All you need to know about autism in children

Dr Riddhi Mehta, a Consultant Developmental Paediatrician, Jaslok Hospital and Research Centre, shares her insights on Autism Spectrum Disorder and how to recognise it and tackle the same

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What is Autism Spectrum Disorder?

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that affects the way a child communicates and relates to other people. Most children with ASD generally have difficulties in the areas of social interaction, use of verbal and non-verbal communication in social settings, restricted interests and play skills with repetitive patterns of behaviour. However, the degree to which it impacts each child’s functioning may vary.

How common is it?

According to the Centers for Disease Control and Prevention in the US, about one in 59 children in the US has been identified with ASD. According to a study done by Inclen Trust International, about one in 100 children in India, between the age of 2-9 years, have Autism.

ASD is about four times more common among boys than girls and occurs among all racial, ethnic and socio-economic groups.

Why does it happen?

There are many causes for ASD, including genetic, biological, and environmental factor. There is a higher risk noted in siblings of children with ASD, children born to older parents, and in those with a genetic condition, like Fragile X syndrome. Vaccines (including MMR) are not found to be associated with ASD.

What does it look like?

Children with ASD do not look different from their peers. However, the concerns raised by the parents are:

  • Not responding to their name even though they hear other sounds
  • Not maintaining eye contact
  • Not pointing at objects to share interests or not looking when another person points
  • Repeating words or phrases said to them more than using spontaneous language
  • Not interacting with other children
  • Not pretend play
  • Unusual responses to touch, smell, taste or textures of thing
  • Some children can have an uneven developmental profile with above average skills in one area of development and significant difficulties in another.

Who can diagnose?

Generally, the assessment is done by developmental paediatricians, psychiatrists or neurologists who use a combination of clinical observations (of the child’s play, communication, and social interaction), and standardized tests to make a diagnosis.

How early can a child be diagnosed?

A diagnosis of ASD can often be made by 18 months and fairly reliably by two years.

Red flags for ASD are:

If a child does

  • Babbles or coo by 12 months
  • Use gestures (point, wave) by 12 months
  • Says a single words by 16 months
  • Says two-word phrases on his or her own within 24 months


  • A child who has lost any of his language or social skill particularly before the age of three years without any apparent cause or a reason.

Is there a cure?

Currently, there is no cure or medication for ASD, although doctors may prescribe a medication to address some medical issue associated with autism, like seizures.

Research shows that early intervention can improve a child’s development. Early intervention services include therapies like speech therapy to help the child communicate better and occupational therapy to help with motor skills and sensory processing. Moreover, there are other behavioural approaches like Applied Behavioural Analysis (ABA), which use a structured way of teaching positive behaviours.

There are many complementary and alternative therapies or interventions available for children with ASD, but very few are supported by research. Caution should be used by parents before adopting any of these treatments.

What is the prognosis?

Each child is unique and has different strengths and challenges. While they may have different learning styles, the thinking and problem-solving abilities of people with ASD can range from gifted to having significant difficulties. Some people may require more help than others in their routine.

Although the symptoms of autism remain throughout the lifetime, the difficulties in children improve with intervention and a supportive and inclusive environment that allows them to reach their potential.

Usually, the results are better, when the child has better language skills, better cognitive skills, and when there is early intervention.

As Temple Grandin, an autism self-advocate and professor of animal science, said about Autism, “I am different, NOT less.”