Autism is a complex neuro developmental disorder which appears in infancy and becomes evident during childhood. There are no reliable estimates for Nepal as autism is not known to many people. There is a lack of awareness amongst peopel and diagnosis on this is weak as the milder cases go unnoticed even by the clinicians. Autism Care Nepal (ACN) estimates autistic population lies between 10,000 to 50,000 in Nepal. As many as 1.5 million people in the US may have some form of autism. Autism affects all races, ethnic groups, and socioeconomic levels. Boys are 3-4 times more likely than girls to have autism.
It has the following three defining characteristic features:
1. Difficulty in social interactions.
2. Impaired verbal and nonverbal (body language) communication.
3. A pattern of repetitive behavior with narrow, restricted interest (also called stereotyped behaviors) such as repeating words or actions, obsessively following routines or schedules, and playing in repetitive ways.
Clinical Features (Diagnosis)
A number of other associated symptoms frequently coexist with autism. Most people with autism have problems using language, forming relationships, and appropriately interpreting and responding to the external world around them.
Autism is a behaviorally defined developmental disorder that begins in early childhood. Although the diagnosis of autism may not be made until a child reaches preschool or school age, the signs and symptoms of autism may be apparent by the time the child is aged 12-18 months, and the behavioral characteristics of autism are almost always evident by the time the child's age is 3 years. Language delay in the preschool years (younger than 5 years) is typically the presenting problem for more severely affected children with autism. Self mutilating behavior includes movements that injure or can injure the child, such as eye poking, skin picking, hand biting and head banging.
Autistic infants show less attention to social stimuli, smile and look at others less often, and respond less to their own name. Autistic toddlers differ more strikingly from social norms; for example, they have less eye contact and turn taking, and do not have the ability to use simple movements to express oneself, such as the deficiency to point at things. Three- to five-year-old autistic children are less likely to exhibit social understanding, approach others spontaneously, imitate and respond to emotions, communicate nonverbally, and take turns with others. However, they do form attachments to their primary caregivers. Autism can occur in association with other difficulties like Cerebral Palsy, Dyslexia, Down syndrome, Visual Impairment, and Seizure Disorder. Autism disorder persists throughout the person's lifetime, although many people are able to learn to control and modify their behavior to some extent.
Different people with autism can have very different symptoms. Health care providers think of autism as a “spectrum" disorder, a group of disorders with similar features (Rett Syndrome, Asperger’s Syndrome). One person may have mild symptoms, while another may have serious symptoms. But they both have an autism spectrum disorder.
There is a wide range of symptoms, severity, and other manifestations of these disorders. The expression of autism spectrum disorders varies widely among affected individuals. A child with significant impairment in all three of the core functioning areas (socialization, communication, and atypical, repetitive behaviors) may have autism, while a child with similar problems but without delays in language development may have Asperger's syndrome.
Some people are affected with fairly mild symptoms and signs of autism. Many of these individuals learn to live independent lives. Others are more severely affected and require lifelong care and supervision. Diagnosis is mainly on the basis of clinical features and by excluding other childhood psychiatric illness.
There is no cure for autism; however, there is good news that with effective and early behavioral therapy the mild to moderately affected children can lead a normal life. The main goals when treating children with autism are to lessen associated deficits and family distress, and to increase quality of life and functional independence. No single treatment is best and treatment is typically tailored to the child's needs.
- A generation ago, most children with autism were institutionalized. This is no longer the case and most children with this disorder live with their families.
- Improving understanding of autism has shown that, regardless of the severity of the condition, appropriate treatment and education can eventually help many children with autism to be integrated into their community.
- Early diagnosis is essential for implementing appropriate treatment and education at an early age, when they can do the most good.
The range of symptoms located along the autism spectrum are so varied and sometimes difficult to pinpoint that labeling famous people with autism can be tricky as well. Among the most well-known speculated to have autism are Bill Gates, Isaac Newton, Albert Einstein. Obviously, these people are considered geniuses in their fields or areas of interests; Albert Einstein seemed to believe that there was certainly something different about himself when he stated, "Do not worry about. your problems with mathematics. I assure you, mine are far greater!"
In Nepal, NGOs working on Autism are: Nepal Autistic Society, Nepal Autism Committee, Gyaneshwor and Autism Care Nepal, Lazimpat, Kathmandu.
- Dr. Vidya Singh