Health experts say Autism patients can ably live a quality life

Autism is a condition that is being diagnosed more and more mainly with in the urban population especially children these days and can be rather challenging to manage both for the patients and caretakers mainly due to lack of knowledge on how to go about it.

Senior Consultant Neurologist Dr. Blessing Taremwa attached to Teamwork Homecare Services breaks down Autism Spectrum Disorder as a neurological and developmental disorder affecting communication, social interaction and behaviors.

Prevalence

A 2022 World Health Organisation review of global prevalence for Autism revealed that globally at least 1 in every 100 children has Autism putting the rate at 1% among children ages 1-7 years globally.

In Uganda specifically in 2018, a study published in the journal of Autism and Development Disorders puts the prevalence of Autism in Uganda among children ages 2-17 years at 107 for every 10000 children which comes down to 1.07%.

Previously classified into about 6 different subtypes including but not limited to Asperger’s syndrome, Childhood Disintegrative Syndrome and Classic Autism among other types, this condition has now been reclassified into 3 broad categories by the Diagnostic and Statistical Manual of Mental Disorders into a single diagnosis of Autism Spectrum Disorder with 3 Levels the first being Level 1 requiring mild support, Level 2 requiring more support and Level 3 requiring a lot more specialised support according to Experts.

Causes

The causes of Autism Spectrum Disorder according to available research include a variety of factors that range from genetic, environmental to neurological.

Among the prominent ones Dr. Blessing Taremwa says are changes in genes (genetic mutations) which increase the risk of autism and having a family history of Autism with in one’s lineage as well.

Environmental factors also do play a part in one getting Autism and prenatal exposure is a key factor here.

“ In cases where a pregnant mother is exposed to toxins, infections or any other stress factors during pregnancy, the chances of having an autistic child go up significantly” he says.

Exposure to air pollution continuously especially to particulate matter does increase the risk too plus infections such as Urinary tract infections and flu.

Neurological factors that include neurotransmitter imbalances affecting dopamine and serotonin in the body do contribute to the onset of Autism too.

“ Some people are also born with differences in their brain structures and function especially the regions of the brain that deal with social communication and behavior”  Dr. Taremwa says.

Having children when one is of advanced age increases the risk of a child being born with Autism.

Poor nutrition during pregnancy especially when the mother has low folic acid during pregnancy can lead to a child being born Autistic.

Complications during child birth such as deprivation of  oxygen can cause a child to have Autism.

Signs and symptoms of Autism?

Julius Habumugisha a Medical Professional and CEO Teamwork Homecare Services says one of the first noticeable sign about an Autistic person is their challenges with social interaction.

“This manifests as difficulty in maintaining and initiating conversation, struggling to understand social cues like facial expression and voice tone plus trouble developing and maintaining relationships” he says.

These people also face communication challenges like delayed or absent language development, trouble with understanding verbal and non verbal communication including eye contact and gestures plus struggle grasping nuances of language like sarcasm and idioms.

Repetitive behaviours and actions also manifest in most cases among the Autistic for example hand flapping, body rocking plus other self soothing actions.

Over insistence on routines or rituals and sensory sensitivities are common as well among patients.

They manifest with strong narrow interests often focusing on very specific activities or topics consistently in discussion and daily lives too.

Autism patients do experience a lot of hypersensitivity to sensory inputs like light or sound and in other cases experience hyposensitivity to the same.

Their motor skills are impaired too or delay to develop making them have difficulty in walking or balancing, clumsiness and coordination difficulty on the whole as well.

The cognitive abilities of Autism patients are often outstanding with attention to detail, analytical skills and problem solving however things like planning, organisation and executive functions (leadership and management) do turn out to be an enormous challenge to them.

Habumugisha notes that Autistic people have great difficulty when it comes to managing emotions leading to regular mood swings and meltdowns.  In addition they struggle to understand and empathize with others emotions.

The severity of these symptoms does vary a lot among individuals with the disease he observes.

Treatment 

Senior Consultant Neurologist Dr. Blessing Taremwa notes that treatment for Autism is aimed at alleviating symptoms, improving behaviour and one’s quality of life.

He says “Behavioral therapies are critical when it comes to the management of Autism.

It begins with Applied Behavioral Analysis (ABA) to ascertain and break down key life skills the patient may be lacking, break them down into small steps and use positive reinforcement to encourage them.

It involves Positive Behavioral Support (PBS) which focuses on the reduction of behavioral problems and increasing of skills plus Occupational Therapy (OT) which enhances sensory integration, motor skills and daily living skills.

Speech and language therapies do also improve the lives of Autistics greatly.

This is done through practice and polishing of basic communication skills which addressing speech delays and disorders.

Speech and language therapies in addition Dr. Taremwa says are administered through Augmentative and Alternative Communication tools such as visual aids and technology to improve on the communication abilities of the patient.

Medications are as well part of the treatment for Autism Spectrum Disorder and according to Dr. Taremwa Selective Serotonin Reuptake Inhibitors (SSRIs) which help with anxiety, depression and managing repetitive behaviours are administered.

Antipsychotics which deal with behavioral issues like aggression and self injury are also given to the patient’s.

Stimulants that help improve one’s attention generally and bring down hyperactivity are also given.

Therapies that are meant to synchronize sensory integration in Autism patients are also administered.

They are aimed at facilitating the integration and processing of sensory information.

Sensory based interventions which use sensory friendly  activities and equipment to reduce anxiety are also administered.

The diet of an Autism patient also needs to be redesigned and streamlined by a Professional Nutritionist.

Dr. Taremwa says, “ Shifting to gluten free, casein free diet for some one Autistic will improve on digestive and behavioral patterns over time.

Giving them nutritional supplements which address overall health and deal away with dietary deficiencies is also helpful.”

Alternative therapies are recommended too to improve the quality of life for Autistic people.

These take the form of music therapy to enhance communication and behaviour, art therapy to explore emotions and expression through art plus animal assisted therapy which involves the use of animals (pets) to improve social skills and reduce stress.

Family and parental support to the patient is also important and it starts with training parents of Autistic children on Autism behavioral management and support methods while broader family therapy to help address relationships, communication and coping skills is also recommended.

Outside the home, Autistic people may also require individualized education programs (IEPs) which often take the form of tailored education plans for school age going children and specialised vocational training for older patients to prepare them for employment and independence.

Prevention

Dr. Fred Mutamba of  homebased medical care firm Teamwork Homecare Services says the chances of a child being born with Autism Spectrum Disorder (ASD) can be reduced first by ensuring an expectant mother gets sufficient prenatal care.

“ This includes getting adequate amounts of folic acid supplements thought out her pregnancy, regular prenatal check ups and avoiding exposure to toxins, tobacco and alcohol consumption” he says.

Genetic testing and counseling for parents to empower parents on how to deal with a would be autistic child if they are susceptible and curtail chances of passing on the disease to children before pregnancy.

Ensuring one is consuming a healthy diet that includes omega 3 fatty acids, whole grains, fruits and vegetables plus engaging in regular exercise.

Ensuring one maintains high levels of hygiene more so during pregnancy and follows all required vaccinations on schedule can greatly reduce the risk of Autism.

For the child regular screening and checkups as they develop and early intervention Incase signs of Autism are detected is also beneficial.

Having a child exclusively breast fed according to Dr. Mutamba and topping it up with a balanced nutritious diet will also give the child considerable safety against Autism.

He says creating a clam, supportive environment and applying adequate stress management techniques for the child is also a good addition.

Avoiding unnecessary medications which includes limiting antibiotics use, keeping off medications with potential neurotoxic effects can also help.

At a policy level experts advise more public education on Autism, integrating children with Autism into the mainstream education system, expanding access to diagnostic, treatment and other health services that help patients and affected families cope with Autism on top of more research funding in causes, new treatment and prevention of the disease.

According to Dr. Mutamba, participating in research, keeping oneself abreast with trends and education in regard to Autism Spectrum Disorder is essential in prevention.