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My child does not speak! He does not like socializing with other children. She avoids looking me in the eye. My child plays with his toys in a repetitive way.
If you have a child with Autism Spectrum Disorder (ASD), here are some of the early traits that you may have noticed in your child.
ASD is an intellectual disability that can lead to significant social, communication and behavioral problems.
In 2013, the American Psychiatry Association merged four conditions – autistic disorder, childhood disintegrative disorder, pervasive developmental disorder – without indication to the contrary and Asperger's Syndrome – into a diagnosis. overall TSA.
"We need to look at the whole child before we make a judgment," says Dr. Subhashini Jayanath, pediatrician consultant in development.
"Basically, we look at social communication, interaction, attention and reciprocity.
"We take into account a little language and non-verbal communication.
"The second thing we observe is the behavior and it's the one most people notice, it's repetitive behavior or rigidity, the need for routine, not loving change, loud noises, some colors , some textures or some foods.
"They also exhibit sensory research behavior, such as licking, smelling things or putting things in their mouths."
Usually at the age of two, medical specialists can make a diagnosis, except in very light or unclear cases.
Current research also shows that ASD can be detected as early as 10 months of age.
The cause of ASD is not clear. There is a genetic component, but we still do not know how many genes, biology and environment are to blame.
The inheritance model is also complex and does not necessarily mean that a parent with ASD will have an ASD child, even if the risk is increased.
However, if parents have a child with ASD, there is a good chance that their next child will also have ASD. There are families with two or three autistic children.
The latest report from the US Centers for Disease Control and Prevention (CDC) reveals that one in every 59 children in the United States has been diagnosed with ASD.
Although there is no data on ASD in Malaysia, increased awareness within the medical fraternity and the public has led to an increase in the rate of ASD diagnoses.
Dr. Subhashini, who recently wrote Autism in Brief: A Guide for Parentssays, "I'm trying to create a clinical patient database here so we can start somewhere, but that's not good enough, because you need a population study.
"However, in the past three years, the number of referrals to the Universiti Malaya Medical Center (UMMC) has increased.
"Previously, there were four patients a week, but now they are around 10 on average.
"If you look at the distribution of patients in the clinics, we first saw children with learning disabilities and Down syndrome, but now 80% of the cases we receive are suspected ASD cases. – there is therefore a radical change.
Sometimes parents may find that although their child has had an interaction well before, the quality of the interaction has deteriorated thereafter. It's a red flag.
"It's usually when parents or teachers share these concerns," notes the senior lecturer of the Department of Pediatrics at Universiti Malaya.
Therapeutic routes
A specialized teacher working with her autistic student during speech therapy sessions. Early and constant therapy can help a child with autism significantly.
Although there is no treatment for ASD, there are evidence-based treatment options. These include speech therapy, occupational therapy, early intervention treatment and applied behavioral badysis (ABA).
Many of these services are affordable and available in public hospitals, but the waiting list is long.
Speech therapy can help autistic children who have major language problems.
"Those who can speak can repeat without understanding. They are verbal, but not functionally communicative.
"For nonverbal children, a speech therapist can also play a role and do things with picture cards to communicate.
"Parents can understand their child and anticipate their needs, but this one must also be understood by other people," says Dr. Subhashini, adding that there is a dire need for speech therapists in the government sector.
In the UMMC, patients have to wait a few months for a session with a speech therapist.
Each individual session is long and, although the child only needs a few sessions, the next one will only be a few months later.
"Meanwhile, I tell parents to do activities with the child, such as reading, or I show them online resources that they can refer to," says Dr. Subhashini.
In the meantime, occupational therapists help the autistic child develop social skills and lead a daily life, for example. eat, eat, drink, dress, etc.
They also work on the hand or fine motor skills such as writing.
Currently, ABA is only available in the private sector. Because it's expensive, the majority of patients can not afford it. A quick check shows that a half-day session starts from 1,000 RMB per month.
Dr. Subhashini said, "There is a big gap between those who can afford it and those who can not.
"Some early intervention centers offer a modified version of ABA.
"Everyone does not need ABA and I do not always prescribe it. I usually tell parents that they can do some things at home and that is more important.
"You can go for any therapy, but parental involvement is key."
Government Initiatives
Once the child is diagnosed, he is eligible for a special needs card (OKU). Although the term OKU may shock some parents, the card serves as a pbadport to obtain services.
It is important for parents to understand that some children with ASD may worsen over time and that if they do not seek treatment, they will regress.
There is no harm in therapy, which is free for children in government centers with OKU card or who are enrolled in public schools.
If the therapy has a positive outcome and the child no longer meets the criteria, the doctor can write a letter to the Social Welfare Department to cancel the registration of the OKU card if stigma is a concern.
For early intervention, the government offers special education schools, as well as the Integrated Special Education Program (PPKI) and the Inclusive Education Program (IPP) in more than 2,000 national schools. .
The PPKI considers that students with special needs, including those with ASD, study in the same school as ordinary students, but in different clbades, while the PPI considers that students with special needs are immersed in the same clbades. same clbades with ordinary students.
There are also community-based rehabilitation centers for children and adults with various disabilities, including ASD, who need help with their basic activities.
Then there is the Permata Kurnia Center in Sentul, Kuala Lumpur, an NGO that provides education only to children with ASD under the age of six, which was created in 2015.
It is an early intervention center to prepare children with ASD for regular schooling. Referral to the program is done by hospitals.
Some very talented children with mild ASD may succeed in mainstream school, although the social aspects of school can be a bit difficult.
Parents can understand their child and can anticipate their needs, but the child must also be understood by other people, says Dr. Subhashini. – NGO SOON HIN / L & # 39;
The majority will need support at school, such as a ghost helper or a special needs teacher who sits with them.
In terms of IQ, many children with ASD have higher than average IQ, while 20% will have learned or engineering skills, which can be detected early.
"If they have the skills, you want to try to support that, but I always tell parents not to go to the extent that you neglect basic things such as personal care and independence of 39, another way.
"It's not necessary to take care of everything else," says Dr. Subhashini.
Parents often ask if there is a particular diet that the child should adhere to.
"We do not have enough evidence to say what works and my fear is that if they exclude a lot of things, the child will have a nutrient deficiency and it's not good for normal growth.
"Some of these children have sensory problems that predispose them to be difficult, so if you restrict them further, they will be less likely to get the nutrition you need.
"In terms of costs, it is difficult to get special foods. If you have limited resources, badign them to a product that will work and focus on therapy, instead of trying diets or foods that may not work. "
Depending on their level of professional and interpersonal functioning, children with ASD may eventually have a career.
"Not everyone can live independently, but ideally, we hope everyone will be fully integrated into society.
"Many people have never been diagnosed with ASD, but now that we are more aware of it, we are putting everyone in the spotlight.
"But then, there is also a possibility of overdiagnosis. We do our best and only tag them when we are sure. "
Effect of digital devices
Dr. Subhashini advises parents to minimize their child's exposure to the display screen on digital devices.
Many parents tell him, when asked, to introduce their child into a digital device as soon as they can sit, which corresponds to the age of six to seven months.
"There is a misconception that children learn a lot from these devices.
"Yes, you can … the child can copy and imitate, but she may not understand what she's doing; it does not get the two-way interaction that the main help supports.
"If you ask me, any child under the age of 18 months should have zero speaking time. It's not that too much time spent on the screen is causing ASD, but it does not help their ability to interact. "
There is also a growing group of children who do not have all the characteristics of ASD but appear to be autistic and referred to specialist physicians within 18 months.
"When you ask parents about recess, they admit it's excessive. Usually, when you reduce these costs, there is a noticeable difference in the child three or four months later, "says Dr. Subhashini.
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