Every child has Right to Understand Learn Talk Read and write. Donot deprive them by saying God has made them special. Help the child understand and communicate with the environment and the society; saving years of disability by chanelising and reactivating the neuroplasticity of the brain. #TimeIsTheKey. #NeedForSpeed #AutismSpeaks
Please feel free to read, share and ask questions below in comments section.Autism in Mumbai: Frequently asked Questions. Please find at bottom a questionnaire based on latest DSM 5 guidelines to understand if your kid may have autism. Remember Diagnosis label is not important, certification is also not important. What’s is important is how to bring a change in the symptom in a given kid in months.
My Child started speaking late, why the doctor calling it Autism? Most autism Kids speak late or are non verbal not because their speech apparatus is faulty but because the neurological circuits required for communication are likely to be faulty. In addition to this social and communication delay [noted before age 5 years], if the kid has any other signs of autism like restless, fixed ideas, repetitiveness and sensory issues; your child is more likely to be labelled as autism spectrum disorder.
My therapist feels my child is hyper; why the Dr is calling it as Spectrum disorder? Restless ness like On The Go Like a Motor is a feature of autistic kids, Which in non medical language is called hyperactivity. Medical diagnosis of hyperactivity has a specific criteria. you may find details at neuropediatrician.com A confusion may make autism kids labelled as hyperactive or mixed diagnosis. There is a difference in hyperactivity of autism kids and hyperactivity ADHD kids.
Can my child with AUTISM go to normal school? is it a permanent handicap? Severity of disability, age of child, extent of communication inability and level of mental subnormality and response to medicine and therapy; help one decide when and how the child may be able to go in a school or a special school. Kids with autism well controlled with medicine and therapy and kids with high functioning autism usually are able to join normal schools . Some Autism kids do suffer from learning disorder which will need care.
Do I really need to spend heavy diagnosing Autism? Diagnosis of Autism is easy with a Neurodevelopmental pediatrician, who will be able to diagnose using some questionnaire and clinical observation fitting in DSM 5/ ICD 11 criteria. Most standard tests are based on old criterias for which one need not spend heavily. instead, one may reserve money for spenidng on therapy, medicines and genetic tests/ MRI brain or EEG as suggested by Dr in some cases.
What are the chances that diagnosis of autism of my child as wrong? He looks just like normal kids. In autism spectrum conditions, its the software and not hardware is often faulty. So most these kids may look normal. Diagnosis of autism is based on questions asked during examination and clinical observation of the child by neuro pediatrician. As diagnosis of autism is by exclusion of other diagnoses, one may investigate for other hidden diagnoses that may present with disorders of speech behaviour and communication.
How many years do I have to give medicines or therapy to my child? Depending on severity of symptoms and age of starting structured therapy and medicines, the time taken for control of key features of autism will decide how long the therapy or medicines may be continued. So it needs periodic /monthly adjustments in therapy and medicines. most kids when settled may have independent life and some level of education. These kids need tutions [therapy] for activities of daily living; so its likely that they may need OT support till adulthood or beyond in certain cases.
My parents say that I was similar when i was young and i was not on any medicines and therapy. Can i just wait and watch? As this is a very gross observation, it is likely to be untrue in exact time frame by recall. Also, once the age of developing brain passes away, one may not be able to bring about major improvements in communication and behaviour of the child. As early intervention is key to all neurodevelopmental disorders; it will be foolish to wait and watch even if advised by some Dr. early Therapy or support never goes waste. List the symptoms and go for symptomatic therapy if you donot agree with diagnosis .
What happens to these kids after 10 years? As mainstreaming-inclusion and not isolation is the law for these kids. Most kids with good communication being established may be able to go to normal or special schools depending on IQ test and level of learning disorder; depending on the improvement noted. Neglected children [without therapy/ medicines] are unlikely to improve significantly.
Who will be my Primary Dr treating; Psychologist, Therapist , Pediatrician or Psychiatrist? A neuro developmental pediatrician will be able to plan the whole management for childhood autism. So its prudent to visit and get a plan for referral follow up and modification of plans as suggested by the specialist pediatrician. Adult neurologists and adult psychiatrists have a less role to play and plan management in these kids.
what is the pathology in autism? As the exact pathology is not known, the therory of sensory chaos explains the concept of autism well in current context. it is a one time damage or insult that had happened in developing brain; by which the information gathered by various senses from periphery are not gathered/processed or communicated correctly within the brain. As different brain structures have reduced communication within brain; the child has issues with communication and behaviour.
This “theory of sensory chaos”, is based on “theory of sense and action“. Whole nervous system works on the theory of sense and action. in simple words an output is always based on input. when input is vague and uncomposed, the out put too will be vague and meaningless.
In autism, there is probability of minor damage in critical areas of brain that are responsible for sense of understanding and communication. if there were major damage, the kid will manifest with major manifestations like handicap.
The parts of the brain that may probably have suffered some minor damage in autism kids are probably cerebellium, hippocampus, thalamus, sensory cortex, temporal lobe and cingulate gyrus. Actually these parts are not damaged but dissociated from each other so as to give a concrete action or response of this dissociated sense.
Dr Kondekar proposes that the reticular formation network of the brain, also called reticular activating system [RAS] of central nervous system that is supposed to connect all these areas is deficient or ill formed due to its highly complex network often formed based on the inputs received. When RAS is deficient, sensory chaos occurs. RAS is internal communication. When brain fails to communicate internally, child fails to communicate externally. Dr Kondekar’s “neuronal nutrition hypothesis” primarly works helping form the RAS internally by bridging all unformed connections, creating more and more networks of bridging neurons eventually reducing the chaos of traffic due to poor communication and regulation. This is bridging hypothesis that works by synaptic pruning. When we build bridges, long and big bridges to tackle the chaos of sensory traffic; we need heavy doses of raw material and a good engineer [doctor too, who has sense of this engineering] one who will plan the networks. This heavy raw material requirement for neuronal extensions and bridges is actually the heart of neuronal nutrition hypothesis.
How does the treatment work? Treatment works by stabilizing the child’s activity for facilitating learning and therapy. There are no proven medicines for curing autism in children. but medicines are often required for controlling accessory features in autism. they are also required to treat added neurological and psychiatric problems like anxiety, psychosis, epilepsy. neuro nutrients does have a role but it is not defined. There is a need for a medicine that cures sensory chaos by building synaptic bridges across the brain making the brain communicate within.
How does therapy work? Therapy works by principles of regulation, structured disciplined training , motor / sensory activity /exercises and stimulating release of adrenaline serotonin dopamine etc. if a child is not learnable or not able to sit at one place, therapy may go unfruitful. Sensory integration and speech therapy are often key therapies in managing autism kids. when you donot get a significant response with any therapy in 2 months, it is important to visit a neuro developmental pediatrician to change plan.
What are sensory issues in Autism? https://kondekar.weebly.com/sensory-issues.html
Home based occupational therapy tips https://kondekar.weebly.com/homeot.html
how autism is different from ADHD? https://pedneuromumbai.blogspot.com/
Any one going to help me in crisis, confusion and chaos?
Read further : sense action hypothesis in understanding autism and cerebral palsy.
Brain : Human and Humanoid PC Analogy
Sense and action:
Brain structure is made of multiple neurons that go from brain to various tissues including senses like skin, eyes, hearing, balance, smell, touch, feel and also to muscles of action. Also the millions of neurons do travel from tissues of sense and action to the brain. So there are many neurons that give input and there are many neurons that give output.
There are many neurons that connect in between for coordination and there is also a sensory processing unit. All this can be considered something parallel to a computer where keyboard and mouse are sensory part and monitor -display- speaker assembly is a motor / action part and CPU of PC is a sensory processing centre.Copyrights : Mumbai Autism Specialist: Know your child if he has any signs or symptoms of Autism: please fill up the form below and submit before u visit; it will reach my email. you may even WhatsApp me with details. Following is a mini DSM 5 check list for helping in diagnosis of autism as per latest international standards of ICD 11.
Human brain is much more complex than this. Despite this, this is the best way to understand how brain works.
So the whole neurology is primarily between sense and action; and sensory processing unit making sense of it.
The software and hardware of brain decides how slow fast or age appropriate brain may function.
Its an electrical chemistry that keeps various parts of brain continuously functioning.
This functioning of brain is needed for learning, developing skills, building intelligence and structured processing and performance more like algorhythms of artificial intelligence for socialisation of humanoid robots.
Learning-skills –intelligence are never ending depending upon the attention oaid to inputs for the same. Each person is a similar looking hardware and grossly unique edition of new software.
Before we know what is autism, I feel one should know and understand a cerebral palsy. Cerebral palsy is a case usually due to some one time irreversible insult /damage or accident to a developing brain.
By insult it’s meant that something not so normal has happened to a developing brain. It can be as simple as child not crying immediately after birth or at times trauma of a forceps or vacuum delivery or premature labour pains or conditions affecting blood circulation, oxygen, sugar, electrolytes etc reaching the developing brain causing a minor or at times major defect in structure or function of brain.
So for all technical reasons, when we say a child has cerebral palsy, we mean a one time damage to developing brain affecting the motor or action group. Often at least two domains of development are affected in cerebral palsy. What we mean by domains of development is the various areas of child development as below: 1. Gross motor / large joint actions, 2. fine motor- small joint actions, 3.language-speech and communication 4.socialisation
So in cererbral palsy, it is must that the child or person will have signs related to muscle actions, the form of hypotonia or hypertonia interfering some way with day to day life. How severely it affects day to day life will be decided by the extent of insult or damage as manifested. Considering the computer analogy we may see this as monitor damaged/deformed , display damaged/deformed, screen is having errors of visualisation, flickering, bite loss, black line, dancing screen, blurred screen etc
All these amount to cerebral palsy.
This means a child with cerebral palsy may have deformed limb or its part; deficit in movement of one or may muscle groups or senses- vision / hearing etc or nerves; or a defective or altered performance or appearance which doesn’t worsen but is not good for a good quality of life.
There always need not be a visible damage or defect. Performance not optimum for the age and stage of life is also likely to be cerebral palsy; more so when no other easily explainable reason is found.
Diagnosis of autism is very simple. So is severity. What is difficult is ruling out other autism like diseases which may have different line of treatment.
Severity of autism is best classified as independent partially dependent and complete dependent with verbal/ nonverbal and with or without neuropsychiatric issues. Younger the age of diagnosis it’s worthwhile to make the child near normal in three months with early meds. www.facebook.com/cdcmumbai
What is standard management or care of autism?
1. Define the problem, Donot delay visiting a neuro ped doctor. Agree the age inappropriatness in your kid. confirm on free whatsapp chat with dr kondekar 91-9869405747. Donot rely on the diagnosis by therapists / psychologist or counselors alone, as they can only manage the components that are seen and wont be able to diagnose or treat the neurological basis or associated symptoms which may have a neurological / developmental or metabolic issue. They may not be aware of diagnoses beyond their speciality.
1. Therapy can be continued pending diagnosis, but delaying diagnosis and evaluation by ped neuro Dr is not advised.
2. Rule out other causes: often this is missed by many doctors that causes similar symptoms. Child may be mistaken as minor delay in communication or speech; or just as minor behaviour issue.
3. divide the issues in priority and short term easy to achieve goals .
4. Work on these with the help of neuro Ped Dr who may suggest some medicines as per international standards or as per experience which help the child be receptive for therapy, by helping sit quiet give eye contact understand socialise, integrate senses and learn from brain to muscles from sense to action.
Therapy works like a train attaching trolleys next to each other so that they can be of help in building milestones and base of learning. Medicines work like train engine making the child respond a lot faster to therapy. Medicines and therapy do require titration.
5. There are different therapists possible for every abnormality u notice but practically in many places its not possible to have every type of therapist. So continue with whatever therapist u can afford. Therapy is important to habilitate the child. However, Many kids may improve without therapy too – takes years and we lose time, but waiting and watching beyond 100 days is not recommended.
6. Whatever route u chose, your specialist should show a definite change in 100 days; if not rethink, revise the diagnosis and management plan with your ped neuro DR.
7. Dont accept a handicap easily and give up hopes of improvement. any time clueless, Whatsapp Dr Kondekar for free chat 91-9869405747
8. Every child has potential and right to improve.
Trainings child to learn action language 9 as is done for deaf children] will take the child away from verbal communication, as we are stimulating motor/action cortex of brain to take over speech cortex. #drSK#Pedneuro#CDC
At times its important to break this take over of action cortex over speech cortex; because if not tackled in time, child will never be able to talk if he is totally into action language.
Habilitation or re habilitation? :
Habilitation is a process aimed at helping disabled people attain, keep or improve skills and functioning for daily living; its services include physical, occupational, and speech-language therapy, various treatments related to pain-spasticity management, and audiology and other services that are offered in both hospital and outpatient locations. Habilitation requires neurological connection to develop mature and improve, from scratch. Neuromodulators are group of drugs that help achieve it faster though never close to normal. Normal habilitation of children below five years in affected in kids with developmental disorders.
Rehab is rehabilitation to gain or develop or improve lost skills
*How much shall we expect from our autism kid?*
Expectations, let’s rename as having newer capabilities is never wrong. We should plan some steps to reach that goal. Suppose we make ten steps to achieve that expectation, we can start working from first.
Younger the child, immature is the brain, easy to train and shape. Elder children have their own maturity so need a different strategy to tackle the expectations.
At times we do have some medicines that may make the brain little immature and receptive and then we can train the child to achieve appropriate goals.what is the age of Ur child and what expectation u r having. No expectations should lead to stress spoiling peace of mind.
– Dr Kondekar
Violent traits in autism?
Violent personality rage phenomena obsessions and behavioral issues are often mixed with autism in a good number or cases. The personality may run in families. There is no point in blaming each other or kid. The frequency and severity of these episodes will help us decide medicines which improve the quality of life with negligible side effects. It’s worth while to save a family from stress which lasts for years than getting wary about side effects which are meagre. Free WhatsApp advice and discussion at 91-9869405747
No Child is hopeless; when you dont see a change; its our duty to introspect and change the strategy .
Giving up gains nothing; persistence pays.
Expect a new positive change every month; note it down. Nutrition of brain and child; diet and quality of life of parents both are equally important for positive outcomes.”
Special children’ is often a term used for children with issues of neuro development, social communication and neurobehavioral adjustments.
Often these kids may look normal and settled in day to day living;but a great majority of these kids need emotional, social and therapy support to cope up with stress, milestones, education, social survival and neuro- medical issues including neuro disabilities.
Prima facie these issues appear like disability or a handicap like situation adding a lots of stress to the child , parent and family, affecting quality of living. book appointment
These children range from personality traits of mild autism to non verbal severe autism; terrible toddler tantrums, to attention deficit or hyperactivity issues. Soft Neurological problems affecting gait, grips, concentration and defective sensory processing of stimuli/ events are commonly associated. These issues ,may be noted in a child in varying proportions, alone or mixed. Often these issues cause or are associated with learning disability and or social disturbances of adjustments.
Some of these kids do have documentable brain damage , power deficit , tone issues , deformities or seizures. Many need not have these issues. Some do have genetic basis, many wont.
*These all cannot be easily understood unless a detailed neuro pediatric evaluation is done for these kids before we plan a random referral advice or suggestion.*
With appropriate diagnosis and zeroing down the key areas of improvement in a given child,in a time scaled fashion can help the therapist and neuropediatrician plan together a collective approach for tackling the various issues mentioned above.
A variety of specialists apart from above may be frequently consulted for advice, therapy, counselling and training with continued occupational therapy and pediatrician assessment. Speech therapists, physiotherapists,educators, remedial educationists, counsellers, psychologists do have a role when indicated.
With regular directed therapies like, NDT Neurodevelopmental therapy,SI Sensory integration, ABA i.e. applied behavioral analysis and adjustments with time discipline, conditioning of events ,show results when individualised.
Some medications do help in a good number of children. An IQ test , BERA and EEG, MRI brain and genetic studies may be needed in some cases.
In our experience we see major changes in speech behavior power tone and social adjustments in 100 days of goal directed therapy.
Please do not hesitate to consult for detailed advise, understanding, treatment and therapy.
pedneuro whatsapp for doubts 7021713681
Occupational Therapist for Child Neurological Issues
Aakaar clinic pedneuro NDT SI and Pediatrician
Laxmi residency, Aakaar clinic, shop 25, first floor, Byculla West, Mazgaon, Mumbai, Maharashtra 400027
When parents ask me “what book one should read for autism cure in their kid”:
dont go for reading books, ask me for free whatsapp tips: 91-9869405747
Starting to learn autism to treat Ur own kid, is like digging the well when u are thirsty. Remember “time is key for developing brain, don’t waste it.”
Ask experts, Ask for help, save time. You may be carrying a wrong diagnosis label given by PHD doctors. Remember medical diagnosis (& treatment too) is best and holistically done by medical Doctors…
What an expert has gone through decades of experience, no single book / page or line can give it. Ask an expert for an individualized action plan. Every kid is different.
Read books once your kid’s needs have met, read books mainly to help others. Read books so That u write books which doctors can read during their medical curriculum, but save time by asking for expert help.. Save Time Save Brain, Think Brain! Please pass on message to needy parents. When thirsty – and u go digging a well, you may end up in a grave than accidental chest. #DrSK
Prime aim of this post is to make parents understand that Time with The Child is Key. Don’t lose the time running after books when you may learn one tip after reading hundred pages. It’s better to get tips from experts who seen hundreds of cases, getting hundreds of queries solved in single consultation, that looking for chance clue in some book whose story may b different from your kid.
Any of one of each of A1 +A2 + A3 + any two of B 1 B2 B3 B4, usually make a kid likely for diagnosis of Autism. Ask for video links of patients who start overcoming these abnormal symptoms including eye contact and communication deficit within 1-2 months of simple treatments. Please WhatsApp for videos / links to 91-9869405747