Autism Spectrum Disorder

World Autism Awareness Day is celebrated on 2nd April and aims to raise awareness to improve the quality of life for those with autism. Autism is classified as a part of the Autism Spectrum Disorder along with Asperger’s, Childhood Disintegrative Disorder and Pervasive Developmental Disorder.

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Autism spectrum disorder (ASD) is a developmental disorder. People with ASD may have difficulty in social communication, interaction and repetitive behaviours, etc. The abilities and behaviour of people affected may vary significantly, some may have advanced communication skills and some may be nonverbal; some may need a lot of help in their daily activities whereas some may need little to no help at all. Due to the wide range of symptoms, autism is now known as autism spectrum disorder.

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Boys are more likely to develop autism spectrum disorder than girls.

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The exact cause of Autism is not yet known but the risk factors include having siblings with ASD, older parents, complications at birth and preterm babies.

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In clinical practice, it is observed that some children show signs such as reduced eye contact, lack of response to their name or indifference to caregivers in early infancy. A few may develop normally for a few months or years of life then they start regressing. Symptoms are normally noticed by the age of two years.

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Symptoms of autism may vary a lot in children, some may show a little low intelligence whereas some may be quick learners but still have difficulty in communication, and no two children appear or behave the same way. Due to such a unique mixture of symptoms, diagnosis may be difficult at times.

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Certain signs and symptoms of ASD that should not be ignored are as follows:

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• Failing to respond to his/her name
• Does not like hugging or cuddling even by parents
• Prefers to be alone
• Does not look into the eye while you talk/ No eye contact
• Delayed speech/ losses the ability to use previously used words
• Cannot start a conversation, can only make requests
• Repeats words/actions like rocking or flapping of hands
• Cannot understand simple questions
• Unaware of others' feelings
• Head banging or biting in severe cases
• Gets fascinated by the details of an object like the wheels but does not understand the function of the object
• Highly sensitive to light or noise
• Fixation on an object or activity with an abnormal focus
• Has very specific food preferences
• Does not like any kind of change in the normal routine

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Children with Autism may also show attention deficit or hyperactivity disorders, there might be gastrointestinal symptoms like diarrhoea or constipation, sleep-related issues or epilepsy.

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The levels of ASD are:

·??????Level 1- Mild autism. Symptoms don't interfere with daily activities or social skills.

·??????Level 2- These children may need speech therapy, social skills training and counselling.

·??????Level 3- Severe autism. They need full-time support in all activities. They may be unable to function on their own.

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Diagnosing ASD may be difficult as there is no test like blood test to diagnose this disorder. The earlier it is detected, the better it is as they may get the early help that is needed. Doctors look at the child's behaviour and development to make the diagnosis. Some may be diagnosed in adolescence. Specialists who do an in-depth evaluation and make a diagnosis are Developmental Paediatricians, Child Neurologists, Child Psychologists or Psychiatrists.

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The Childhood Autism Rating Scale (CARS), Indian Scale for screening of Autism, Vineland Social maturity Scale (VSMS) and M Chat are some of the few scales used by specialists for assessing patients.

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There is no particular treatment for Autism. The goal of the treatment is to reduce the symptoms and support the development and learning to maximise the child's ability to function.?

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Certain individualised therapies are the mainstay in managing this condition:

• Educational therapy- Structured educational programmes to improve social and communication skills.
• Family therapy- Family members can learn how to interact and play with children
• Occupational therapy- Improves fine motor activity, balance and comprehension thereby improving daily activity skills.
• Speech Therapy- In children where the speech is delayed or where it has regressed.

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These may help children with social, functional and behavioural skills.

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Some children as they get older, start engaging with peers and show fewer behavioural disturbances. Children who have mild autism may lead normal to nearly normal lives.

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There are no conventional medicines that help improve autism symptoms. Although certain psychoactive drugs, anti-depressants, anti-psychotics, anti-epileptics and stimulants may help children with hyperactivity, anxiety or sleep disorders.?

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Homoeopathic treatment along with ancillary measures helps to bring about a significant change in functioning with a better adaptation of the children to their environment.?

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A few Homoeopathic remedies that may be of help in ASD are:

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1. Carcinosin: Given to children who are talented but are obsessive, compulsive, stubborn, and also have sleep-related issues. They may also be hyperactive and may have significant attention deficit. These children may not like to be contradicted.
2. Agaricus: Children may be indifferent to the surroundings, and may mutter, talk, shout, or sing but do not answer direct questions. There may also be involuntary jerking.?
3. Cuprum?Metallicum: The child is very stubborn, angry, and inflexible. Very aggressive towards the parents. They are usually averse to touch or being approached.?
4. Baryta?Carbonicum: These children may have poor social, communication and language skills. Children who need this remedy are very shy. Extremely shy of strangers. They are very timid and may hide behind the furniture and cover their face with their hands & peep through their fingers. They may have a weak memory.
5. Kali?Bromatum: Individuals who need this are hyperactive and have a very short attention span. They are fidgety and restless. While talking they may omit or mix up a few words.

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For individualized remedy selection and homoeopathic treatment of autism, the patient should be consulted by a qualified homoeopathic doctor in person. A thorough; detailed history is taken by the homoeopathic physician, and the patient is observed in his/her day-to-day functioning, at school and during therapies.

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No diet is considered best for autism but certain foods like eggs, nuts, seeds, beans, a vitamin B12-rich diet or supplements and zinc may help improve the symptoms and overall health.

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Certain foods if avoided may improve the symptoms, reduce restlessness and improve concentration. These foods are:

• Milk and dairy products, such as casein in milk may lead to the production of exorphin which can lead to brain fog and inability to concentrate.
• Gluten may lead to systemic inflammation and reduces the good bacteria in the gut, which may lead to anxiety
• Sugar as it is pro-inflammatory.
• Food additives, preservatives and MSG (monosodium glutamate) should be avoided as they may trigger autism symptoms.

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Research shows that early intervention (preschool) is always the best as it helps your child learn critical, social, functional and behavioural skills. Contact your child’s doctor if you notice any difference from the normal behaviour or if you have any other concerns about the way your child plays, learns, speaks, or acts.