World Autism Awareness Day: Has The Pandemic Caused An Increase In Autism Too?

Clinicians report surge of cases mimicking autism among kids during the COVID -19 pandemic. Here's how to protect your child from the threat of virtual autism.

Worldwide, about 1 in 44 children have autism spectrum disorder (ASD), according to the US Centre for Disease Control and Prevention (CDC), which estimated the prevalence of autism based on 2018 data. Prevalence means a condition relative to all people in a population and is shown as a percent. It has literally doubled in 10 years as per statistics of 1 in 88 in year 2008. Such a significant upward trend is attributed to both increase in awareness and a complex interaction between epigenetics and environmental factors. It's World Autism Awareness Day tomorrow! So, let's try to understand the reasons behind the increase in autism prevalence. Has Covid-19 pandemic anything to do with it?

To find out, we spoke to Dr Isha Soni, a senior occupational therapist, and co-founder of Lexicon Rainbow Therapy and Child Development Centre, Lexicon Group of Institutes, Pune. Below are excerpts from the exclusive interaction:

What are the causes of autism?

Though it is difficult to pinpoint one single robust cause of autism yet, a lot is yet unexplained about environmental factors increasing the risk of genetic predisposition causing autism. Only a few genetic conditions like Rett's Syndrome, Tuberous sclerosis, Schuurs Hoeijmakers syndrome, Fragile X are known genetic causes of autism.

Scientists all over the world are intensely researching on increased screen time exposure being one of the environmental factors. The known suggested environmental factors till date are increased maternal age, exposure to anticonvulsants, infections during pregnancy and maternal complications.

Has the pandemic caused an increase in autism too?

The COVID-19 pandemic brought about a significant impact on toddlers globally. They were bound within the confines of their homes with exposure to a very limited number of people, in most cases, only two, parents. Even as the parents of these toddlers were showing resilience to the novel situation of working from home while also managing all the household chores, most toddlers were left to enjoy screen. It kept them busy and the parents sane!!

Most parents felt that it kept their toddlers engaged simultaneously learning rhymes, poems and other educational programs. But this exposed the toddlers to hours and hours (4-6 hours/day) of screen time as opposed to the norms of "no screen time" till age 18 to 24 months as recommended by American Association of Pediatricians. For children aged 2 to 5 years, less than an hour of screen time is the maximum permitted.

A study published in Journal of American Medical Association (JAMA) Pediatrics warns that kids' literacy and language skills suffer due to excessive screen time. It shows evidence of decrease in white matter in brain of children exposed to excessive screen time. This white matter in brain is responsible for brains internal communication network and also build language skills.

Prior to the COVID -19 pandemic as well, a Romanian psychologist, Marius Zamfir, coined the term "Virtual Autism" in 2018. His study (2012-2017) mentions that consumption of more than 4 hours screen time per day causes autism like symptoms in children aged 0 to 3 years like avoidance of eye contact, no response to name call and being indifferent to their surroundings. He said in a Romanian public information campaign that "Children's brains are getting used to getting pleasure without making any effort at all"

In June 2021, when most clinicians of child development department resumed full fledged practice, they saw a sudden surge of cases mimicking autism. On parental history, it was noted that the children had shown delay or a regression in speech and social skills over the last 6 months with a history backing increased and unlimited screen time during 2020. Most cases were in the age range of 18 months to 4 years, coinciding with the period of onset of symptoms for autism. After taking a detailed history from caregivers, the paediatricians had termed them "high-risk for autism" and recommended complete withdrawal of screen time and begin occupational and speech therapy at the earliest.

How to save our toddlers from the threat of virtual autism?

At Lexicon Rainbow Therapy and Child Development Centre, Pune, we got almost 6 new referrals each day with similar history. Now, post 6 months of intense and consistent intervention, these kids have shown significant recovery in terms of social, language skills and increased eye contact. There is a significant difference observed between typical autism and virtual autism in terms of response to therapy. Kids with virtual autism show a faster response to therapy and the autism like symptoms go away.

More face-to-face interactions, sensory play, exploring the home environment, reading books, quality time with caregivers is recommended to avoid this threat. Parents are fully jeopardized when their child is suspected to have autism, since it has no cure. We may encounter more such pandemic situations in the near future and better be well equipped to save our toddlers from threat of virtual autism.

It's a wait and watch game for few years till we have a robust data to find out if this pandemic actually caused a rise in cases of autism and the controversy of environment factors vs genetic predisposition shall continue!!

Every year, World Autism Awareness Day is observed on April 2 to raise awareness about this condition and highlight the need to help improve the quality of life of people with autism.