Dr Anjan Bhattacharya Senior Consultant Developmental Paediatrician Nabajatak Child Development Center, Kolkata
Okay, known facts first to set the scene!
1. What is Autism?
Autism is a Developmental Disorder. To help people understand the neurological basis of Developmental Disorders, they are also called Neurodevelopmental Disorders or NDDs.
Autism is one of the many NDDs, where (1) Social Communication is atypical and (2) Behaviour is Repetitive and Restrictive, giving rise to the disordered appearanceof individuals affected.
Nowadays, the coinage demands we call it Autism Spectrum Disorder or ASD. But for ease of reading, we are calling ASD, autism here. That is, when we say autism, we mean ASD,
2. What's new?
There is an Effective Treatment for Autism
This science is yet not a decade old, if you go by published evidence. In 2016, the IMPACT study showed that, like all Non-communicable Diseases (NCDs), such as Asthma, Diabetes, Blood Pressure or Eye Powers, Autism may also not have any cure but an Effective Treatment is highly available. The Kolkata Developmental Model, was published in 2019 but was effectively treating Autism since 2007 in India's first Child Development Centre in any corporate healthcare sector.
Kolkata Developmental Model [KDM] was developed indigenously utilizing latest science, which was unique in its clinical effectiveness.
KDM was so advanced, that it was presented at the annual scientific conference of the Royal College of Paediatrics and Child Health [RCPCH], UKin Glasgow and over the highest academic science body of Europe, EACD's [European Academy of Childhood Disability] various conferences at Paris, Tbilisi, Barcelona andLjubljana and holds high esteem in the scientific world of childhood disability.
KDM was indigenously developed at India's first Child Development Centre [CDC] at Apollo, Kolkata by it's head and is currently practiced at Nabajatak Child Development Centre [NCDC] at Salt Lake, Kolkata, where the inventor is a Director.
3. Early Intervention - how early?
The concept of Neural Plasticity has electron microscopic video proofs now to show how nerves make requisite connections, when aberrant connectivity are effectively treated early. With age, the wrong nerve connections get soentrenchedthat untangling them gets harder and harder, making treatment longer and longer.
Early Intervention therefore, needs Early Detection.
4. Early Detection - how early?
Advent of modern science is truly remarkable. Trained professionals can pick up risk of Autism at birth.
5. At birth!!! Really?
O yes! Late Professor Hans Prechtl's General Movement Assessment (GMA) can detect risk of Autism between birth and three (0-3) months of age with 60-67% accuracy in expert hands! This is as opposed to 0% using any other methods!!!
Super experts, trained in Advanced GMA (aGMA) can even calculate the Optimality Score to be more precise, since GMA can predict risks of other NDDs too with varying precision (for example, GMA can predict risk of Cerebral Palsy [CP] with 97-98% accuracy), while aGMA can predict, if the asymptomatic newborn is going to have Autism, CP or Learning Disability at that young age of 0-3 months! [Optimality Score 25-28 = no risk of disability; 8-12 = risk of CP; 12-24 = risk of autism or other]
6. Is Early Detection at Birth very difficult?
Risk detection using GMA is unbelievably easy!
That may be the reason, why everybody is still not doing it! But it is so easy that it is bound to become norm soon.
Afterall, Indian Academy of Pediatrics has made Risk Stratification using GMA and other necessary science part of their current Presidential Action Plan [RACE module ToT].
It involves expert observation (and video) of 3 minutes duration of a fully awake and active baby. The entire analysis (Basic or Advanced) can then be done by the expert at convenience!
7. Is it very costly?
Not costly at all! The entire cost is in finding an expert and getting the expert professional's time commitment.
Therefore, it is a cheap, non-invasive and expertise-dependent clinical test.
8. Which babies should get this test done?
Current recommendation is that all at risk newborn babies should go for this test.
However, in some countries, like Australia, parents are getting this test done on demand. Their reason is, "you never know!" or "makes sense"!
9. Which babies are at risk?
GMA is recommended for newborn babies with history of:
This is not an extensive list, so if in doubt, please consult a GMA aware physician.
Nabajatak CDC is unique where there are three professionals who are trained by Professor Christa Einespieler who worked with late Professor Hans Prechtl and are accredited by GM Trust International, Graz University, Austria. All three of them are trained in both Basic and Advanced GMA. So, your newborn child is in safe hands! NCDC has been salvaging babies, who otherwise would have a disabled life, instead back to normal functioning.
10. What if we miss the 0-3 month period?
GMA has best predictive value when done within the first 3 months of life. However, the window of opportunity exists till 5 months (0-20 weeks) of age.
However, when you are reading it, your child may be already past 5 months of age or even 5 years, for that matter!
Do not worry! Autism can be treated effectively at any age. It is only that the advanced is the age, the longer is the need to treat effectively! Science has come off age for autism, finally! What a relief!!
NCDC is there to take care of all your worries and make them disappear! Do not delay!
11. I am an adult with autism. Can I be treated effectively now?
Of course you can be treated effectively! However, your doctor will first discuss with you, if you at all need to be treated or not! If you are functional and doing well in life otherwise, the need to be treated has to be fully discussed with you first.
This question is becoming increasingly important because, especially in the western nations, recently the trend is that,the moment a child is detected with autism, parents are putting themselves up for diagnostic evaluation.
It is only a matter of time that in countries like India, it will be trendy too.
The issue will be having enough trained professionals. This is being addressed by West Bengal Government's University of Technology called MAKAUT through their Post Graduate Diploma course.
Currently, doctor, engineer, therapist, psychologists, nutritionists, policy makers, business developers and administrators are all training under the supervision of internationally qualified teachers to bring you the best possible solution around India. You or your child will currently receive the effective treatment in the hands of these super-teachers that MAKAUT entrusted their PG Diploma on!
12. Can I not just do Speech Therapy instead?
Speech Therapists in the NHS, UK are currently refusing intake for Speech Therapy, if anyone has Autism diagnosed.
Afterall, autism is not a speech disorder. Therefore, developed world has stopped doing unnecessary, unscientific and harmful intervention completely by now!
The Kolkata Developmental Model, since 2007, has never used Speech Therapy to their effective treatment regime for autism, thereby reaching their very high level of success over one and half decades now!
13. So, what is this Effective Treatment for Autism?
In a nutshell, it is expert multidisciplinary management utilizing biopsychosocial model of intervention through careful individualization. It is a complex process, best left in the hands of the experts to work in collaboration and tandem.
In the western world, such treatment are available in the Child Development Centre throughout the country with the Developmental Paediatrician as the Inclusive Leader.
In an effort to make this available to India's districts, Nabajatak CDC has been successful instarting a Post Graduate Diploma under a collaborative programme [CCPTR] of West Bengal Government University of Technology, famously called MAKAUT on the topic of Early Intervention. Director of NCDC is also the Director for this very first (and currently only) Early Intervention course on Early Intervention for Neurodevelopmental Disorders.
14. What is the outcome of an Effective Treatment in Autism?
The treated individual should be able to study in a mainstream school. Just like people affected by NCDs (Asthma, Diabetes, High Blood Pressure, Myopia etc) one can hardly tell that the individual has any affliction, a person with autism should be impossible to differentiate from the other so called ânormal' next person. That is an effective treatment.
Just like, if a myopic wears glasses, everyone knows he has myopia without anybody announcing (but not in asthma, diabetes or hypertension), sometimes a well treated autistic may be spotted too!
But they should be able to pass board exams, hold jobs like anybody else, marry successfully and have children.
Since, disability lies only in the eyes of the beholder, there is no reason why, with effective treatment, there should be any hullabaloo about "them" and "us"! We are basically the same people, with one NCD or the other!
Indian Government's Gazette on Disability Act 2016, updated on 18thApril, 2024 has Developmental Paediatrician now mentioned officially! Let us celebrate this year by treating autism like any other health condition, fully treatable with expert intervention.
We can shed off stigma of autism, since it can be so well treated now!
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