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 disorder (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 behaviour 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 a lack of social reciprocation.

• When autistic children have reached school age their withdrawal may diminish or be less obvious, particularly in high functioning children.

• In late adolescence they often desire friendships, 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 a sexual relationship.

• 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 a 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 sometimes exhibit speech that contains echolalia both immediate and delayed.     Eg: If the child is asked “what is your name?” he repeats the same “what is your name”? If the mother says “my name is Aditya”, then only the child repeats “my name is Aditya”. Though the response was right that was unintentional.

• Sometimes 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 sometimes excel in some tasks for eg: A child may learn to read fluently at preschool ag.

• Very young autistic children who can read many words, however, have little comprehension of 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-believe 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 the autistic disorder exhibit sudden mood changes, with bursts of laughing, anger, and crying without an obvious reason.

Response to Sensory Stimuli

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

Hypersensitivity:

• 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 footsteps at the door, they react negatively by screaming to that sound and sometimes 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 most of the sounds of the peer group can’t distract them from the routine, stereotyped and unproductive activity.

Treatment and management

Homeopathic treatment- Homeopathic medicine is one of the most popular alternative systems used for Autism treatment. Homeopathy is a safe and gentle system of healing, which tries to identify the root cause of any problem by taking a detailed case history, which includes the current complaints of the patient, his/he passed medical history, family history, nature and disposition of the patient and many other finer factors. Basically, homeopathy 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 behaviors, 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).

 

Floortime therapy

• The intervention is called Floortime because the parent gets down on the floor with the child to engage him at his level.

• The goal in Floortime 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.”

• Floortime 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, making fewer utterances, and fail to use language as a means of social initiation.

 

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Sleep Management: Introduction

When many people are faced with a stressful situation at work, they respond with complete commitment, by working intensely hard at resolving it. To do this, they may work all hours, cancel vacations, and cut back on sleep, all to make more time to tackle the problem. If this is short-lived, then negative effects will be minimal and success will often be spectacular. However, if this level of hard work is sustained for a long time without relief, people increasingly risk ill-health and burnout.

We rest and sleep because we need to:

1.Rest and Relaxation

2.Sleep

Rest and Relaxation:

Rest is what we do to let stress subside. Rest at the end of a day, and at the end of a week, helps us to calm down. Doing fun things that we enjoy in our leisure time compensates us for the stress we experience at work, bringing some balance back into life. This is particularly important if we routinely experience unpleasant levels of stress. A good way of getting rest and reducing long-term stress is to take up an enjoyable, non-rushed sport or hobby. If you spend all your working day competing, then can be very pleasant to be completely non-competitive for some of your free time. 

Slow physical activities such as sailing or walking are good for this, as are others where there is little or no pressure for performance. Reading novels, watching television or socializing can also be very restful. Vacations are particularly important, and you really do need to take these. Where possible, take two weeks off rather than just one week: A common observation that people make is that they really do not start to relax properly until the end of their first week of vacation. Make sure that you take your vacations and that you use them to relax. Also, make sure that you get enough good quality rest during the week, so that you can keep on enjoying life to its fullest.

Sleep:

On average, people need around eight hours of sleep a night (although this can vary between three hours and eleven hours, depending on the person and his or her age). If we are regularly short of sleep, then our concentration and our effectiveness suffer and our energy levels decline. We have all seen and experienced this. This diminishes our effectiveness in our job, and can therefore increase stress: As our concentration wanders, we start to make mistakes. As our energy declines, we become less proactive in what we do, reducing our control over events. This means that a situation that is already difficult and stressful can become worse, needing even more sacrifice to bring it back under control. Make sure you get enough sleep. If you have become used to being tired all the time, you will be amazed by how sharp and energetic you will feel once you start sleeping normally.