Catch autism early: Key steps for early intervention to support autistic people

Swapnil was met with a distressing ordeal when he sought to top up his familys health insurance plan The Bengalurubased father was stunned by State Bank of Indiarsquos discriminatory response when he disclosed his sons autism diagnosis to the insurance agentDespite maintaining coverage for himself and the other three family members the insurance provider abruptly removed his son from the Arogya Plus policy and retained the other three When Swapnil contacted the manager he clarified that there was no policy provision for his sonrsquos conditionFeeling betrayed and marginalised Swapnil reached out to other health coverage providers like TATA AIG ACKO Insurance and Star Health Insurance but was met with similar responses ldquoI filled out their online form disclosing my sonrsquos developmental delayautistic condition But their websites are designed in such a way that I could not proceed any furtherrdquo Swapnil tells MiddayAlso Read No policy for disability Health cover denial sparks mothers advocacy for autistic sonWhen Midday reached out to SBI they refrained from commenting on the same Unfortunately Swapnils experience mirrors that of Geetha another parent from Bengaluru who encountered similar discrimination from Care Health formerly Religare Insurance company when she disclosed her sons autism diagnosis This systemic exclusion of autistic individuals from health coverage highlights a pervasive issue in the insurance industry underscoring the urgent need for reform and greater awarenessDespite these challenges hope remains on the horizon for families navigating the complexities of autism Health experts emphasise the crucial role of early intervention in supporting individuals with autism and their familiesBy equipping parents with comprehensive knowledge about autism they can effectively navigate the hurdles and advocate for their childrens rights Through increased awareness parents and caregivers of autistic children can enable neurodivergent individuals to receive the support and respect they rightfully deserveGenes Primary factor contributing to autismGenetic mutations stand out as the primary contributor to Autism Spectrum Disorder ASD involving approximately 65 genes informs Dr Sakshe or Sakshi Jain a consultant psychiatrist from Ruby Hall Clinic Pune ldquoThese mutations often manifest as chromosomal abnormalities such as deletions inversions and duplicationsrdquoTwin studies have shown a significant correlation where if one twin has autism the chances of the other twin having ASD are as high as 80 per cent Moreover siblings of individuals with autism exhibit distinct traits including superior verbal and spatial skills but may struggle with tasks involving planning and verbal fluencyAlso Read Dealing with autism What you need to know about the disorder and how you can help people with itAdditionally ASD is often accompanied by comorbid conditions such as fragile X syndrome Down syndrome Duchenne muscular dystrophy neurofibromatosis type 1 and tuberous sclerosis complex Advanced parental age particularly maternal age over 40 is associated with an increased likelihood of autism in offspring Other risk factors include low birth weight metabolic imbalances exposure to heavy metals and environmental toxins as well as fetal exposure to substances like valproic acid or thalidomideMisdiagnosis or underdiagnosis of Autism Spectrum Disorder ASD in females is a concern possibly influenced by factors such as the masculinising effect of fetal testosterone XY theory and decreased autosomal penetrance theoriesThese theories suggest that females may carry mutations related to Autism Spectrum Disorder on autosomal chromosomes contributing to the higher prevalence of ASD in males Additionally family history plays a significant role as parents who have one or more children with autism have an increased likelihood of another child being autisticDifferentiating between developmental variations and potential signs of autism in infants and young childrenDevelopmental milestones are essential markers of a childs growth but its crucial to note that theres a wide range of typical development Jain remarks that similar to the Hindi saying teen tigada kaam bigada Autism is characterised by a triad of pathogenic features including lack of communication interaction and repetitive behavioursSigns that may indicate potential autism spectrum disorder ASDLack of response to their name by 12 monthsLimited or lack of pointing or gestures to show interest by 12 monthsDelayed speech or lack of speech by 16 monthsAvoidance of eye contact or limited social interactionRepetitive behaviours such as handflapping rocking or spinning objectsDifficulty in understanding or expressing emotionsEarly signs and symptoms of Autism Spectrum Disorder ASDAccording to the World Health Organisation it is estimated that worldwide about 1 in 100 children has autism Recent international studies have also revealed that one in 68 people have autism As it becomes the third most common developmental disorder India houses approximately 18 million people living with autismHealth researchers have documented a deficit in attention skills of children living under ASD including problems using eye gaze to coordinate attention following the attentional focus of another person and drawing anotherrsquos attention to an object of interest shares Dr Ishu Goyal deputy consultant neurologist from Sir HN Reliance Foundation HospitalThe symptoms can be observed as early as 6 months when the baby shows limited smiling or nonmeaningful smiles only As the baby grows and is expected to attain social milestones like nonverbal communication of extending hands to be lifted or waving bye When the baby does not show any such behaviour autism should be suspected and milestones should be observed carefully adds GoyalSteps for parents if they notice potential signs of autismThe treatment of Autism Spectrum Disorder ASD involves both psychosocial and pharmacological interventions Psychosocial interventions typically include early intensive behavioural and developmental approaches ldquoOne such model is the CLAbased model which heavily relies on techniques derived from applied behaviour analysis This intervention is usually implemented on a onetoone basis for numerous hours each weekrdquo shares Jain During these sessions therapists work closely with the child focusing on practising specific social skills and behavioursEarly intervention is key Parents should consult with their paediatrician or a developmental specialist if they have concerns about their childs development The healthcare provider may conduct developmental screenings or refer the child to specialists for further evaluation if necessaryAdditionally parents can seek evaluation through developmental paediatricians child psychologists or other specialists experienced in diagnosing ASD Its essential for parents to document their observations and concerns to provide comprehensive information to healthcare professionals during evaluations stresses JainThe interventions may commence as early as the diagnosis is established This includes behavioural developmental educational social pharmacological and psychological approaches Goyal informs that ldquobehavioural therapy encourages favourable behaviour and ignores unfavourable behaviourrdquoStress is laid on the development of language milestones that are mostly affected Simultaneous emphasis is given to educating the child in ways and techniques to increase concentration Also slow involvement in the surroundings and with peers is facilitated along with training to modify responses to unwarranted stimuliResources and support services for parents of children with autism1 Early intervention programs such as speech therapy occupational therapy and applied behaviour analysis ABA can help address the specific needs and challenges of children with autism2 Educational resources and programs tailored to children with ASD including specialised schools or classrooms can offer support and accommodations3 Local autism support groups and organisations can provide valuable resources information and emotional support for parentsGenetic or environmental factors enhancing the risk of autismGenetic factors Mutations in various genes contribute significantly to ASD with around 65 genes identified to be involved Family history plays a role with parents who have had one child with autism having an increased probability of another child being autisticEnvironmental factors Factors such as advanced parental age especially maternal age low birth weight exposure to certain toxins or medications during pregnancy like valproic acid or thalidomide and metabolic imbalances can increase the risk of autism