Parents and pediatricians/physicians play a vital role in the early diagnosis of autism in children. Earlier there were no clear guidelines for autism screening in India. Since the prevalence of autism was less during the earlier days, physicians and pediatricians were less aware of the red flag signs of autism. This means autistic children were left undetected and did not receive early intervention. Hence, the early detection of autism in children was completely dependent on the parent’s ability to identify the problem. Usually, parents start to notice signs during 4-5 years of age. This delay in identification is mainly due to the fact that autism has no physical markers. Here are some of the reasons why several symptoms of autism are missed out by Indian parents.
- Usually, most children develop their motor skills within 2 years of age and autism does not affect motor skills development. Even an autistic child achieves motor skill development within 2 years of age like any normal child.
- Most autistic children also develop rote skills. Rote skill is memorizing and repeating alphabets and numbers. A child with rote skill need not essentially be with good communication skills. Quite often excellent rote skill is misjudged as being excellent in communication while actually the opposite might be true. An autistic child develops rote skills like any other normal child but they may have poor communication skills. This can be an early clue.
- Indian parenting is all about how well behaved a child is. So if a child is quiet and keeps to him or herself, it is to be taken as a ‘well-behaving child’. If a child remains quiet and secluded from parents and others, it is advised to look into this issue and see if there are any other factors that are bothering the child. Even normal children sometimes tend to be dull, quiet and secluded due to some other problems. If there are no problems then suspect autism.
- Along with speech and language problems, another common symptom that occurs in autistic children is hyperactivity (behavioral problems). Since autism affects the brain nerve cells, the information that is passed through these brain nerve cells is passed on differently with lesser intensity. This can cause the typical behavioral problems as reported in autistic children.
- Some autistic children also face sensory problems. They might react in an extremely aggressive manner for something that may appear normal to us. Or they might have no reaction to something that we might consider big. They are quite unpredictable in most cases. So you can look out for these clues too.
- Most parents dismiss behavioral problems like hyperactivity, aggression, and tantrums by regarding them as an act of playfulness or naughtiness.
- Other symptoms include problems with eating, sleeping, toileting, poor posture, seizures, poor understanding, etc.
Most of the behavioral symptoms discussed here are not identified by parents in their children. They rather fail to. That is why it is very important to assess the social-emotional interactions of the child very keenly. The time taken for parents to recognize symptoms and to get it warranted by a physician or pediatrician is crucial for starting an early intervention.
A study shows that there is a lag of nearly two years before the parents grow suspicious of their child’s activities. And most parents in India seek multiple opinions till they come to terms that their child has autism. Despite all of these factors, the average diagnosing age has been steadily decreasing due to the increasing awareness among parents and physicians/pediatricians about Autism. This is indeed a good sign. However, the rural and remote regions of India still face a lot of trouble in getting help for their children.
Since each individual with autism has different manifestations there is no set medical test like a blood test to rule out autism. Rather there are several interactive and question-based screening tests to identify the problem. The two-step autism screening method includes Developmental screening and Comprehensive diagnostic evaluation.
Developmental Screening – The First-step Evaluation
- A rather simple and a short test to check if the child has acquired basic skill milestones or if they have some delays in acquiring.
- The doctor then questions the parents followed by talking and playing with the child to see how the child learns, speaks, responds, moves and behaves. This is done immediately after the first.
- A delay in any of these parameters could give a potential indication of autism.
Comprehensive Diagnostic Evaluation – The Second-step Evaluation
- This evaluation involves assessing the child’s behavior and overall development.
- The parents are also interviewed to document any abnormal behaviors noticed by the parents at home or somewhere else.
- Other parameters that are evaluated are hearing, vision screening, genetic testing and other medical testings.