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What is Autism Spectrum Disorder and how is it diagnosed?

Pediatric clinics around the world are experiencing a high number of referrals for children with Autism spectrum disorder (ASD). The Centre for Disease Control (CDC) puts the prevalence of Autism at 1 in 44 children which is a high number.

Children with ASD typically show difficulties in communication, socializing and behaviour. The common red flags for ASD include the child not talking at expected times, not responding to his or her or their name, displaying repetitive behaviour such as flapping of arms when excited, sensory behaviors like blocking ears to sounds or staring at lights. They can show strong and unusual interests with objects. Even play can be unusual.

Why diagnose early? There is evidence that early diagnosis and appropriate intervention can lead to improved developmental outcomes. The rate of improvement depends on the individual child as well as the intervention. Intervention involves identifying the child’s needs and providing strategies to improve communication, socialization, learning and behaviour. This is done by a combination of input from early educator, occupational therapist, speech therapist and behavioral therapist. It is recommended that Intervention should be a minimum 24 hours per week and as early as possible.There are still many families who are not aware of ASD and quite delayed in seeking help for their child. This may impact developmental outcomes for the child.

What are the causes? This is not fully understood but genetic predisposition and high paternal age are thought to be associated. More recently we are observing an association with social isolation and increased screen time. There are no biological or genetic markers for ASD. Diagnosing ASD is done by a clinical assessment of development and behavior and applying diagnostic criteria as per DSM 5 or ICD10. Sometimes psychometric assessments are used to support or clarify the diagnosis of ASD.

At Rainbow Banjara we have an experienced team of clinicians and allied professionals which includes Neurologist, Developmental pediatrician, Psychiatrist, Clinical psychologist, Early educator, Occupational therapist, Speech therapist, Neuro developmental therapist and Counsellor. Children referred to us are assessed first by the developmental pediatrician. The presentation of ASD can be complex and often associated with co-morbidities. An in-depth assessment of development and behaviour is required which gives a holistic picture of the child’s strengths and difficulties. The parents are counselled about ASD and then referred for further assessments by therapists. The therapists then provide guidance and intervention to the family in the areas of communication, sensory integration , learning and behaviour. Co-morbidities such as hyperactivity, anxiety and attention problem that frequently occur are also managed.

Diagnosis of ASD is not always straightforward and requires a detailed and a multi-disciplinary assessment. There is an increasing awareness of this condition with some families seeking help early but much needs to be done to increase awareness, diagnose early and provide early intervention.

Dr. Pratima Giri


Rainbow Children's Hospital, Banjara Hills