AUTISM SPECTRUM DISORDERS

• Autism spectrum disorder is a neurodevelopmental condition characterized by qualitative impairment in social interaction and communication as well as repetitive stereotyped behavior, interests, and activities
• Autism is Classified under pervasive developmental disorders. Pervasive developmental disorders have got the following types
  1. Autistic disorder or autism
  2. Asperger disorder
  3. Rett syndrome
  4. Childhood disintegrative disorder
  5. PDD not otherwise specified

• Triad of AUTISM

  • Impaired socialization
  • Impaired communication
  • Stereotypic behaviour

It is a spectrum of disorder of varying etiologies – 

• Structural and functional abnormalities of brain e.g.- increased grey matter of frontal and temporal lobe anatomical and functional difference in the cerebellum and limbic system 

• Genetic risk factors - like gene mutations, ASD is more common in boys than girls, the concordance rate of identical twins is higher compared with the concordance rate in fraternal twins

• Environmental factors- dietary factors, exposure to drugs, and environmental toxins e.g. lead, insecticides, automotive exhaust, hydrocarbons, flame retardants, polychlorinated biphenyls

• The child is always involved in solitary play with more attention to inanimate objects than peers.
• Communication delay or total lack of development of language
• Impairment in social interaction
• Lack of eye contact
• Preoccupation with one or more stereotyped restricted patterns of interest
• Intellectual impairment
• Language impairment

• Based on clinical features
• DSM 5 criteria
• Comprehensive evaluation of
  • Social interaction and communication skills
  • Language and comprehension skills
  • Behaviour
  • Cognitive development
  • Associated conditions

• Hearing and vision testing: to rule out comorbidities or other causes of developmental delays and behavioral disorders
• Genetic testing: fragile X syndrome, tuberous sclerosis (if suspected)

• Speech therapy
• Occupational therapy
• Family support and counseling

Ayurvedic Treatment

• Adopt Unmada chikitsa
• Importance to Snehapana and sodhana

 Snehana

• Thiktaka gritha -if there is hyperactivity, temper tantrums
• Kalyanaka gritha:- if higher mental faculties are to be addressed 
  • Up to 1 year: given as drops: always one should have a proper assessment of agni before administering sneha kalpana - 2drops to 5 drops depending on agni
  • Above 1 year: always start with a minimum dose- even 2 drops will be sufficient to get the desired effect
  • Properly monitor the status of agni and increase the dose                                  

Anulomana

• Avipathi choorna  
  • 2to 5 years: ½ to ¼ tsp twice daily 
  • 5 to 10 years: ½ tab – 1 tsp twice daily

Samana oushadas

• Kalyanaka gritha , Maha paishachika gritha , Chandanadi kasahaya
• Manasamitra vatakam
  • 1 to 5 years: ½ to ¼ tab twice daily  
  • 5 to 10 years: ½ tab – 1 tab twice daily