Awareness on Autism
Parents often become concerned about a child by 18 months as language development does not occur as expected.
Autism is characterised by impaired reciprocal social interactions, aberrant language delay and restricted behavioral repertoire. It typically emerges in young children before the age of 3 years.
Parents often become concerned about a child by 18 months as language development does not occur as expected.
History
In 1867, Henry Maudsley noted a group of very young children with severe mental disorders who had marked deviation, delay, and distortion in development. In 1943 Leo Kanner, coined the term infantile autism and provided a clear, comprehensive account of the early childhood syndrome. Kanner suspected that some children with this disorder had been misclassified as mentally retarded or schizophrenic. Before 1980, children with autism spectrum disorders were generally diagnosed with childhood schizophrenia.
Reciprocal social skills
Infants many lack a social smile and anticipatory posture for being picked up as an adult approach. They often do not acknowledge or differentiate the most important persons in their lives. Deficit is seen in ability to play with peers and to make friends. Their social behavior is awkward and may be inappropriate. Children with autism cannot infer the feelings or mental state of others around them and so lack of social or emotional reciprocity is noticed.
Stereotyped behaviour
The activities and play of these children are often rigid, repetitive, and monotonous. Ritualistic and compulsive phenomena are common in early and middle childhood. They exhibit sudden mood changes, with bursts of laughing or crying without an obvious reason. Autistic children have been observed to over respond to some stimuli and under respond to other sensory stimuli (e.g., to sound and pain). Autistic children are generally resistant to transition and change.
Treatment
In view of the multidisciplinary nature of working with a child with autism one clinician should be the primary child psychiatrist/pediatric neurologist/developmental pediatrician. The important areas to focus on are: Education through psychosocial interventions, help for the family,medication, specific therapies and dietary therapy. All cases attending the Niloufer Hospital are started on a gluten free, casein free diet and many children begin to show improvement in eye contact, language, and responsiveness within days to weeks. Hyperactivity does not improve completely, and many children are subsequently diagnosed to be hyperactive at other centers. The result of research studies is mixed; some children respond positively.
DR M Hrishikesh Giri Prasad, MBBS, DCH, MD (Psychiatry)
Assistant Prof. Child Psychiatry,
Dept. of Child Psychiatry,
Niloufer Hospital
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