Make a difference to their lives

ALLAHABAD:Abhimanyu is a sweet 7-yr-old boy sitting quietly in the class. He is given acolour pencil and a sheet by the teacher to draw. He starts drawing lines andcontinues making them repetitively. He speaks but cannot understand instructionseasily. They have to be repeated several times. Surabhi and Anusha are 14 yearsold and they are being taught daily activities like folding a cloth to make ahandkerchief or holding a glass. Their hands keep on moving and they cannotconcentrate. Wonder why? Abhimanyu, Surabhi and Anusha are autistic children.Dr Neera Banerjee, project director, Umang school for Children withSpecial Needs, Allahabad informs that autism is a brain development disordercharacterized by impaired social interaction, problems with verbal andnon-verbal communication, and unusual, repetitive or severely limited activitiesand interests. It is the result of a neurological disorder that affects thefunctioning of the brain. Experts estimate that three to six children out ofevery 1,000 suffer from autism, with males four times more likely to have autismas compared to females.There are no medical tests for autism. It isprimarily diagnosed by presence or absence of certain behaviours. These signsbegin before a child is three years old. Parents are usually the first to noticesymptoms of autism in their child. As early as infancy, a baby with autism maybe unresponsive to people or focus on one item intently for long periods oftime. Such a child may appear to develop normally and then withdraw and becomeindifferent to social engagements, she says.According to estimates,India has 1.5 million autistic children. The World Health Organisation (WHO) hasdesignated April 2 as World Autism Awareness Day to sensitise people on the needto integrate autistic children with mainstream life."Children withautism may fail to respond to their name and often avoid eye contact with otherpeople. They have difficulty interpreting feelings of others as they do notunderstand voice modulations and facial expressions meaning thereby that theylack empathy," says Dr Asha Mishra, principal, Umang School for Children withSpecial Needs, who has spent a life-time serving these children.Majority of such children engage in repetitive behaviour such asrocking and twirling or in self-abusive behaviour such as biting or headbanging. "Akhil, a 9-yr-old autistic child in our school, harms himself often byhitting himself on the chest. There we need to divert his attention by givinghim a colourful ball or slate and chalk. The object given to him is blunt so asto ensure that he does not hurt himself," she adds. Children withautism don't know how to play interactively with other children, informs DrDeepak Aggarwal, a paediatrician. Some speak in singing patterned voiceregarding the narrow range of their favourite topics, without understanding thelisteners' interest in the conversation. These children usually have reducedsensitivity to pain but abnormally high sensitivity to sound, touch or sensorystimulations. This may be the reason for their resistance towards cuddling orhugging, he reasons. About a third to a half of individuals withautism do not develop enough natural speech to meet their daily communicationneeds. They tend to start speaking later as compared to other children and mayrefer to themselves by name rather than I or me. Other aspects, such as atypicaleating, are also common but are not essential for diagnosis. Autistic childrenare less likely to make requests or share experiences, and are more likely tosimply repeat others' words, says Dr Aggarwal.Autism is the mostcommon condition in a group of developmental disorders known as Autism SpectrumDisorders (ASD). These also include related conditions such as Asperger syndrome(which has milder signs and symptoms), Rett syndrome, Childhood DisintegrativeDisorder and Pervasive Developmental Disorder Not Otherwise Specified (referredto as PDD-NOS). Causes of autism are still unknown. Scientists opinethat genetics as also environment play a role as a number of genes associatedwith the disorder have been identified. Studies conducted on people sufferingfrom autism show irregularities in several regions of the brain. Experts alsopoint at abnormal levels of serotonin or other neurotransmitters in their brain.All these suggest that autism could result from disruption of normal braindevelopment in early foetal stages, due to defects in genes that control braingrowth and regulate how neurons communicate with each other.Autismhas a strong genetic basis. Recent studies suggest that some people have agenetic disposition to autism. In families with one autistic child, the risk ofhaving a second with the disorder is approximately ten per cent. The number ofpeople known to have autism has increased dramatically since the 1980s, partlydue to changes in diagnostic practice; though the question of whether actualprevalence has increased is unresolved.Autism is a complex disorder.A comprehensive evaluation requires a multidisciplinary team including apsychologist, neurologist, psychiatrist, speech therapist and otherprofessionals to conduct thorough neurological assessment as also in-depthcognitive and language testing. If a child is not interacting or responding andremains subdued, then parents should ensure early intervention, suggests Dr AjayGopal, a city-based paediatrician.Autism has no cure. Manyinterventions (medicines, diet plans) have been tried but nothing has beenproven yet. Autistic children may be deficit in ability to communicate but theyhave special skills in other areas. Appropriate training programme which isspecific to a child's need and rightly focused on his skill enhancement ensuresthat the child can progress to his fullest potential. "Many autistic childrenhave been integrated into normal schools. This is dependent on factors such asskill profile of the child, early diagnosis and appropriate intervention," saysShikha Bose, a teacher at Umang. "Nitin, an 11-yr-old autistic child in ourschool has learnt to read and write and is ready to join prep class in a normalschool," she adds happily.Best treatment for autism is to impartstructured education and training so as to eventually make them self-reliant andsuitably rehabilitate them to live an independent life with as little help aspossible. Parents have large role to play in development of such children. Loveyour child. Treat him/her as normally as possible. It may take longer for theautistic child to learn necessary abilities to function independently in thesociety as an adult. However, with love, patience, early intervention andeducation, people with autism can be integrated into society and do lead happyproductive lives, advises Dr Banerjee. (Names of children have beenchanged)