A couple came to my clinic and the lady said, “madam, our son is 19 years old. He is an autistic child, he still shits his pants, is very aggressive, shouts and screams a lot, throws things and often hits us. Since he is a grown up child it hurts when he hits”.  I asked them if they had sent him to any rehabilitation professional.

The mother exclaimed, “Oh yes madam; we started sending him to a center as soon as we realized that our child was different. There he went for approximately 3.5 years. After 3 years we realized that our child started sitting for a few minutes, recognized letters and started writing. That was a positive progress sign but we realized that still he could not eat by himself; I had to feed him every time.

He could not undress /dress himself. Then we went to an occupation therapy center. After one meeting, the sir told us to send him at his center. We started sending him there. He had been there almost for 2 years. Again there was a change in him, he started wearing his clothes, started eating, sitting for a long time: around half an hour. But he could not speak properly.

He repeated only what he heard. He does not even call us mumma and papa yet. After these occupation therapy classes we sent him to a speech therapy center as well. It’s been around 12 years since we are roaming here and there; from one class to another. The problem still persists. Now we find our self helpless. Madam I have cardiac problem and his father is diabetic. Who will take care of our son after us? This is a great worry madam!”

I told them, I could understand their worry and that they ought to let me study his papers/diagnostic report. They said nobody had given them any report. I was surprised that nobody gave them any reports and they merely stared at each other’s faces blankly.

If we analyze the above case, three different professionals had worked with the child over a period of 12 years. The child is still not diagnosed properly; the severity, nature of the disability(ASD or High functioning ), co morbidity, developmental analysis etc. is still not clear. Without knowing the need of the child, different therapists worked on the case. The basic toilet training has not been done yet and severe behavioral problems are still present. This has not happened only with this family. Most of the autistic children and families go through similar situations.

On the Autism Awareness Day, I would request to all the parents that it’s high time now, wake up and cater to the scientific awareness, training about the Autism, about the professionals working in this area. Where ever you are taking your child; first ask the professional about his registration, how & what he would work. Start asking questions.

Dealing with autism, we need a multidisciplinary approach, differential diagnosis, and integrated plan for the child. The therapies must be started after differential diagnosis by a registered rehabilitation/ clinical psychologist. A disability certificate can be issued after presenting the report of diagnosis.   Opinion form a neuro-pediatrician is must.

Task Need Analysis, Toilet Training (if required) Functional analysis, Applied Behavior Analysis, Discrete Trail Training, Picture Exchange communication System, Pivotal Response Treatment, Sensory Integration Therapy, Occupation Therapy, Play Therapy, Social Stories, TEACCH (Treatment and Education of Autistic and Communication related handicapped Children), Music Therapy, etc. are evidence based rehabilitation programs. According to the need of the child the rehabilitation plan must be developed by a qualified professional. He must know “What Works When”

Neuro- therapy, water therapy, flower therapy, stone therapy, hypno-therapy, crystal therapy still need research evidence in the area of Autism.

Autism is a condition that needs support for life. The modalities mentioned above will definitely ease the child’s life; however the parents need train themselves for supporting their child along with these therapies. They can become the best therapists for their child.