General treatment guidelines about Childhood Autism
1. General guidelines about Childhood Autism The onset is usually before the age of 3 years
Pervasive developmental disorder defined by the presence of abnormal and/or impaired development in areas of social interaction, communication and restricted, repetitive behaviour.
Social interaction and reciprocity | Patterns of Communication | Restricted, Stereotyped, Repetitive Behaviour |
· Lack of responses to other people’s emotions · Lack of modulation of behaviour according to social context · Poor use of social signals · Poor social communication (lack of eye- contact, lack of social smile, etc.) | · Lack of use of language · Impairment in make- believe and social initiative play · Lack of reciprocity in conversational interchange · Poor flexibility in language expression |
· Rigidity in routine, interests, activities incl. play patterns · Attachment to unusual, typically non-soft objects · Motor stereotypes |
History taking and examination including MSE Annexure 1 Special emphasis
· Medical history
2. a) Investigations required
i. Psychometric investigations: Indian Scale for Assessment of Autism (ISAA), Childhood Autism Rating Scale (CARS)
ii. Laboratory: (if physical complications are present)
b) Comorbidity
c) Differential Diagnosis – specific developmental disorder of receptive language with secondary socio-emotional problems; reactive attachment disorders or disinhibited attachment disorders; mental retardation with some associated emotional or behavioural disorders; schizophrenia of unusually early onset; and Rett’s syndrome
3. Treatment
a) Psychopharmacology
· Only if anxiety or depression is comorbid
b) Psychosocial Intervention
Psychoeducation – nature of illness, etiology, progression, consequences, prognosis, treatment.
For patient | For Caregiver/guardian |
At the time of consultation | At the time of consultation |
Psychotherapy
i. Play therapy – Play therapy is a form of therapy used primarily for children. That is because children may not be able to process their own emotions or articulate problems to parents or other adults. It can also help the child explore emotions and deal with unresolved trauma.
ü Creative visualization
ü Story telling
ü Role play
ü Arts and crafts
ü Toy phones, blocks, construction toys
ü Dance and creative movement
ü Musical play
ii. Behaviour Therapy -Behavioral therapy is a term that describes a broad range of techniques used to change maladaptive behaviors. Behavior techniques use reinforcement , punishment, shaping, modelling, and related technique to alter behavior
iii. Occupational Therapy-Occupational therapy is a healthcare profession that involves the use of assessment and intervention to develop, recover, or maintain the meaningful activities, or occupations, of individuals, groups, or communities. It also can help them regain independence in all areas of their lives.
iv. Family counselling
c) Combined Treatment
4. Follow-up
a. Psychiatry OPD/ DMHP
b. Physical check-up at OPD
c. Through telephonic conversation TeleManas14416/18008914416
5. Referrals
a) Depending upon the severity and complications of the patient, he/she may need to be referred to Psychiatry/medicine department.
b) To TeleManas
c) To the nearest DMHP
d) To psychiatry OPD at Kulikawn Hospital and ZMC
e) To higher centers outside Mizoram through Referral Board.
References
No references available