During my recent visit to India, I came across an article written by a mother whose child was diagnosed with autism.  The article portrayed the difficulties she faced in obtaining help for her son with autism and how she set up a parent support group in Mumbai for parents with autistic children.  This made me realise about many children and adults with autism in India and how they may not be receiving help.  This also made me realise that autism is not a disorder confined to western society, it is seen in many other cultural and ethnic groups. Dr. Raghu Raghavan writes ...

What is Autism?
For many years, autism was believed to be the result of being possessed by an evil spirit, similar to other conditions like mental illness and personality disorders rather than a developmental disability.  The film 'Rain man' portrayed the picture of a highly intelligent person with autism and the associated behaviours.

As a result of scientific studies, autism was initially identified as a syndromal collection of observed behavioural symptoms, which emphasised the relative impairments of social relationships and language.  Children and adults with autism can be distinguished from children and adults with other types of developmental problems by using these basic features:

An impairment in the ability to interact socially
Problems in communication
Certain bizarre behaviours
Bizarre responses to sensory stimuli
Impairment in the use of imagination or imaginary play.

Many children and adults with autism also have severe learning disabilities.  They may also have other disabilities such as visual impairment, hearing loss, physical disability or a communication disorder such as word-finding difficulties.

There is now general acceptance among the scientifically oriented that autism is a neuro-developmental disorder with an organic basis.  The association with epilepsy, the presence of neuro-biological abnormality, the lack of gross environmental pathology, and the associations with a genetic basis and with various medical causes of learning disability all combine to indicate both a primary, inherited disorder and a secondary symptomatic one.  Autism can be diagnosed in the first three years and is more prevalent amongst boys than girls.

Some common misconceptions about Autism
Autism is not a disease; it is just a label for a collection of behaviours.  It is not a mental illness.  Autism is not caused due to abnormal parenting. indeed, there was a notion that children became autistic as a maladaptive response to a threatening and unloving environment.  Research in this field have discredited this notion.

Management of Autism
There are a large number of treatment programmes on the market, many of which are very expensive both in terms of money and in the amount of time family needs to dedicate to the afflicted child.  Based on different theoretical standpoints and addressing different aspects of autism, these treatments claim global improvement in the conditions of the patients, but such claims are not supported by comparative or objective evaluation.

Education and Training
It is believed that a systematic and well-structured programme with clearly defined steps would enable the child or adult with autism to learn social behaviours.

Communication Training
This is aimed at developing better communication by speech, sign or gesture.

Behaviour Management
Children and adults with autism show a range of stereotyped and ritualistic behaviour, which interfere with learning.  Aggressive behaviour is frequently seen in this population and may represent a means of communication, or gaining attention, of relieving boredom or be the response to a perceived threat.  Behavioural management should be based on a full assessment of the function of these behaviours following a systematic behavioural approach.

Support for Family
The families of autistic children or adults will require a lot of help and support due to the disruptive nature of the disorder.  The care of a child or adult with autism is difficult and puts unusual stress on the family and marriage.  Parents will need a lot of reassurance and practical ideas and support.  Joining a local parent support group and the National Autistic Society helps to remove the sense of isolation and to provide practical ideas about specific forms of help and how to obtain these.

There is a lot of misunderstanding regarding autism in our society.  Many of those suffering from autism do not get help and guidance.  Autism still pose major challenges to parents, clinicians and researchers as its nature, causative factors and effective treatment approaches are still not well understood despite the advances in medical science.

Further information can be obtained from the National Autistic Society (http://www.oneworld.org/autism_uk/ or
Tel. 020 7833 2299)

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