Doctors discuss and decode autism at WCNR 2018

A panel discussion on autism was held at the World Federation for Neuro Rehabilitation 2018 conference, several doctors put forth their views on autism and its causes and treatment options. Each doctor helped add meaning to the discussion with their experience in dealing with the disorder


Day one of the 10th World Congress for Neuro Rehabilitation held at Renaissance Conventional Centre, Powai had an elaborate session on autism and other related disorders.

Dr Vrajesh Udani, a well-known neurologist at PD Hinduja began the session by speaking about the neurobiology of autism.

Autism is a disorder of complex information processing involving several domains. There are widespread disturbances in cortical grey matter and white matter functional connectivity. It is largely a genetic disorder possibly affecting genes subserving synaptic function/ fetal cortical development/early regional overconnectivity/later underconnectivity,” said Dr Udani during his talk.

He pointed out that there has been dramatic increase in incidences of Autism Spectrum Disorder (ASD) over the last two decades and it suggest of possible environmental triggers/ influences.

While making a presentation on the same, Dr Udani said, “Recent incidence estimates 1 in 68 children. There has been a 4-5 fold increase in ASD from 1997 to the present. Prevalence estimates from India (Action for Autism) state that 1.7 million people of ASD in India.”

Dr Samir Dalwai, developmental and behavioural paediatrician and chairperson, India Academy of Paediatrics chapter of neurodevelopmental Paediatrics, spoke about the clinical features and early identification.

“Speech is not an independent milestone in development. It is only one single step on the highway of social communication. You cannot ‘teach speech’ without all the preverbal development being perfect,” said Dr Dalwai.

He also elaborated on milestones of verbal communication that can help in early detection of ASD. “These milestones include both receptive and expressive speech ,” said Dr Dalwai. He said at 12 months, the child should follow one action command (without gesture) and say one meaningful word.

“At 18 months , the child should follow two actions command and say a sentence of two meaningful words. At 24 months, the child should follow three action command and say a sentence of three meaningful words,” explained Dr Dalwai.


In his talk, Dr Dalwai said in social and communication disorders, the delay is classified into receptive-expressive and non-verbal and verbal.

He further said abnormalities in social-communication include – saying nonsense words, there is meaningless repetition of words, lack of symbolic play, lack of joint attention, convey needs by pointing or dragging beyond 2 years and repetitive behaviours, restricted actions.

Dr Neelu Desai, neurologist with PD Hinduja Hospital gave a talk on diagnosis and comorbidities attached with autism.

She said autism screening is a must in routine paediatric clinics. “All children should be screened with standardised autism screening tool at 18 and 24 months,” she said.

In her talk, Dr Desai also pointed out comorbidities are frequent in ASD. “It is difficult to recognise due to communication impairments and challenging behaviours. Organic explanations should be sought in problem behaviours,” revealed Dr Desai’s presentation.

She said there is a growing evidence of immunological, gastrointestinal metabolic and endocrine dysfunction in ASD- therapeutic implications.

The session had a panel discussion where case studies were discussed at length.

The autism and related disorders session concluded with a talk on pharmacotherapy by Dr Anaita Hegde, Pediatric Neurologist at Jaslok Hospital, who said pharmacotherapy has a small but a significant role in the treatment.