What is Autism Spectrum Disorder?
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder caused by differences in brain development and functioning. It affects how a person communicates, interacts socially, behaves, and learns. ASD is called a “spectrum” because individuals can experience a wide range of symptoms and levels of severity, from mild to severe.
Key Characteristics
ASD is primarily characterised by difficulties in three core domains:
1. Social Interaction
- Difficulty in social reciprocity and emotional sharing
- Limited eye contact, facial expressions, and body language
- Difficulty forming and maintaining relationships
2. Communication
- Delayed speech or absence of speech
- Difficulty initiating or sustaining conversations
- Unusual language patterns such as echolalia or monotone speech
3. Behaviour and Interests
- Restricted, repetitive patterns of behaviour
- Strong resistance to change or insistence on routines
- Highly focused or intense interests
- Sensory sensitivities (sound, light, texture, smell)
Age of Onset
- Symptoms usually appear before the age of 3 years
- ASD is a lifelong condition, though symptoms may improve with early intervention
Learning and Cognitive Aspects
- Intelligence levels vary widely
- Some individuals may have intellectual disability, while others may have average or above-average intelligence
- Many individuals show strengths in:
- Visual thinking
- Pattern recognition
- Memory and attention to detail
Epidemiology
- Global prevalence: approximately 1 in 100 children
- Increasing diagnosis due to:
- Better awareness
- Improved diagnostic criteria
- Higher diagnosis in males, though girls are often underdiagnosed
Causes
There is no single cause of ASD.
Major contributing factors:
- Genetic predisposition (high heritability)
- Prenatal and perinatal factors
- Environmental influences during pregnancy
Vaccines do not cause autism, this has been conclusively disproven by scientific studies.
Diagnosis
- No blood test or imaging test for ASD
- Diagnosis is clinical, based on:
- Behavioural observation
- Developmental history
- Standardised assessment tools
- Early screening is critical for better outcomes
Treatment and Management
There is no standard cure, but early and sustained intervention significantly improves quality of life.
Common Interventions
- Behaviour therapy (e.g. Applied Behaviour Analysis)
- Speech and language therapy
- Occupational therapy
- Physical therapy
- Play-based and social skills therapy
Medication
- Used only to manage associated symptoms such as anxiety, hyperactivity, or aggression
- Not used to “treat” autism itself
Autism in Adulthood
- ASD continues into adulthood
- Challenges include:
- Employment and workplace inclusion
- Independent living
- Mental health issues such as anxiety and depression
- Adult support systems are limited, especially in developing countries
Awareness and Global Frameworks
- United Nations Convention on the Rights of Persons with Disabilities (UNCRPD)
- Sustainable Development Goals (SDGs) emphasise inclusion and dignity of persons with disabilities
Legal and Policy Framework in India
Rights of Persons with Disabilities Act, 2016
- Expanded recognised disabilities from 7 to 21
- Explicitly includes Autism Spectrum Disorder
- Provides:
- Right to inclusive education
- Reservation in education and employment
- Social security and welfare benefits
Key Challenges in India
- Late diagnosis due to lack of awareness
- Shortage of trained specialists
- Urban-centric intervention facilities
- Social stigma and misinformation
- High financial burden on families
Emerging Perspective: Neurodiversity
- Autism increasingly viewed as neurological diversity, not merely a disorder
- Focus on:
- Strength-based inclusion
- Dignity and autonomy
- Social accommodation rather than “normalisation”
Way Forward
- Universal early screening at Anganwadi and school level
- Teacher and healthcare worker training
- District-level early intervention centres
- Employment-linked skill development for autistic adults
- Shift from charity-based to rights-based and inclusion-based approach
