UNDERSTANDING AUTISM IN CHILDREN
Dr Sushil Sharma & Dr Ravinder K Gupta
In recent years, the number of Autism Spectrum Disorder (ASD) diagnoses have risen worldwide with India being no exception. There has been a rising trend observed in our UT of Jammu and Kashmir as well including in both the urban and rural areas over the past few years. As we observe Autism Awareness Day on 2nd April, it is crucial to address concerns associated with Autism, focusing on prevention, early pointers, and the role of screen exposure in child development. There is also a pressing need to delve into the various challenges it presents, including social stigma, lack of early intervention, and limited resources for comprehensive management.
Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that affects millions of children worldwide. Children with autism often display distinctive characteristics, particularly limitations in their social interactions, communication, and behaviour. One of the most striking features is their preference for objects over human interaction. Unlike other children of their age, who typically seek connection and comfort from their caregivers or peers, children with autism often become intensely focused on objects. This could manifest in behaviours such as repetitive play with toys, lining up objects or fixating on certain parts of them, rather than engaging in imaginative or cooperative play. This preference for objects over people can be an early indicator of this condition. These children may avoid eye contact, have limited verbal communication, and show little interest in socializing. This lack of social engagement often leads to delays in language development and social skills, which are critical aspects of early childhood growth.
Autism often becomes apparent in the first few years of life. Parents and caregivers may notice early signs as early as 6 to 12 months, including a lack of response to their name, limited use of gestures or expressions, or difficulty in forming bonds with others. Delayed speech and language skills are also common, with some children showing no verbal communication by the age of 2 years.Various studies suggest that early detection and intervention can lead to improved outcomes for children with autism, which emphasizes the need for increased awareness and support.
Antenatal Prevention: Can Autism Be Prevented?
While the precise causes of autism are still being explored, some studies suggest that certain antenatal factors may play a role in the development of autism. Maternal health, nutrition, and the avoidance of harmful substances like alcohol and tobacco are critical to minimizing risks. Antenatal care that includes proper screening for genetic predispositions and prenatal care could play a crucial role in reducing autism-related risks. Antenatal education and regular healthcare can provide mothers with the tools to mitigate these risks.
The Role of Screen Exposure
In today’s digital age, children are exposed to screens from an early age. Too much screen time can detract from the time children would normally spend interacting with others and exploring the world around them. It is essential for parents to limit screen exposure, especially for children under two years old to encourage healthy cognitive and social development. While research is still ongoing, many studies have suggested a potential link between excessive screen time and developmental delays, including autism-related symptoms. Prolonged exposure to screens, especially in the early years of life, may interfere with the development of social and communication skills. Indian academy of Pediatrics has issued age-based guidelines regarding screen time
4Children under 2 years: No screen time. The Indian Academy of Pediatrics (IAP) highlights the importance of face-to-face interaction during this critical developmental phase.
4Children aged 2-5 years: Limited to 1 hour per day of high-quality content. Parents are encouraged to watch with their children to enhance the learning experience.
4Children aged 5 years and above: Screen time should be limited to 2 hours per day. The focus should be on educational content, with breaks in between to prevent eye strain and promote physical activity.
Diagnosis: Early Intervention is Key
The diagnosis of autism involves a comprehensive evaluation by a multidisciplinary team of healthcare professionals, including Pediatricians, psychologists, and speech therapists. There is no single test for autism, so the process typically involves observing a child’s behaviour, developmental history, and conducting standardized tests. Several screening tools, such as the Modified Checklist for Autism in Toddlers (M-CHAT), can help identify children at risk of ASD. Parents and caregivers who notice any red flags should seek professional advice immediately to ensure that their child receives the necessary support.
Management: Tailored Therapies for a Spectrum Disorder
Autism is a spectrum disorder, meaning its presentation and severity vary widely between individuals. As such, the management of autism requires a personalized approach, with a focus on therapies that address communication, behaviour, and social skills.
Early intervention programs, such as Applied Behaviour Analysis (ABA), speech therapy, and occupational therapy, have been shown to have some effect in improving the skills and functioning of children with autism. More importantly, Parents and caregivers benefit from understanding the nature of the disorder, available resources, and strategies to create a supportive home environment for their child.
While many people associate Autism with challenges, there is an increasing recognition of the incredible talents, contributions, and achievements of individuals on the spectrum. In every corner of society-from science and technology to art and sports-people with autism are not only overcoming obstacles but are also changing the world in remarkable ways. As society moves toward greater inclusion and acceptance, these autism achievers are proving that neurodiversity is a strength, not a limitation. Temple Grandin, one of the most prominent figures in the autism community, revolutionized the livestock industry with her designs for animal handling systems. Another standout is Satoshi Tajiri, the creator of the Pokémon franchise. Among the many inspirational stories from India is that of Jiya Rai, a 16-year-old girl who became the youngest and fastest para swimmer in the world to successfully swim across the English Channel.
India-Specific Challenges
Over the past decade, India has also begun to witness a cultural shift, with society moving away from ignorance and stigma towards inclusion and empowerment. Still, Autism in India is sometimes met with a mix of misunderstanding and social stigma. Many families still face difficulties in accepting the diagnosis, fearing societal judgment. Furthermore, there is a lack of specialized professionals and centers equipped to provide early intervention, which is crucial for improving long-term outcomes for children with ASD. Awareness in rural areas remains limited, and families in remote regions often struggle to get the support they need.
Awareness: A Crucial Step Toward Inclusivity
Increasing awareness about autism is essential for creating a more inclusive society. By educating the public about the signs and symptoms of autism, we can ensure that children receive the support they need at an early age. Schools, healthcare professionals, and communities should prioritize training and resources to improve their understanding and ability to support children with ASD.Greater acceptance of neurodiversity and the promotion of inclusive practices in schools and workplaces are vital steps toward a more equitable society.
Moving Forward: Building a Better Future for Children with Autism
As the awareness and understanding of autism continue to grow, we must ensure that children with autism are given every opportunity to thrive. This year,2025, the theme of World Autism Awareness Day is “Advancing Neurodiversity and the UN Sustainable Development Goals (SDGs).” The focus is on the significance of acknowledging and promoting neurodiversity while coordinating initiatives with the larger sustainable development objectives.
Parents, healthcare providers, and educators must work together to ensure that children with autism receive the support and opportunities they need to succeed. Autism in children presents unique challenges, but with early detection, effective management, and a supportive environment, children with ASD can lead fulfilling lives. Moving forward, we must foster a society that not only acknowledges autism but embraces the potential of every child.
The Indian Academy of Pediatrics (IAP) dedicates this day to raise awareness about autism spectrum disorder (ASD) and to foster a society that values neurodiversity, encourages inclusion, and provides equal opportunities for all individuals, regardless of their differences. This day also give opportunity to educate the public about the challenges and strengths of those on the autism spectrum, to celebrate the contributions of individuals with autism, and to advocate for greater understanding and acceptance within society.
“Light It Up Blue” is a global initiative that began in 2010, aiming to raise awareness and understanding of autism by having people wear blue and lighting up landmarks, buildings, and homes in blue on World Autism Awareness Day (April 2nd) and throughout Autism Awareness Month. The colour blue, associated with calmness and acceptance is the primary colour designated for autism. Its popularity also stemmed from the worldwide Autism Speaks initiative. People can participate by wearing blue clothing, using blue light bulbs, changing social media colours to blue, or posting blue photos.
(The writers are working at Department of Pediatrics, Acharya Shri Chander College of Medical Sciences, Jammu)
