Early intervention for autism way to go

World Autism Awareness Day is celebrated on April 2 every year to make people understand and accept people with autism, promote global support, and inspire people. It is a day that spreads awareness of kindness and autism.

This year’s theme is: Integration in the Workplace – which aims to direct attention towards the obstacles that people with autism face on a daily basis. This topic highlights the difficulties that people with autism face in the workplace.

With the outbreak of the COVID-19 pandemic, education for people with autism has been particularly disrupted highlighting the need for more inclusion to help integrate people with autism.

Autism, or autism spectrum disorder (ASD), applies to a wide range of neurodevelopmental conditions that distort an individual’s communication and social interaction skills.

People with autism have challenges with social skills, repetitive behaviors, speech, and nonverbal communication.
There may be signs of a child suffering from this condition before the child reaches the age of three. There are many subtypes of autism, often influenced by a combination of genetic and environmental factors. Because autism is a spectrum disorder, each person with autism has a distinct set of strengths and challenges.

The ways in which people with autism learn, think, and solve problems can range from highly skilled to very challenging.
Some people with autism may need a lot of support in their daily lives, while others may need less support in some cases and live completely independently.

ASD can be associated with other conditions including intellectual disability, attention deficit hyperactivity disorder (ADHD), anxiety disorders, obsessive-compulsive disorders, and epilepsy.

The exact prevalence of autism spectrum disorder in Ghana is unknown, but Victor Lothair, a researcher, estimated its prevalence at 0.7 percent in Africa using six different countries with Ghana. The United States estimates a prevalence of 1 in 54 children with a higher prevalence in boys (4:1) of ASD.

The exact cause of autism spectrum disorder is still being investigated, but there is ample evidence to show that it is largely a polygenic condition with some environmental risk factors.

Some of the environmental factors that have been identified include certain infections during pregnancy such as German measles, sodium valproate intake during pregnancy, and many others. Red flags or features that may indicate autism may include a poor or inconsistent response to a name even though the child has normal hearing.

Delayed use of communicative gestures such as pointing, waving, and gesturing, poor eye contact, and poor attention to voice are worrisome signs.
Repetitive behavior or activities such as hand flapping, whole-body shaking or spinning or unexpected reactions to the way things look, smell, feel, sound, and move may be early indicators.

Picky or selective feeding habits, delayed communication, or frequent language are also reasons to suspect autism.

Some children may engage in solitary play or in typical or unusual and narrow play of interests and games. Emotional disorganization, tantrums, and upset over small changes in their environment are also indicators.

There is no blood test or brain imaging used to diagnose autism spectrum disorder. It is diagnosed using special assessment tools that look for features of ASD. This is done through an intensive interview (autism interview) along with observing the child and interacting with the specialist.

There is no cure or medication for autism spectrum disorder but there is evidence-based treatment that works well when done consistently and when started early. Early diagnosis and early intervention give the best prognosis in autism spectrum disorder. Concerns about the child’s communication or suspicion of the child’s presence should require a prompt evaluation by a health professional who will refer you to the appropriate place for evaluation.

You may be asked to have your child’s hearing checked and other blood tests or imaging studies may be done depending on the relevant results.

Treatment modalities include speech therapy, occupational therapy, behavioral therapy, and special education support. There are medications for the associated problems seen in some individuals with autism spectrum disorder including ADHD, epilepsy, sleep problems, constipation, etc.

Depending on the severity and level of autism spectrum disorder, some children will do well in regular schools with special educational support – something this year’s theme is known and highlighted as inclusion.

Others will do better in private schools. Others may start from early intervention centers/private schools and move into the mainstream when they have acquired sufficient communication and self-help skills.

Every child with autism is different and there is no one-size-fits-all when it comes to program planning. Therefore, it is important to have people who can help make such decisions and periodically evaluate the decisions.

Take home a message that autism is real and that the biological condition is definitely not spiritual. There is treatment and early diagnosis makes a big difference. Treatment needs consistency and can be time consuming, but when given the right support, individuals with autism can thrive and use their unique abilities to do amazing things. We, as a society, need to learn to accept individuals of different abilities and stop stigmatizing individuals and families who are affected by autism.

“Let’s wait and see ‘he will come out of it’ is never a good idea. If your child already has autism or some form of communication delay, it is best not to wait for early intervention and see.”

Special thanks to Dr. Marilyn Marple Wilson, Pediatric Neurologist, who works at Mission Paediatrics in Caprice, Accra.

The author is a member of the Ghana Pediatric Society.

Author’s email: This e-mail address is being protected from spambots and spambots. You need JavaScript enabled to view it.

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