Autism PDF
Autism PDF
Autism PDF
Chapter 1
Indroduction
Historical Overview
People often state that autism happened
only in the twentieth century. But, just like many
disorders which we identify now, autism is believed
to have always existed. It was just not identified as
a specific disorder. References to individuals whose
descriptions are similar to the characteristics of
autism have existed through history. Amongst these
were the holy fools who were a much venerated
people in ancient Russia, dating back to the
sixteenth century. These individuals were reported
to be eccentric, given to parroting, with stereotypic
speech and actions, obsessive interests, and lack of
social awareness. Late eighteenth century accounts
of the Wild Boy of Aveyron discovered in a forest
in France, who was later named Victor, offers us a
description that is remarkably similar to Kanners
a couple of centuries later. From the accounts of
Victor that are available, there is evidence of a
Chapter 2
Chapter 3
The following are a list of some behaviors that can be used to formulate
questions which may be useful in reviewing the diagnostic criteria.
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Chapter 4
Treatment
Early Intervention
As noted above, children with autism can
make significant gains through educational
intervention, and particularly when the
intervention is early. Early intervention has been
shown to result in the child needing fewer special
education and other allied services later in life and
some children being indistinguishable from their
typically developing peers in their later years.
The concept of early intervention in India
is still in its infancy. Such intervention relies on
a chain of events which, at the current time, is
lacking. Namely, a parent must identify some
atypical behavior in their child and bring it to
the attention of a pediatrician or their health
worker; that pediatrician must identify the
behaviors as possible symptoms of autism (rather
than merely delayed development, a typical
development, or another disorder); that
pediatrician must also know of a referral to
provide to the parent; the parent must follow
up on the referral; the agency or individual to
whom the child has been referred must concur
with the diagnosis of autism and be willing to
provide services to the child and family.
Other Treatments
The growing popularity of the Internet has
contributed to openness to new ideas about autism
in India, and its influence is not inconsequential.
However, information from the Internet has had a
flipside as well. In recent years, the focus has
shifted somewhat from education to a spate of
alternative therapies that often make parents
hopeful of a cure. Children with autism are often
normal in appearance, making parents believe that
if they could just find the key to unlock the enigma
of their child all would be well. This makes parents
greatly susceptible to proponents of cures that are
largely unproven. The propagators of unproven
treatments range from animal trainers to
performing artists to sometimes even medical
professionals. Many of the therapies being pushed
do in fact have positive effects, not just for persons
with autism but for all people. These include
activities such as yoga, or keeping Labradors as pets,
or horse riding. But they are not therapies that have
been proven to bring about any changes in the core
areas of impairment in autism.
As noted above, treatment for autism in India
is far broader than just educational interventions.
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Chapter 5
Parental Reactions
Given that Indian society views disability as
a tragedy worse than death, it is not surprising
that families may feel the desire to hide the
diagnosis, or even the individual with disability,
from the world in order to avoid societal censure
and ridicule. Coming to terms with a diagnosis of
disability in a child is never easy. Families almost
always go through a process of grieving with
emotions that may range from confusion, guilt,
shock, frustration, anger, denial, anxiety, shame,
resentment, inadequacy, depression, to the
question Why me? When the diagnosis is one of
autism the situation is even more complex.
Compared to other disabilities, a child with autism
might be physically normal and healthy at birth,
and for the initial years parents may imagine they
have a regular child. Some parents experience
confusion and helplessness if their child is
non-responsive or aloof, or if as often happens their
child experiences a regression following a period
of apparently typical development.
Family Issues
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Chapter 6
Vocational Training
Training in work skills among young adults
and adults with autism needs to focus on their
strengths. In general, individuals with autism
perform best at jobs which are structured and
involve a degree of repetition. They thrive in an
environment that is structured and well organized.
Persons with autism often excel in tasks involving
numbers, book keeping, data input, accounting,
Employment Opportunities
In addition to training in vocational skills,
there are autistic individuals who are in open
employment or in sheltered workshops in India,
and these individuals cope with their special needs
and adapt to the work environment, even in the
absence of required training and supports. People
who have autism are currently employed as artists,
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Living Options
Independent living options for adults with
autism in India are currently non-existent. There
are mixed disability facilities, but most do not want
to handle any individuals perceived to have
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Chapter 7
Historical Overview
India has a long history of rehabilitation
training, with the earliest being for the locomotor
impaired and for the visually impaired. While some
of these trainings are under the Medical Council
of India, a very large number are regulated by the
Rehabilitation Council of India. Particularly in the
areas of mental disability, the role that the
Rehabilitation Council of India plays is significant.
The development of human resources for
autism specifically relies on the presence of
children with autism in significant numbers, the
acknowledgement of their specific needs, and the
acceptance that specialized teaching can lead to
development in the core areas of impairment. For
a very long time there was a strong belief that
autism was largely indistinguishable from mental
retardation, and hence there was no need to waste
resources in providing training for those who teach
individuals with autism. In addition it was felt to
be a rare condition and not of particular relevance
2004-05
2005-06
2006-07
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Chapter 8
Advocacy
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Chapter 9
Future Perspectives
The pioneering study by Dr. Simon BaronCohen, Jane Allen and Christopher Gillberg (1992)
using Checklist for Autism in Toddlers (CHAT)
demonstrated that it is possible to detect autism in
toddlers at 18 months and is effective too. It is
essential that a broad spectrum of professionals are
made aware so as to ensure accurate and early
diagnosis. Work has to begin on providing
information on screening for developmental
disabilities as well as a better referral process to all
professionals who may play a role in diagnosis, as
well as those who could aid in screening. This
includes general medical practitioners as much as
psychiatrists and paediatiricians, community health
workers, educators, psychologists, CBR workers,
personnel in Child Guidance Clinics and Local
Level Committees set up by the National Trust, to
list a few.
Epidemiological Studies
Currently, there are no clear studies on the
number of individuals with autism in India. Most
studies and reports are based on the numbers
reported in the USA and the UK. An important
need is an epidemiological study that will provide
a clear indicator of the numbers affected, and
thereby provide the push for action required.
Societal Attitudes
Interventions
Current understanding indicates that
teaching based on behavioral models are the most
effective treatment options. However, such
interventions are effort intensive and take a great
deal of planning, monitoring and hard work, and
can seem less inviting then other interventions.
However, behavior based education must be the
focus for the future, since it is the only
demonstrated intervention that will enable
individuals with autism lead as inclusive a life as
possible.
Parent Training
Further, with the exception of a few parentinitiated support groups, few families of children
with disabilities in India have access to mental
health professionals or an outlet for their own
feelings of grief and helplessness is an urgent need.
There is urgent need for services to support
parents with coping strategies to deal with the stress
of parenting a child with autism.
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