Early intervention for autism is the way forward

World Autism Awareness Day is celebrated on April 2 every year to build understanding and acceptance for people with autism, foster global support, and inspire people. It’s a day that spreads kindness and autism awareness.

This year’s theme is: Inclusion in the Workplace– which aims to draw attention to the barriers people with autism face every day. This theme highlights the difficulties encountered by people with autism at work.

With the outbreak of the COVID-19 pandemic, education for people with autism is particularly disrupted, highlighting the need for greater inclusion to help integrate people living with autism.

Autism, or Autism Spectrum Disorder (ASD), applies to a wide range of neurodevelopmental conditions that distort an individual’s communication and social interaction skills.

People with autism have problems with social skills, repetitive behaviors, speech and non-verbal communication.
Indicators of a child with this condition may be evident before a child reaches the age of three. There are many subtypes of autism, mostly influenced by a combination of genetic and environmental factors. Because autism is a spectrum disorder, each autistic person has a distinct set of strengths and challenges.

The ways people with autism learn, think, and problem solve can be very skilled or very difficult.
Some people with ASD may need a lot of support in their daily lives, while others may need less support in some cases and live completely independently.

ASDs can be associated with other conditions, including intellectual disability, attention deficit hyperactivity disorder (ADHD), anxiety disorders, obsessive-compulsive disorder, and epilepsy.

The exact prevalence of ASD in Ghana is not known, but Victor Lotter, a researcher, estimated a prevalence of 0.7% in Africa using six different countries with Ghana included. The United States estimates a prevalence of 1 in 54 children with a higher prevalence in boys (4:1) of ASD.

The exact cause of ASD is still under investigation, but there is ample evidence to show that it is largely a multigenetic condition with certain environmental risk factors.

Some identified environmental factors include certain infections during pregnancy like rubella, taking sodium valproate during pregnancy and many others. Red flags or characteristics indicating the possibility of ASD include poor or inconsistent response to the name even if the child has normal hearing.

A delay in the use of communicative gestures like pointing, greeting, nodding, poor eye contact and poor attention to voice are worrying signs.
Repetitive behavior or activities like hand-clapping, rocking, or full-body spinning or unexpected reactions to the look, smell, feel, sound, and movement of things can be indicators. early.

Picky or selective eating habits, delayed communication, or repetitive language are also reasons to suspect ASD.

Some children may indulge in solitary play or typical or unusual and narrow interests and games. Emotional dysregulation, tantrums, and being bothered by minor changes in their environment are also indicators.

No blood tests or brain imaging are used to diagnose ASD. It is diagnosed using special assessment tools that look for characteristics of ASD. This is done through an in-depth interview (autism interview) accompanied by observation of the child and interaction with the specialist.

There is no cure or medication for ASD, but there is evidence-based treatment that works well when done consistently and when started early. Early diagnosis and early intervention give the best prognosis in ASD. Concerns about a child’s communication or suspicion that a child is on the spectrum should warrant prompt evaluation by a medical professional who will direct you to the appropriate location for an evaluation.

You may be asked to check your child’s hearing and do other blood tests or imaging tests depending on the related results.

Therapeutic therapies include speech therapy, occupational therapy, behavioral therapy, and special education support. There are medications for the associated problems seen in some people with ASD, including ADHD, epilepsy, sleep problems, constipation, and more.

Depending on the severity and level of ASD, some children will do well in mainstream school with special educational supports – something known and highlighted by this year’s theme as inclusion.

Others will do better in specialized schools. Others may start with early intervention centers or special schools and move on to mainstream education when they have acquired sufficient communication skills and autonomy.

Every child with autism is different and there is no one size fits all when it comes to program planning. It is therefore important to have people who can help make such decisions and evaluate the decisions periodically.

The take-home message is that autism is real, and it is a biological condition, certainly not a spiritual one. There is treatment and early diagnosis makes a big difference. Treatment needs consistency and can take a lifetime, but when given the right support, people with autism can thrive and use their unique abilities to do amazing things. As a society, we must learn to accept people with different abilities and stop stigmatizing individuals and families affected by autism.

‘Let’s wait and see’ ‘he/she will be fine’ is never a good idea. If indeed your child has autism or some form of communication delay, it is best to intervene early and not wait.

Special thanks to Dr Marilyn Marbell-Wilson, pediatric neurologist, who works at Mission Paediatrics in Caprice, Accra.

The author is a member of the Pediatric Society of Ghana.

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