“Early detection of autism allows to set up a program of interventions specifically designed for the child,” said Dr Samir Dalwai, who is a developmental and behavioural paediatrician and the chairperson, India Academy of Paediatrics chapter of neurodevelopmental Paediatrics
“Generalised therapies may not help because no two children are same. There may be other neurological, genetic problems associated with autism like fragile X syndrome, ADHD, anxiety, seizures (fits), eating problems, constipation and sleep disorders. A program helps you to tackle all of this holistically,” he added.
He revealed that in the 15 years of his career, he observed lack of interaction to be a major problem in children diagnosed with autism.
“After birth, the child lacks interaction skills and hence fails to learn social human behaviour from the people around him. And thereby fails to learn speech. Due to poor interaction with humans, he is drawn more towards objects and gets fascinated by patterns and designs. Thus, autism manifests as poor human social communication and obsession with repetition and patterns,” said Dr Dalwai.
He explained that intervention should begin by focusing on the first step which went wrong and that is interaction.
He further elaborated, “Unless the child learns to interact better he will not learn social communication. So I advise parents to interact more. Draw your child’s attention. Make yourself more interesting to the child. Children are drawn and attracted by cartoons. So shut off the TV and be as animated as a cartoon and your child will be drawn towards you. This is how you can increase the child’s ability to interact. Once that improves, he will automatically pick up on social behaviour like any other child.”
Dr Dalwai also pointed out that sleep is extremely important for brain development. He stated saying, “A child needs 10 to 12 hours of continuous sleep, rather than multiple naps, by the age of two. A way to achieve this is to wake up your child by 8:00 am every morning and not allowing him/her to nap through the day,” he added.
In the session on autism and related disorders, Dr Dalwai emphasised on speech not being an independent milestone in development.
He further said, “It is only one single step on the highway of social communication. You cannot ‘teach speech’ without all the preverbal development being perfect.”
He also elaborated on the milestones of verbal communication that can help in early detection of Autism Spectrum Disorder (ASD). “These milestones include both receptive and expressive speech,” said Dr Dalwai.
He mentioned that at 12 months of age, the child should follow one action command (without gesture) and say one meaningful word.
“By 18 months, the child should follow two actions command and say a sentence of two meaningful words. By 24 months, the child should follow three action commands 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 two categories: receptive -expressive along with non-verbal and verbal.
In conclusion, he further said abnormalities in social-communication include – saying nonsense words, meaningless repetition of words, lack of symbolic play, lack of joint attention, convey needs by pointing or dragging beyond 2 years of age and repetitive behaviours and restricted actions.