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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?
Yes, you have a free Whatsapp helpline for parents. Whatsapp 91-9869405747 , for day to day tips in managing and understanding autism kids visit : www.facebook.com/cdcmumbai www.neuropediatrician.com
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.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
Neuro developmental Pediatrician Mumbai , Autism Dr Mumbai 