1 . AUTISM seems an inevitable consequence, of the last few decades, when Indian families have moved from large joint families to smaller nuclear families, whereby the toddler finds limited avenues of socialization and human interaction in the form of nonverbal and verbal interactive communication. We can call it the side effects of the Westernization of our rich Indian Culture.
In the past Centuries, our families were having abundance of caretakers for any infant, who would be carried and cuddled , all day long.
2 . The current prevalance ratio of Autism features in 1 out of 65 young kids is quite alarming and this may further expand in coming times , if we fail to address and revisit our cultural trends. Agreed there is a genetic predisposition to the problem, which is however poorly defined as yet.
3. Classic Clinical Profile of Autism in a child ( 18 months to 3 years) is that of a toddler ( largely male) who is typically :
- unusual / absent responsiveness to our name calling
- absence of warm, joyful reciprocating expressions
- obsessed with the OBJECT that he is playing with
- repetitive actions like hand flapping
- no social gesturing with people around. Avoids Eye contact .
- appears detached from the close surroundings
Autism needs to be seen in a new light ……… and I am in agreement with the……………………….. Theory of Social Interaction and the Social Communication Sequence – as proposed by New Horizons Child Development Center and Dr . Samir Dalwai – since it seems to me that Doctors need a novel approach to resolve such a complex problem.
4 . The established SOCIAL COMMUNICATION SEQUENCE of five steps from Maternal calling to Nonverbal and Verbal communication ( receptive and expressive ) and finally Speech evolvement progressing to Reading / Writing skills ought to be established only sequentially . These early phases form the solid foundation of literary excellence in the older child and the adult professional, which is actually our desired goal.
5 . Any attempt to break and bypass this Social Sequence in a child with ASD and hurriedly acquire verbal skills/ speech by virtue of expert training and schooling can only end up with poor outcomes, which may be, actually more frustrating.
6 . Even if the autistic child has to now acquire Social Interactions and growth of Verbal communication at a relatively older age, that’s the right way to proceed . All Interventions for ASD problems are focussed on this premise. Human Interactions have to be the Remedial Interface in place of OBJECTS and DIGITAL SCREENS .
7 . Society’s evaluation parameters of Intellectual abilities in a given child apply only to those kids, who have no such deficits of social and communication abilities .
8. Those kids, who are suspected of having ASD features on M-CHAT assessment , need to be nurtured with professional guidance by Development experts and the parents ought to be partners in child grooming – with structured programs.
9 . Any half-baked approach to quick resolution of the serious issues of ASD, may only give some limited relief . The future progress may still resemble an abnormal gait on the career path .
10 . There may be many theories of causation of ASD , since it has a vast spectrum of presentations. Alternative therapies always emerge in such difficult medical scenarios and family resources may be easily misdirected the WRONG WAY. However, Pediatricians have to lead and guide the Society and the aggrieved parents of the index child to a more basic way of first understanding and thereafter monitoring such specially enabled children.
11 . AUTISM AWARENESS shall always remain an integral part of the overall concept of ECD , meaning Early Childhood Development .
12 . Digital Gadgets like Mobiles and Tablets have been like ADDICTIONS for all adults in the Digital World and Socializing amongst human beings has been therefore CRUCIFIED as a direct consequence. Young kids are not spared from this Contagion either.
✳️ ANY TIME is therefore SCREEN TIME nowadays. ✳️
Jai IAP. Jai NDD CHAPTER of IAP.
Views are based on my understanding of this topic of great relevance plus serious concern in a digital world.
Dr . Dhananjay Shah
Ped. Practice of 40 years
@ Rajkot. Gujarat.