Information and Frequently Asked Questions
by Indian Parents
This is by far the
most frequently asked question. Briefly, it is a severely incapacitating
life long developmental disorder that typically occurs in the first
three years of life. It causes impairment or disturbance in three main
areas Social skills, communicative (verbal as well as non-verbal) skills
and in their repetitive and restricted behaviors. Autistic individuals
may show abnormal responses to sensations. Any one or more of the senses
may be affected. All these difficulties manifest themselves in behaviours
i.e. abnormal ways of relating to people, objects and events in the
is known as a spectrum disorder, because the severity of
symptoms ranges from a mild learning and social disability to a severe
impairment, with multiple problems and highly unusual behavior. The
disorder may occur alone, or with accompanying problems such as mental
retardation or seizures. Autism is not a rare disorder, being the third
most common developmental disorder, more common than Downs
Syndrome. Typically, about 20 in a population of 10,000 people will
be autistic or have autistic symptoms. 80% of those affected by autism
are boys. Autism is found throughout the world, in families of all economic,
social, and racial backgrounds. Doctors, politicians, and rickshaw drivers
alike all have autistic children.
is a person with autism like?
child with high functioning autism may have a normal or high I.Q.,
be able to attend a regular school and hold a job later in life. However,
this person may have difficulty expressing himself and may not know
how to mix with other people. Moderately and more seriously affected
children with autism will vary tremendously. Some autistic children
do not ever develop speech, while others may develop speech but still
have difficulty using language to communicate. Often, there is an
unusual speech pattern, such as echoing whatever is said to them,
repeating a word over and over, reversing "you" and "I"
when asking for something, and speaking only to express needs, rather
child with autism looks just like any other child, but has distinctive
behaviour patterns. A child who is autistic may enjoy rocking or spinning
either himself or other objects, and may be happy to repeat the same
activity for a long period of time. At other times, the child may move
very quickly from one activity to another, and may appear to be hyperactive.
Many autistic children have sensitivity to certain sounds or touch,
and at other times, may appear not to hear anything at all. Autistic
children may have very limited pretend play; they may not play appropriately
with toys or may prefer to play with objects which are not toys. Autistic
children may be able to do some things, like sing songs or recite rhymes
very well, but may not be able to do things requiring social skills
is autism diagnosed?
There are no medical or genetic tests that can detect autism.
These can only rule out other conditions. A diagnosis of autism requires
a sensitive and experienced doctor to observe the child very carefully,
ask the parents about the development of the child, and then objectively
follow internationally recognized criteria for diagnosis. Onset may
occur at birth, or a child may have a period of normal development followed
by a deterioration of verbal and social skills around 1 1/2-2 1/2 years.
Where onset is at birth, the disorder can be detected as early as a
year. Autism may occur alongside conditions such as mental retardation
and hyperactivity, but the autistic traits in the person are typically
what require attention.
is the cause of autism?
At this point in time we do not know what causes it. However,
current research indicates that anything that can produce structural
or functional damage to the central nervous system can also produce
the condition of Autism. We know that certain viruses and known genetic
conditions are associated with Autism. In addition, there are families
that have more than one child with autism. At present, it is believed
that about 10% of all cases can be accounted for genetically. It is
difficult to tell parents why their child has autism since researchers
believe the problem to be caused by different factors, and in most cases,
the cause is never known. Autism is not caused by an unhappy
home environment, both parents working, mental stress during the pregnancy,
poor handling by the mother, an emotional trauma, or other psychological
factors. You cannot cause a child to become autistic.
it be prevented? Can it be cured? What is the treatment?
At this point we do not know what causes Autism and so cannot
fix (cure) what is wrong in the child's brain. Many therapies (medications,
diets, etc.) are being tried but nothing is proven. Similarly, without
knowing the cause of autism, there is no way to prevent it. At present,
there is no cure for autism: there is no medication, no pills, no injections
which can make the problem go away. The only consistently effective
treatment for autism is a structured training program; therefore, a
combination of a good school and parent training is the best known treatment.
Autistic children can make significant
progress if the intervention is appropriate and consistent. Early intervention, before the child is five, is especially
crucial to the childs progress. This is why an early and accurate
diagnosis is so important. Autistic children grow to become autistic
adults, and there is a particular need for meaningful outlets for social
interaction and employment where possible.
is it different from Mental Retardation?
When a person has M.R. there is a more or less even impairment
in skills in all areas of development. Therefore, if an M.R. child of
8 years has a mental age of 5 then all his skills would be roughly around
5 years (i.e. motor, communication, social, self-help, cognition etc.).
In Autism, there is an uneven skill development- in fact this is the
hallmark of autism. In some areas the child may show age-appropriate
skills; in some the skills may be below the developmental level; and
then again there are people with Autism who possess exceptional skills
i.e. beyond their age level.
the child ever live an independent life?
Autism is a spectrum disorder. Currently there is no reliable
objective measure of how severe the Autism is in an individual child.
Children with Autism have potential for building up their skills and
they can be helped if they receive early, well-focused intervention.
Depending on the child's individual skill profile and the appropriateness
and intensity of intervention he or she receives, children with Autism
can lead relatively independent lives.
are the chances of her going to a regular school?
There are a number of autistic children who have integrated into regular
schools. The chances depend on several factors. The most important is
"What is the skill profile, how early diagnosis was received, and
thereafter the kind of early intervention provided?" Most children
with Autism have different learning styles from regular children and
therefore teaching styles also need to be different. In some schools
this is not understood and therefore children with Autism face difficulties;
after Grades 4 or Grade 5 many have to drop out.
and will my child ever speak?
A large member of autistic children (about 30-50%) do not use speech.
It is very difficult to say when and whether the child will ever speak.
It is confirmed that there is no difficulty in their physical abilities
that stops them from speaking. Some children who might have spoken
as infants and then lost their speech may or may not get their speech
back. Currently, it is unknown why some children develop speech and
others do not. Experience with children with autism has shown that if
the environment is accepting, and people are aware of the kind of speech
they themselves need to use with the child, it can produce positive
Speech Therapy help?
Speech Therapy can help some children. It is absolutely essential for
the speech therapist to understand Autism and also the individual child.
Otherwise, the conventional methods of speech therapy help children
with Autism very little, because as stated above, the inability to speak
is not a physical problem. However, every child with autism can benefit
from interventions that emphasize communication.
is he hyperactive?
Hyperactivity can have a medical reason. However, most children with
Autism are restless because of an impairment of their imaginative and
social skills. They cannot play with their toys and other children meaningfully
and find it very difficult to occupy themselves. Often they eat a lot
to keep themselves occupied. Hyperactivity can be reduced as the children
are taught new skills and ways to keep themselves occupied.
are chances of Autism in the next child born to us? Can we have a normal
About 10% of the cases of Autism can be accounted for genetically. If
there is one child with Autism in the family, risks of having another
child with autism is much higher than in the general population. So
far, there is no reliable test to detect Autism in the foetus.
does he keep playing with his fingers/ rocking himself back and forth/
spinning around etc?
Children with Autism respond to sensations abnormally. They often have
a condition known as sensory dysfunction this means either over or under
stimulation in any one or more of the sensory modalities (hearing, sight,
taste, touch, smell, balance). One theory is that these unusual mannerisms
like flapping and rocking etc. are natural responses or methods of coping
with sensory difficulties. These behaviours may help them to relax.
there any hostel for such children?
Unlike some Western countries, in India there are few hostels for people
with mental disabilities and ones exclusively for autistic individuals
do not exist here. However, it is now increasingly accepted that during
the early years of development, it is important for an autistic child
to live and grow in a home environment. As the child grows up, he can
be trained to live in a group home but it is very important for the
autistic people living in such homes also to integrate with society
in general and not just be abandoned in a home or hostel.
they get married and have regular children?
The essence of marriage is companionship. It is a union between two
consenting adults and it involves adjustment and carrying on day to
day responsibilities of life. It also involves an ability to the plan
the future etc. Before deciding to marry an autistic person, the following
things need to be considered:
--The level of functioning of the person.
--That the partner understands the needs of, and that he or she knows
everything about, the autistic
spouse (if one of them is not autistic).
-- Financial status (employment, family support etc.)
However, since marriage is an issue of social commitment and companionship,
by the very nature of the condition many able people with autism and
their families choose not to marry.
people with Autism also mentally retarded?
It is very difficult for people with autism to take an IQ test
because they may have certain skills but are not able to use them or
exhibit them in a test. About 50% of people with autism are also mentally
retarded, just the way that people with cerebral palsy or down's syndrome
can have mental retardation. Autism can occur in association with other
difficulties like Cerebral Palsy, Dyslexia, Downs Syndrome, Visual Impairment,
and Seizure Disorder.
a child has autism and mental retardation or any other condition which
needs more attention, autism or mental retardation (or any other condition)?
If a person with autism also has Mental Retardation (or any other condition),
his training will need to primarily address his Autism. This is because
autism is a condition that affects all aspects of a persons behavior
and development. Our goal is to help the person become integrated into
society and so it is important to focus on the development of social,
communicative and adaptive skills. However, for a child with Cerebral
Palsy for instance in addition to the above occupational therapy may
also have to be provided. Similarly, for a child who also has Seizure
Disorder or any other medical condition, appropriate treatment will
Answers to Questions by Parents
for Autistic Disorder from DSM-IV
Specific Symptoms for Newborns to Eighteen Month Olds with Autism