Articles on global perceptions of autism

Mild Autism Is Reversible With Educational and Behavioral Approaches

Mrs. Anupama Maruvada, Psychologist
Autism is a lifelong, developmental disability that affects how a person communicates with and relates to other people, and how they experience the world around them.Educational and behavioral approaches are often a core feature of the overall treatment plan for children with an Autism Spectrum Disorder (ASD). Limited evidence-based research is available for most of the behavioral and/or educational based programs. These approaches are particularly difficult to study using traditional research methods. For one reason, It is difficult to control many factors that can interfere with or bias results. It is also often difficult to exactly reproduce any single intervention across settings. One exception to this frustrating lack of evidence is the growing amount of success using early intensive intervention programs for children with ASD. Such programs generally involve many hours of therapy each week for children between the ages of 2 and 7.Many studies have shown that behavioral interventions can improve intelligence test scores, language skills, and academic performance of young children with ASD. Some studies have also shown improvement in behavioral or personal and social skills."Behavior Therapy Normalizes Brains of Autistic Children"Autism likely has deep genetic roots, but the latest research provides hope that some learning techniques can lessen symptoms of the developmental disorder. Ten years ago, autism was rarely detected before ages 3 or 4. Now, more autistic children are being identified when they are toddlers. In children with the mild cases of autism, cognitive behavior therapy techniques resulted in changes in their brains that made them “indistinguishable” from those of unaffected children of the same age — essentially normalizing them, according to many researchers.I, as the Clinical Director, with 15 years of experience in the field developed 3 different programs to normalize autistic children using lot of research happening world wide.1. Infant Brain Stimulation2. BMSI program3. Behavior Therapy ServicesBy using these programs, at CBT 2, we have 99% success in showing improvement in children with ASD. We believe that each child is a unique individual with a unique learning style. We therefore design comprehensive, individualized Behavior programs to meet the specific needs of each child and his /her family. We, at CBT 2, use standardized assessments to know where the child stands, develop unique programs for the child and determines the number of hours the child may require therapies. We then gather data to track improvements. These daily reports generate monthly reports to indicate progress of the child. If regression is occurring, we will be able to identify at the earliest and prevent.

Diagnosing Autism in Children - List of Early Symptoms

Dr. N. P. Karthikeyen
Characteristics of children with Autism:These are listed here to enable all parents to be aware and pick up warning signs early and act. Prefers to be alone; aloof manner,Little or no eye contact,Insistence on sameness; resistance to change,Difficulty in expressing needs, and no single finger pointing.Repeating words or phrases in place of normal, responsive language,Laughing,crying, showing distress and tantrums, for reasons not apparent to others,May not want to cuddle or be cuddled,Unresponsive to normal teaching methods,Sustained odd play, spins objects, inappropriate attachments to objects,Apparent over-sensitivity or under-sensitivity to pain,No real fear of dangers, Noticeable physical over-activity or extreme under-activity,Uneven gross/fine motor skills,Not responsive to verbal cues; acts as if deaf although hearing tests are in normal range,A word of Caution to parentsWe emphasise that these standardised behavioural data are aimed at creating awareness but not phobia. Having any of these features in itself is not indicative of autism, but warrants further follow up and formal evaluation by a multi-disciplinary team. For example, in the social/educational system of United States of America, all infants who exhibit developmental deviations are closely observed and monitored with appropriate intervention until they are able to reach a Yes or No category on a definitive diagnosis. This ensures that no child is left out in the system and enables early intervention (where necessary) which is very crucial for prognosis.

Positive Signs for Autism

Dr. N. P. Karthikeyen
The incidence of Autism spectrum disorder (ASD) is reaching epidemic proportions, believed to affect approximately 1 in 166 live births. It is our sincere aim to create a “POSITIVE AWARENESS” on Autism both among the professionals and parents.Red Flags for Possible ASD Although autism is only considered to manifest around18 months of age, recent developments in research have indicated that it can be identified much earlier. Some of the characteristics they may exhibit include-Arching their back away from their caregiver to avoid physical contact,Failing to anticipate being picked up,As infants,they are either passive or over agitated babies. A passive baby refers to one who is quiet most of the time making little, if any, demands on his/her parents. An over agitated baby refers to an infant who cries a great deal,sometimes non-stop, during his/her waking hours.Some autistic toddlers reach/rush through developmental milestones, such as crawling, and walking, much ahead of time; whereas others are considerably delayed. The absence of eye contact is to be observed in particular even during the breast fed phase of life.Please understand that ‘A child with autism is not merely a compilation of symptoms.’ Because significant evidences now link the molecular pathways of cellular stress response to the onset of chronic inflammation associated with chronic diseases.‘Bodily symptoms could be the manifestations of signalling and metabolic derangements that may have widespread effects integrally related to what we now call autism.’Thus in autism, inflammation and decreased connectivity could hamper simultaneous and complex coordination between functional areas of the brain explaining the impaired social and communication skills.Our research indicates that restoration of Molecular order could activate the dormant neuronal pools,improve connectivity and restore functional integration.

Is Your Child Hyper Active or Difficult to Manage?

Dr. Rahul Varma, Pediatrician
All children between 18 to 24 months should be screened for hyperactivity and Behavioral disorders like Autism etc. (as per recommendation of American Academy of Pediatrics).It can be easily done in OPD setting using M- chat (23 point Questionnaire). it takes hardly 10- 15 minutes.. If positive, child can be referred to Child developmental specialist for detailed work up.It is available at Maya clinic (No extra charges).Feel free to discuss with our child specialist/Pediatrician.The American Academy of Pediatrics (AAP) recommends screening all children for autism at the 18 and 24-month well-child visits in addition to regular developmental surveillance. This type of screening can identify children with significant developmental and behavioral challenges early, when they may benefit most from intervention, as well as those with other developmental difficulties. For screening to be effective, it must be applied to all children – not only those with Symptoms. Modified Checklist for Autism in Toddlers (M-CHAT): In most offices, Pediatricians use the M-CHAT, a 23-point questionnaire filled out by parents. Most families find it easy to fill out. Using this standardized screening, Pediatricians can pick up children at risk for ASD and will be prompted to start conversations about language delay, concerns about behavior, or possible next steps for a child at risk with additional genetic, neurologic, or developmental testing.Screening Isn’t Diagnosing!It’s important to note that screening isn’t diagnosing. If your child has a positive screen for an ASD, it doesn’t mean he or she will be diagnosed on the spectrum. And further, if your child screens normally but you continue to worry about ASD, don’t be shy. Screening tests are just that—screening—and don’t identify all children with ASD. The rate of success for the M-CHAT, for example, isn’t 100%, so it is used in combination with health and family history to identify children at risk. Your opinions as a parent are irreplaceable and of the most importance.If You Are Concerned and Your Child Has Not Been Formally Screened:Talk with your Pediatrician about doing a formal screening. Many screening tools are available.

Child Development and Autism: What You Need to Know!

Dr. Vykunta Raju K. N, Neurologist
INTRODUCTIONAutism includes a wide spectrum of neuro developmental disorders, characterized by impairment in several areas of development. Recently these disorders are being referred to as autistic spectrum disorders (ASD) to include a broader behavioral phenotype. Sometimes the terms autism and ASD are used interchangeably.DefinitionThe core features of autistic spectrum disorders are:· Qualitative impairment in reciprocal social interactions · Qualitative impairment in communication (verbal and non-verbal)· Restrictiveand stereotypical patterns of behaviors, interests, or activitiesIn addition, children with autism may have unusual responses to sensory experiences or perceptions.Autistic Disorder All of the following symptoms/deficits may/may not be present in a child. Since there is a wide variation in presentation of Autistic disorder, variable combination of symptoms may be present in a given child.1) Deficits in reciprocal social interaction· Delay in the appearance of social smile · Impairment in the non-verbal behaviors used for social interaction (eye-to-eye contact,facial expressions, body postures and gestures)· Child may appear to be “in his/her own world”· There may be lack of spontaneous sharing of enjoyment and interests with other people· Social interaction is rarely initiated spontaneously· Contrary to popular belief, autistic children can show definite signs of attachment with familiar people or even clinginess to a specific care giver· On the other extreme, these children may display excessive familiarity with strangers due to the absence of social inhibitions and stranger anxiety2) Deficits in verbal and non-verbal communication· Approximately 50% never develop speech. In the remaining 50%, language acquisition is delayed and deviant · This may manifest with impairment in the ability to initiate or sustain a conversation, or stereotyped, repetitive use of language · Children may exhibit repetition of words or phrases regardless of meaning or relevance (echolalia) and pronominal reversal (substituting ‘I’ for “you’ or vice-versa)· The child may not be able to understand gestures or use them during communication · There is an absence of effort to indicate an item of interest to another person 3) Stereotypic behavior· Restrictive and repetitive behaviors present as stereotypic movements (body rocking, finger twirling, hand flapping, spinning and tip-toe walking) · A preoccupation with certain ideas or objects (i.e. a fascination with certain numbers, letters, schedules, animate or inanimate objects) · An apparently inflexible adherence to specific, nonfunctional routines or rituals 4) Sensory deviance · These may be visual (seeing things from a particular angle), auditory (appearing deaf at times, clapping hand over their ears), olfactory (sniffing objects) or perceptual (refusing to eat food with certain textures or tastes, mouthing of objects, compulsive touching of certain objects or textures, diminished response to pain)· Increased sensitivity to touch, including but not limited to the feel of running water, adversity to bathing5) Play · This may be a typical or deviant, and if present, is mechanical and repetitive· Imaginative play is markedly impaired or absent· The child may play with objects which are not usually used for play by children of the same developmental level. E.g. A six-year old child collecting and playing with shoes, papers or wrappers· Lining things up6) Abnormalities of mood or affect· Mood may be inappropriate to the situation or circumstances.· This may be in the form of uncontrollable crying or laughing in a situation where it is not warranted. 7) OthersThese children may be oblivious to hazards or may have excessive fear of harmless objects. CLINICAL SPECTRUMEarly pointers to autismEarly red flag signs in communication Early red flag signs in social functioningClinical features of Autistic disorder The manifestations vary depending on the developmental level, age of the child, and degree of impairment.Note: This may not be true for children with Asperger disorder who can often pass as “typical” until a much later age (10-12 years).Co-morbidities of autistic spectrum disorders· Psychiatric disorders: Attention Deficit Hyperactivity Disorder, anxiety disorders, disruptive behavior disorders, mood disorders, tics and Tourette disorder.· Mental retardation· Epilepsy/Seizures· Feeding disturbances and gastro-intestinal problems· Sleep disturbances· Hearing impairmentNatural course ofAutistic disorder· It is very important to remember that the clinical spectrum changes with age and attainment of developmental maturity. · The specific characteristics change as the child grows older, but the deficits continue into and through adult life with broadly similar patterns. · During infancy, most children have a history of delayed or unusual development. Some children (33%) may give a history of normal development with regression becoming apparent between 1 and 3 ½ years. Often delays and deviations in language become apparent during the 2nd or 3rd year and are a common cause of seeking professional help. Up to 25% of children with autism had a history of normal development to approximately 18-24 months of age followed by a loss of social and communication skills· As the child develops, the child may become more willing to be passively engaged in social interaction, but their behavior is still deviant with unawareness of other people’s boundaries or inappropriate intrusiveness· Hyperactivity improves and ritualistic behaviors start decreasing during adolescence· Depression may develop in some high functioning autistic individuals who have limited social and language skills when they struggle with the normal desire to be apart of a group.BROAD PRINCIPLES OF MANAGEMENTThe goals of management comprise of: · Advancement of normal development (acquisition of cognitive, communication and social skills)· Promotion of learning and problem solving in structured semi-structured and unstructured settings· Reduction of maladaptive behavior that impede learning· Treatment of all co-morbid conditions· Assistance of families to cope with autismManagement of primary problemsThe earlier and more frequent the intervention, the better the prognosis. Universally accepted goals are improvement of the overall functioning status of the child by development of communication, social, adaptive, behavioral and academic skills. Therapy with young children focuses on speech and language, special education, parent education, training and support and pharmacotherapy for certain target symptoms. Older children and adolescents with greater intelligence but poor social skills and psychiatric symptoms may require psychotherapy, behavioral or cognitive therapy and pharmacotherapy.Behavioral & Psychological Treatment:2- 3 years children · Target deficits in learning, language, imitation, attention, motivation, compliance and initiative of interaction· Behavioral methods/ communication/ occupational/ physical therapy/ social play intervention· Physical activity to develop motor coordination (games/ puzzle/ paint)· Encourage interaction and use of language at snack time3- 9 years children · Provide a structure to enable a child to acquire social skills and functional communication· Involve parents to use the skills and behavior learned at school when at home· Encourage to grow his/ her areas of strength· Skills as learning how to behave in social gatherings and in making friendsAddress practical matters in activities of daily living Pharmacological treatment · There is no pharmacological cure or substitute for appropriate educational, behavioral, psychotherapeutic, vocational, and recreational programs· Medication is used only as an adjunct to these core interventions· The goals are to minimize core symptoms, prevent harmful behavior (aggression, self-injury) and maximize the benefits of non-medical intervention. · A decrease in these behaviors may facilitate communication, learning, socialization and integration into community settings.Management ofassociated problems/ co-morbidities· Mentalretardation - Acquisition of skills employed in the activities of daily living · Eating Disorder - Cognitive Behavior therapy and routine activity· Sleeping disorder - Use of appropriate medications and routine activitySteps for prevention            Secondary and tertiary prevention can be done by· Genetic counseling (especially genetic and metabolic conditions associated with Autistic disorder and Rett disorder)· Increasing awareness among parents and community.· Increasing index of suspicion among primary care providers to enable early diagnosis.· Increasing awareness and sensitizing kindergarten, nursery and primary school teachers · Appropriate management as early as possible. Referral Pattern· High index of suspicion and early identificationo By increasing awareness among parents and teachers (play schools and regular schools) o Awareness among doctors- general pediatricians/ psychologists/ pediatric neurologists· Creating a network of agencies who can diagnose and manage such children so that appropriate and timely referral canbe possibleRehabilitationProviding multidisciplinary assessment and advice to prevent development of secondary complications. The rehabilitation team should be staffed by a team of specialist professionals who work as a co-coordinated multidisciplinary team to enable people to transfer skills acquired during therapy sessions to their daily living activities. These include a developmental pediatrician/neurologist, a psychiatrist, ophthalmologists and optometrists, audiologists, psychologists, occupational and physical therapists, speech and language pathologist, behavioral expert and special educator.Special benefits · National Trust for Welfare of Persons with Autism, Cerebral Palsy, Mental Retardation and Multiple Disability Act, 1999 has provisions for legal guardianship of the four categories and creation of enabling environment for as much independent living as possible. The Ministry of Finance has included income tax exemption for parents/ guardians of children with autism according to Section 80DD andSection 80U of the Income Tax Act 1961.· The NationalTrust also provides following assistance for persons with disabilities: Economic rehabilitation of persons with disabilities comprise of both wage employment in organized sector and self-employment (3% reservation in employment in government establishments; wage employment in private sector; self-employment; special benefits for women and children with disabilities; provision of barrier-free environment).· NHFDC schemes implemented through state channelising agencies (SCA) and nationalized banks: Loan upto Rs. 3.00 lakh can be availed for self-employment amongst persons with mental retardation, cerebral palsy and autism Management of the family with an affected child· Developing social support groups· Counseling the familyAssessment of medical comorbid aspects1. Assessment of vision and hearing: in all children 2. Assessment of mental Retardation: in all children3. Electroencephalography: indicated in children with suspected seizures, unusual behavior, symptoms of regression, unusually poor sleep or regressive loss of previously acquired sleep. 4. Neuro-imaging: indicated in children with focal neurological signs, dysmorphic features or regression. 5. Assessment of sleep disorders: indicated when the sleep problems cause considerable stress and interfere with family functioning.6. Assessment of feeding problems: if leading to significant malnutrition7. Genetic referral and testing (DNA analysis, High-Resolution Chromosome Analysis): indicated in the presence of dysmorphic features or a positive family history of mental retardation of undetermined etiology. Genetic testing for Fragile X syndrome and Rett disorder is available. 8. Metabolic testing: indicated when there is additional history of episodic lethargy and cyclic vomiting, early seizures, dysmorphic features, mental retardation or regression. 9.  Screening for lead levels: indicated for children with significant geophagia or pica.

How to Cope When You Know Your Child Has Autism

Dr. Santosh R Joshi, Homeopath
The diagnosis of your child having Autism can be a tough one, but in life we have to face the challenges thrown at us. One best part is that autism is not a life threatening disorder and when handled in a proper manner can be handled successfully.Some of the best ways to cope up can be:Taking proper guidance from a certified professional about what is autism and how to deal with it.Accepting that your child is having autism and it can be handled.Sensory issues, comprehension, hyperactivity, behavioural issues can be safely dealt with the right homeopathic medicines by a qualified homeopath.Nutritional interventions, GFCF diet can definitely help but has to be started after consulting a Nutrition expert.If you are unable to cope up with the social issues take help of your counselor or you can talk with your family and friends who can be of great help. There is no harm in reaching out for help.Community groups can also be a great boon to get over psychological pressures and also address the needs of your growing child.In our practice we have seen that major stress is caused when there is lack of acceptance that the child is suffering from autism. When parents work as a unit along with the intervention team then amazing outcomes have been seen. When the child is small and growing up the major worries are about speech, social interaction , sensory issues ,eye contact and stereotyped behavior to name a few. When the child is in the teenage and there are hormonal changes taking place it can be quite challenging to handle your kid, during such times one should take professional help in how to deal with the issues that the autistic teenager must be facing.Be sympathetic and try to understand the needs of the child and provide them with the necessary measures so they can adapt to the change and also live with their peer group. We were able to help children who used to have violent behavior outbursts, obsessive compulsive behavior, sensory issues with the right Homeopathic medicines. Parents should also continue the therapies and should also have a rational, realistic goal which can be achievable .The aim should be make the child independent so in the future they can live on their own. Some of the other issues that can be faced are in a school where there can be complaint every now and then try to meet the management of the school and make them understand what are the requirements and how the issues that the child is having can be handled in a positive way. This has helped quite some parents who came to us and we tried to resolve these by spreading awareness and some case the inclusive education for ably disabled has also made an impact. Check for the facilities that your country provides for autistic individuals and take the benefit.Let's join hands to make living Simple and Easy for ably disabled and be more empathic towards the families.

Autism: What does it mean?

Dr. Radhika Bharath, Physiotherapist
Autism and Autism spectrum disorder (ASD) are both the general terms used for a group of disorders of brain development. ASD is a lifelong developmental disability that affects the way an individual relates to his or her environment and their interaction with other people (Autism Spectrum Australia, 2014). The word spectrum denotes a range of difficulties that people with ASD experience and the degree to which it may be affected. While some may be able to lead relatively normal lives, others may have an accompanying learning disability and require continued specialist support (Autism Spectrum Australia, 2014). People on Autism spectrum may have the following:Unusual sensory interests such as sniffing objects or staring intently at moving objects.Sensory sensitivities including avoiding everyday sounds and textures such as hair dryers, vacuum cleaners and sand.Intellectual impairments or learning difficulties.Red Flags that indicate your child may be at risk of Autism (Autism speaks, 2014):Absence of big smiles or other warm, joyful expressions by six months and thereafter.Absence of back and forth gestures such as pointing, showing, reaching or waving by 12 months.Absence of back and forth sharing of sounds, smiles or any other facial expression by 9 months.No babbling by 12 months.Absence of words by 16th month.No meaningful, two-word phrases (not including, imitating or repeating) by 24th months.Any loss of speech, babbling or social skills at any age.What causes Autism?First and foremost, as we know that is no single cause that leads to autism just as there are many types of autism. It is a combination of various factors, most important of them being a rare gene change or mutation associated with autism (Autism speaks, 2014). There are certain cases where the chances of the baby are at a high risk of exposure to autism:In the case of genetic pre-disposition to autism, a number of non-genetic or environmental factors stresses to further increase the child’s risk for autism.Maternal illness during pregnancyAdvanced parental age at time of conceptionCertain difficulties during birth, particularly those involving periods of oxygen deprivation to the baby’s brain.Research also proves that the ladies having good amount of folic acid and vitamin including a rich and healthy diet are at a less risk of having baby’s with autism. Hence it is essential to have a check on the vitamins, folic acid levels not only during pregnancy but before and after as well. Management of Autism:Treatment strategies for autistic children and parenting tips:Don’t wait for diagnosisBest thing you can do is to start the treatment right away (with physiotherapy, speech therapy and many more)As parents learn about autismBecome an expert on your childAccept your child as he/she isDon’t give upWhile helping Children with Autism:Be consistent (with therapists, schools, homes)Stick to a schedule (as children with autism tend to do best when they have a strong schedule or daily routine)Reward good behaviourCreate a home safety zoneFind nonverbal ways to connect:Look for nonverbal cues (making gestures and body language)Figure out the need behind the tantrum (get to know why your child is feeling ignored or left out , a result of which is he/she throwing tantrums)Make time for funPay attention to your child’s sensory sensitivities.Create a personalized autism treatment plan:Focus on your child’s strengthsKnow your child’s weaknessesWhat are the behaviour causing most problemsWhat important skill is your child lackingHow does a child learn best (through listening, seeing, doing )Finding help and support:Approach autism support groupsContact special schools where your child does not feel left out.Individual, marital and family counselling.

Delayed Speech: Can It Be Autism?

Dr. Rakesh K Jain, Neurologist
Autism spectrum disorder (ASD) is a range of complex neurodevelopment disorders, characterized by social impairments, communication difficulties, and restricted, repetitive,and stereotyped patterns of behaviour. Males are four times more likely to have an ASD than females. A recent study in US found 1 in 68 children suffering from autism.The main feature of ASD is impaired social interaction.  As early as infancy,a baby with ASD may be unresponsive to people or focus intently on one item to the exclusion of others for long periods of time.  A child with ASD may appear to develop normally and then withdraw and become indifferent to social engagement.Children with an ASD may fail to respond to their names and often avoid eye contact with other people. They have difficulty interpreting what others are thinking or feeling because they can’t understand social cues, such as tone of voice or facial expressions, and don’t watch other people’s faces for clues about appropriate behaviour. They lack empathy.Many children with anASD engage in repetitive movements such as rocking, or self-abusive behaviour such as biting or head-banging.  They also tend to start speaking later than other children. Children with an ASD don’t know how to play interactively with other children. Some speak in a sing-song voice about a narrow range of favourite topics, with little regard for the interests of the person to whom they are speaking.Children with characteristics of an ASD may have co-occurring conditions, including Fragile X syndrome (which causes mental retardation), tuberous sclerosis, epileptic seizures, Tourette syndrome, learning disabilities, and attention deficit disorder. About 20to 30 percent of children with an ASD develop epilepsy by the time they reach adulthood. Very early indicators that require evaluation by an expert include:If you find any of these features in your child, please consult the local pediatrician or child neurologist if available who can assess your child in detail. There is no single blood test to diagnose autism. However, the doctor needs to look into certain disorders in which children have similar features or having features of autism in addition to other signs of that disorder. E.g. Tuber sclerosis, Landau-kleffner syndrome (a form of Epilpesy), other childhood epilepsies, some metabolic and genetic disease. So your doctor may do some blood test, hearing assessment, EEG, etc. depending upon the presenting features and assessment.Twin and family studies strongly suggest that some people have a genetic predisposition to autism. Identical twin studies show that if one twin is affected, there is up to a 90 percent chance the other twin will be affected. In families with one child with ASD, the risk of having a second child with the disorder is approximately 5 percent, or one in 20. This is greater than the risk for the general population.   For many children, symptoms improve with treatment and with age. Children whose language skills regress early in life (before the age of 3) appear to have a higher than normal risk of developing epilepsy or seizure-like brain activity. During adolescence, some children with an ASD may become depressed or experience behavioural problems, and their treatment may need some modification as they transition to adulthood. People with an ASD usually continue to need services and supports as they get older, but many are able to work successfully and live independently or within a supportive environment.There is no cure for ASDs. However, it is important to diagnose it early and look for associated conditions like ADHD (Attention deficit hyperactive disorder), Epilepsy, sleep disorders, etc. Earlier is intervention, better is the outcome. Therapies and behavioral interventions are designed to remedy specific symptoms and can bring about substantial improvement. The ideal treatment plan coordinates therapies and interventions that meet the specific needs of individual children.  Educational/behavioural interventions: Therapists use highly structured and intensive skill-oriented training sessions to help children develop social and language skills, such as AppliedBehavioural Analysis. Family counselling for the parents and siblings of children with an ASD often helps families cope with the particular challenges of living with a child with an ASD.Medications:  Doctors may prescribe medications for treatment of specific autism-related symptoms, such as anxiety, depression, or obsessive-compulsive disorder. Antipsychotic medications are used to treat severe behavioural problems. Seizures can be treated with one or more anticonvulsant drugs. Medication used to treat people with attention deficit disorder can be used effectively to help decrease impulsivity and hyperactivity.Other therapies:  There are a number of controversial therapies or interventions available, but few, if any, are supported by scientific studies. Parents should use caution before adopting any unproven treatments. Although dietary interventions have been helpful in some children, parents should be careful that their child’s nutritional status is carefully followed.Conclusion: Autism is seen commonly now a day. The main features are delayed speech, poor eye contact and social interaction and restricted interest with repetitive behaviour. Parents and physician should aware of its early symptoms so that early intervention can be started.

Is Tinnitus Treatable?

Dr. Rajesh Kr. Bhardwaj
When Dinesh Thakur came to me with a sudden onset constant sound in his left ear of one day's duration I was apprehensive. However, a quick look into his ear canal showed me that ear wax had been pushed deep inside and was touching his eardrum (he had tried to clean his ears with cotton swabs the previous day - a habit we forbid all the time- and managed to push his ear wax deeper). I took out the ear wax with a suction machine and the sound in his ears went away immediately! He went away relieved and happy!Not every story ends so happily because treating Tinnitus can be frustrating for both the sufferer and the doctor. Tinnitus is defined as the sound you hear inside your ear in the absence of an external stimulus. That is, the ear hears a sound which nobody around is hearing - the sound emanates from within the ear itself.Tinnitus can be of many types - continuous /intermittent, low frequency/ high frequency/ multiple frequencies, pulsatile/ not pulsatile, single ear/ both ears, associated with hearing loss/ normal hearing and many others. The common causes of tinnitus areear infectiondrug inducedpost-traumatictumours - in the ear or in the brain However, in a large majority of cases, no cause can be found. The patient just wakes up one morning with the sound in the ears.Apart from a thorough ENT examination, work up usually includes an Audiogram ( a hearing test) and an MRI of the brain.Treatment of Tinnitus can be difficult. Though many drugs have been tried none has been found to be very successful - however, each patient has to be evaluated independently and appropriate treatment options offered.In the event, all treatment options fail we try Tinnitus Retraining Therapy as well as use devices like a "Tinnitus Masker" to drown out the noxious sound.Some advice for all tinnitus sufferers -Stop smoking - nicotine is strongly TinnitogenicAvoid exposure to loud sounds - no going out to Pubs etc. Avoid listening to music on your headphonesAt night - Tinnitus is always worse at night because ambient noise levels go down - in that case keep some background noise like radio or TV (switched on at low volume) to inhibit the sound.All the best.

Tips for Better Hearing - How to Avoid Hearing Loss?

Dr. Sivaprasad Reddy, Audiologist
Who should and how to prevent hearing loss?Hearing loss of permanent type is called Sensorineural hearing loss. It is irreversible and is believed to be the direct consequence of damaged inner/ outer hair cells or the nerve fibres attached to these hair cells deep in the inner ear. While a very small percentage of individuals are born with a Sensorineural hearing loss, a majority of them acquire it over the age, and the onset NOT necessarily limited to old age.It is apparent that a majority of parents of pre-teen kids are concerned about their kids’ music listening habits. The concerns are even more with a majority of teens using earphones as a regular accessory and ‘unsafe’ volume as a style statement. In post-teen years, the youth is increasingly being exposed to smoking and disco music (sound intensity is often more than 95 dB). In the adulthood, exposure to some unhealthy living habits and unsafe levels of work-related noise lead to Sensorineural hearing loss. After the middle age, a cumulative of health conditions and increased genetic manifestations make it tough for your ears. Generally acquired a type of Sensorineural hearing loss often starts at high-frequency zones of the inner ear and spreads to other parts as well, often at a gradual pace year after year. Hence, it is important to take care of inner ear and prevent Sensorineural hearing loss by individuals of all age groups. Pick and choose one or more from the following tips according to the cause of hearing loss suspected by your audiologist or ENT doctor.Regular (once in 6 months) hearing check-up is mandatory for everyone diagnosed with the Sensorineural hearing loss. While it is helpful to follow these tips, it is important to start using a hearing aid when the Sensorineural hearing loss is more than 35 dB in one or both ears. Ignoring hearing loss beyond 1-2 years is shown to have several influences on brain functioning and those even more challenging to deal with.1. Use earplugsThe louder the noise and the longer you're exposed to it, the greater the chance of damaging your hearing. Protect your ears with ear protectors – earplugs or earmuffs – and get away from the noise as quickly or as often as you can. If you can't leave the venue, take regular breaks. A 10-minute rest break will give your ears some time to recover.2.  Turn down the musicDon't listen to your personal music player at very high volumes and never to drown out background noise. If the music is uncomfortable for you to listen to, or you can’t hear external sounds when you’ve got your headphones on, then it's too loud. It's also too loud if the person next to you can hear the music from your headphones.3. Use the 60:60 ruleTo enjoy music from your MP3 player safely, listen to your music at 60% of the maximum volume for no more than 60 minutes a day. All MP3 players bought within the EU have a 'smart volume' feature, so use it if you have one. It will help you regulate the volume.4. Wear headphonesWhen listening to your personal music player, choose noise-cancelling headphones, or go retro with older muff-type headphones. These block out background noise and allow you to have the volume lower. Earbud style headphones and in-the-ear headphones are less effective at drowning out background noise. Try to take regular breaks from your headphones, though, to give your ears a rest.5. Turn down the dialTurn down the volume on your TV, radio or hi-fi a notch. Even a small reduction in volume can make a big difference to the risk of damage to your hearing. If you need to raise your voice to be heard above the sound, turn it down.6. Good DietYou can increase your inner ear’s resistance to the boon of age-related hearing loss by keeping a healthy dose of:Zinc - found in dark chocolate, oysters, eggs, nuts, pumpkin seedsResveratrol – found in red wine and grapesN-Acetyl Cysteine (NAC) – found in poultry foods and yogurtOmega-3 Fatty Acids – found in salmon fish, flax seeds, krill oilVitamin A – found in carrot, sweet potato and green y leaf vegetables7. Don't put up with work noiseIf you’re experiencing noise at work, talk to your human resources (HR) department or your manager and ask for advice on reducing the noise and getting hearing protection.8. Do not Honk          Your vehicle horns can damage the hearing of the others. Restrain from honking and help others live peacefully.9. Be careful in the carListening to music in a confined space increases the risk of hearing damage. Don’t listen to music too loud for too long.10. Have a hearing detoxGive your ears time to recover after they’ve been exposed to loud noise. You need at least 16 hours of rest for your ears to recover after spending around two hours in 100dB sound, for example in a club. Reducing this recovery time increases the risk of permanent deafness.