASD and people with Asperger’s syndrome have a high aptitude and if not more normal intelligence, It is a high functioning form of Autism.
You might have heard about Asparagus Syndrome from a famous Indian Movie “My Name is Khan”
They face social challenges and unusual behaviors and interests but have no problem with language or intellectual disability
It is a milder form of Autism
- Autistic Disorder
They have similar symptoms to Asperger’s syndrome but Autistic disorder is a more intense form of Autism,
People with autistic disorder often have problems with language and intellectual disability
- Pervasive Developmental Disorder (PDD) – Not Otherwise Specified
It is an unusual form or Atypical form of Autism, The person with PDD have some characters similar to Asperger’s syndrome and Autistic Disorder but not all
You can understand it like this
People with Autism severe to Asperger’s syndrome but milder than Autistic disorder
Cause of Autism?
The exact cause of ASD is not known, There are some risk factors that can cause Autism
- It can be hereditary, If you have an immediate family member with Autism
- Can occur due to genetic mutations
- Old couples are more likely to give birth to a kid with Autism
- Environmental conditions like exposure to heavy metals and toxins
- Complications with pregnancy like extreme premature delivery (Within 26 weeks or 6-7 months), low birth weight, multiple pregnancies can cause Autism
- Research suggests that having prenatal vitamins (Containing folic acid) before and though pregnancy can reduce the chances of Autism
There is a myth associated with vaccines causing Autism,
In 1998 A study suggested that measles, mumps, and rubella (MMR) vaccine could cause Autism, However, this myth was debunked and the claim got withdrawn in 2010
What are the tests to diagnose autism?
There are as such no genetic or lab test for Autism, The diagnosis of Autism is done by observing behaviors and performing certain standard behavioral tests.
Early diagnosis of Autism can make a huge difference in the lives of kids with Autism, Every child should be given an assessment at their 18th and 24th month.
Modified Checklist for Autism in Toddlers Revised with Follow Up (M-CHAT-R/F)
It is basically a Yes/No questionnaire with 20-23 questions answered by the parents of toddlers age 16-30 months.
There are 2 questionnaires that are to be answered
Revised Questionnaire-M-CHAT-R and
Followup Questionaire M-CHAT-F
and based on that ASD can be diagnosed, There are still chances that the test might give you a false positive.
- If you point at something across the room, does your child look at it? (FOR EXAMPLE, if you point at a toy or an animal, does your child look at the toy or animal?) Yes/No
- Have you ever wondered if your child might be deaf?Yes/No
- Does your child play pretend or make-believe? (FOR EXAMPLE, pretend to drink from an empty cup, pretend to talk on a phone, or pretend to feed a doll or stuffed animal?) Yes/No
You can try taking an online test here
Autism Diagnostic Observation Schedule (ADOS)
It is one of the most reliable standards tests for diagnosing Autism and Pervasive Developmental Disorder (PDD) across all developmental levels, ages, and language skills.
The test is performed by a professional administrator
The test has four modules each of which takes 30-45 mins to administer, Modules are assigned based on age and language skills
- Module-1 is used for children who do not use phrase speech consistently.
Phrase speech is defined as using non-echoed three-word remarks.
- Module-2 is used for children who have achieved using phrase speech consistently but struggle with fluent speech.
- Module-3 is used for children who can speak fluently.
- Module-4 is used for Adolescents and Adults who can speak fluently.
You can read about ADOS more here
Childhood Autism Rating Scale (CARS)
It is a diagnostic test for kids older than 2 years,
The test is a behavioral rating tool that can tell the difference if your child has autism or other developmental delay disorders like mental retardation.
Following characteristics are evaluated in the test:
- Object use
- Body use
- Verbal communication
- Non-verbal communication
- Listening response
- Visual response
- Emotional response
- Adaptation to change
- Relationship to people
- Level and consistency of intellectual response
- Taste-smell-touch response and use
- Fear and nervousness
- Activity level
- General impressions
Autism Diagnostic Interview~ Michael Rutter, Ann Le Couteur, and Catherine Lord 2003
A standard way to diagnose is an Autism Diagnostic Interview (ADI), It used to diagnose autism in kids older than 2 years.
The interview process takes around 2-3 hours to administer and score, The ADI focuses on 3 main domains
- Reciprocal Social Interactions
- Language and Communication
- Restricted, Repetitive, and Stereotyped Behaviours and Interests
The interview questions cover eight basic content domains
- Early Developmental Milestones
- Interests and Behaviors
- Social Development
- Language Assertion and Reduction
- Person’s Background- family, education, previous diagnoses, and medications
- Behaviors such as aggression and self-injury
- Current Status of Language and Communication
- Overall Behaviour
Diagnosing Asperger’s Syndrome
Asperger’s Syndrome can be specifically diagnosed using
- Autism Spectrum Screening Questionnaire (ASSQ)
- Childhood Asperger Syndrome Test (CAST)
Autism Treatment in India 2020
Currently, there is no cure for Autism spectrum disorders all treatments available only help in alleviating the symptoms associated with ASD.
The aim is to help the individual navigate better in daily life.
Every person with ASD has different needs so the treatment options are always individual.
Following are the treatments being given to treat Autism in India
#1 Physical therapy in India
Physical therapy is provided for children who have gross motor difficulties and delay
children with the autism spectrum disorder may or may not have gross motor delays or difficulties and the therapy has to be tailored to the children who do have that particular problem
These are the kids who have difficulty with higher-level motor functioning like
- Difficulty with pedaling a tricycle or
- Sense of themself in space like they can have difficulty with boundaries or
- Negotiating themselves in group settings
This is where physical therapy would be of benefit, It can be provided in schools or in combination with occupational therapy
As kids graduate and get older a lot of physical therapy can be incorporated into sports and to activities and a lot of it can also be done in the home after training the parents.
you can combine physical therapy with massage and movement and it gradually but consistently does make a difference
for children who have delays or have difficulty in that area physical therapy is important to intervene with as a therapeutic modality
Physical activities and movement are an important part of treatment and should not be avoided.
#2 Occupational Therapy in India
Children diagnosed with ASD often have fine motor difficulties and delays, Occupational therapy can help them is improving activities like
- grasping pencil, grass or pincer
- tying shoelaces
- using the hand and eye coordination
Another area that is getting very interesting or included with occupational therapy is the area of sensory integration
sensory integration is something that children with the autism spectrum have difficulty with, they get overstimulated by different sounds or movement
Being able to integrate stimulation from your senses is something that’s important and sensory integration therapy helps to deal with this disorder
- Brushing or a massage and holding can be very calming for a child
- for a child some children who are very fidgety you can have them sit on a particular cushion which allows them a little movement and flexibility
- some children have difficulty with transitioning and moving from the playground to coming back into the classroom or one activity to another
providing a little bit of sensory calming like reorientation movement on a ball or jumping on a trampoline before they get down to work
- using a certain kind of vest which can give them a sense of being grounded and can help them, therefore, attend better to what has been done
There are several approaches being taken and the approaches vary from person to person
#3 Behavioral Therapy in India
Behavioral therapy is a broad term that covers several therapies used in treating mental health disorders,
The approach is also used in treating ASD depending on the individual’s requirement
- Applied Behavior Analysis (ABA)
ABA therapy is based on the principle of that behavior is changeable through positive reinforcement
ABA therapy simply expands this training in intensive ways until each child struggling with autism reaches new milestones and develops the habits he will need to live a full life as an adult
- Cognitive Behavioral Therapy (CBT)
CBT is a theoretical approach where a therapist will work with the patient to examine his/her thoughts feelings and behaviors and the different ways they intersect
CBT aims to define the things that set off of a particular behavior so that the child can start recognizing those moments himself and practice some different behavioral or mental path to that situation
- Verbal Behavior Therapy (VBT)
Used to teach children who are non-vocal communicate effectively and how to use words to get the desired response
Like teaching them to vocalize their request-“I want a candy”
- Social Skills Group
It is often noticed among kids with ASD that they are comfortable speaking with adults but find difficulty in speaking with their peers
Social skill groups help children use pragmatic language and manage real-world challenges with their peers.
There are other behavioral therapies like Relationship Development Intervention (RDI) or Developmental and Individual Differences Relationship (DIR) Therapy that can help children with their specific needs.
#4 Speech Therapy in India
Many people with ASD have. a major problem with verbal and nonverbal communications and find it hard to interact socially
Speech therapy addresses a wide range of communication issue for people with ASD
People with ASD might
- Not speak at all
- Murmur grunts, cries or harsh sounds
- Use strange words or words of sounds
- May just copy what the other person says to them
- Or maybe he/she can use the right sentence but have an unexpressive tone
All these problems are treated with speech therapy, Speech therapists have a unique way of working with every patient.
They will find a suitable way of teaching a person with ASD to communicate well, like using picture boards with words, electronic talkers, typing, etc.
#5 Stem Cell Therapy in India
There is a huge hype around Stem Cell Therapy (SCT) for Autism
In India STC is advertised a lot as a treatment for Autism, if you search Autism treatment in India you are most likely to land on an STC treatment
But here’s what you need to know about stem cell therapy and Autism
Though the cause of Autism is not known there are some prevailing theories and understood patterns
One theory suggests that an immune disfunction might cause inflammation in the brain
This inflammation may change interactions between neurons or other connections brain makes which results in Autism
Cord blood stem cells can
- Modulate immune response
- Reduce inflammation
- Stimulate Tissue Repair
And therefore SCT is being viewed as a potential treatment for stem cell therapy
The clinical study was done by Dr.Michael Chez involving 30 children with Autism
The study showed that after 6 months of SCT some children showed improved social interactions, However, it was not a statistically significant finding.
Hear about it from Dr.Michael himself
Yet in India, it is strongly advertised as a treatment of Autism, While the claims and results might be true Stem Cell Therapy as a standard treatment of Autism is not accepted by everyone.
Read more about stem cell therapy here
#6 Dietary Approaches in India
Some dietary treatments have been developed to treat ASD symptoms
There is very little evidence to support the use of these dietary treatments for children with ASD but many have found it effective.
- Diets are suggested to be without artificial additives like coloring agents or preservatives
- Some suggest a gluten-free diet
- Some suggest removing specific foods from a child’s diet and using vitamin or mineral supplements
- There are many dietary treatments that suggest that food allergies or lack of vitamins and minerals cause symptoms of ASD
Medication in India
Please note there is no medicine that can cure Autism or its core symptoms
However, medications can help a child with ASD function better like managing high energy levels or inability to focus, anxiety and depression or seizures
Complementary and Alternative Medicine Treatments in India
Parents and healthcare professionals often use treatments that are outside of what is typically recommended by pediatricians
These treatments are categorized as Complementary and Alternative Medicine Treatments (CAM)
These include dietary supplements, Chelation, mind-body medicine, etc.
Most of these treatments have not been studied for effectiveness and some treatments like chelation often prove to harm the child then aid him
According to CDC about 10% of parents go for dangerous treatments of ASD, Please don’t fall for such claims and always discuss the claimed treatment with your doctor first.
Stay Aware Stay Safe
Homeopathy for Autism?
We at HealthifyFeed do not talk much about homeopathy treatments due to lack of knowledge in this field
But to make this guide more comprehensive we will mention about the homeopathy treatment for Autism as well
A homeopathy is a form of alternative medicine, It claims to treat Autism through their remedies
homeopathic remedies like Carcinocin and Baryta Carb are used in the treatment of Autism,
Baryta Carb is expected to stimulate the development of the brain, Many homeopathic doctors have claimed good results.
Effectiveness of Homeopathy is not known, Many suggest homeopathy to be a pseudoscience
Autism Spectrum Disorder (ASD) are diseases similar to any other disease yet there exist a social stigma around these diseases
It is really important for people to understand that these disorders are already difficult to deal with for parents and children and this added social stigma adds more to this existing problem
We all at some time face difficulty in expressing ourselves, communicating or understanding something and we would not feel nice if anyone would frown upon us in our difficult times
People with ASD are just as normal as us, They just find dealing with daily life a bit more difficult than us.
Let’s educate ourselves around Autism ad end this existing stigma, Let’s make this world a better place for everyone.