Catch signs of autism as early as possible

KUALA LUMPUR: Treatment and therapy do not happen soon enough for many autistic children due to a delay in diagnosis.

To the untrained eye, a child with mental developmental issues does not appear different from a normal child, physically. However, someone with autism or Autism Spectrum Disorder – a central nervous system fault from birth – will struggle with communication, social integration and behavioural problems.

Prince Court Medical Centre (PCMC) consultant paediatrician and neurologist Dr Mohd Feizel Alsiddiq Mohd Fakharuddin said although awareness of autism is growing, a misreading of 'speech delay' – seen as indicative of autism – can occur.

"Very often, parents will bring their child to the hospital because their child is late in beginning to talk. However, one must bear in mind that not all late-talkers have autism," he said.

No clinical test

Dr Mohd Feizel said early therapy and education suitable to the level of autism can help identify potential in an autistic child in terms of learning, communication and social skills that will lead to a better life.

There is no clinical test that can diagnose an autistic child, he explained, but an evaluation can be done through behavioural observation and by identifying the traits of autism in the person.

"The examination must eliminate a hearing impairment because if the child has one, it may be the cause for his communication and social problems and not autism. If hearing impairment has been ruled out and the analysis clearly points to autism, the child will be referred to the early intervention programme," he said.

One of the problems faced by autistic children relates to sensory integration which affects the way they interpret sensory input.

"For example, if we see stripes, they may see a different pattern in terms of size and form, like wavy or irregular lines," he said.

Genetic issue

At PCMC, autism cases are handled by a team consisting of an occupational therapist for children, speech therapist and physiotherapist who will study the issues faced by the patient and provide continuous therapy.

For now, there is no scientific answer as to what causes autism but studies suggest that genetics and environmental factors can contribute to disorders in the mental development of children.

Even so, Dr Mohd Feizel advised pregnant women to take care of their health and to go for regular prenatal check-ups, as well as take iron and folic acid supplements and other vitamins recommended by their physician.

"Don't take any medicine without your doctor's advice. This includes epilepsy medicine as it can expose the developing foetus to risks. The expectant mother should also be alert to the dangers of high blood pressure and diabetes," he said.

Dr Mohd Feizel said parents should pay close attention to their child's development and watch for signs – even slight ones – of autism as early treatment will help the child to lead a fulfilling life.

Monitor the child's development

"In the beginning, it was difficult for me to accept that my child was severely autistic because an earlier diagnosis didn't suggest it," said Sufaini Bidin, 41, whose eight-year-old daughter Qamara Rihanna Army Rosdi is undergoing an early intervention programme meant for those with autism and special needs.

Mild autism was detected in Qamara Rihanna when she was just a year old.

"I always monitored her development but realised she had autism as her growth was not the same as her sister's (when she was the same age as Qamara)."

Sufaini also noticed that Qamara Rihanna was not meeting the developmental milestones as her peers who suffered from the same kind of autism.

"Qamara was already showing symptoms of autism then, like not pointing her finger or waving her hand, and pulling my hand when she needed something," said the mother-of-two.

Not satisfied with her daughter's development, Sufaini again took Qamara Rihanna to a specialist who confirmed her two-year-old (at the time) was highly autistic.

Stern approach

Following the diagnosis, Sufaini took on the approach of being stern when teaching her child, making sure that she gave her instructions clearly and refusing to succumb to her antics.

"Some parents are too soft with their autistic child and this leads to defiant behaviour," said Sufaini, pointing out that an unmanageable child is usually referred to as an 'autism emperor'.

Believing that each child has his or her own unique talents, she nurtures her daughter's interest in cooking, colouring and doing jigsaw puzzles.

Although Qamara Rihanna is not the same as the other children her age, Sufaini is proud of how far her daughter has come in terms of organising herself and finishing tasks she has been given.

She cautions parents to never compare their children to others or consider their shortcomings a problem.

"Qamara has good problem-solving skills such as knowing to reach for a chair when she wants to get something from a high place, and also has good recall ability, such as remembering where a store is located in a mall," said Sufaini.

Early intervention

Bringing up an autistic child is challenging but they are a gift from God, she said.

"If your child has autism, don't feel sad but take it positively as God will bless you for taking care of one of His special children," said Sufaini, who runs Qamara Therapy and Special Education Centre, which offers an early intervention programme for children with autism and other learning disabilities.

She and her husband Army Rosdi Abdul Razak, 45, opened the centre in 2012 after failing to find a suitable programme for their own daughter.

Their early intervention programme is aimed at helping autistic children and children with special needs to become independent and realise their full potential.

Sufaini and her husband are confident that with the appropriate early intervention, whereby the children's potentials are unleashed by the therapists at their centre, they could easily integrate into society. Occupational therapy and speech therapy are key components of Qamara Centre's early intervention programme.

Spotting the warning signs

According to Prince Court Medical Centre consultant paediatrician and neurologist Dr Mohd Feizel Alsiddiq Mohd Fakharuddin, parents should look out for the following signs of autism in their children:

Delay in speaking or not being able to speak by the time the child is 18 months old.

Does not easily respond with laughter/smiles by age six to nine months.
Rarely makes eye contact with parents when they interact with their child.
Does not play with other children.

Does not or rarely responds to his or her name by age 15-18 months.

Does not show social skills like clapping or waving or imitating the behaviour of family members by age 18 months.

If a child shows any of these symptoms, he or she should be taken to a doctor. Such signs are detectable when a child is as young as 18 months to two-and-half years old.

The symptoms shown by the child will reflect the level of severity of his or her autism.

If the child's autism is at a severe level, his or her symptoms will become obvious when the child is 18-24 months old. For others, the symptoms become noticeable when the child is between two-and-a-half and three-and-a half years old. — Bernama