The sooner the better — a formula a parent has to live by when bringing up a toddler. Children grow up fast but their brain or neurological development happens even faster, much faster than we realise. Hence, symptoms of the autism spectrum too become visible quite early in a child’s life — when he is barely two years old. It is a condition that a child is born with and might have to live with but for timely intervention. April is Autism Awareness Month and just the right time to spread the news that autism can be managed with proper treatment at the right time.
Somenath Mukherjee is a senior speech language pathologist at Speech Plus in Calcutta, a clinic that works with autistic children. He says, “There is a golden period of intervention for autism. Most parents come to us only after the real time has slipped away.” The reasons are several but social stigma and too little time spent with the child to catch the cues are two of the obvious ones. “We have also seen many a time that parents are ignorant or unaware of what autism is, and that the condition is controllable or manageable with proper treatment and care,” he remarks.
Vedyant Biswas is seven and studying in a well-known English medium school in Calcutta. Till the age of four, he could not speak at all. He was also hyperactive and could not sit still. Both his parents were working and so he spent more time with his grandparents than his parents. “This is one of the reasons he was not communicative and kept to himself most of the time. When it was time to send him to school, we realised his problem and took him to a speech pathologist,” says his mother Pragna Paromita Biswas. Vedyant had to be treated for about a year and a half before he could speak fluently.
“It is the mother who first comes to know about any abnormal behaviour a child demonstrates,” says Mukherjee, a founding member of Speech Plus. This is because she spends more time with the child than the paediatrician. But how will a parent know what symptoms to look for? Mainak Santra, a consultant speech language pathologist at Speech Plus, lists a few issues.
“Does the child make eye contact when spoken to? Does he respond to his name? If he doesn’t, that should ring a bell,” says Santra. “It is a very tricky issue as many a time even medical practitioners dismiss such cases thinking the child has a hearing problem,” he adds.
A few other things to keep an eye out for are: difficulty in mixing with other children of his age, inappropriate laughing or giggling, apparent insensitivity to pain, preferring to remain alone, unresponsive to normal teaching methods and verbal cues, throwing tantrums for no apparent reason, repeating words or phrases, odd play habits, staring at spinning objects for hours and so on.
A lot of children fall within the autism spectrum these days. If we go by statistics, in the 1970s the ratio of autistic children was one in every 10,000. In 2018 it is one in every 68 children. Such children may have low birth weight, a virulent infection as an infant, epilepsy or birth asphyxia. Sometimes, the mother might have had suffered from epilepsy, hypertension, asthma or conceived with assisted fertility. In some cases, it might also be genetic.
How the toddler manages depends a great deal on how parents handle him or her. “It is essential to know what a parent should do or not do while engaging with a toddler,” says clinical psychologist Sathi Das. She recalls counselling a young boy who had trouble communicating. “The parents would often leave the child to play with the mobile phone while they were busy. This is extremely harmful. The rhymes on the mobile do not allow for interaction. It is one-way communication where the child does not have any chance to participate,” she says.
A child has the capability to pick up three or four languages at the same time if they are exposed to that many. But smart TVs, computers, video games and cartoon networks are not the way to teach a child language skills. Two way communication and sign language that parents use to communicate with the child is crucial.
“A child’s neurological development is at its peak between the age of two and three. If your child is not able to communicate his needs and cannot speak a word or two when he is turning two, you should start observing the child more intensely,” adds Das.
The Speech Plus team is developing a screening app — named Pehchaan — for children at risk of autism. “While time is the most crucial thing, it seems parents do not find time to cover the distance required to reach us for early diagnosis. This app is for those parents and has many parameters for measuring a child’s mental development,” says Mukherjee.
The app is loaded with videos for proper understanding of normal and abnormal behaviour. There are about eighteen points mentioned in the app, a child will have to be positive on nine to be diagnosed as suffering from an autistic spectrum disorder. A little more awareness about autism might save a child’s future.