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Autism Spectrum Disorder: An Overview

Autism, or Autism Spectrum Disorder (ASD), is a pervasive neurological developmental disability that hampers normal brain development. It affects speech and nonverbal communication, social skills, cognition, and behaviour.

This condition becomes apparent in early childhood and affects the child’s overall development. Roughly three million people live with ASD in India. Autism is known as a spectrum disorder as its symptoms and characteristics appear in a variety of combinations that affects people in different ways.

There is a wide range of severity of Autism. Each person with autism has a distinct set of strengths and challenges. Different people with ASD disorder are observed to have a wide range of IQs. Some people with ASD do not use any verbal forms of communication whereas some are highly verbal and conversational.

Some children are capable of managing their daily tasks independently, whereas some face severe challenges in doing so and need constant help. Some people are doing perfectly fine in their jobs and have families, while others are completely withdrawn from all forms of social interaction.

Autism Spectrum Disorder is not a single disorder, rather it’s a spectrum of different disorders that share a core of symptoms. Every patient that suffers from ASD disorder will have some problems with empathy, social interaction, communication, and regulating behaviour. The levels of disability and the combination of various symptoms can vary from one patient to another. Also, two patients who suffer from signs and symptoms of autism spectrum disorder can look quite different when it comes to behaviours and abilities. Hence it is important to develop a tailored treatment and management program for each patient. 

As a parent, you may hear many different terms that can apply for your child with autism, if they are diagnosed with ASD disorder. The terms will include high-functioning autism, atypical autism, and autism spectrum disorder, along with the pervasive developmental disorder. 

These terms can be overwhelming and confusing especially doctors don’t explain the jargon to you. Ensure that you ask and clarify all your doubts with the doctor or psychiatrist to ensure that you as the parent are apprised with the condition of your child. It might also be advisable to get a second opinion on the diagnosis if you’re unsure or uncomfortable with the doctor.

People with Autism can be characterized not only by these areas of the challenge but also by significant areas of strength. A child with Autism has a certain set of abilities and aptitude which should be identified and encouraged by the parents, therapists, and teachers. An autistic child may exhibit some of these skills – 

  • Good visual and spatial memory
  • A methodical and organized way of doing things
  • Ability to understand abstract concepts
  • Excellence in the area of their interest
  • Attention to detail
  • Interest in languages (among children who can speak well)

Parents often confuse Autism with ADHD. Despite some similarities, ADHD is not a spectrum disorder. One major difference between the two is that children with ADHD don’t tend to lack socio-communicative skills. The exact reason for what causes Autism is unknown.

Recent research and developments in the Neurological Disorders study suggest that there’s no single cause for Autism. Given the complexity of the disorder and the fact that symptoms and severity vary, there can be a wide range of factors which might cause damage to the central nervous system at an infant stage. Various combinations of genetic and environmental factors might trigger it. 

Some of the suspected causes of autism spectrum disorder include – 

  • Having an immediate family member with an autism
  • Genetic mutations
  • Parents who have children late in life
  • Fragile X syndrome and other genetic disorders
  • A pregnant woman who have conditions like diabetes and obesity or who drink alcohol during pregnancy
  • Low birth weight
  • Metabolic imbalances
  • Exposure to heavy metals and environmental toxins
  • A history of viral infections
  • Untreated condition like rubella (German measles), or phenylketonuria, a metabolic disorder caused by the absence of an enzyme
  • Fetal exposure to the medications valproic acid (Depakene) or thalidomide (Thalomid)

Symptoms of Autism Spectrum Disorder

The usual signs of Autism show up when a child is between 2 and 3 years old, but Medical experts think it begins at a much earlier stage when the brain starts to develop. Signs and symptoms of autism spectrum disorder start during early childhood and it eventually branches out as problems when functioning in society; this includes in school or at work.

Children will show autism spectrum disorder symptoms within the first year. Some children will develop normally in the first year, and they will show symptoms between the second and third years. 

The intensity of the signs and symptoms of ASD might vary from mild, moderate to severe. A child with severe motor skills and cognitive impairment may also develop epilepsy.

However, a specific set of behaviours are indicators of the condition. During the physiological and psychological developmental phase, the following traits can be looked out for. Children with autism may face difficulties in – 

Communication – 

  • Difficulties in forming meaningful sentences while talking. 
  • Even when they have extensive vocabularies, they might face difficulty communicating.
  • Repeating words or phrases they hear 
  • Repeating actions again and again
  • May use sign language while speaking
  • May or may not learn a language at all
  • Inability to explain their feelings, emotions and needs.
  • Inability to interpret conversation, voice, facial expressions, body language.
  • Inability to have eye contact when someone is speaking.

Social interaction – 

  • At an early stage of infancy, they may not display any anticipatory posture or smile for being picked up by an adult. 
  • Difficulty in interacting with people and learning social skills
  • Difficulty in making friends or do not want the company and instead plays alone.
  • Avoids eye contact
  • Inability to understand the feelings or emotions of others around them, due to which they may not reciprocate with an appropriate response.
  • Trouble adapting to routine changes
  • May respond differently to the way things smell, taste, look, feel, or sound

Sensory – 

  • Difficulty in hearing
  • Extremely sensitive to smell, touch, taste, sound, light, and colour
  • Sensitivity to certain types of food
  • Uncomfortable with touch or physical contact

Behaviour – 

  • Difficulty in following directions or instructions
  • Shows unusual attachment to an object or a toy
  • Unusual interest or obsessed about specific activities
  • Activities and play are generally rigid, repetitive, and monotonous
  • Not afraid of a real dangerous situation, but fearful of harmless objects
  • Sudden mood changes: bursts of laughing or crying without obvious reason.
  • Hyperkinesis, which is a condition of excessive abnormal movements due to an increase in muscular activity. It is a common behavioural problem in a child with autism, and it may alternate with hyperactivity.
  • Aggression and temper tantrum prompted mostly by change and demands.
  • Short attention span, poor ability to focus on a task
  • Feeding and eating problems

Observing the symptoms that manifest themselves can help bring doctors to prescribe an effective treatment plan for autism spectrum disorder. Lack of awareness of the signs and symptoms of autism delays the parents’ ability to identify the problem at an early stage. As there are many other conditions that can co-exist with Autism such as learning disability, mental retardation, motor difficulties, hyperactivity, seizures, hearing or visual impairment. Complications with social interactions, communication and behaviour can lead to various other drawbacks such as – 

  • Problems in school and with successful learning
  • Employment problems
  • Inability to live independently
  • Social isolation
  • Stress within the family
  • Victimization and being bullied

Diagnosis

There is no single medical test for diagnosing ASD. A set of specific assessments and evaluations are required to confirm the condition. Some of the assessments include:

Physical and Nervous system (Neurological) test – A neurological examination is the assessment of sensory neuron and motor responses, especially reflexes, to determine whether the nervous system is impaired. 

Autism Diagnostic Interview-Revised (ADI-R) – The Autism Diagnostic Interview-Revised (ADI-R) is a structured interview used for diagnosing autism, planning treatment, and distinguishing autism from other developmental disorders. This test helps to determine problems with language and communications, reciprocal social interactions, and restricted, repetitive, and stereotyped behaviours and interests.

Autism Diagnostic Observation Schedule (ADOS) – ADOS is a standardized diagnostic test for Autism Spectrum Disorder (ASD). The test consists of a series of structured and semi-structured tasks that involve social interaction between the examiner and the patient.

Childhood Autism Rating Scale (CARS) – This assessment tool works by rating your child’s behaviour, characteristics, and abilities against the expected developmental growth of a typical child. This test evaluates characteristics like an emotional response, relationship to people or an object, adaptation to change, fear and nervousness etc.

Gilliam Autism Rating Scale (GARS) – GARS assists teachers, parents, and physicians in identifying ASD in individuals and estimating its severity. It is one of the most widely used instruments for the assessment of autism spectrum disorder (ASD) in the world.

Pervasive Developmental Disorders Screening Test (PDDST) – PDDST is a screening tool designed to identify ASD in children between 12 to 48 months old. Consisting of a 23 item questionnaire, it is designed to be used by the child’s parent or other main caregivers.

Your doctor may also recommend a combination of tests such as DNA testing for genetic diseases, behavioural evaluation, visual and audio tests to rule out any issues with vision and Hearing completely unrelated to autism, and occupational therapy screening etc.

 

Treatment of Autism Spectrum Disorder

For proper ASD treatment, the doctor will first have to drill down and diagnose the exact symptoms which your child is facing. Early diagnosis and treatment are imperative, especially during the preschool days, because it will help the child overcome their developmental delays. If you’re worried that your child has Autism Spectrum Disorder, then you must seek out a clinical diagnosis and treatment plan at Cadabams which is equipped to provide the highest level of care and best treatment for autism in India

The primary goals of autism spectrum disorder treatment are to help the child improve their abilities to integrate into their academic careers, develop meaningful relationships, and to increase the possibility of maintaining independent living as adults.

Children with autism can make significant progress with a properly structured ASD treatment. What works for one child might not work for another. Tailored treatment for you or your child is what you need. There are two ways ASD can be treated – Therapy like ABA or Medications.

Applied Behavior Analysis (ABA) – It is a therapy based on the science of learning and behaviour. This analysis helps to understand how behaviour works and how it gets affected by the external environment. This therapy helps to increase cognitive, social, behavioural, fine motor, play, and self-help skills. The child is taught to work on structured tasks and subtasks, ranging from simple to complex ones. The child is taught to learn and complete each task at a time. This method uses rewards to help the child learn and maintain desired behaviours and skills. Type of ABA include – 

Discrete Trial Training (DTT) – It is a method of teaching in simplified and structured steps. Instead of teaching an entire skill in one go, the skill is broken down and “built-up” using discrete trials that teach each step one at a time.

Early Intensive Behavioral Intervention (EIBI) – EIBI uses the principles of behaviour analysis to increase positive and useful behaviours and decrease unwanted behaviours such as tantrums, aggression, and self-injury. It is a highly structured approach for teaching children under five years of age.

Pivotal Response Training (PRT) – Psychologists, Special education teachers, and Speech therapists widely use PRT to increase positive social behaviours and to provide relief from disruptive self-stimulatory behaviours. It is a play-based autism therapy which focuses on child’s development instead of working on one specific behaviour.

Verbal Behavior Intervention (VBI) – VBI teaches communication and language. This approach encourages people with autism to learn language by connecting words with their purposes. Rather than focusing words as labels, it teaches why we use words and how they are useful in making requests and communicating ideas.

Treatment and Education of Autistic and related Communication Handicapped Children Method (TEACCH) – TEACCH  is an evidence-based service, training, and research program for individuals of all ages and skill levels with autism spectrum disorders. TEACCH provides clinical services such as diagnostic evaluations, parent training and social play, parent support groups, recreation groups, individual counselling for higher-functioning clients, and supported employment.

Medications for Autism Spectrum Disorder (ASD) can help with symptoms, like attention problems, depression, hyperactivity, insomnia, trouble focusing or anxiety. Risperidone (Risperdal) is the only drug approved by the FDA for children with ASD. Some doctors also prescribe medicines like serotonin reuptake inhibitors (SSRIs), anti-anxiety medications, or stimulants. Some other alternative treatments for managing autism may include:

  • high-dose vitamins
  • chelation therapy, which helps flush metals from the body
  • hyperbaric oxygen therapy
  • melatonin to address sleep issues

Although ASD in itself can’t be cured, however, the treatment methodology involves reducing the symptoms of ASD and improving the person’s abilities to function. Treatments like speech therapy for Autism Spectrum Disorder can also help in improving the social, communicational, functional, and behavioural skills of patients suffering from Autism Spectrum Disorder. Interventions or therapies are designed to reduce some of the developmental problems faced by a child with autism. Your doctor might include some therapies to your treatment plan – 

Developmental, Individual Differences, Relationship-Based Approach (DIR) – This therapy is also called floortime as it focuses on how the child deals with sights, sounds, and smells. It also helps deal with the emotional and relational development with the parents or caregivers.

Occupational Therapy – This therapy enables the child to live an independent life. It includes day to day skills like eating, dressing, bathing, and relating to people.

Sensory Integration Therapy – Helps the child deal with sensory information like sights, sounds, and smells. It helps greatly when a child is bothered by certain sounds or does not like to be touched.

Speech Therapy – It helps improve communication. With alternate methods like gestures, picture boards, etc., this therapy helps an autistic child to learn how to express his/her thoughts and ideas to others.

Music Therapy – Singing, composition, and live music-making are used in this form of therapy. This type of intervention used with children and teens with ASD improves social behaviours, increases focus and attention, increases communication attempts like vocalizations, verbalizations, gestures, and vocabulary, reduces anxiety, and improves body awareness and coordination.

Behaviour and communication therapies – This treatment plan for autism spectrum disorder aims to address social, language, and behavioural problems through programs.

Educational therapies – These programs help improve the interpersonal and communication skills of children.

Family therapy – In this therapy for autism spectrum disorder, parents, and other family members are taught to engage in plays and mock scenarios with patients to help them learn social interaction.

Before opting for any therapy, treatment, or medications, do seek sound medical advice. You can also research about the ASD treatment cost in India to explore all the options available as a parent and caregiver.

Autism FAQs: All you need to know

What are autism spectrum disorders?

Autism spectrum disorder (ASD) is a developmental disorder that disrupts a person’s communication and behaviour. Conditions like Asperger’s syndrome, Pervasive developmental disorder, Autism, Childhood disintegrative disorder are few types of autism spectrum disorders.

What are the symptoms of autism spectrum disorders?

Few major symptoms include – 

  • Making inconsistent or little eye contact
  • Aggression and temperamental issues
  • Tending not paying attention to people
  • Repeating certain behaviours
  • Sensitive to the sense of smell, taste, touch, light etc.
  • Difficulty in following directions or instructions.
  • Sleep problems and irritability

What is Asperger’s syndrome?

Asperger syndrome, also known as Asperger’s, is a mental health disorder characterised by significant difficulties in social interaction. Unlike autism, Asperger’s disorder shows less severe symptoms and the absence of language delays. Signs of Asperger’s usually begin before two years of age and usually lasts for an entire lifetime.

How is ASD diagnosed and Treated?

Diagnosis of ASD is difficult as there’s no particular medical test to detect the condition. Doctors check out the complete medical and developmental history of a child and study their behaviours to make a diagnosis. There are a series of assessments and tests, which helps to rule out other mental health conditions and helps to figure out what are the coping mechanisms a child is using to deal with his daily life. This helps the doctor to decide on how much of help he needs and what is the best suitable treatment for the child.

What are the causes of autism spectrum disorders?

The exact reason for ASD is still not known. Some of the suspected cases of Autism are – having an immediate family member with autism, low birth weight, being born to older parents, metabolic imbalances, exposure to heavy metals and environmental toxins, and/or genetic mutations.

For the best autism treatment in Bangalore, book an appointment at Cadabam’s.

Why Cadabams?

Cadabam’s is one of the best autism treatment centres in Bangalore. Our team of psychiatrists are experts in psychosocial rehabilitation and cognitive behavioural therapy (CBT) ), interpersonal and social rhythm therapy (IPSRT), and family-focused therapy have proven to be highly effective in cases of Autism Spectrum Disorder. Our autistic centre has over two decades of expertise in handling the most complex cases of Autism Spectrum Disorder and offers the best ASD treatment in India.

Luxurious Living

At Cadabams, we provide clean, modern, fully furnished accommodations with all the necessary creature comforts.

Modern Amenities

Kitchen and dining hall, laundry facilities, indoor games area, yoga and meditation hall, outdoor games area for cricket, badminton, Round the clock psychiatrist and counsellor support, 24×7 ambulance on demand.

Healthy Cuisine

Our everyday menu is curated by Dieticians aimed at providing healthy and nutritious and tasty meals to satisfy everyone’s palate.

Entertainment Options

Recreation facilities such as TV, sports, gym, picnics and outings and more.

Difficult to make friends or relationships

MEDICATION: Certain class of medications helps in some of the symptoms like controlling repetitive thoughts, behaviour and control aggression and temper tantrums.

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