জনপ্রিয় পোস্টসমূহ

শনিবার, ১৬ নভেম্বর, ২০১৩

“Autistic Children in Bangladesh”




Introduction

According to Society for the Welfare of Autistic Children (SWAC)-
           “Autism is a life long neuron-developmental disorder which usually appears is a child by the age of three, although some characteristic features may be present even on first birthday”.

Two most years there is something of melancholy in the very sound of the words “Loneness,” “Alone”, “Solitary” and “Solitude” itself. This is because man is a “social animal” and naturally longs for the company of his fellows. Men are liked such animals as deer, cattle, and sheep, that live together in hands and flocks; and so most man feel lost and miserable when cut off from all human society. Hence, as a rule, man dread solitude. This feeling about solitude is well experience by the Autistic children.

                 All parents want a favorable environment for their own child and also healthy, sweet and normal child suitable to that very environment. Hence, the parents become anxious about the normal growth of the child even before its birth. The baby develops gradually in accordance with its age. But when at the age two or two and half years, the conversation or language development or exchange of communication of the child legs behind in proportionate to its age, when it plays by its own choice or feels attraction to the similar objects, then anxious arises in the minds of parents. They come close to doctor who terms the baby as' Autistic Child' after observation.



Autism is the name of a disease of the brain. The cause and exact treatment for its complete cure is not yet known. At present, autism is a incarnate panic for the parents throughout the world. The number of autism affected children is increasing rapidly in the world. It is also increasing in Bangladesh at an alarming rate. In this epoch of information technology, we should acquire correct knowledge about autism, its provable treatment and necessary preventive steps.

 Bangladesh id an over and thickly populated country of the Asian continent. The identify of it to the world is a developing country. The population of this country is about 14.70 cores. About 934 persons live in each per square mile. The people of this country have to lead lives by facing the various natural disaster, illiteracy, poverty; ill health and unemployment are the daily associates of the people here. About 10% of the total population of Bangladesh is disabled [NFOWD: 2003:248]. According to world estimated there are about 14 million disable people in Bangladesh and most of it are children.[ Delhi conference:2008].


Work with disability started in Bangladesh from 1977 but the services are still very limited. According to UNESCO 2% of the disable population receive any survive in developing countries and the situation is no better in Bangladesh. The ministry of social welfare has introduced disability allowance and 10% quota in the job market for disable over two years ago but things have not improved much at all. About 500 organizations are working with disability all over the country services for the disabled are mainly concentrated in the capital city. There are several schools caterings for disabled children in Bangladesh and about 20 are working in the capital city of Dhaka. Every child has a right to education. But the general education system in Bangladesh does not eater for the needs of the disabled children, Let alone the ones with autism.

There is widespread ignorance, prejudice and superstition about disability in the society, especially between the illiterate and poor. In the most cases in rural areas and slums, children with autism and other disabilities are kept hidden or taker to priests for prayers and treatments as they think the children are possessed. That's why we have to realize that disability or children with autism is not a curse. All of us should come forward with Love and care to our chosen friends.[[1]].



 The world civilizations are now 21st century, the age of new technology and discovery innovation and wonders. The people of 21st century are faced challenges of which one of the most critical issues is disability. Although it was identified in 1943, Autism is still relatively unknown disability. Autism is literally a hidden disability in Bangladesh because it is still not recognized as a Separate disability in by the government or other organizations. Disabilities are categorized as follows: physical, visual, hearing, speech and intellectual. NGO's are trying to establish autism as separate disability. Only a few NGO's then can address the rights and needs of the person’s effort to sensitize and Disorder (ASD). They (NGO's) are making every effort to sensitize and development program for the benefit of children with autism through ministries of' Social Welfare' and ' Women and Children's Affairs'.



There is no data available to know the extract prevalence or autism in Bangladesh. It is estimated that on child in 50is affected by autism. Which means the approximate number of ASD’s in Bangladesh is no less than 28000 [ Anwar Hossain: An overview of  Autism in Bangladesh: 15 January 2008]. In the United State, there are at least 4, 00000 people with autism, about one third of who are children. Autism is one of the most retardation, epilepsy and cerebral palsy occur move frequently. Although ‘classic’ autism occur in about 4 to 5 of every 100 children, a broader definition including children with less severe but still significant symptoms valises the incidence to about 16 out of 1000 children. Children with the most severe form of this discover provably make up only about 2 to 3 percent of children with autism in our country or society like as its kind of mental retardation. Actually autism is not occurring from any kind of trauma or emotional weakness. It’s a special type of physiological discover. Innumerous people are helplessly suffering with their autistic children.
‘There is no known single cause for autism but it is generally accepted that it is caused by abnormalities in brain structure of function. Autism may not be completely curable but if an autistic child is helped properly and treated with patience his/her condition can improve dramatically. It all depends on the combined efforts to the parents, teacher, neighbors and relatives and awareness from society as a whole Einstein was an autistic and so was Leonardo Ad Vinci. They could improve their condition through combined effort [star weekend magazine, January 18, 2008].

Children with autism are one of the most widespread problems in the world, and it has become one of the most visible and articulated social issuers in Bangladesh. At present, the children with autism have been a major concern for government, donors, NGOs and other civil society groups in Bangladesh. After all if we like to address the problem the combined efforts to the parents, teacher, neighbors, and relatives and awareness from society as a whole are required.

Family, creating among the all sections of the people, United Nations has declared April 2, 2008 as “World Autism Awareness Day”. First World Autism Awareness Day and 10th National day for the people with disabilities was observed in the country at April 2, 2008 with a view to creating awareness about autism and developing the autism children through behavioral intervention [The Daily Star, April 3, 2008]. For providing education, training and rehabilitating them through appropriate intervention, two non-profit organizations were established in Chittagong and Mirpur at Dhaka, named Autistic Children Welfare Foundation. Bangladesh [ACWFB]. [April 12, 2008, the Daily Star].

Rationality of the Study:

The rational for why present study is conducted has been shown under the coverage of following points of view:

Autism is one of the most widespread problems in the world. This problem is arising alarmingly in Bangladesh day by day. Over the most decade autism has become one of the most visible and articulated social issues in Bangladesh. But today all sections of the society are not concern about the issue. Even people of our country are not able to realize the situation. So, the people of Bangladesh need to knowledge about Autism.

A large number of children affect autism. But we think they affect ‘Bengali term- Voute Dora (Holding ghost)” or mad and don’t treat proper treatment.
I want to build up awareness of autism among Bangladeshi.

The parents of autistic children are frustrated by the child’s inability to communicate; impulsiveness; emotional unresponsiveness; self-destructive behavior and eating and toileting problems. The parents of autistic children need guideline to cope their children.

The study will provide the basis weather there is any necessity of changing the present attitude of the family with the answer of where and how much.

The study will determine the role of the society, NGO, Government and family towards the autistic children.


Objectives of the Study:

  • Demographic condition of the autistic children;
  • Familial condition of autistic children;
  • To know about education and care management of autistic children
  • To know previous social and mental condition before taking education and care
  • After taking education and care how an autistic child adjust with society.
  • To reveal the opinion of the guardians of autistic children.
  • To know the difference between Autistic children and general children.
  • To inform the government, non-government helps for Autistic children at present.
  • To know the opinion of the guardian for solving the problems of Autistic children.
  • To compose the recommendations for developing their conditions by the given information and opinion. 

Hypothesis of the Study:

This study starts with the general premise that Autistic children in Dhaka are unable to proper support from their house and state or both. The current situation of autism is very painful in our society. A number of assumptions are made as probable. Answers to the research questions and the above incapacities of the study groups. This research with examine for evidence either to prove or disprove there assumptions or to expand theory. It postutolates that.

Hypothesis-1:
The relation between the Autistic children and their family relation are not well.

Hypothesis-2:
Autistic children and socio-cultural impact on Bangladesh Society.

Hypothesis-3:
It has been taken some rules and regulation for autistics children by government.

Methodology of the study:

 This study is a data exploratory sample survey with qualitative study based on case study and in-depth interview.

Field Site:
 The area has been selected the Dhaka City. This study was based on five autism related organization; namely Society for the Welfare of Autistic Children (SWAC), Society for the Intellectual Disabled (SWID), Autistic Children Welfare Foundation (ACWF), Autism Welfare Foundation (AWF) , Institution of Education and Research Center (IER);

Population of the Study:
All the Autistic children of Society for the Welfare of Autistic Children (SWAC), Autistic Children Welfare Foundation (ACWF), Autism Welfare Foundation (AWF), Institution of Education and Research Center (IER), Society for the Intellectual Disabled (SWID), IN Dhaka city were included in this study.
Sample and Sampling Technique:
The present study is conduct on the basis of sample survey. The samples are taken simply at random and 50 Autistic children are selected.
Sources of Dada:
Information, Necessary for the study was collected from primary source. Autistic children’s guardians, teachers and five organizations related autism, Society for the Welfare of Autistic Children (SWAC), Autistic Children Welfare Foundation (ACWF), Autism Welfare Foundation (AWF), Institution of Education and Research Center (IER), Society for the Intellectual Disabled (SWID), Dhaka were the source of information.

Technique an Instrument of Data collection:

Two collect data interview schedule was applied as instrument. Using the interview schedule, written in Bangali a comprising both structure an unstructured questions was collected by direct interview technique.

Data processing, analysis and interpretation:

After adequate collection of information, its has been edited, classified on the basis of several characteristics, summarized and organized for the purpose of the study. Processed data is analyzed by the help of SPSS and manually, after processing and analyzing of data, it was accordingly interpreted.

Operational definition of the study:

Autism:

Autism is the development constraints of the brain which is generally noticed within the age of three of child’s birth. Consequently, there lies hindrance in exchanging language with other, in establishing social relationship and in power of sensibility etc. Autism is not a mental disease.

Autistic Children:

Children affected with autism are termed as autistic children. Quick diagnosis and intervention on manner can influence a notable permanent positive impact on the total development of the autistic children. Autistic children can highly be benefited from a proper education and care action. 

Social and Mental Development:

In this study, social and mental development means behavior and interactions with family and peers, adjustment to different environments and social and communication skill of an autistic child.

Education and Care Management:

Education and care are the rights of every human being. Here, education and care management mainly means a special and specific education and care action that should be provided only for autistic children. Because close communication with others involved in our child’s education and care will help all concerned. The best treatment for children with autism is a term approach and a consistent, structured program of education and care management.

Literature Review:

Internet was the primary sources of information. In internet, we collected about autism, types, symptoms, diagnosis and treatment of autism and the research work of the researcher. We also collected many articles, bulletins, bruisers, magazines and autism organization’s report from relevant field   
Ø      A research paper of “autism and psycho-social condition of autistic children of Bangladesh”. - Sheikh Mahbubur Rahman (August 2006).

In the world civilization of twenty first century, we are engaging our selves with high advantage by using new technology where as Autism are an unknown disability. The research work has been done for the objective to know the knowledge, attitude and practices of Autistic children of Bangladesh.

Autism is an unknown disability to the people of Bangladesh. Many of them think that they affect ‘Bengali term- Voute Dhora (Holding ghost).
And so they don’t give proper treatment. This kind of child is acquainted with their family as burden. As their interacting and adjustment power is low, they need help for everything. The research has led for the rationality of awareness about autism.

In the research, two organizations have selected for the collection of data. These are Society for the Welfare of Autistic Children (SWAC) and National Autistic Society (NAS). Researcher used the methodology of case study and interview for data collection.

In the study, maximum number of respondents (50%) was mother of the autism child, while minimum number of respondents (10%) was others (grandfather, grandmother, sister etc). 40% of respondents were father. In the study, it was observed that mother of autistic child is playing an important role for the child. IN the study, 80% of children with autism were boys and only 20% were girls, 40% respondents mentioned age 1 to 3 years in the first diagnosis age of child with autism. Maximum number of the autistic children (40%) mentioned the type of communicates verbally ‘speak’ while minimum number of the autism children (10%) mentioned the type of communications verbally both meaningless word/sound and weep. 80% of other family members on their autistic children helped to take care of autistic children. 70% of respondents answered that autism can’t be cured. But they expected that cure would be invented in future.

Ø      In 2000 D. Power edited a study “Children with Autism: A Parents Guide”. This study was conducted for the parents of children with autism. Asperser’s Disorder and related conditions.

This edited text book based on ten experience writer’s article. The study examined the thousands of families of children and adults with autism and expressed parent’s statement. The study also informed about autism, its types, symptoms, diagnosis, treatment etc. ‘Yours Child Development’ chapter provided with some of information that would need in order to influence child’s development most effectively.

‘Finding the Right Early Intervention and Educational Programs’ chapter was designed to ease entry into the world of early intervention and special education. It presented an overview of common placement option in special educational programs and reviews the evaluation and eligibility process.

Ø      Attwood’s (1997) study entitled “Asperser’s Syndrome :
                A guide for parents and professionals”. This book detailed the characteristics of Asperger’s Disorder and outlines approaches to reducing undesirable behavior and included a useful question and answer section, diagnostic criteria and an extensive research guide.

Autism er Neel Jagat; Mohammad Nazmul Haque, Md. Mahabub Morshed; Publisher- Tofazzal Hossain, Bishwa Shahitwa Bhaban, Bangla Bazar, Dhaka-1100.

In The book the authors have shown the causes, symptoms, effects of autism, statistical data of autism and several other data that have helped me in my thesis.

News wise 2008- A study led by researchers at the University of Southern California (USC) and Vanderbilt University have identified a specific gene variant that links increased genetic risk for autism with gastrointestinal (GI) conditions. The findings suggest that disrupted signaling of the MET gene may contribute to a syndrome that includes autism and co-occurring gastrointestinal dysfunction, says principal investigator Pat Levitt. Ph.D. director of the Zilkha Neurogenetic Institute at the keek school of Medicine of USC and chair- designate of the Department of cell and neurobiology.

The disabled, Special education demanding children, Rumiz Uddin Ahamed, Hasina Morshed and Farida Aktar, Mita Traders, Published- July,2010

They tried to show in the above book that the autistic children are socially very indifferent or self-centered, repetitive or busy with self-stimulating behavior and lack a significant sub-edition behavior.

     Moreover, the subject of their discussion has become helpful for my thesis.


The Prothom Alo, Journal’ 4 April 2012, The Prothom Alo: Various report published on 4 April 2012 in the Journal have made my research paper very easy.

Ø      In 1999 Myles conducted a study entitled “ Asperger’s Syndrome and difficult Moments: Practical Solutions for Tantrums, Rage and Meltdowns”. A brief guide to managing problem behavior in children with Asperger’s Disorder  and other PDDs, using functional analysis. This book wrote for teachers, also useful to parents.
All of this research was worth it. Here’s how it’s helped his son:




Alex before he did his research




Alex today after a lot of research
1.

No real friends

1.

Several close personal friends

2.

Unable to handle change

2.

Handles changing situations well

3.

Can’t play with friends

3.

Plays well with friends

4.

No therapist



Great therapist

5.
Thought everyone hated him

5.
Understand that people love him
6.
Lack of self esteem

6.
Proud of his accomplishment
7.
Little cooperation

7.
Full cooperation
8.
Very disorganized

8.
Learned organization skills

The researcher mentioned that although his story has a positive ending, he met many people during his research whose stories had not ending well. They were struggling to make it through each day, constantly sick with worry that something horrible would happen to their loved one before the autism was brought under control.[[2]]




Ø      Howlin’s “Children with Autism and Asperger’s Syndrome: A guide for Practitioners and Careers” (1998) wrote for professionals, but of use to parents. This study presented a comprehensive look at autism and Asperger’s disorder, covering all the major issue of treatment, education and behavior.  


Autism: A Conceptual Framework:

Most of us are unfamiliar with the concept of autism or if we have heard, do not have the distinct idea. Although it was identified in 1943, autism is still a relatively unknown disability; children and adults with autism are unable to relate to other in a meaningful way, their capacity to understand other person’s feelings. Autism is a life long developmental disability threat prevents individuals from properly understanding what they see, hear and otherwise sense. These results in severe problems relating to social relationship, communication and behavior. Autism spectrum disorders (ASDs) are a group of developmental disabilities that are caused by a abnormality in the brain that often makes it hard to communicate with and relate to others. With autism, the different areas of the brain fail to work together.

 “ Autism is a complex disorder of the central nervous system that has the following three defining core features: a) Problems with interactions; b) impaired verbal and non-verbal communication, and c) a pattern of repetitive behavior with narrow, restricted interests.”
        
               According to Sharmin Haq and Asim Das

[Source: The Dhaka University Journal of Psychology, 2007, Vol-3, P-111]


American Psychiatric Association Said-
“Autism is considered a pervasive developmental disorder (PDD) which refers to sever and pervasive impairment in several areas of development: reciprocal social interaction skills, communication skills, or the presence of stereotyped behavior, interests and activities.”

Dunlop & Buaton-Pierce (1999) said-
“Autism is a behavior based syndrome and its definition is based on the behaviors a person displays that has this type of disorder.”

Autistic Children’s Welfare Foundation, Bangladesh (ACWFB) said-
“Autism is a life long developmental disorder that causes qualitative abnormalities in reciprocal social interactions, patters of communication and rigidities in thinking and behaviors. It is characterized by a qualitative impairment in verbal and non-verbal communication, in imaginative actively and in reciprocal social interaction. Individual with autism is often described as being completely indifferent to the world around them, living only within them.”

Autism remains a challenging condition for individuals and their families. But the prognosis today is much better than it was a generation ago. At that time, most people with autism were placed in institutions. Today, with appropriate therapy, many of the symptoms of autism can be improved, though most people will have some symptoms throughout their lives. Most people with autism are able to live with their families or in the community. The prognosis for individuals depends on the degree of their disabilities and on the level of therapy they receive. 

Historical Background:

Autism is considered a very common development disorder, which appears one in every 160 children. [National Institute of Mental Health-NIMH; star weekend; 18 July 2008]. However, it was not identified with a separate name until the middle of the both century when Dr. Leo Kenner (1943) in the united states identified and described this specific disorder as a infantile autism and Hans Asperger’s (1944) in Germany described a similar type of disorder which was named Asperger’s syndrome. [Mayes and Callous 2003].




Autism has a long past but a short history. As early as the late eighteenth century medical texts described cases of children who did not speak, were extremely aloof and who possessed unusual memory skill. But it was not until 1943 that the condition was given a name in the year, Dr. Leo Kanner described the common characteristics of 11 children he had studied between 1938 and 1943. These children shared several features, the most notable of which was extreme isolation or withdrawal from human contact beginning as early as the first year of life. So Kanner was convinced that autism was present from birth or shortly there after that he adopted the terms “early infantile autism”.
In 1799, a French doctor, J.M.G. Itard, was given change of a boy about twelve years old, known as Victor that “wild boy of Aveyron” who had been found wandering and living wild in the woods. The child’s behavior was very abnormal. Itard be isolated from humans from an early age. Pine, another eminent doctor of the time, disagreed with Itard over this and believed that the boy was severely mentally retarded from birth, reading the story, now it is possible to see that victor behaved like an autism child. Some people have suggested that he was autistic because he was abandoned in infancy. It seems much more likely that he was separated from or abandoned by his parents in the troubled times following the French Revolution, because he was autistic and difficult to manage and not the other any pound. [Lorna wing; 1980:2]. Over a century later, in 1919 an American psychologist, Lightner Witmer, wrote an article about Don, a boy of two years and seven months who also behaved like an autistic child.

In naming this condition, Kanner borrowed the term from a Swiss Psychiatrist named Eugen Bleuler in 1911. In his writings, Bluler used the term “Autism” to withdraw from hostile, unnurturing human world and were afflicted with a disorder similar schizophrenic.

In 1962, the first society for parents and interested professional workers was set up in the United Kingdom subsequently such associations have been formed in many different  countries [Lorna Wing; 1980:3].

Now autism is considered a spectrum disorder (ASD) as it comprised of disorders in there major developmental areas such as speech, communication and serial interaction; impairments show a variety of characteristics as well as the complexity of the disorder which may range from mild to severe [Autism Today, 2005]. Still today, the causes and treatment of autism is a subject for research and different researcher findings suggest that it can be caused by both genetic and environmental factors [More,2005; Autism Today, 2005]. There are a number of development disorders such as Asperger’s syndrome and Rell’s disorders that have similar characteristics as autism, but at the same time, are very much distinct from each other. [American psychiatric Association-APA,2000; More, 2005].

Although autism still remains somewhat of a mystery, much progress has been maid in understanding how it affects children. More works remains to be done, but today the stereotypes and myths of the past that so hurt parents and families are being replaced by facts. [Power, 2000:39]

Today, we know that this is not true. Children with autism d not withdraw because they feel rejected. Unfortunately, many parents particularly mother were labeled cold, ungiving, unnurturing ‘refrigerator parents’ who had in large past caused their child’s autism. There were also persistent notions that autism was more common in families of higher socio-economic status. Needless to say now know this is wrong; autism affects children of all classes, nationalities, races.

Types of Autism:
The condition “autism” is really one of a set of five closely related conditions. These five conditions which all share symptoms, fall under the board diagnostic umbrella called “Pervasive Developmental Disorders” or PDD. According to the American Psychiatric Associations Diagnostic and Statistical Manual, which is the standards reference manual used in diagnosing autism.

There are five types of PDD.
a)      Childhood Autism
b)      Aspersers
c)      Rests disease
d)     Childhood disintegrates.
e)      PDD NOS or pervasive developmental disorder not other wise specified. (Power; 2009:9).

This section will give general guidelines, providing a superficial understanding of the differences between these above-mentioned disorders. A better, more specific understanding of these disorders is given by the specific DSM IV criteria for each disorder.

a)      Childhood autism:
                This syndrome always presents before 36 months of age. These children may have speech developmental and social interactive regression, usually around 18 months of age. The diagnosis of childhood autism must meet the specific DSM IV criteria and will therefore present with poor eye contact, pervasive ignoring, language delay, and other features, per definition, these children will have a severe impairment in speech, communication, or social interaction. May of them will be completely non-verbal and “in their own world”.

  • Impaired Social Interaction:
   Children with autism seem to live in their own world. They may not seek out the company of other children or adults, and may relate to other people even their own parents and siblings-as objects or tools rather than as people. Children with autism have a very hard time-sharing the enjoyment of their experiences with others. In many ways children with autism do not understand that their own enjoyment and experience can be made more fun if shared with someone else.

  • Impaired Communication:
   Children with autism often do not communicate with the people in their world in typical way. It can be very difficult to engage them in conversation or to obtain information from them verbally.

  • Repetitive, Stereotypic or odd patterns of Behavior, Unusual Interests or Responses to the Environment:
 Children with autism often have intense interests and preferences that are quite difference from other children. Many of these children become agitated by people, objects and situations that appear be gain to the rest of us. [Power,2000;12-13]


b)     Asperser’s Syndrome:
First described by Hans Asperser of Vienna in 1944. Whose work was not generally known in English translation until 1981, the disorder was not listed in the Diagnostic and statistical Manual of Mental Disorders (DSM).

Asperesr’s share with autism a severe and sustained impairment in social interaction, and restricted and repetitive patterns of behavior and interests. But people with Asperser’s do not have the significant delays in language, cognition, self help skills or adaptive behavior that are typical in autism; they are often physically clumsy and awkward, more obviously than children with easily or early, and may be misdiagnosed as Tourists syndrome, Attention Deficit Disorder, Oppositional Defiance. Disorder, Attention Defiance. As with autism, the disorder may be the largest type on the autism spectrum, affecting 35 in every 1000 people.

People with Aspersers may have an exceptional talent or skill with which they are preoccupied. It is conjectured that several people of remarkable genius may have had Asperser’s including Albeit Einstein, Vladimir Nabokor, Ludwig Wittgenstein, Bela Bartok and Andy Warhol of Canadian interest is a front page story in the globe and Mail (1st February 2000) entitled “Was Glenn Gould autistic” The possibility that Aspersers Syndrome could explain Goulds social deficiencies, obsessive perfectionism and intolerance of change was raised in the 1996 biography by psychiatrist peter Oswald, Glenn Gould; The Ecstasy and tragedy of Genius and is now elaborated by the musicologist timothy Maloney. Gould was acutely sensitive to light, sound and temperature, and had a phobia about shaking hands as well as a limited range of preference foods. His bizarre mannerisms as a concert. [Lorna Wing: 1980]

These are kids with a form of autism that affects language less, yet there are difficulties with appropriate speech and communicative development. Mostly, however, these children have social interaction difficulties and impairments related to a restricted, repetitive, stereotype behavior. These kids may have very high IQs may do very well academically, have a superior memory for “unimportant” details, such as the birth dates of all baseball players, some historical or A typical example of a child with Asperses syndrome would be that of a child who has some odd behaviors, poor eye contact, “sluggish” social interaction abilities. And an extreme interest in a central topic such as a washing machine. 

The child likes to sit and watch the washing machine door rotate knows everything about it including its operative and professional manual and may spend hours preservation about it. Such a child when he has a play date may try to involve his “friend” in his most exciting interest (the washing machine) without realizing how boring it is to others and that will be the end of the play dales forever. This pattern may present itself in different degrees and circumstances, but the principle is the same: the lack of the ability to understand how other people perceive what you do, say, or express with body language.

c)      Childhood disintegrative disorder:
  These are kids who develop normally for the first 3 years of life. Later they seem to regress and develop some autistic features associated with a severe functioned impairment these children must be thoroughly evaluated for the possibility of the development of seizures, affecting the speech areas of the brain or Landau deferrer syndrome (acquired epileptifor aphasis), where seizure activity “robs” the brain from previously acquired speech.

Very few children who have an autism spectrum disorder (ASD) diagnosis meet the criteria for childhood disintegrative disorder (CDD). An estimate based on four surveys of ASD found fewer than two children per 100000 with ASD could be classified as having CDD. This suggests that CDD is a very rare form of ASD. It has a strong male preponderance. Symptoms may appear by age 2, but the average age of onset is between 3 and 4 years. Unit this time, the child has age appropriate skills in communication and social relationships. The long period of normal development before regression helps differentiate CDD from Ret syndrome. 

The loss of such skills as vocabulary is more dramatic in CDD than they are in classical autism. The diagnosis requires extensive and pronounced losses involving motor, language and social skills. CDD is also accompanied by loss of bond bladder control and oftentimes seizures and a very low IQ. [Power; 2000:24-25]

d)     Retts disease:
  Included under the FDD umbrella is Rett’s disorder. This genetic condition was first identified 40 years ago by Address Rett, an Austrian physician and later by Bangt Hagberg-a Swedish physicians. This affects only girls. These are girls- who develop normally until 6 month of age and regress. Their regression is associated with microcephaly (small head). The head size seems to stop growing from 6 months and on, from the time of the observed regression. Recently a specific chromosomal marker (MEC-P-2) has been associated with this disorder and is now commercially available in some laboratories. (Power; 2000:15)

e)      Pervasive developmental disorder: not otherwise specified (FDD;NOS):
 
PDD:NOS will present similarly to the kids who have autism (some people argue that these conditions should be combined as one) but will have a lesser degree of a severe impairment. These kids are more likely to be verbal and have some degree of verbal or non-verbal effective communication, yet they must have the autism features (as per the DSM IV criteria) and a severe impairment in social interaction, communication or repetitive stereotype behavior. This term is reserved for children with a severe impairment who do not fully qualify for any other autistic diagnosis, due to age of onset or combination of autistic features.


The symptoms of Autism:

Autism is a spectrum disorder. The symptoms and characteristics of autism can present themselves in a wide variety of combinations from mild to severe. Although autism is defined by a certain set of behaviors, children and adults can exhibit any combination on the behaviors in any degree of severity [Prospectus: SWAC]. Symptoms almost always start before a child is 3 years old. Usually, parents first notice that their toddler has not started talking yet and is not action like other children the same age. Symptoms of autism include:

A delay in learning to talk, or not talking at all. A child may seem to be deaf, even though hearing tests are normal.

Repeated and overused types of behavior interests and play. Examples include repeated body rocking, unusual attachments to objects and getting very upset when routines change.[Internet]

There is no “typical” person with autism. People can have many different kids of behaviors from mild to severe. Parents often say that their child with autism prefers to play alone and does not make eye contact with other people. Autism may also include other problems:
Many children have below-normal intelligence. Teenagers often become depressed and have a lot of anxiety, especially if they have average or above average intelligence. Some children get a seizure disorder such as epilepsy by their teen years.
The symptoms of autism are divided in some areas. Such as-
a)      Core symptoms: The severity of symptoms varies greatly between individuals; however, all people with autism have some core symptoms in the areas of:

  1. Social interactions and Relationships:
          Symptoms may include; - significant problems developing nonverbal communication skills, such as eye-to- eye gazing, facial expressions and body pasture.

Failure to establish friendships with children the same age.

Lack of interest in sharing enjoyment, interests or achievements with other people.
Lack of empathy, people with autism may have difficulty understanding another person’s feelings, such as pain or sorrow.

  1. Verbal and non-verbal communication: Symptoms may include; Delay in or lack of learning to talk. As many as 50% of people with autism never speak.

 Problems taking steps to start a conversation. Also people with autism have difficulties continuing a conversation one it has begun.

Stereotyped and repetitive use of language. People with autism often repeat over and over a phrase they have heard previously (echolalia). Difficulty understanding their listener’s perspective. For example, a person with autism may not understand that someone is using humor. They may interpret the communication word for and fail to catch the implied meaning.

  1. Limited interests in activities or play: Symptoms may include; an unusual focus on pieces. Young children with autism often focus on parts of toys, such as the wheel on a car, rather than playing on parts of toys, such as the wheels on a car, rather than playing with the entire toy.

Preoccupation with certain topics. For example, older children and adults may be fascinated by train schedules, weather pattern or license plates.

A need for sameness and routines. For example, a child with autism may always need to eat bread before salad and insist on driving the same route every day to school.
Stereotyped behaviors. These many include body rocking and hand flapping.

b)      Symptoms during childhood: Symptoms of autism are usually noticed first by parents and other caregivers sometimes during the child’s first 3 years. Although autism is present at birth (congenital), signs of the disorder can be difficult to identify or diagnose during infancy. Parents often become concerned when their toddler does not like to be held; does not seem interested in playing certain games, such as peek a book; and does not begin to talk. They also may be confused about their child’s hearing abilities. It often seems that a child with autism does not hear, yet at other times, he or she may appear to hear a distant background noise, such as the whistle of a train.

With early and intensive treatment, most children improve their ability to relate to others, communicate and help themselves as they grow older. Contrary to popular myths about children with autism, very few are completely socially isolated or “live in a world of their own”.

c)      Symptoms during adolescent and teen years: During the teen years, the patterns of behavior often change. My teens gain skills but still lag behind in their ability to related to and understand others. Puberty and emerging sexuality may be more difficult for adolescents and teens with autism than for others this age. Teens are at a slightly increased risk for developing problems related to depression, anxiety and epilepsy.
d)     Symptoms in adulthood: Some adulthood: Some adults with autism are able to work and live on their own. The degree to which an adult with autism can lead an independent life is related to intelligence and ability to communicate. At least 33% are able to achieve at least partial independence.

Some adults with autism need a lot of assistance, specially those with low intelligence who are unable to speak. Part-or-full-time supervision can be provided by residential treatment programs. At the other end of the spectrum, adults with high-functioning autism are often successful in their professions and able to live independently, although they typically continue to have some difficulties relating to other people. These individuals usually have average have average to above-average intelligence.

e) Other symptoms: Many people with autism have symptoms similar to attention deficit hyperactivity disorder (ADHD).But these symptoms, especially problems with social relationship are more severe for people with autism. About 10% of people with autism have some form of savant skills-special limited gifts such as memorizing lists, calculating calendar dates, drawing or musical ability.

Many people wit autism have unusual sensory perceptions. For examples, they many describe a light touch as painful and deep pressure as providing a calming feeling. Others may not feel pain at all. Some people with autism have strong food likes and dislike and unusual preoccupations.

f) Severity of symptoms: Autism presents in a wide degree from those whose are nearly dysfunctional and apparently mentally retarded to those whose symptoms are mild or remedied enough to appear unexceptional (normal) to the general public. Their peers of then classify these autistic people as 'nerds'.

g) Low and High functioning: It terms of both classification and therapy, autistic individuals are of the divided into those with an IQ<80 referred to as having "low functioning autism (LFA)". While those with IQ>80 are referred to as having "high functioning are more generally applied to how well an individuals 





[1]. Anwar Hossian: An overview of Autism in Bangladesh: 15 January 2008

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