Autism is a lifelong developmental disability that typically appears during early childhood and can impact a person’s social skills. Autism is defined as a spectrum disorder that affects people differently. It impacts the individual throughout its lifespan. As there is no known cause of autism, early diagnosis can help the person to live a quality life. On this World Autism Day, we at Medicircle, are conducting World Autism Day Awareness Series to impart knowledge and awareness amongst the general public about the therapies and treatments available to improve the quality of individuals and the acceptance in this society by interviewing eminent Paediatric Neurologists, Speech Therapists and Clinical Psychologists.

Dr. C P Ravi Kumar is working as a Consultant Paediatric Neurologist at Aster CMI hospital. He has spent over 14 years in training and working in the UK. He has worked as a Paediatric Consultant at The Royal Alexandra Children's Hospital in Brighton, UK. He undertook specialized training in Childhood Epilepsy and Neurology in reputed teaching hospitals in London, including Guys and St. Thomas hospital, and Young Epilepsy. He underwent training in interpreting EEG’s in Cleveland, USA under Professor Hans Luders. His special area of expertise is in Epilepsy management, including ketogenic diet and vagal nerve stimulation. Dr. Ravi is a faculty member for British Paediatric Neurology Association (BPNA) and teaches pediatric epilepsy training and childhood headache training program. He is a member of the Association of Child Neurology in India and the faculty in various epilepsy related training programs.

No identification of root cause

Dr. Ravi speaks, “Unfortunately, as a Medical fraternity, we have not been able to identify the root cause of Autism. There are many hypotheses, but none of them have a direct relationship with the cause. So, it is thought that there are a lot of environmental toxins that may be increasing the risk of autism, which we've seen over days. The numbers are increasing because there is increased awareness also. That is how these children have been picked up, the number can actually be more. In the past, the word Autism itself was not familiar to the medical fraternity and especially to the public. But now even in countries like India, at least the metros are familiar with the word. And Google has also helped in raising awareness. So, the awareness is definitely better than what it was. But unfortunately, we have not been able to find the cause.”

Red flags are the signs of danger

Dr. Ravi mentions, “usually one can identify this disorder in between 18 to 24 months of age. By two years of age, most of these children will have some red flags. Red flags are some danger signs which will point towards Autism. Any medical doctor will be able to guide and identify if there are any red flags of Autism. A child should be able to speak at least 20 to 200 single words by this time. They should be able to make eye contact and good social interaction. If it is not happening, then it is time to seek doctor’s help.”

Development is the most important aspect

Dr. Ravi explains, “Autism is defined as a neurodevelopmental disorder. So, it's something to do with the nervous system and the development part. Development is the most important aspect of Autism. The predominant area is Social Communication. Social communication is the biggest area that gets affected in autism, which impairs normal day to day activities like the interaction of the child with other individuals. Otherwise, these children are physically fit and healthy. In addition, some children have various kinds of spectrum of this issue. For example, somebody has a repetitive behavior, somebody has a problem with sensory processing, and some may have a complete lack of nonverbal skills. So, there are a lot of issues that each of these children can have. That is why the word Autism Spectrum Disorder comes in.”

Some specific symptoms of Autism

Dr. Ravi adds, “So, to be more specific there is a lack of eye contact, lack of social interaction, lack of emotional empathy, no interaction of sharing smile or pain, repetitive behaviors and sensory processing. Repetitive behaviors may include craving for the same type of food or playing with only one type of toy. Pressure cooker noise or a honk from a vehicle can really turn their world upside down which shows the problem in sensory processing. Many children don’t like a haircut, they cannot tolerate it. They are very much sensitive if someone touches their hair, this is also an example of sensory processing.”

Early intervention with customized therapy is the key

Dr. Ravi stresses, “early intervention is the key. The earlier you identify, the sooner you start the therapy, the best outcome you will get. And when it comes to therapies, a good assessment is needed, to find out what are the domains which are affected in this channel. No single therapy can work for all children. So, the assessment helps in identifying the therapy that suits a particular child. For every child, there has to be a customized therapy. Hence it is important to get a proper assessment so that you identify what are the affected domains and can get customized treatment.”

All about Brain Child Trust

Dr. Ravi informs, “Brain Child has been set up in 2018.  We have been working to set up Child Development Centres in tier 2 cities. So far, we have been successful in establishing it in two cities. And hope we will be able to reach out to more places. Presently, most of the neurological services are limited to metro cities and parents have to really struggle a lot. As I have mentioned earlier that Autism or any other neurodevelopmental disorder needs long term treatment. And it is not practically possible for parents to visit any big city for helping out the child. Hence, we want to reach out to them so that we can provide services to the family of small cities also.”

(Edited by Renu Gupta)