Autism is not as daunting as it seems

Monday was World Autism Awareness Day. It was a decade since the United Nations declared so. The purpose of the declaration seems to have been at least partly served. There is greater awareness about autism today. Most people in urban regions know that it starts in childhood; that some children with autism show repetitive behaviours like rocking or spinning; that therapy helps many of them. Given its increasing incidence, nearly one in 125, many people even know of someone with the condition. In 2008, the UN stressed the importance of improving the quality of life of people with autism so that they can brought to the mainstream society. That is a loftier and as yet unrealised goal.

Understanding the condition is the first step in helping. Autism is a neurodevelopmental disorder that has as its chief features, deficits in social interactions and communication. Restrictive and repetitive patterns of behaviours and interests are seen both in children and adults with autism.

The term Autism Spectrum Disorder(ASD) is used to denote the fact that not all people have all the symptoms and that the severity of the condition also varies. What causes autism and consequently these symptoms is still not known.

Researchers explain that wiring in the autistic brain is different from that in the non-autistic brain. A piece of jigsaw puzzle is often used by autism organisations as their logo to signify just this challenge. The following analogy can perhaps explain how a person with autism feels in our world: "Imagine being dropped in a foreign country's market place. You don't know the language but people are yelling instructions at you or asking questions. You are assailed by uncomfortable smells, sounds and sights that others don't mind. What would you do? retreat to a corner? avoid eye contact? or you may even throw a tantrum because that is the only way you know to communicate."

While this analogy may be simplistic it does give a "neurotypical" person an idea of what a "neuro atypical" person such as one with autism experiences. Because people with autism have sensory issues, some sounds may be too loud, some lights too harsh and even a light touch may trigger an exaggerated response.

Identifying and treating early: Autism is four times more common in boys than in girls and often there is a family history of ASD. There is no laboratory test for Autism. It is diagnosed using behavioural evaluations and developmental scales. Babies who do not smile or respond to their names by six months, older babies who don't use gestures or speech and children who also show certain repetitive motor and other behaviours, should trigger warning bells. Even babies as young as 18 months can be diagnosed.

Treatment consists of structured approaches to reduce sensory and behavioural issues, improve motor coordination, facilitate verbal or sometimes even non-verbal communication. A team approach to treatment works well. A developmental neurologist or a paediatrician may be involved in the initial evaluations. Speech pathologists, occupational therapists, clinical psychologists and special educators work as a team to assess and treat the child. Adult-oriented interventions centre around training for, finding and keeping employment. In some cases, independent living may also be encouraged.

Society's role

It is the duty and responsibility of any civil society to accept all kinds of differences including neurogenic ones. Becoming sensitive to the problems faced by those with ASD will encourage society to find ways and means of integrating them into the mainstream. Regulating the environment by avoiding triggers, creating a predictable routine and using simple short sentences to communicate are steps that can be easily taken by those around. There are several organisations in India doing remarkable work in treating ASD as well as in advocacy. Action for Autism is one such organisation responsible for getting the National Trust Act passed that recognises ASD as a distinct condition. Earlier to that, ASD was clubbed with mental retardation.

Just as it is essential to distinguish ASD from mental retardation which is associated with low IQ, it is also essential to remember that only some individuals with a form of ASD called Asperger's have very high IQs. The code breaking autistic genius of Hollywood movies is indeed a rare phenomenon. As we observe yet another autism Awareness Day, let us remember that celebrating each individual's unique abilities is the best way to help those with ASD realise their full potential.

(The author  is  a speech pathologist)