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Expert Speak

Autism

Ms Kalpana Satheesh , Speech Therapist and Audiologist

 

What is Autism?

Autism is a developmental problem seen in small children that impairs their speech and communication skills. Speech milestones seem delayed. Children do not respond when called by name.

Autistic children are physically and quite often mentally normal. Some autistic children are “high functioning” autistics. Their IQ is high. They have better language skills. A small percentage of autistic children solve complicated jig saws and are good with numbers.

What causes Autism? Is there any pattern to it?

Till date no cause has been identified. Perhaps it would be easier to find a cure if a cause was identified!

It affects children from any type of background: rich or poor, educated or uneducated! Earlier it used to be thought that parental neglect of the child had a role to play. Now even that is being ruled out.

How does one identify an autistic child?
How is a medical diagnosis made?

A mother usually notices that the child does not speak much and does not smile. Look for some of the behavioural characteristics of an autistic child.

There are no tests or scans that can detect or confirm autism. An autistic child does not communicate easily. As he does not even respond when called by name, he is often mistaken to be deaf. It does take some experience to detect autism, even for a speech pathologist.

Usually, autistic children respond to music. I play music and look keenly for a response. I get a hint from this. The child is also put through audiological tests to confirm that hearing is normal and the child is indeed not deaf. The child also has to be reviewed by a neurologist to rule out neurological problems and a psychiatrist to determine baseline intelligence.

Unfortunately, many autistic children are fitted with hearing aids when they do not need any owing to poor diagnosis.

Is there a cure for Autism?

Unfortunately there isn’t yet. But the possibilities of integrating autistic children into society are greater now. It depends early intervention and on the parental attitude.

What kind of intervention do you suggest?

It has to be team work. The speech pathologist, the parent, the school/ the special educator have all got a role to play. In fact in an Indian family I expect a total environment change to accommodate an autistic child: the extended family, the neighbours should all be able to help.

Autistic children are very stubborn in their ways. This provokes two types of emotion in the family elders: anger or a wrong kind of sympathy. Both are unhelpful. Structured learning programmes are really helpful.

What is the prognosis you give to parents?

The first meeting is the most important. Parents have to be told that their child may never be normal. They find it very difficult to accept this as they come with so much hope.

When I first diagnose autism, I counsel the mother. I explain what autism is and that there is no magical cure or medicine for it. I chart out a programme for the mother explaining how she can interact with the child and involve him in each of the daily activities.

We work on an individualised programme to increase the vocabulary and interactivity of the child.

Can autistic children be academically educated?

Mildly autistic children with high function can be integrated into normal schools after/ with the aid of structured programmes. One of my patients is in a normal school and has won oratorical competitions. However, all children do not have the same level of disability and do not progress at the same rate.

But I feel it is more important for autistic children to learn practical things: playing in a group, communicating with family, increasing vocabulary etc. Personalised academic inputs can be given in the form of tuitions.

What are the main problems in integrating an autistic child?

Parents lose motivation. After a couple of visits, they feel that it is too much trouble. They start looking for an easy cure, (though there is none). They go from doctor to doctor which actually does not serve any purpose.

Those who stick with a learning programme devised depending on individual capacity, on the other hand, progress well.

Would you like to give some tips on management of an autistic child?

  • Do not compare the skills of the child with other children, autistic or normal.
  • Do not leave the child to be on his own. It only helps increased withdrawal. Try to involve the child in some activity or the other.
  • Many autistic children like to go out. May be a mother can use an outing to teach him and get him involved in the environment.
  • It is alright to be firm with an autistic child. You do not have to beat him or be harsh, but you can persuade him to perform a task and reward him. Too often families find it easier to let an autistic child have his way.

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