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Autism Treatment and Management

 

 

Autism is a neurodevelopmental disorder characterized by impaired social interaction, verbal and non-verbal communication, and restricted and repetitive behavior. Autism are  the pervasive developmental disorders (PDD), a family of conditions marked by early-onset delays and deviance in the development of social, communicative, and other skills.

It usually becomes apparent within first three years of life but some mild cases get diagnosed during early schooling. Autism is a disorder of neural development characterized by impaired social interaction and verbal and non-verbal communication, and by restricted or repetitive behaviour.  But many parents feel that their kids start showing autistic traits suddenly after a period of normal development.

What is Autism Spectrum Disorder (ASD)?

The autism spectrum disorder describes a range of conditions classified as pervasive developmental. ASD includes autism, Asperger syndrome, pervasive developmental disorder not otherwise specified (PDD-NOS]. These disorders are characterized by social deficits, communication difficulties, stereotyped or repetitive behaviours and interests, and in some cases, cognitive delays.

Signs and Symptoms of Autism-

Impairment in Social Interaction:

  • Autistic children do not exhibit subtle reciprocal social skills, Less frequent or poor eye contact is common.
  • Impaired, but not totally absent of attachment behaviour, lack of social smile and anticipatory posture.
  • Inability to acknowledge or differentiate the most important persons in their lives ”parents, siblings, and teachers” .
  • They show extreme anxiety when their usual routine is disrupted.
  • Inability to perceive the feelings and intention of others surrounding  them or they lack theory of mind. It leads to lack of social reciprocation.
  • When autistic children have reached to school age their withdrawal may diminish or less obvious particularly in high functioning children.
  • In late adolescence they often desire friend ships ,but the difficulty in interaction and lack of theory of mind inhibit them to do so
  • In adulthood occasionally they have sexual feelings but  lack of social competence and skills prevent them from developing sexual relation ship.
  • Cognitively, children with autistic disorder are more skilled in visual-spatial tasks than in tasks requiring skill in verbal reasoning and their rote memory is also good.

Impairment in Communication and Language

  • Autistic children are not simply reluctant to speak, and their speech abnormalities do not result from lack of motivation. Language deviance is characteristic of autistic disorder.
  • In contrast to normal and mentally retarded children, autistic children have significant difficulty putting meaningful sentences together even when they have large vocabularies.
  • In the first year of life their pattern of babbling is minimal and abnormal. Some children emit noises like clicking, nonsense syllables in a stereotyped fashion without intending communication
  • They some times exhibit speech that contain echolalia both immediate and delayed.     Eg: If the child is asked “what is your name”? ,he repeats the same “what is your name”? If mother says “my name is Aditya”, then only  the child repeats “my name is Aditya”. Though the response was right but that was unintentional.
  • Some times they recall and speak a word, which was spoken to him or heard in the past, in an irrelevant context.
  • About 50% of autistic children never develop useful speech. some children some times excel in some task for eg: Achild may learn to read fluently at pre school age .
  • Very young autistic children who can read many words however ,have little comprehension what they read.

Stereotyped Behaviour

  • In the first years of an autistic child's life, much of the expected spontaneous exploratory play is absent.
  • Toys and objects are often manipulated in an unusual  manner, with few or less symbolic features. Autistic children generally do not show imitative play and make belief play.
  • The activities and play of these children are often rigid, repetitive, and monotonous.
  • In the first years of an autistic child's life, much of the expected spontaneous exploratory play is absent.
  • Toys and objects are often manipulated in an unusual  manner, with few or less symbolic features. Autistic children generally do not show imitative play and make belief play.
  • The activities and play of these children are often rigid, repetitive, and monotonous.

Autistic children are generally resistant to transition and change. Eg: Moving to a new house, moving furniture in a room, or a change, such as having breakfast before a bath when the reverse was the routine, may evoke panic, fear, or temper tantrums.

Instability of Mood and Affect

  • Some children with autistic disorder exhibit sudden mood changes, with bursts of laughing, anger and  crying without an obvious reason.

Response to Sensory Stimuli

Most of  autistic children show excessive interest  in music, moving spinning objects and up&down movements.

Hyper sensitivity :

  • Autistic children have been observed to over-respond to some stimuli and under- respond to other sensory stimuli (e.g., to sound and pain). They react excessively  to a very subtle sound for eg; with the slight sound of foot steps at the door, they react negatively by screaming to that sound and some times they avoid simple touch .

Response to Sensory Stimuli

Hypo sensitivity:

  • Some  children  do not respond to a physical injury by crying to seek help. Even lot of sounds of the peer group cant distract them from the routined, stereotyped and unproductive  activity.

Treatment and management

Homoeopathic treatment- Homeopathic medicine is one of the most popular alternative systems used for Autism treatment. Homoeopathy is a safe and gentle system of healing, which tries to identify the root cause of any problem by taking a detail case history, which includes the current complaints of the patient, his/he past medical history, family history, nature and disposition of the patient and many other finer factors. Basically, homoeoapthy is a completely symptomatic treatment.

Applied Behaviour Analysis(ABA):

ABA uses careful behavioral observation and positive reinforcement or prompting to teach each step of a behaviour . A child’s behaviour is reinforced with a reward when he or she performs each of the steps correctly.Undesirable behaviours, or those that interfere with learning and social skills, are watched closely.

ABA treatment can include any of several established teaching tools: discrete trial training, incidental teaching, pivotal response training, fluency building, and verbal behavior (VB).

 

Floor time therapy

  • The intervention is called Floor time because the parent gets down on the floor with the child to engage him at his level.
  • The goal in Floor time is to move the child through the six basic developmental milestones (self regulation and interest in the world; intimacy or a special love for the world of human relations; two-way communication; complex communication; emotional ideas; and emotional thinking) that must be mastered for emotional and intellectual growth.
  • From a mutually shared engagement, the parent is instructed how to move the child toward more increasingly complex interactions, a process known as “opening and closing circles of communication.”
  • Floor time does not separate and focus on speech, motor, or cognitive skills but rather addresses these areas through a synthesized emphasis on emotional development.

Occupational Therapy

  • Occupational Therapy ,the aim is to maintain, improve, or introduce skills that allow an individual to participate as independently as possible in meaningful life activities. Coping skills, fine motor skills, play skills, self help skills, and socialization are all targeted areas to be addressed.
  • A person with autism can be aided both at home and within the school setting by teaching activities including dressing, feeding, toilet training, grooming, social skills, fine motor and visual skills that assist in writing and scissor use, gross motor coordination to help the individual ride a bike or walk properly, and visual perceptual skills needed for reading and writing.

Speech Therapy

  • The communications problems of autistic children vary to some degree and may depend on the intellectual and social development of the individual.
  • Though some autistic children have little or no problem with the pronunciation of words, most have difficulty effectively using language.
  • Even those children who have no articulation problems exhibit difficulties in the pragmatic use of language such as knowing what to say, how to say it, and when to say it as well as how to interact socially with people
  • Many who speak often say things that have no content or information. Others repeat verbatim what they have heard (echolalia) or repeat irrelevant scripts they have memorized. Some autistic children speak in a high-pitched voice or use robotic sounding speech.
  • Two  skills for language development are joint attention and social initiation.
  • Joint attention involves an eye gaze and referential gestures such as pointing, showing and giving. Children with autism lack social initiation such as questioning, make fewer utterance and fail to use language as a means of social initiation.

 

 

 

 

 

 

 

 

 

 

 

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