We live in a fast-paced world. With ever-growing cities, career options, and technology around us, all that we can think of is nothing but speed. By being a part of this rat race, which has eaten us all, we tend to forget that slow can be normal too! Autism, a very commonly prevailing condition in children around us, is one such normal which is often overlooked or ignored by most of us.”
Autism Spectrum Disorder (ASD) is a complex developmental condition that affects communication, restricted interests/repetitive behavioral patterns, and social interactions. With early identification and intervention, children on the spectrum can lead meaningful lives and achieve their full potential. In India, awareness and understanding of ASD have been growing, but early detection remains a challenge due to societal stigma, limited resources, and a lack of awareness among parents and caregivers. The early signs of ASD in children should be identified and an early consultation must be sought for timely intervention of children suffering from ASD.
What is Autism Spectrum Disorder (ASD)?
ASD is a neurological and developmental disorder that typically appears in early childhood. The term spectrum reflects the variation in symptoms and also includes disorders which were classified separately earlier(eg; Asperger’s). While the exact cause is still unknown, research suggests a combination of genetic and environmental factors.
Children with ASD may exhibit a range of behaviors and developmental differences, which can vary in severity. These may affect their ability to communicate, interact socially, and engage in everyday activities.
Why Early Detection Matters?
Early detection and intervention are crucial for children with ASD. Research shows that early therapy can significantly improve communication, cognitive development, and social skills. In India, many children go undiagnosed until they enter school, by which time early intervention opportunities are missed. Parents and caregivers are thus encouraged to accept this condition and come out of the loop of social stigma to provide their children with the best care and upbringing.
Early Signs of Autism Spectrum Disorder in Indian Children
Recognizing the early signs of ASD can help parents seek timely medical advice and appropriate therapies. Below are common signs to watch out for in young children:
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Delayed Speech and Language Skills
- Limited or no babbling by 12 months
- Not using single words by 16 months or two-word phrases by 24 months
- Difficulty understanding or following instructions
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Limited Eye Contact and Social Interaction
- Avoiding eye contact with parents or caregivers
- Preferring to play alone rather than interacting with other children
- Limited response to their name being called by 12 months
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Repetitive Behaviors and Restricted Interests
- Repeating the same actions, words, or sounds (echolalia)
- Intense focus on specific objects or activities like playing with wheels of the toy.
- Unusual hand movements, such as flapping or spinning
- Liking for sameness of the environment at home/school
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Sensory Sensitivities
- Overreaction to sounds, textures, lights, or smells
- Dislike for being touched or cuddled
- Seeking sensory input, such as staring at spinning objects
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Difficulty in Understanding Social Cues
- Struggling to interpret facial expressions or gestures
- Limited use of gestures, such as pointing or waving
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Unusual Emotional Reactions
- Sudden meltdowns without an apparent reason
- Difficulty in regulating emotions
- Limited empathy or awareness of other people’s feelings
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Motor Skill Delays
- Mild walking delays
- Difficulty in fine motor activities like holding crayons, or playing with toys requiring fine movements
Cultural and Societal Challenges in India
In India, several factors hinder early diagnosis and intervention of autism spectrum disorders. Some of these include:
Stigma and Social Taboos
- Many parents fear the social stigma associated with developmental disorders.
- Some families may delay seeking help due to concerns about societal judgment.
Lack of Awareness
- Parents and even some healthcare professionals may not recognize the signs of autism.
- Misconceptions about the condition, such as viewing it as a behavioral issue still persist.
Limited Access to Specialized Care
- Rural areas often lack access to pediatricians or specialists trained in developmental disorders.
- Availability of therapy centers is limited to urban regions, where too there is a certain limitation of availability of care.
Language and Cultural Barriers
- Most assessment tools are in English and may not cater to Indian languages.
- Cultural differences in social norms can sometimes mask symptoms.
Despite the challenges that persist, the level of care has improved significantly over the past few years. Indian families have also come a long way in acknowledging ASD and seeking care.
What can parents do if they notice signs of ASD?
If a parent suspects ASD in their child then the following should be done:
Consult a Pediatrician
Instead of worrying, parents should discuss their concerns with a pediatrician who can provide a preliminary assessment and refer them to specialists in case of need.
Seek a Developmental Assessment
Parents can also directly consult a developmental Pediatrician/ Pedaitric Neurologist, child psychologist, or speech therapist for a detailed evaluation and diagnosis of ASD.
Early Intervention Programs
In case a diagnosis points to ASD then parents should positively enroll their child in early intervention programs that focus on speech therapy, occupational therapy, and behavioral interventions. Just a diagnosis doesn’t help, it is taking these right steps that can help in the betterment of ASD.
Involve the Family
Family involvement in therapy can enhance its effectiveness and provide emotional support for the child. After all, it is the environment that plays the most important role in the development of the child.
Support Groups and Resources
It is wonderful that in India too we are beginning to have strong support groups for specific diseases and conditions. Interacting and joining like-minded support groups and organizations specializing in autism care, such as the Autism Society of India, Action for Autism, and/or local support groups can be beneficial.
Therapies and Interventions Available in India
Various therapies are available to help children with autism develop essential skills:
Applied Behavior Analysis (ABA)
One of the most effective therapies for children with autism, focusing on positive reinforcement.
Speech and Language Therapy
This helps children develop communication skills, both verbal and non-verbal.
Occupational Therapy (OT)
This therapy aids in improving fine motor skills and coping with sensory sensitivities.
Social Skills Training
This focuses on helping children understand social cues and build meaningful relationships.
Parent-Child Interaction Therapy (PCIT)
Teaches parents techniques to improve their child’s behavior and communication skills.
Depending on the individual needs of a child, the therapy required can be suggested by the expert. Parents should discuss the needs and outcomes and ensure they continue to provide their child with the right support as prescribed.
In India, many children diagnosed with ASD have made remarkable progress with early intervention and consistent therapy. Just one positive step from the parents can be life-changing for little children, and completely transform their growth and development.
What can be done at home?
Human interaction is the foremost requirement of any child especially with autistic children.
Limiting screen time is the first change to be brought at home.
Involving the children in household chores like cleaning, folding clothes, making chapatis etc can be done.
Reading books and painting with the child also improves the interaction with the adults.
Parent has to stay calm even when the child has a meltdown. Leading a disciplined life itself would be great example for the child.
Parental Mental health and coping skills are the most important factors in parenting a difficult child. Always maintain positive attitude and try to get connected to various autism groups to share your journeys.
Take home message
While autism spectrum disorder presents unique challenges, it also brings the opportunity for parents and caregivers to understand their child’s individual strengths and needs. Early detection, timely intervention, and family support are key to helping children with ASD thrive.
Parents in India must be vigilant about their child’s development and seek professional advice if they notice any signs of autism. With growing awareness, improved resources, and the dedication of parents and healthcare professionals, children with ASD can lead fulfilling and independent lives.
ASD is a developmental disorder that affects communication, social interactions, and behavior. It is called a spectrum disorder because symptoms and severity vary widely among individuals.`
Early signs include delayed speech development, limited eye contact, repetitive behaviors, and, difficulty understanding social cues, etc.
Autism can often be diagnosed as early as 18 months, though some children may not receive a diagnosis until they are older as early signs are often missed.
Early detection allows for timely intervention, which can significantly improve a child’s communication, social, and cognitive skills. This can help them lead better lives.
Challenges include social stigma, lack of awareness, limited access to specialists in rural areas, and cultural misconceptions about developmental issues.
Parents should consult a pediatrician or developmental specialist/ Pediatric neurologist, seek a detailed assessment, and enroll their child in early intervention programs.
Therapies include Applied Behavior Analysis (ABA), speech therapy, occupational therapy, social skills training, and parent-child interaction therapy (PCIT). However, the need for specific therapy varies and can be best suggested by experts after a detailed assessment of children.
Autism is a neurological and developmental condition influenced by genetic and environmental factors. More involvement and interaction with children in their growing-up years can help make this condition better.
Yes, organizations like the Autism Society of India and Action for Autism offer resources, support groups, and information for parents.
Yes, with early intervention, consistent therapy, and family support, many children with autism develop essential skills to lead independent and meaningful lives.
Author: Dr. Ramya Bandi
Consultant Pediatric Neurologist