Dr. Jhanvi Jasrotia and Dr. Ravinder K Gupta
Autism Spectrum Disorder (ASD) is a lifelong condition that affects how a person communicates, interacts, and processes the world around them. With early diagnosis and intervention, children with ASD can thrive and reach their full potential.
As we observe World Autism Awareness Day on 02 April 2025, with the theme ‘Advancing neurodiversity and the UN Sustainable Development Goals ’, it highlights the intersection between neurodiversity and global sustainability efforts, showcasing how inclusive policies and practices can drive positive change for autistic individuals worldwide and is crucial to increase awareness, foster inclusivity, and promote early diagnosis and intervention to improve outcomes for individuals with ASD.
The term “Autism” was first coined in 1911 by Swiss psychiatrist Eugen Bleuler, who used it to describe symptoms of schizophrenia that involved withdrawal from social interaction. However, the modern understanding of autism began in 1943 when Leo Kanner, an Austrian-American psychiatrist, published a paper describing 11 children with “autistic disturbances of affective contact.” Around the same time, Hans Asperger, an Austrian paediatrician, identified a milder form of autism, which later became known as Asperger’s Syndrome (now integrated into the broader ASD category).
Today, Autism Spectrum Disorder (ASD) is recognised as a neurodevelopment disorder characterised by challenges in social communication, restricted interests, and repetitive behaviours. The term “spectrum” reflects the wide variation in symptoms and severity among individuals with ASD.
Autism is one of the most studied neuro developmental disorders, and its prevalence has risen significantly over the past few decades. According to the World Health Organisation (WHO) and the Centers for Disease Control and Prevention (CDC):
- Prevalence: Approximately 1 in 100 children globally has ASD, while in some countries like the United States, it is estimated at 1 in 36 children (CDC, 2023).
ASD is four times more common in boys than in girls, although recent research suggests that girls may be under diagnosed due to subtler symptom presentation and is found across all racial, ethnic, and socioeconomic groups, though disparities exist in access to diagnosis and treatment.
In India, approximately 18 million people are affected by autism, representing about 12.7% of the total population. The prevalence of autism in India is rising, with an estimated one in 68 children diagnosed with the disorder. Boys are affected more frequently than girls, with a ratio of about 3:1.The increased prevalence is attributed to greater awareness, improved diagnostic criteria, and broader definitions rather than a true rise in cases.
Causes of Autism Spectrum Disorder
The exact cause of autism remains unknown, but research indicates that it arises from a combination of genetic and environmental factors.
- Genetic Factors
- Studies have shown that autism is highly heritable, with a concordance rate of 50-80% among identical twins.
- Multiple genes are implicated in ASD, including SHANK3, CHD8, and SCN2A, which are involved in brain development and neural connectivity.
- Genetic syndromes like Fragile X Syndrome, Rett Syndrome, and Tuberous Sclerosis are associated with autism.
- Environmental Factors
- Prenatal Factors: Advanced parental age, maternal infections (e.g., rubella, cytomegalovirus), diabetes, obesity, and exposure to certain medications (e.g., valproic acid, thalidomide) during pregnancy.
- Perinatal and Postnatal Factors: Premature birth, low birth weight, and exposure to air pollution and heavy metals have been linked to increased ASD risk.
Debunking Myths
Despite persistent misinformation, vaccines do not cause autism. Extensive scientific studies have refuted any link between childhood vaccinations, such as the MMR (measles, mumps, and rubella) vaccine, and ASD.
Dietary changes and use of other modalities : Gluten free , caesin free diet is not recommended in ASD unless they have celiac disease or gluten sensitivity.
Symptoms of Autism Spectrum Disorder
The region of Jammu and Kashmir is witnessing a growing number of autism cases, particularly in the virtual sphere. Several factors contributing to this surge include low public awareness, a lack of basic services, and poor diagnostic practices.
Parents of children with special needs, such as autism, ADHD, and other developmental conditions, face a unique set of challenges. They often feel isolated and overwhelmed by their circumstances. The greatest challenge these families face is the lack of awareness about autism, not only among the general public but also among medical professionals.
Autism, being a spectrum disorder, manifests differently in each child, and its symptoms—such as communication difficulties, social interaction challenges, and restricted behavior—are frequently misunderstood. This lack of understanding often leads to stigmatisation and social exclusion, making it even harder for families to seek help or find acceptance in their communities. Furthermore, the scarcity of specialised educational and therapeutic services adds to the burden families face, leaving them without the necessary resources for supporting their children effectively.
ASD symptoms typically appear before the age of three and vary in severity. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) categorises ASD symptoms into two main domains:
- Social Communication and Interaction Challenges
- Difficulty with eye contact, facial expressions, and gestures.
- Lack of interest in peer relationships or difficulty forming friendships.
- Delayed or absent speech development (some children remain nonverbal).
- Difficulty understanding social cues, emotions, and conversational norms (e.g., taking turns in conversation).
Increased screen time of the child .
- Restricted, Repetitive Behaviours and Interests
- Repetitive movements like hand-flapping, rocking, spinning.
- Intense focus on specific topics or objects e.g., trains, numbers, maps.
- Adherence to routines and distress when routines are disrupted.
- Sensory sensitivities e.g., aversion to loud noises, bright lights, or certain texture.
Associated Symptoms
- Intellectual disability or, conversely, above-average intelligence in specific areas e.g., mathematics, music, artistic approach .
- Anxiety, ADHD, sleep disturbances, and gastrointestinal issues are common co-occurring conditions.
Diagnosis of Autism Spectrum Disorder
There is no single test to diagnose ASD. Instead, doctors use behavioural observations, parental reports, and standardised screening tools.
- Early Screening and Developmental Monitoring
- The American Academy of Pediatrics (AAP) recommends ASD screening at 18 and 24 months using tools like the Modified Checklist for Autism in Toddlers (M-CHAT-R/F).
- Parents and caregivers should watch for early warning signs, such as lack of babbling, pointing, or social responsiveness by 12 months.
- Comprehensive Diagnostic Assessment
- Conducted by specialists like developmental paediatricians, child psychologists, or neurologists.
- Includes standardised tools such as:
- Autism Diagnostic Observation Schedule (ADOS-2)
- Autism Diagnostic Interview-Revised (ADI-R)
- Genetic Testing: Recommended in some cases to identify underlying genetic conditions.
Is There a Cure for Autism?
Currently, there is no cure for autism. However, early intervention and supportive therapies can significantly improve a child’s quality of life. The goal is to help individuals with ASD develop skills to lead fulfilling and independent lives.
Intervention and Treatment for Autism Spectrum Disorder
- Behavioural and Educational Therapies
- Applied Behaviour Analysis (ABA): Evidence-based therapy that helps with skill-building and reducing unwanted behaviours.
- Speech and Language Therapy: Improves communication, including the use of augmentative and alternative communication (AAC) devices.
- Occupational Therapy: Helps with daily living skills and sensory integration.
- Social Skills Training: Teaches children how to interact with peers and understand social cues.
Autism education by establishing inclusive practices in all mainstream schools, providing training for educators, and integrating inclusive policies into the educational system. NGOs and community groups should amplify their advocacy efforts to raise awareness and promote acceptance of autism.
- Medication
While no medication treats autism itself, some medications help manage associated symptoms with doctors guidance .
- Alternative and Complementary Therapies
- Dietary interventions (e.g., gluten-free, casein-free diets) lack strong scientific backing but are used by some families.
- Animal-assisted therapy (e.g., equine therapy, service dogs) has shown benefits for some children.
- Home based therapy
- Parent Training Programs help caregivers understand and support their child’s development.
- Support Groups provide emotional and practical guidance.
–Play therapy– This will be a learning exercise for your child, through play. You can start by connecting with your child through simple games. Bubble-blowing, chase-and-tickle or swinging.
–Speech Therapy– Autistic children often have trouble with speech and language. Speech therapy is a complex field. However, there are ways for parents to provide certain aspects of speech therapy, with relatively minimal training.
–Floortime– Floor-time is very similar to play therapy. The whole concept is that parents should introduce “circles of communication” to their autistic child. Floor-time autism therapy and treatment, encourage the child to participate in back and forth interaction. This helps them expand their social skills, while also making emotional connections.
–Relationship development intervention– This particular autism therapy technique is goal-oriented. It requires that parents work with a consultant, to help their children develop social and communication skills.
–Parent-child interaction therapy– This intervention technique is for autistic children who display aggressive behaviour. It is implemented by parents or caregivers who are trained by a professional. Its goal is to de-escalate any negative behaviour patterns between parents and children.
April 2nd marks World Autism Awareness Day, a global initiative to increase understanding and acceptance of Autism Spectrum Disorder (ASD). As a paediatrician, we have encountered numerous families navigating the complexities of an ASD diagnosis. While awareness has increased over the years, there is still much to be understood about this neurodevelopment condition.On World Autism Awareness Day, let’s advocate for acceptance, inclusion, and access to essential services for individuals on the autism spectrum. Every child, regardless of their challenges, deserves the opportunity to reach their full potential.With early diagnosis, tailored interventions, and societal support, individuals with ASD can lead meaningful and productive lives.
Indian Academy of Pediatrics (IAP) dedicates this day to raise awareness about autism spectrum disorder (ASD) and to foster a society that values neurodiversity , encourages inclusion and provides equal opportunities for all individuals , regardless of their differences. This day also give opportunity to educate the public about the challenges and strengths of those on autism spectrum , to celebrate the contributions of individuals with autism and to advocate for greater understanding and acceptance within society.
Theme for 2025 : EMPOWERING AUTISTIC VOICES
Slogan : Different, Not Less
Light it up blue
The blue autism ribbon is perhaps the most well-known symbol for autism awareness. It represents hope, support, and understanding for individuals on the spectrum
Blue is associated with calmness and acceptance, making it a fitting color to represent the autism spectrum. By wearing blue, individuals can show solidarity with the autism community and contribute to a greater understanding and acceptance of autism. When we wear blue, it’s not only about keeping that conversation going about autism but, it’s also making sure that those with autism and their families don’t feel alone. So on April 2nd and throughout World Autism Month in April please wear blue, and have others do the same.
The authors are from Department Of Paediatrics, Acharya Shri Chander College Of Medical Sciences (ASCOMS Jammu).
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