Autism spectrum disorder and its care in Bangladesh
Autism or autism spectrum disorder (ASD) refers to a group of neurodevelopmental disorders, which is characterised by the challenges of social behaviour, speech, language, and communication. Nowadays it is becoming a major concerning issue worldwide. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5, published in 2013), it includes Asperger's syndrome, childhood disintegrative disorder and pervasive developmental disorders not otherwise specified (PDD-NOS) as part of ASD rather than as separate disorders. Through a required substantial support an ASD child or adult can perform and manage his/her daily activities.
In the Southeast Asia region, it is estimated that every 1 in 160 children has ASD. Recently, the Bangabandhu Sheikh Mujib Medical University (BSMMU) in Bangladesh confirmed that almost 2 in 1000 children have been suffering from ASD in Bangladesh. Wherein, the urban prevalence is higher than the rural areas.
Usually, all symptoms of ASD appears between 18 to 36 months of age. In this case, the awareness and skills of primary health care service provider play a vital role to ensure appropriate referral systems for exact intervention in the healthcare services delivery system for children with autism. Because early intervention can change the course of life of an autism affected child.
A child with ASD first visits the primary health care centre with his/her parents for checking developmental milestones. Based on the developmental milestone checklist the responsible primary health care provider screens a child's development and refers to a paediatrician at the district level when something abnormal is detected. A paediatrician who is specialised in paediatric neurology screens the child and refers the child to the specialised hospital at the tertiary level of healthcare for combined screening and therapeutic services. The tertiary level healthcare facility has health care professionals specialised in several fields which is necessary for the diagnosis and therapy of ASD.
The earlier children with autism spectrum disorder get help, the greater their chance of treatment success. Early intervention is the most effective way to speed up your child's development and reduce the symptoms of autism over the lifespan. When your child has autism:
• Learn about autism. The more you know about autism spectrum disorder, the better equipped you will be to make informed decisions for your child.
• Become an expert on your child. Figure out what triggers your child's challenging or disruptive behaviours and what elicits a positive response. If you understand what affects your child, you will be better at troubleshooting problems and preventing or modifying situations that cause difficulties.
• Accept your child. Rather than focusing on how your autistic child is different from other children and what he or she is "missing," practice acceptance. Feeling loved and accepted will help your child more than anything else.
• Do not give up. It is impossible to predict the course of autism spectrum disorder. Like everyone else, people with autism have an entire lifetime to grow and develop their abilities.
The writer is the Research, Monitoring and Evaluation Officer at the Centre for the Rehabilitation of the Paralysed (CRP)
E-mail: monitoringeval@gmail.com