Autism or Autism Spectrum Disorder ASD refers to a broad range of conditions characterized by challenges with social skills, repetitive behavior, speech, and nonverbal communication. The current understanding of autism is that it is one of the most common developmental disabilities. 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 their acceptance in society by interviewing eminent Paediatric Neurologists, Speech therapists and Clinical psychologists.

Madhavi Adimulam is the Co-founder and Director of the organization called Kidsens. Kidsens assist child development in the first six years of childhood when interventions work the best and enable the child to realize their full potential. She is also the founder of Ananya Learning Center- An Early Intervention Center started in 2007. Madhavi is a specialist in Diverse Education Needs with over 20 years of experience in Autism Spectrum Disorder, Developmental Delays, and Attention Deficit Hyperactivity Disorder ADHD.

Diagnosis of Autism 

Madhavi Adimulam informs, “Autism is diagnosed when the child is 2 years old. Usually, an experienced pediatrician and clinical psychologist can easily spot that there is a developmental issue in the child. With clinical experience, it can be the spot that the child is facing a challenge. In India, a psychologist can help do the assessment of the child. The first point of contact is the pediatrician in our country. The parents usually complain the following 

A child is not speaking  A child is not sitting in one place  He is not responding to name-calling  He is not smiling  He is not playing with others  He is aloof all the time 

An assessment is done in children called the Childhood Autism Rating Scale which is most common in India. There are age criteria for diagnosis of autism in the child which is 2 years.” 

Prevalence of Autism in children 

Madhavi states, “14 years ago when I started the center, I used to get a case once in two weeks. But now, it’s very prevalent with so many calls with new diagnoses for the age group of 2 - 3 years. Parents call our centers for occupation therapy, behavior therapy, and speech therapy. Unfortunately in India, we don’t have the statistics because nobody does a survey in India to find out the exact prevalence. But the USA statistics say that autism is a prevalent one in 45 children. Parents are not trained to observe these symptoms. Parents do not get trained on how to bring up a child. It is a sorry state affair where the parents are waiting for a child to speak. Most of the parents think that the child will outgrow the condition thinking that baby boys respond late.

She further explains, “Autism is more prevalent in boys than girls. It is a myth about autism where parents think that boys respond late. If the child comes to us at an early stage of 2 years, there can be a remarkable improvement in the child. However, if the child comes at the age of 3 with symptoms of autism then there is a huge gap between his peers who are developing normally at that age”. 

The correct age to diagnose autism in children 

Madhavi informs, “Children generally speak at 1.5 years of age. If a child comes with this problem at the age of 3 years which means they are lagging behind by 1.5 years of age among their peers. So this gap is very difficult to fill up. It takes double the time to teach the child the language which the child will learn naturally. So the child most likely will not be able to catch up with his peers. So we insist on early intervention. We inform the parents not to wait for a diagnosis. If your child is not speaking, start with speech therapy. “

Important and key signals to look for in children to rule out autism 

Madhavi says, “Here are the key signals to look for in children starting to suffer from autism.

At 3 months of age, when you call the child, he will turn his neck  At 1 year of age, the child will start to sit and walk with support

However autistic children, on other hand, start losing interest in people around them. There is a neurological delay in development where they lose the language and social skills. It is important to meet your doctor for help in case of autism symptoms.”

Traits that cannot be missed in an autistic child. 

Madhavi points out, “Some traits that are worth mentioning about autistic children 

Autistic children are very picky eaters.  They are very sensitive to nail cut and hair cut They cannot sleep well and are sensitive to the slightest noise”

The real cause of autism still remains unknown and unclear

Madhavi says, “Research is going out to find out the cause of autism. However, it still remains unclear what causes autism. Once we know the cause of autism, the treatment can be better. Nobody knows what triggers autism. I feel that there are many lifestyle changes that trigger this condition of autism such as increasing screen time. Nowadays, when a child is born, the parents are buying an iPad for them. iPad is a glorified babysitter.”

Mother’s mental and physical health during pregnancy is linked with autism

Madhavi informs, “Some studies also say that stress during pregnancy might trigger autism in children. This is especially seen in working mothers. The age of the mother is also important during pregnancy. There is a lot of link of autism with a mother's physical and mental health during pregnancy. Most of the mothers are working and sitting in front of the laptop 8 - 9 hours per day. The child’s development starts right from the womb. 

Stick to your roots and follow Indian traditions which will help improve the development of the child. 

Madhavi says, “I always advise mothers to listen to their grandparents and talk to them. It is important to follow your tradition and do whatever your grandmother or mother did during their pregnancy. Our Indian tradition is enriched and helps in the healthy development of children. In India, we do not buy baby food, but we make baby food. 

Go back to our roots Eat healthy food Be physically active  Be spiritual  Keep mind sane  Keep body healthy Be in a positive environment  Do your regular check-ups 

Remember, pregnancy is not a disease, it is just an extension of womanhood. This is the most important and the best phase of our life where we are giving birth to one more life. 

Screening time for children 

Madhavi informs, “The allowed screen time for children below 2 years is 0 hours. There are cases where children right from the age of 6 months spend 8 hours a day in front of the screen. The mothers are busy working all day tidying up, cleaning, cooking, and washing. This will hamper the brain development of the child. It's a disaster and we are inviting trouble.We need to be careful.” 

(Edited by Dr.Rati Parwani)