Autism is a brain developmental disorder. This disorder is also called autism spectrum disorder (ASD), and children with this disorder have been increasing in recent times compared to earlier. This disorder is estimated to be 1 in 36 as per recent CDC figures. Kids with ASD present with a lack of response when their name is called, not looking into the face or eyes of others, are immersed in their own world, unable to communicate their needs by speech or to point or gestures, playing to self and not mixing with children, doing some repetitively same acts or behaviour or excessive interest in particular objects or discomfort with specific sounds or change of routine. The unfortunate part of this disorder is that there was no medication till now targeting the core domains of Autism. However, there were good chances of improving the child with psychological and other interventions. Many parents were in a state of confusion regarding the management of this disorder. Parents have a false notion that pills or syrups may make their kids normal. There are doubts regarding which medical professional to contact, assessments that may be needed, the available treatment options, and the type of diet to be given for kids with Autism.
In this article, I will be narrating the above aspects so that parents will get clarity. Usually, Medical disorders are diagnosed as per the specific criteria given by the respective organizations in their field. In similar lines, Autism is also diagnosed by DSM-5 criteria given by the American Psychiatric Association and ICD 11, and as per these criteria, it is diagnosed worldwide. There were some medical professionals who were well versed with these criteria because they learned and examined the disorder during their training in the respective medical field. Child Psychiatrists and Psychiatrists were the primary medical professionals who were trained to diagnose autism spectrum disorders as they are well-versed in identifying different behavioral disorders in children. Recently, pediatric neurologists and developmental pediatricians were receiving training for identifying autism. Since Autism is a Brain developmental disorder and there is no medication to develop the brain, the only we can improve the kids with Autism is by stimulating their brains from the external world. This stimulation can be achieved by the different inputs of the parents or family members and also from therapists. Parents should receive training about the activities and interventions they have to do while the child is with them at home. The therapies that were needed in the majority of Kids with ASD were occupational and speech therapy. These therapies were given by qualified professionals who graduated in their specialty and are designated occupational therapists (B.O.T) and speech therapists (B.A.S.L.P). In this regard, parents must check in these aspects to get a good improvement in their kids. The other professionals are Clinical psychologists who will be doing psychological assessments and Special educators who will be giving interventions about education. There were some other medical conditions that can present with signs of Autism. Hence, proper evaluation by child psychiatrists or child neurologists has to be done before going to therapy.
Parents should also monitor the child's progress with Child psychiatrists while undergoing therapies, as they can help if their kids are not improving. In some kids, there may be hyperactivity, and if the hyperactivity is not treated well, the kids may not have good improvement. Psychological assessments like MCHAT, CARS, INCLEN, and ISAA will help clinicians confirm diagnoses. In some kids with associated neurological problems, an EEG and MRI may be needed. Blood and urine investigations may be needed if the kid is suspected to have neurometabolic disorders. BERA may be needed if the kid is suspected of having a hearing impairment. If there is consanguinity in parents, the child is suspected to have other anomalies in the body, or if the parents are planning for the next pregnancy, genetic investigations may be planned.
Interventions given by the Parents and Therapists were considered Core treatments for autism spectrum disorder as they stimulate the Brain. Research supports that all these interventions work well, and they will have good improvement if they are started as early as possible and before the age of five. Hence, parents should continuously engage the child to stimulate the brain. Engaging the child with screens or mobiles will cause the child to have ASD symptoms or not improve the child as they will deprive every day environmental stimulation, which is very much needed by the normally developing brains, and parents should be strict in not giving any screens to the child and zero screen time has to be perfectly ensured. Reputed medical journals, WHO, and pediatric associations have already narrated the negative effects of screens, and guidelines have been issued. Some nutrients (L Carnosine and Omega fatty acids) were reported by some research to help improve the symptoms of ASD. In some proportion of kids with ASD, they may have dysregulation of normal healthy bacteria in the intestines, and sometimes they may present with digestive issues like constipation. In these type of kids probiotics or Gluten casein free diet may help. High-sugar products have to be avoided as they can trigger hyperactivity. There is some proportion (approximately fifteen percent) of kids who can resolve symptoms of ASD, and in follow-ups, they may not be coming in the category of ASD. There is some research about stem cell therapy in ASD. Still, currently, the National Medical Council or ICMR does not recommend it for Autism, and this could be due to a lack of adequate evidence of a therapeutic strategy for ASD.