Why thousands of Indian children with Autism are diagnosed late: Doctors explain what early intervention can change

Every child develops differently. Some speak early, while others take a little longer. Some are outgoing, while others are naturally quiet. But sometimes, what appears to be a simple delay may actually be an early sign of autism.

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that affects communication, social interaction, behaviour, and sensory processing. It is called a "spectrum" because no two autistic individuals are exactly alike. Some may require significant support throughout life, while others may live independently and excel in academics, arts, technology, or business.

The challenge in India is that autism is often misunderstood. Many families still associate it with intellectual disability, poor parenting, or behavioural problems. As a result, important signs are frequently overlooked.

Dr Ajit Singh Baghela, Sr. Consultant-Paediatric Neurology, Artemis Hospitals, explains, "Autism spectrum disorder is a neurodevelopmental disorder that affects communication, behavior, learning and social interaction. In India awareness about autism is increasing but many children are still diagnosed late. Parents often miss early signs, thinking the child will 'catch up' with age. However, early intervention can be a huge difference in a child's development and overall quality of life."

For many families, the first signs appear quietly. A toddler may avoid eye contact, respond less often to their name, become unusually sensitive to sounds, or engage in repetitive behaviours. These signs can emerge as early as 18 months to 2 years of age, yet many children are not assessed until much later.

One of the biggest challenges is not the lack of symptoms, it is the lack of recognition.

In many households, developmental concerns are dismissed with well-meaning advice. Parents are often told that boys speak late, that children develop at different speeds, or that the child is simply shy.

Then there is the issue of stigma.

Many families hesitate to seek professional help because they fear judgment from relatives, schools, or society. Some worry about labels. Others are unsure about where to go or whom to consult.

Access remains another major barrier. While metropolitan cities may have developmental pediatricians, child neurologists, psychologists, occupational therapists, and speech therapists, smaller towns and rural areas often lack these services.

Research has repeatedly highlighted these challenges. A review examining autism in the Indian context found that lack of awareness, delayed access to specialists, and limited support services continue to affect timely diagnosis and intervention.

Dr Rafat Trivedi, Senior Consultant - Pediatric Neurology & Epilepsy, Marengo Asia Hospitals, Gurugram, says, "One should consider autism more as a neurodevelopmental problem rather than as a disease, and needs proper knowledge and timely clinical intervention."

He further adds, "The early years of a child's development are absolutely crucial. One must look out for early symptoms such as delayed language development, lack of eye contact, repetitive actions, sensory sensitivity, or problems with socialisation. Early diagnosis can aid us in starting interventions at a time when their brain is more flexible and adaptive to therapy."

The human brain develops at an astonishing pace during the first few years of life. Millions of neural connections are formed every second during early childhood.

This is precisely why experts place so much emphasis on early intervention.

Early intervention does not mean changing who a child is. It means helping the child build skills that allow them to communicate better, participate in daily life, express their needs, and become more independent.

Dr Baghela explains, "Early intervention is offering therapies and support during the early years of brain development. At this stage a child's brain is very adaptable, making it easier to improve communication, learning, behaviour and social skills."

He adds, "Speech therapy, occupational therapy, behavioural therapy and special education programs can help children become more independent and confident."

Studies have consistently shown that children who receive support during their early developmental years often demonstrate improvements in communication, social understanding, emotional regulation, and adaptive skills. Early intervention may also reduce stress for families by helping parents understand how their child learns and communicates.

One of the biggest misconceptions surrounding autism is that therapy exists to make autistic children behave like everyone else.

Experts say that is not the goal.

The real goal is to help children navigate the world more comfortably and confidently.

Dr Kirti Yadav, Head SBU – Rehabilitation, Marengo Asia Hospitals, Gurugram, explains, "Rehabilitation has an important role in developing life skills and building confidence among children. It is not just about enhancing their speech and behaviour; it also helps children become a part of schooling, family, and society."

She further notes, "Contemporary rehabilitation for autism requires a multidisciplinary approach that includes occupational therapy, speech therapy, sensory integration, behavioural therapy, psychology, and parent training."

Every autistic child is different. Some may struggle with communication. Others may face sensory challenges. Some may need support in school settings, while others may require assistance with social interactions.

That is why experts increasingly advocate for individualized care rather than a one-size-fits-all model.

Dr Trivedi emphasizes, "No two children with autism are alike, making it crucial for each of them to have customised treatment plans."

India has taken steps toward supporting children with developmental disabilities. The Government-backed National Trust for the Welfare of Persons with Autism, Cerebral Palsy, Mental Retardation and Multiple Disabilities Act, 1999 supports several initiatives focused on disability rights, inclusion, and early intervention.

Yet awareness must move beyond hospitals.

Teachers, anganwadi workers, pediatricians, school counsellors, and parents all play a role in identifying developmental concerns early.

Dr Yadav stresses, "Families need proper guidance early in life; the whole future of a child can change with the right interventions. Intervention in autism is all about the possibilities."

Dr Baghela echoes the same sentiment, "Autism is not a limitation. Children with autism with acceptance, proper guidance and early intervention, can lead meaningful and productive lives."

The conversation around autism in India is gradually changing. More parents are seeking developmental assessments. More schools are discussing inclusion. More healthcare institutions are creating early intervention programs. But experts agree that much more needs to be done.

Because when support arrives early, the benefits often extend far beyond childhood. They can shape education, employment, relationships, independence, and self-confidence for decades to come.

And sometimes, what changes a lifetime is not a breakthrough treatment. It is simply being understood at the right time.

This article includes expert inputs shared with TOI Health by:

Dr Ajit Singh Baghela, Sr. Consultant-Paediatric Neurology, Artemis Hospitals.
Dr Rafat Trivedi, Senior Consultant - Pediatric Neurology & Epilepsy, Marengo Asia Hospitals, Gurugram.
Dr Kirti Yadav, Head SBU – Rehabilitation, Marengo Asia Hospitals, Gurugram.

Inputs were used to explain what autism is, why many children in India continue to face delayed diagnosis, and how timely identification and early intervention can significantly improve communication, learning, social development, and long-term quality of life.