Unfastening the uncertainty

April is World Autism Month, and we pledge to go blue to increase global understanding and acceptance. Autism spectrum disorder (ASD) and autism are both general terms for a group of complex disorders of brain development.

Autism affects the way an individual perceives the world and these disorders are characterised by difficulties in social interaction, verbal and non-verbal communication and repetitive behavior.  However, symptoms and their severity vary widely across these three core areas.

Taken together, they may result in relatively mild challenges for someone on the high functioning end of the autism spectrum. For others, symptoms may be more severe, as when repetitive behaviors and lack of spoken language interfere with everyday life.

There is no one cause for autism. However, most cases involve a complex and variable combination of genetic risk and environmental factors that influence early brain development. While the causes of autism are complex, it is abundantly clear and to be taken the fact that it is not caused by bad parenting or cold mothers. The misconception that, unloving mothers caused their children's autism even now creates tremendous burden of guilt among parents.

Early red flags

The Centers for Disease Control and Prevention (CDC) have identified possible red flags for autism spectrum disorder in young children, including:
Not responding to his/her name by 12 months of age
Not pointing at objects to show interest by 14 months
Not playing "pretend" games by 18 months
Avoiding eye contact or preferring to be alone
Getting upset by minor changes
Flapping their hands, rocking their body or spinning in circles
Having unusual and sometimes intense reactions to the way things smell, taste, feel and/or look
If there is a strong concern that your child is showing possible signs of autism, then a diagnostic evaluation should be performed. This typically involves an interview and play-based testing with your child done by a psychologist, developmental-behavioral pediatrician, child psychiatrist or other providers
Developmental pediatrician-a doctor who has special training in child development
A child psychologist and/or child psychiatrist-a doctor who has specialized training in brain development and behavior
A neuropsychologist-a doctor who focuses on evaluating, diagnosing, and treating neurological, medical, and neurodevelopmental disorders

The team may have included  a speech & language pathologist , typically part of a diagnostic team or in other multidisciplinary collaborations in  diagnosing the presence or absence of ASD and conducting a culturally and linguistically relevant comprehensive assessment and intervention of language and communication, including social communication skills,an occupational therapist to evaluate skills for appropriate play or leisure skills, learning and self-care skills and an audiologist to rule out hearing loss. Its goals include helping a child or an adult to gain age-appropriate independence and participate more fully in life. A multi-disciplinary evaluation is important for diagnosing autism and other challenges that often accompany such as delay in motor skills. If your child has not been evaluated by a multi-disciplinary team, you will want to make sure further evaluations are conducted so that you can learn as much as possible about your child' s individual strengths and needs.

Differential diagnosis

Many neuro-developmental, mental and behavioral disorders may present with symptoms that suggest the possibility of autism but which are not autism.

Nowadays electronic screen media exposure is tremendously high in young age without much parent interaction during the exposure is associated with short attention span, language delay and hyperactivity results in autistic like features and not necessarily autism spectrum disorder.

If there are concerns about a child's or young person's development or behavior, and especially if the possibility of autism has been raised, parents, carers and the child or young person may be anxious to know without delay what the nature of the problem may be.

A typical parent or other layperson in doubt of autistic features might start with an Internet search on "autism research." This brings up hundredsof thousands of links. Unfortunately, web browsers doesn't necessarily put the most credible sources at the top. The most popular online videos were primarily uploaded by non-professionals and provided limited content regarding ASD. Family members have the potential of comparing their infant's or child's behaviors to those seen on internet and, based on those comparisons, seek professional guidance or feel reassured not to pursue it.

It is important to establish an accurate diagnosis, whether that is autism or an alternative condition. An inaccurate diagnosis of autism based on internet results may result in the use of an inappropriate treatment and may cause anxiety and distress to the child or young person and their parents/carers respectively.

Early intervention
Significant improvement in autism symptoms is most often reported with intensive early intervention. Early attention to improving the core behavioral symptoms of autism will give your child - and the rest of the family - several important benefits that you will not gain if you take a wait-and-see approach until your child enters school at age four or five. A good early intervention program has at least four benefits

It will provide your child with instruction that will build on his or her strengths to teach new skills improve behavior and remediate areas of weakness.
It will provide you with information that will help you better understand your child's behavior and needs.
It will offer resources, support and training that will enable you to work and play with your child more effectively.
It will improve the outcome for your child.
For these reasons, an intervention programme for your child should be implemented as soon as possible after he or she receives a diagnosis. They have a unique profile of strengths and needs and require intervention services and teaching approaches that are sensitive to these needs. With proper supports in place, people with autism are able to live fulfilling lives, as independently as possible.

(The writer is a speech language pathologist)