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Autism is a complex developmental disability that appears during the first three years of life. It is the result of a neurological disorder that affects communication skills. Autism is four times more prevalent in boys than girls.

Children and adults with autism have difficulties in verbal and non–verbal communication, social interaction, and leisure or play activities. The disorder makes it hard for them to communicate with others and relate to the outside world. In some cases, aggressive and/or self–injurious behavior could result.

Persons with autism may exhibit repeated body movements (hand flapping, rocking), unusual responses to people, or attachments to objects, and resistance to changes in routine.

A center for autistic children exists at Priyanj Ashiana (Telephone: +91 022 8841193), Sanket Building, Evershine Nagar, Malad (W), Mumbai. Here, children receive structured intervention on a one–to–one basis. A monthly parent enrichment program has also been recently started.

Rubina Lal, a lecturer at SNDT and chairperson of the advisory board of the above institute feels there is no awareness in our society about autism. She calls for Government intervention in bringing about better understanding among parents.

“The general public, psychologists and teachers need to be educated about autism. Children are rejected from special schools because of the complexity of the disorder. Most teacher training courses do not have autism as a component. Even some doctors are unaware of it, and hence unable to guide the child and parents in the right direction, she asserts”.

Bina Modak, parent of an autistic child, and a member of the Forum for Autistic Awareness, who also co–ordinates with local parent support groups in Mumbai, says, “There are very few schools in Mumbai which cater to autistic children’s needs”. Bina has a Master’s Degree in Social Work, and has been in the field as a professional educator for a number of years. “I was in the field, so I had the advantage of knowing where to get help from. But there is this growing need to build up a local directory which could enable parents to find themselves a school or a trainer who caters to the special needs of the autistic child in a locality of their choice”. They are working at building up this special directory. She remembers how difficult it was for her in the beginning, but “Overall, 11 years down the line, it has been a rewarding experience”.

Dr Vibha Krishnamurty, developmental pediatrician from Jaslok Hospital, cites two problems that affect the 18 lakh population of autistic children in India. She says, “Thirty per cent autistic children are not retarded. They are not allowed admission in regular schools and they don’t need to be in schools for the mentally retarded. If regular schools were a little more flexible, then it would make a difference”.

Intervention between the ages of 2 and 3 plays a crucial role in the development of a child. Research reveals that there is a considerable amount of improvement if early intervention occurs.

Program Alternatives
Various program components share an emphasis on early, appropriate, and intensive educational interventions for young children. Other common factors may be some degree of inclusion – mostly behavior–based interventions – programs which build on the interests of the child, extensive use of visuals to accompany instructions, highly structured schedule of activities, parent and staff training, transition planning and follow–up.

Various types of therapies are available, including (but not limited to) applied behavior analysis, auditory integration training, dietary interventions, discrete trial teaching, medications, music therapy, occupational therapy, physical therapy, sensory integration, speech/language therapy and vision therapy.

A well–designed intervention approach may include some elements of communication therapy, social skill development, sensory integration therapy and applied behavior analysis, delivered by trained professionals.

A structured education and behavior program that contains a one–on–one teacher to student ratio or small group environment may best address the more severe challenges of some children.

In addition to appropriate educational supports in the area of academics, students with autism should have training in functional living skills at the earliest possible age. Learning to cross a street safely, to make a simple purchase, or to ask for assistance when needed, are critical skills, and may be difficult even for those with average intelligence levels.

In Conclusion
To be effective, any approach should be flexible in nature, rely on positive reinforcement, be re–evaluated on a regular basis, and provide a smooth transition from home to school to community environments. As a result of the challenging behavior of their children, relationships with service providers, attempting to secure appropriate services, resulting in financial hardships, or very busy schedules, families often have difficulty participating in typical community activities. This results in isolation and difficulty in developing needed community support. With appropriate intervention, many associated forms of behavior could be changed positively. The majority of children and adults will, however, continue to exhibit some manifestations of autism to some degree throughout their entire lives.