An Inclusive & Supportive World for those with ASD

World Autism Awareness Day - April 2nd
“LIGHT IT UP BLUE”

Autism spectrum disorder is a neuro-developmental disorder distinguished by significant deficits in social interaction and communication and repeated and confining behaviour, with a prevalence of nearly 1 in 68 children in the US, 1 in 500 children in India and an overall prevalence of 1 in 100 worldwide as per WHO statistics.

The term autism was first used by Eugen Bleuler, a psychiatrist, to classify a set of symptoms thought to be symptoms of schizophrenia like acute social withdrawal.

Then, in 1943, Dr Leo Kanner described autism as a disorder that affected a person’s social skills and emotional response in an article he penned – “Autistic Disturbances of Affective Contact”. A year later, Hans Asperger in his article “Autism Psychopathology Article” described autism as a condition that afflicted children of normal intelligence and affected their social and communication skills. The above articles played a key role because they helped classify autism as a condition that was different from schizophrenia.

With further research on autism, the United Nations General Assembly declared that April 2nd would be observed as World Autism Awareness Day to promote awareness about the condition and to contribute to further research to enhance the management of the condition as well as to promote a society that is inclusive of those affected with autism.

The idea that autism involved a variety of possible conditions as set forth in 2013 by the American Psychiatric Association. It comprehensively compiled all the subgroups of autism into one all-encompassing group which took into account the symptoms, their seriousness and the way they were displayed.

The theme for World Autism Awareness Day 2023 is
'Light It up Blue'.

Autism spectrum disorders (ASD), previously known as pervasive developmental disorders, are a heterogeneous group of neuro-developmental syndromes, with polygenic inheritance, characterised by a wide range of impairments in three domains, namely:

• Social communication
• Restricted and repetitive behaviours and
• Aberrant language development and usage

According to DSM-5, the defining features of deficits in social communication and restricted and repetitive behaviours are usually present in the early developmental period (infancy). When subtle, they may not be identified till school age years and approximately one-third of these children exhibit features of intellectual disability.

The prevalence of ASD is estimated at approximately 1% in any population. It is 4 times more common in boys than in girls.

- Courtesy “Intervention Guide for ASD” - NIMHANS, Bengaluru

Core Symptoms in ASD: [as per developmental levels]

Persistent Deficits in Social Communication and Interaction

In Preschool Years:

• May not develop a social smile.
• Lack of anticipatory posture for being picked up.
• Less frequent and poor eye contact.
• Atypical, minimal attachment behaviour.
• May not explicitly acknowledge their parents and siblings from others.
• May not react when left with strangers.
• Often feel and display extreme anxiety when their usual routine is disrupted.

In School Age and Later:

• Difficulty in spontaneous play activities with peers.
• Disability in developing friendships; often have awkward and inappropriate social behaviour.
• Lack of conventional back and forth conversations not understanding the emotions or feelings of others.
• Restricted and Repetitive Patterns of Behaviour, Interests and Activities

This is manifested in the following ways:

• Exploratory play is restricted.
• Atypical play with toys and objects.
• Do not show imitative play.
• More rigid, repetitive and monotonous play activities.
• Ritualistic and compulsive behaviours are common.
• Often seem to enjoy spinning, banging and watching water flowing.
• Often strong attachment to an inanimate object.
• Increased self-stimulatory/self-injurious activity.
• Stereotypies, mannerisms and grimacing frequently.
• May have fear, panic or temper tantrums in new environments.

They also have some associated physical characteristics like:

• Minor physical anomalies e.g., ear malformations.
• Remain ambidextrous (both right and left-handed).
• Abnormal dermatoglyphics (fingerprint patterns).

ASD is typically a lifelong disorder but with variable severity and prognosis. Children with ASD with IQ levels above 70 with average adaptive skills and language communication abilities by 5-7 years of age have the best prognosis.

So, early identification and initiating interventions like occupational therapy, behaviour therapy and speech therapy help them fair well later in life.

WHO Key Facts & Take-Home Messages:

• Autism – also referred to as autism spectrum disorder - constitutes a diverse group of conditions related to the development of the brain.
• About one child in 100 has autism.
• Characteristics may be detected in early childhood, but autism is often not diagnosed until much later.
• The abilities and needs of autistic people vary and can evolve over time. While some people with autism can live independently, others have severe disabilities and require life-long care and support.
• Evidence-based psychosocial interventions can improve communication and social skills, with a positive impact on the well-being and quality of life of both autistic people and their caregivers.
• Care for people with autism needs to be accompanied by actions at community and societal levels for greater accessibility, inclusivity and support.
• Courtesy WHO

To Conclude:

We emphasize again that autism spectrum disorder (ASD) is a developmental disorder present since birth and we all have to be aware of the symptom complex even in the early infancy stage. We need to sensitise and educate parents to seek professional help for assessments and appropriate interventions.

As this year’s theme for World Autism Awareness Day is “Light It up Blue”, we request that everyone wear blue and try to illuminate their homes, buildings and landmark in the colour blue to show our solidarity with those affected by autism as well as to promote awareness about autism. On this day we celebrate the uniqueness of these lovely children with autism and pledge to support them and help them accomplish their full potential.

“When you meet someone with autism, you meet a person, not a diagnosis.”

- National Autistic Society