Autism is a complex neurobehavioral condition that includes impairments in social interactions, developmental language, and communication skills combined with rigid, repetitive and stereotypic behaviours. No two children with Autism are the same since Autism is a spectrum ranging from mild to severe, hence these disorders are grouped commonly under Autism Spectrum Disorders (ASD).
Initially thought to be less common, Autism incidence is steadily increasing with the current incidence reported as being 1 in 59 children. This apparent increase is due to the increasing recognition and diagnosis of this condition. ASD is commonly due to an underlying genetic disorder, metabolic disorder, structural changes or injury to the brain tissue.
Common associations with ASD include epilepsy, learning difficulty, hyperactivity or behavioural disorder, poor sleep patterns, food fussiness, etc. Children with ASD need an accurate diagnosis and medical management of the underlying condition, if any, like epilepsy, metabolic disorder, etc.
Medications are indicated for the treatment of seizures, extreme irritability, stereotypic repetitive behaviours, significant hyperactivity, and poor sleep patterns. The core symptoms of ASD like poor communication – language and socialization skills require long term interventional therapies including speech and occupational therapy which is the mainstream treatment for children with ASD.
The earlier the diagnosis is made, the better it is so that the above therapies can be initiated at an early age (ideally by 2 years) for the best results. Few cases of Autism are due to underlying epileptic disorders like Landau Kleffner Syndrome or Electrical Status in Slow Wave Sleep syndrome and show a remarkable improvement in terms of speech and communication once epilepsy and EEG findings improve. Similarly, certain metabolic disorders like Phenylketonuria can also present as Autism but require different dietary and supplementation therapy. Disorders like Tuberous Sclerosis and many brain developmental disorders can also have Autism as one of their symptoms. With recent advances in diagnostics and therapeutics, most of the ASDs are now understood to have a neurobiological and neurogenetic basis therefore proper evaluation to make an accurate diagnosis is essential not only for treatment advice and long term prognostication but also for preventing recurrence in future pregnancies.
Dr. Minal Kekatpure, Senior Consultant Neurology – Paediatric, Mazumdar Shaw Medical Center, Bommasandra