Following signs and symptoms are to be found in an autistic child:

1. Impairments in Socialization:

Lack of Social and emotional sharing

Failure to develop friendships

Lack of eye contact

Difficulty in relating to others in a meaningful way

2. Impaired Verbal and Non-Verbal Communication:

Delay in development of spoken Language

No attempt to communicate by other means

Inability to initiate conversation

Stereotyped or Repetitive language

Lack of imaginative play

3. Repetitive or stereotyped Patterns of behavior:

Repetitive mannerism e.g. hand flapping, door closing

Restrictive Patters of interests

Preoccupation with parts of objects

Adherence to routines.

Autism has remained a mystery for researchers, neurologists, and psychiatrists for centuries. A definitive cause of autism is not known, but a portion of researches are being conducted to find out the actual source, but with specialized intervention and support people affected with autism can lead more achieving and productive lives.

There are over 60 million people with autism across the world, striking nearly four times as many boys as girls. Many Third World countries in Africa and Asia, including Pakistan, do not have access to any public services. The situation is quite alarming; especially in a country like Pakistan where due to the absence of financial resources, reasonable education remains a fantasy for an average person, affording rehabilitation facilities to an autistic child is well-nigh impossible.

In Pakistan autism is pretty much a new phenomenon since only private institutions are working in this area. Seminars and workshops are being conducted to create awareness among parents, professionals and government authorities. There is a need to create awareness about autism at public level because there is no institute at government level who offer services to children with autism.

Prevalence of Autism and general situation is as follows:

• Autism Spectrum Disorder: 1:68 kids

• No Diagnostic and Rehabilitative resources in the major cities of Pakistan.

• No perception of early detection, sensory issues and home-based interventions by child care specialists.

• Lack of awareness and means of Learning for the Medical & Rehabilitation Teams.

• Lack of awareness and means of Learning for the Special Education and support staff teams.

The major challenge is the stigma attached to the word autism. Acceptance of this problem lacks not only in the society but also in the members of the affected families. There is no ample data present on children with disabilities. The schools are only in main cities of the country and only elite class can afford the services and treatments. There are NGO’s (Non-governmental Organization) who works for the entire community of special children and not for autistic children especially.

There is a lack of trained professionals in this field and moreover, there are no such institutions that train professionals completely for the training of children with autism, but recently some of the institutes have taken initiative and have included autism and its treatment options as part of their post magisterial program curriculum. Health insurance facility should be provided to people with disability so that they can live their life independently and as fully as possible, but presently such facility is not available. Inclusion of Autism in the disability Act should be enacted. At present, the needs of autistic children in Pakistan are not being met in either regular or special education systems. With proper guidance, understanding teacher or an aide, a highly functioning autistic child could do very well in a mainstream school.

The majority of the cases the parents will notice the signs of ASD when the child is around 2 years old. In some cases, mild symptoms of ASD may not be detected until adulthood.

Make regular visits to your GP (General Physician). They will conduct a screening test for your child known as CHAT (Checklist for Autism in Toddlers). This screening test consists of series of questions regarding the child, which can be;

Does your child take interest in making friends or in social activities?

Does your child pretend, for example, talking on a toy phone, or pretend another thing?

Has your child ever brought anything to show you?

The GP may conduct a series of exercises with your child, encouraging them to engage in imaginative play, or asking them to point out certain objects

The causes of ASD are still unknown. However, it is thought that several environmental and complex genetic factors are involved, which can be described in two ways;

Primary or idiopathic ASD —where no underlying medical condition can be found to explain the symptoms of ASD.

Secondary ASD – where an underlying medical condition is thought to be responsible, or partially responsible, for the symptoms of ASD.

Primary ASD

Studies conclude that there are mainly four primary causes for ASD

Genetic factors

Environmental factors

Psychological factors

Neurological factors

Genetic factors

Mostly researchers believe that there are a certain set of genes that a child inherits from their parents that make them vulnerable to developing an ASD. ASD has been known to run in the family, for example, if the first child has developed an ASD then there is a 5-6% chance of the Cases of ASD have been known to run in families. If an older child develops an ASD, there is a 5–6% chance that any new child born to the same parents will also develop an ASD, or if one of the identical twins develops this disorder, then there is a 60% chance the other twin will also develop ASD. Currently not the specific test has been introduced for testing of genes for any sign of ASD. Researchers are trying their best to minimize this development through genetic alterations, but so far they have been unsuccessful.

Environmental factors

Researches have also concluded that ASDs are not primarily caused by genes, but also by a few environmental factors. The think that a person is born with a vulnerability to an ASD, but it develops only if that person is exposed to these environmental factors.

A mother having a viral or bacterial infection during pregnancy.

Smoking during pregnancy.

The father’s age.

air pollution

pesticides

Psychological Factors

The possible psychological factors behind ASD are based on a concept known as TOM (theory of mind). The ability of a person to understand others mental states, with each person they meet, have their own set of beliefs, intentions, emotions, likes and dislikes. Most children without ASD have a full understanding of TOM by the age of four. But children with ASD have very limited understanding or no understanding of TOM. Due to this, a child with ASD has problems with interacting with other people or children of their age.

Neurological factors

Much research into neurological factors that may be associated with ASD has focused on part of the brain that matches your emotions to the situation you’re in (the amygdala).

The amygdala chooses emotional responses from the part of the brain that regulates your emotion (the limbic system) and relays them to the part of your brain that processes sensory information (cerebral cortex). Brain imaging studies carried out in people with ASD suggest that the connections between the cerebral cortex, the amygdala, and the limbic system have become scrambled. As a result, people with ASD may suddenly experience an extreme emotional response when seeing a trivial object or event. This may be a reason why people with ASD are fond of routines: they have found a set pattern of behavior that does not provoke an extreme emotional response. It may also explain why they often become very upset if that routine is suddenly broken. This confusion of emotional responses may also explain why children with ASD are interested in topics that most children would find boring, such as train timetables.

Another area of research into ASD has focused on special types of brain cells called mirror neurones, which were first discovered in the 1990s. Mirror neurones are thought to enable us to copy other people’s actions. At the most basic level, mirror neurones may give a baby the ability to return their mother’s smile. As a person becomes older, the mirror neurones create more complex pathways in the brain that may be involved in many of the higher brain functions, such as:

language

the ability to learn from others

the ability to recognise and understand other people’s emotional states (theory of mind)

Brain imaging studies have found that mirror neurones do not respond in the usual way in people with ASD. Mirror neurone dysfunction may be responsible for the difficulties children with ASD have with language, social interaction and some types of learning.

Secondary ASD

Some conditions that are known to cause symptoms of ASD are listed below:

Fragile X syndrome.

Tuberous sclerosis

Rett syndrome

When a child has been diagnosed with ASD parents react in different ways, some feel relieved because they have understood the reason behind their child’s unusual behavior, while others receive a great shock and become worried about the future of their child. However, in turn, the diagnosis gives you a chance to guide their development and growth and offers an insight into your child’s personality and character. Many parents are keen to find out about the disorder as much as they can when their child is diagnosed with ASD. To cater this need of the parents Pakistan Center for Autism (PCA) has developed a spectacular website which not only has a wide range of resources, it also helps in training parents and teachers on how to handle a child with ASD.

Autism and Asperger syndrome are both parts of a range of related developmental disorders known as autistic spectrum disorders (ASD). They begin in childhood and last through adulthood.

ASD can cause a wide range of symptoms, which are grouped into three categories:

Social interaction is problematic and very difficult.

Impaired language and communication skills

Unusual patterns of thought and physical behavior

Currently, there is no known cure for ASD. However, a vast range of treatments, including specialized education and behavioral programs, can improve symptoms. It is estimated that 1 in 150 children have ASD, comparatively this condition is common is boys than in girls.

Types of ASD

There are mainly three types of ASD (Autistic Spectrum Disorder) and they vary from mild to severe with each person. But there a few ASD symptoms which are common in all three of these types;

Epilepsy

Tourette’s syndrome

Attention deficit hyperactivity disorder (ADHD)

Dyspraxia (developmental coordination disorder)

The three types of ASD are;

Autistic Disorder or classic autism

Asperger syndrome

PDD-NOS or atypical autism