World Autism Awareness Day: Here’s how to manage autism spectrum disorder

By: Dr. Sankalp Dudeja, Consultant Pediatrics and Neonatology at Cloudnine Group of Hospitals, Gurugram

World Autism Awareness Day: Autism spectrum disorder (ASD) is a neurodevelopmental disorder and typically diagnosed in children. Here’s how to deal with autism children.

Developmental disability, known as an autism spectrum disorder (ASD), is brought on by differences in the brain. Individuals with ASD may struggle with repetitive activities or interests, as well as social communication and engagement. Moreover, people with ASD may learn, move, or pay attention differently.

Like other neurodevelopmental impairments, autism spectrum disorders are typically not “curable”. Chronic treatment is required for a better lifestyle. The main objectives of treatment are to reduce the core symptoms and related deficiencies, increase functional independence and quality of life, and lessen stress in the family.

Ways to manage Autism Spectrum Disorder

Here, we will discuss the interventions which help mitigate the core features of autism spectrum disorder, which include impairment in social reciprocity, deficits in communication, and restricted repetitive behavioral repertoire.

1. Educational interventions

Education is characterized as the encouragement of skill and information acquisition to support a child’s development of independence and self-reliance. Together with academic learning, it also includes socializing, the development of adaptive skills, communication, and the generalization of knowledge across various contexts.

2. Specific strategies

Educational programs for kids with autism spectrum disorder include several specific techniques such as:

Applied behavior analysis: The technique of using interventions based on learning principles discovered via experimental psychology research to systematically change behavior is known as applied behavior analysis (ABA). An essential component of the behaviorally-based treatment of undesirable behavior’s is functional behavior analysis, often known as functional evaluation. The majority of problem behavior’s have some sort of adaptive purpose and are reinforced by the outcomes, such as gaining adult attention, a desired object, activity, or sensation, or eluding a demand or undesirable scenario. The primary focus of ABA is the accurate measurement and impartial assessment of observable behavior in pertinent contexts, such as the home, classroom, and community.

Speech and language therapy: Due to their social communication difficulties, people with ASDs typically benefit from treatment from a speech-language pathologist. A majority of children with ASDs can learn to speak in meaningful ways, thus a child’s chronological age or lack of the usual necessary abilities shouldn’t prevent them from receiving speech-language services. It is frequently successful to improve communication by using augmentative and alternative communication modalities, such as gestures, sign language, and picture communication software.

Occupational therapy: Traditional occupational therapy frequently encourages the development of academic and self-care skills such as clothing, manipulating fasteners, using utensils, and academic skills such as cutting with scissors, and writing.

3. Medical management

Children with ASDs have the same basic healthcare needs as children without disabilities and benefit from the same health promotion and disease-prevention activities, including immunizations. They might also have some co-morbid conditions that call for medication.

Seizures: Between 11 per cent and 39 per cent of those with ASDs are reported to have epilepsy. The same criteria used for all children with epilepsy, including an accurate diagnosis of the specific seizure type, guide anticonvulsant treatment in children with ASDs.

Gastrointestinal problems: Several ASD patients have symptoms like persistent or recurrent stomach pain, nausea, vomiting, diarrhea or constipation. When a youngster exhibits a shift in behavior, such as aggressive outbursts or self-harm, occult gastrointestinal discomfort should also be taken into account.

Sleep disturbance: Sleep problems are common in children and adolescents with ASDs at all levels of cognitive functioning. In some cases, there may be an identifiable etiology such as obstructive sleep apnea or gastroesophageal reflux; assessment and treatment are guided by history and physical examination. When there is no known medical explanation, behavioral therapies such as sleep hygiene practices, restricting daytime sleep, developing healthy evening routines, and extinction techniques are frequently successful.

Evaluation of challenging behaviors: Problematic emotional reactions and behaviors such as aggression and self-injury are common in children and adolescents with autism spectrum disorder. In some cases, medical factors may cause or exacerbate maladaptive behaviors, and recognition and treatment of medical conditions may eliminate the need for psychopharmacologic agents. Otitis media, otitis externa, pharyngitis, sinusitis, tooth abscess, constipation, urinary tract infection, reflux, colitis, allergic rhinitis, and other conditions can all be sources of discomfort.

Psychopharmacology: Pharmacologic interventions may be considered for maladaptive behaviors such as aggression, self-injurious behavior, repetitive behaviors (for example, perseveration, obsessions, compulsions, and stereotypic movements), sleep disturbance, irritability, anxiety, hyperactivity, inattention, destructive behavior or other disruptive behaviors. After treatable medical causes and modifiable environmental factors have been ruled out, a therapeutic trial of medication may be considered if the behavioral symptoms cause significant impairment in functioning. Selective serotonin-reuptake inhibitors (SSRIs), atypical antipsychotics, and stimulants are examples of medications that can be used.

4. Family support

Management should focus not only on the child but also on the family. In addition to educating parents about ASDs, providing anticipatory guidance, training and involving them as therapists, assisting them in accessing resources, providing emotional support through tried-and-true techniques like empathetic listening and talking through issues, and supporting them in advocating for their child’s needs, doctors and other health care professionals can help parents.

ASDs are chronic conditions that affect nearly 1 of every 150 children and require multi-disciplinary support!

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