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Dr. Gokul Ratakonda


Autism, medically known as autism spectrum disorder, comprises a range of developmental disorders characterised by:

  • Difficulties in communication (verbal and non-verbal)
  • Impaired social interactions
  • Repetitive behaviours or restricted interests and activities

Autism is a condition in which the brain of an individual works in a different way from other people. Individuals with autism are also different from each other. The disorder is not yet fully understood, and there is no cure available currently; however, people with the disorder are capable of having a relationship, friends, job, etc., like any other person, albeit with a little extra support from family or close ones. While some people with the disorder may have learning disabilities, the intelligence of individuals with autism ranges from average to above average. In a supportive environment, people with the disorder are more likely to develop new skills and learn to function independently. Studies indicate that diagnosis and early intervention treatment services help people with the disorder to learn essential social, communication and life skills required to lead a good quality of life.

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The term autism spectrum disorder includes:

  1. Autistic disorder (classic autism): This is the most common type. Typical disabilities faced by people with the disorder include challenges in social interactions and communication, unusual interests and behaviours, significant language interruption and, in some cases, intellectual disability.

  2. Asperger syndrome: This syndrome is a mild form of autistic disorder. Although people with the disorder may have social challenges and unusual interests and behaviours, they do not have an intellectual or social disability.

  3. Pervasive developmental disorder – not otherwise specified (atypical autism): Individuals are diagnosed with the disorder when they meet only some of the criteria required for diagnosing autistic disorder or Asperger syndrome.


The symptoms may range from mild to severe, usually begin during early childhood by the age of 12-18 months or even earlier. The symptoms usually persist for most of life. Infants with the disorder may not show any of the following normal developmental behaviours:

  • Babbling one-syllable words

  • Pointing at objects to show interest

  • Smiling or responding to the mother’s voice

  • Reaching out to others with their hands

  • Maintaining eye contact 

Children with autism may:

  • Ignore other children

  • Prefer to be alone

  • Not participate or show interest in pretend or make-believe play

  • Spend hours sitting silently, repeatedly arranging objects in order or concentrating on a specific object or topic

  • Remain silent or not converse much with others

  • Have different speech patterns than usual, e.g., asking “do you want water” instead of saying “I want water”

  • Echo the words of the opposite person in a conversation

  • Develop obsessive habits or routines

  • Become preoccupied with objects in an intense manner

  • Intentionally try to injure themselves

  • Show aggressive, hyperactive, impulsive or destructive behaviours

  • Repeat a particular movement such as swaying, clapping, etc.

  • Repeat phrases

  • Have difficulty understanding the feelings of other people

  • Have difficulty relating to other people’s interests

  • Show unusual reactions to certain sounds, tastes, smells, etc.

  • Lose skills that they once possessed

Causes And Risk Factors


The exact cause of autism is unknown. Studies on people with the disorder suggest that certain genetic and environmental factors, including the ones mentioned below, disturb the growth and development of the brain during the foetal stage. 

  • Defects in genes that control the growth and development of the brain

  • Defects in genes responsible for the regulation of communication between different cells of the brain

  • Environmental triggers, such as viral infection or exposure to air pollutants, during pregnancy that influence or affect gene function

Risk Factors

The risk of autism is high in the following children:

  1. Babies born to parents who already have a child with autism

  2. Babies born prematurely

  3. Babies born with low body weight

  4. Babies born to older parents

  5. Children with genetic/chromosomal conditions such as tuberous sclerosis or fragile X syndrome

  6. Certain prescription drugs (valproic acid and thalidomide), when taken by women during pregnancy, can increase the risk of having a child with autism


Since studies have not been able to identify the cause of autism, there are no preventive measures available currently to prevent the disorder.


Currently, there are no specific tests to diagnose autism. Generally, the parents of the child will be asked to look at and record the behaviour and development of the child to help diagnose the disorder. Specialists may evaluate vision, hearing, language skills and motor coordination. A child is diagnosed to have autism when he/she shows the following symptoms from early life and the symptoms affect the child’s life significantly:

  • Repetitive and restricted behavioural patterns, activities and interests

  • Difficulty in interaction and communication with people in multiple social situations

Typically, children can be diagnosed with autism around two years of age. However, since the symptoms in some children are subtle at such a young age, they may not be diagnosed until they start going to school or until adulthood.


There is currently no cure for autism. However, studies indicate that interventional treatment services during early childhood can help children with the disorder to learn and develop important life skills.

Interventional treatment services include education programs and behavioural therapy and employ intensive and structured skill-oriented training sessions to help the child develop language and social skills, encourage positive behaviour, etc. Since the symptoms of autism manifest differently in different people, individualised treatments are often required to get the best results.

Medicines cannot cure or treat the main symptoms of autism; however, they may help manage symptoms such as anxiety, depression and obsessive-compulsive disorder that are often related to autism. Certain medicines that may be prescribed in individuals with autism are:

  • Anti-anxiety medicines to treat behaviours associated with anxiety

  • Antipsychotic medications to reduce irritability, aggression and repetitive behaviours

  • Central nervous system stimulants to treat impulsive behaviour

  • Antidepressants to treat repetitive behaviour and depression

Lifestyle / Management

Here are some tips that parents with a child with autism can use to help their child cope with
day-to-day life:

  1. To help the child communicate:

    1. Speak clearly and slowly

    2. Use simple and clear words for communication

    3. While communicating with the child, use the child’s name so they know you are speaking with them

    4. Allow the child to take extra time to understand the message or instruction given to him/her

    5. Use pictures or gestures to support your conversation

    6. Take help from a speech and language therapist

  2. Children with autism may be fussy eaters, in that they only eat foods with specific colour or texture. They may eat too much or too little. They might have problems with choking and coughing while eating. In such a case, parents can keep a food diary to record the child’s eating habits, so that they can identify problem areas. Parents should consult the doctor if their child has problems with eating.

  3. If the child has difficulty sleeping, parents should:

    1. Keep a diary to record the child’s sleeping habits to identify any problems

    2. Make sure the child’s bedroom is dark and quiet

    3. Maintain a bedtime routine

    4. Allow them to wear earplugs if necessary

  4. Some children with autism are prone to complete loss of control or meltdowns, especially when they become overwhelmed. Parents of such children should:

    1. Keep a diary of the child’s meltdown to identify things that act as triggers

    2. Remove or turn down bright lights

    3. Allow the child to listen to soothing or calming music

    4. Inform the child about any changes in routine before executing them

  5. Parents should teach their child with autism about the importance of keeping oneself clean and having a nice appearance. Help the child develop a fixed routine to spend time on self-hygiene.

  6. Few autistic children are oversensitive or under-sensitive to crowds, noise, light, etc., and other sensory information present in the environment. Parents can try the following tips to deal with such sensitivities:

    1. If the child is sensitive to sound, allow the child to use noise-cancelling headphones or earplugs.

    2. Parents should give some extra time to let the child process the things said to them. However, if the child tends to ignore sounds, parents can try speaking loudly.

    3. If the child is overwhelmed with new places, parents can try taking them to new places at quiet times and gradually increase the time spent there during subsequent visits.

    4. If the child gets easily overwhelmed, arrange a “quiet space” for them.

Prognosis And Complications


Autism is a lifelong condition, and children may often require continued support and services most of their life. However, many individuals can live a normal life as symptoms of autism usually become less severe or noticeable with age. Therefore, parents who have a child with autism should be prepared to adjust to the needs and treatment of the child.


Conditions that commonly affect people with autism include:

  1. Dyslexia: People with dyslexia have problems with spelling, writing and reading.

  2. Dyspraxia: People with dyspraxia have trouble with movements (clumsiness) and difficulty following instructions.

  3. Attention deficit hyperactivity disorder: People with this condition get distracted easily and find it difficult to concentrate. Extra support may be required to help such individuals at school or at work.

  4. Insomnia: People with insomnia find it difficult to sleep.

  5. Learning disabilities: People with learning disabilities find it difficult to learn new skills, understand complicated information or look after themselves.

  6. Mental health problems: Individuals with autism are likely to have anxiety (feeling worried most of the time), obsessive-compulsive disorder (a feeling of compulsion or need to perform certain actions) or depression (a feeling of hopelessness or unhappiness).

  7. Epilepsy: People with epilepsy may have a tingling sensation in the limbs, strange tastes or smell or seizures (shaking violently and collapsing).

  8. Joint problems: Individuals with autism may have painful joints.

  9. Other problems: These include constipation, diarrhoea, etc.



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