Times of India
02 April 2011
By Anurita Rathore

On World Autism Day today, developmental psychologist Prathama Raghavan throws light on need for autism awareness and to understand those with this disorder
Today is World Autism Day... do you think there is an increasing awareness on autism in India?
Awareness about autism is increasing everyday, owing to parents of children living with autism and also to those working in this field in India. Of course, much of it is majorly in big cities. Smaller cities need to catch up.

While many may understand autism to be a neuro–development disorder, what are its key symptoms and when can they be detected? There are children with low levels of autism who can play a musical instrument or draw/paint and then there are those who do not have control over their movements/don’t recognise some of their immediate family members too. What distinguishes these extremes?

Autism is a complex neuro–developmental disorder characterised by qualitative impairments in verbal and non–verbal communication and social interaction. Children with autism often have restricted interests and repetitive patterns of behaviour. It is a spectrum disorder, which means that all people diagnosed with Autism Spectrum Disorders will have difficulties in the same domains (communication, social interaction and restricted interests/repetitive behaviours) but the extent or the manner in which the impairment alters/affects their behaviour will be different.

Autism Spectrum disorder is typically identified by parents around the age of 2 ½ to 3 years, frequently diagnosed by professionals around the age of 3 years.
The key symptoms are

• Lack of eye contact
• Lack of reciprocal social smile
• Does not respond to name
• Does not point
• Does not play with toys, plays alone
• Delay in language development
• Does not initiate interaction
• Has repetitive finger or hand movements
• Has repetitive language
• Has restricted interests

It is a combination of these factors that are present in Autism Spectrum and to different levels. It is neither just one nor necessarily all of these symptoms.
Is the number of those born with autism in India on the rise? What could be the reason behind the increasing number of cases in recent times?
We do not know and cannot say if there is an increase in the number of children born with autism in India today because little research has examined this. Most recent studies internationally place the prevalence of Autism Spectrum Disorder at about six in every 1000 children.

This estimation of prevalence today is more than what studies estimated 15 years back. And it has been attributed more to the increasing awareness and the evolution of the characteristics used in the diagnosis of autism.

How can people around an autistic child/person be more sensitive in dealing with them? Can showing love and affection help them respond better?
I think it is very important for families of children living with autism to have good knowledge about autism and interventions that can help the child learn necessary skills to adapt to the environment. Like all children, they need love, affection and care to develop their full potential.

Early intervention through special education, sensory integration, speech therapy and occupational therapy can go a long way in helping children with autism develop necessary skills. Some children with autism will begin to use language as a communication tool but not all, therefore it is necessary for parents to be open to other forms of communication such as using sign language or a picture communication system discussed and planned with professionals working with the child.

Children living with autism typically have difficulty learning social rules and codes of conduct. It is essential to be consistent with rules and consequences when teaching them.

• Since children living with autism may take a longer time learning things that might come easily to other children, it is important to be patient with them.
• A consistent plan should be made together with parents and professionals for managing difficult behaviour.
• Having a daily routine for the child with some activities where they can have some choices.
• Affection, hugs, big smiles, encouraging words can be very rewarding for the child and could also be used to reinforce appropriate behaviour.

Many believe autistic children are mentally retarded. Please set the record straight.
Some children with autism also have mental retardation. Autism and mental retardation are two different disorders that occur together in some cases. Mental retardation is a generalised impairment in cognitive/intellectual functioning and adaptive behaviour. Presence of mental retardation is not necessary for a diagnosis of autism.

Does a pregnant lady need to be careful about anything specific to avoid autism in her child? (Also, is it genetic?)
The causes of autism are still vague but a lot of research is happening in this field and evidence pointing towards genetic factors and neurological abnormalities are coming up. There is no evidence of peri–natal or prenatal causes for autism.

Please share any hopeful experience you may have had when doing your research on autism.
I noticed that parents of children diagnosed with autism who I worked with, put in tremendous efforts in the early stages (2 ½ to 4 years). Working with different professionals, reading on the internet, through internet groups, trying several interventions doing many activities with the child at home and this helped their children learn adaptive behaviours and language.

Parents play a key role in helping children and making the most of the resources available especially in developing countries like India where services available are not uniform throughout the country.
— PRATHAMA RAGHAVAN IS PURSUING HER PhD ON AUTISM SPECTRUM DISORDER