I am Dr. Lata Bhut, I am a pediatrician specially trained to handle a developmental problem in children and running Palak Child Development Centre in Mayur Vihar, Phase- 2, Delhi.
Today I am going to talk about Autistic spectrum disorder, earlier I spoke about how to suspect a child for high-risk Autism based on signs and symptoms, today I am going to talk about the evaluation and management of such children. Autism is a social communication skills disorder where this impairment nonverbal and verbal communication both and there repetitive behavior patterns which impaired child day to day functioning. Speech delay is the commonest presentation although they can be some intellectual disability in some children. So early intervention is very important because in earlier years especially below the age of 3 years brain has compass fantastic capacity to rewire in response to environmental stimulation and 1 to 3 years is the best age to teach speech and language to a child. So American Academy of Pediatrics recommends starting early intervention starting specially below 2 years of age and do not wait till the diagnosis made because diagnosis may take some time, so all children should be scream for Autism between 18 to 24 months of age using a screening tool by a pediatrician and once a pediatrician suspects a child to be high risk for Autism, child should be referred to a development pediatrician or even if the parents suspect the child to be at risk for Autism they can come directly to the child development centre or to developmental pediatrician and the child is handled by multidisciplinary team of developmental paediatrician, paedia technologies, clinical psychologist, occupational therapies, special educators, speech and language therapist and parents are a part of the Core Team. In the diagnosis hearing assessment is very important because there is speech delay and other tests are done based on the clinical features and decide by the doctor, a detailed evaluation is done by the team using Autism diagnosis tools and once a diagnosis made or even before that early intervention is started once we suspect Autism. Early intervention involves intensive behavior modification therapy to teach nonverbal communication, speech, improve cognition, improve the independent self-help skills of the child and to enumerate the problematic behavior of the child. Occupation therapy, especially by the therapist trained in sensory integration, aims to develop self-help skills and fine motor skills and to enumerate the problematic sensory behaviors because if the child problem is sensory issues then the child can have difficult behavior, difficulty in learning and also in feeding. A special educator aims to give remedial education to help in academics and speech therapist in to develop speech of the child. It has to be individualized, goal-oriented, the intensive systematic model where we review it time to time because a development of change time to time, parents are a part of a Core Team. At least 25 hours per week of therapy should be given which means some hours at the center and followed by at least one and a half and two hours at home therapy should be done. And coming to the medications there is no medication to cure or Autism, although we can give medicines to enumerate the problematic behaviors and prognosis the earlier we start the better it is.
For any further queries, you can contact me on Lybrate.