“Medical experts call for a multi-faceted approach including therapies and enrolment in schools to improve the lives of autistics and those suffering from virtual autism”
Sheikh Mustafa
BARAMULLA: Meet Iqbal, a 13-year-old boy from Sheerwani Pora, Boniyar in District Baramulla.
He’s enrolled in Government Boys Middle School Gawas, but his interactions are minimal. He communicates in short, monosyllabic responses and does not engage much with his classmates. At home, Iqbal prefers solitude, avoiding social interactions and play.
Diagnosed with autism, his behaviors reflect his challenges in connecting with others, both in school and at home.
Sheikh Murtaza, his classmate, is bewildered by his reclusiveness. “We often ask him to play with us and join us for lunch during lunch break, but he turns his back and sits alone without saying a word,” he says.
His brother Naseer Ahmad Dar is at his wit’s end dealing with Iqbal’s condition. “Our father is a simple labourer,” he says, adding that it makes it difficult for the family to cope with Iqbal’s exceptional needs.
It was not until Iqbal was two that the family noticed the subtle signs of autism – delayed speech, and repetitive behaviours like flapping his hands and clinging to certain specific things. He also had difficulty with communication and social interactions.
The family noticed but attributed these behaviours to typical toddler development. But as he grew, the signs persisted and even became more pronounced. That is when the family started taking Iqbal to different doctors and specialists.
“After a thorough evaluation, my brother was diagnosed with autism spectrum disorder (ASD). The diagnosis gave our family a greater understanding of Iqbal’s unique challenges and strengths, guiding us in providing the necessary support and resources for his development,” Naseer says.
Steady Rise in ASD
In recent years, the Kashmir valley has witnessed a concerning trend a steady rise in the number of children diagnosed with Autism Spectrum Disorder (ASD). This neurodevelopmental condition, characterized by challenges in social interaction, communication, and behavioural patterns, has become an increasing concern for parents and healthcare professionals in the region.
As per reports, “Over 400 children with Autism Spectrum Disorder (ASD) were registered at the Child Guidance and Wellbeing Center of Institute Of Mental Health and Neurosciences (IMHANS) Kashmir.” Autism is a neurological disorder in which the child’s communication skill gets delayed.
Dr Mudasir Hassan a renowned Child Psychologist at Government Medical College Baramulla (GMC) explains, “Autism spectrum disorder (ASD) is a complex neurodevelopmental condition that typically appears during early childhood. It is characterized by a range of social, communication, and behavioral challenges.”
Currently, there is no complete cure for ASD. However, early intervention and appropriate treatments can significantly improve the quality of life for individuals with ASD and their families, he says.
Therapies such as applied behavior analysis (ABA), speech therapy, and occupational therapy can help individuals with ASD develop essential skills, communicate effectively, and manage challenging behaviors. Additionally, support services, including educational accommodations and social programs, can play a vital role in helping individuals with ASD reach their full potential.
While the exact causes of ASD are not fully understood, it is believed to be influenced by a combination of genetic and environmental factors.
Symptomologies
Dr Hassan elaborates that “there are three main symptomologies in autism. First, children may speak late, and their communication and developmental skills can be delayed. Second, they may struggle with making eye contact. Third, they often exhibit behavioural abnormalities, such as needing to keep things in a specific order and having a strong attachment to certain objects, like toys, pens, or bottles, which they persistently focus on.”
Additionally, Dr. Hassan notes that “children with autism might prefer to stay isolated even in social gatherings. However, they are generally able to recognize their parents, especially their mothers, and can identify happy or sad moments, although they may not fully understand or respond to them.”
They are also often sensitive to loud noises and bright lights.
Dr. Mudasir explains that autism exists on different levels, each with distinct symptoms. As doctors or psychologists, we use specific criteria to diagnose autism, which is only recognized by psychologists. These levels include mild, moderate, severe, and profound autism.”
He also adds that “each level of autism needs to be diagnosed, typically between ages 2 and 2.6, although some symptoms can be noticed earlier, even in infancy. It’s crucial to evaluate psychiatric comorbidities, such as hearing issues, which might affect a child’s speech development. Paediatricians often identify early signs of autism and provide preliminary diagnoses, which are then confirmed by psychologists. But today, advanced devices and machines can help diagnose these issues early, particularly in infants, making it essential to assess whether a child may be developing autism.”
As per a recent report by CGWC-IMHANS which was sponsored by UNICEF, the prevalence of Autism Spectrum Disorder (ASD) is about 2.34 percent among children under the age group of four to six years in the Kashmir valley.
ASD and Virtual Autism
Dr. Hassan explains that autism can be influenced by several factors, including biological, neurological, genetic, and environmental issues like maternal smoking, thyroid problems, blood pressure issues, chemical imbalances, or birth injuries.
What concerns him is the rapidly rising cases of Virtual Autism in Kashmir. This is distinct from ASD. It is a condition that occurs when young children are exposed to too much screen time, such as on phones, tablets, computers, and televisions. Symptoms include social withdrawal, communication issues, and developmental delays
Children exposed to mobile phones as early as age 2, a key developmental stage, may experience delays. He notes that 50 to 60% of children he’s seen with autism have had high screen time, which may contribute to their condition.
Studies suggest that “Constant exposure to devices like smartphones, personal computers, and television can severely affect mental health- increase stress and anxiety, for example, and cause various sleep issues in both children as well as adults.”
A report surveying the impact of screen addiction across India reveals, “The survey conducted among 3,000 participants revealed that an overwhelming 95 per cent of Indian parents are deeply concerned about screen addiction, while 80 per cent and 70 per cent expressed worries regarding gaming addiction and adult content consumption, respectively.”
A report on virtual autism shows that “In 2023 Kashmir saw an increase in cases of virtual autism, with 78 children registered at the Child Guidance and Wellbeing Centre (CGWC).
“In 2022, 75 children with autism were registered at CGWC and prior to that 189 autism cases among children were registered from 2019-2021.”
Dr. Hassan emphasizes the importance of limiting screen time for children and encourages parents to spend quality time with them for optimal development. He notes that “In Kashmir, many children develop autistic features between the ages of 4 and 6 due to excessive mobile phone use. Additionally, he addresses a common misconception that late speech development in children is always genetic, emphasizing that environmental factors can also play a role.”
Diagnostics & Treatment
Dr. Hassan points out the progress in healthcare access and awareness over recent years. He notes that while parents were once hesitant to seek medical help, especially for autism, today, many—particularly educated parents—are more proactive in seeking early intervention.
However, he stresses the importance of consulting psychologists alongside pediatricians for accurate autism diagnoses. He calls for an increase in specialized professionals like audiologists, clinical psychologists, and speech therapists in the medical field.
Dr. Hassan also supports the National Medical Commission’s guidelines to include psychologists in new government medical colleges and advocates for their involvement in early diagnosis and intervention.
Dr. Hassan highlights that early detection is key to effective autism treatment. Diagnostic tools, such as the Autism Rating Scale and other machine- and scale-based methods, are used to assess symptoms.
Specialists, including audiologists for hearing issues, speech therapists for communication challenges, and psychologists for behavioral concerns, are involved in the diagnostic process.
Therapies are tailored to the child’s specific needs. Dr. Hassan also notes that comorbidities, like autism with a low IQ, can impact progress, whereas children with autism and a higher IQ may show better improvement. He stresses the importance of early diagnosis and prognosis.
Additionally, he highlights available treatment facilities, including specialized centers like DICS at GB Pant Hospital and those in Baramulla, encouraging their widespread use.
Autism is not fully curable but can be managed to a great extent, especially if diagnosed early. Here the role of pediatricians and psychologists is very significant.
There is bigger success with Virtual autism which too is not fully treatable. Since it is a neurodevelopmental condition, it affects individuals throughout their lives. However, there are now various advancements and new technology and early interventions and therapies that can significantly improve the quality of life and functioning for individuals suffering from it.
Dr Hassan talks about many such success stories of children suffering from virtual autism who were weaned away from mobile phones and enrolled in play schools and kindergartens. Significant improvement was observed in many of them, he says.
While emphasising the greater need for conducting awareness programs to discourage early mobile phone use and warn people about how they can hamper the neurodevelopment of children, Dr Hassan avers that a crucial role needs to be played by schools, teachers and parents in creating healthy social interactions for children.
Healthy social interactions can help prevent virtual autism and manage ASD, besides therapies. A combination of the two is the most effective approach.
Social Interaction
The vital role of social interaction in managing autism spectrum disorder (ASD) becomes evident through real-world experiences. A compelling case from Kashmir illustrates this through the story of two brothers, shared by their father’s cousin, a female PhD scholar from the University of Kashmir.
The older brother’s journey is particularly revealing. While living in the United States, his parents’ demanding work schedules limited their family interaction time. He began showing concerning signs – withdrawing into corners, struggling with communication, and avoiding interaction even with his parents. Initially, doctors discovered and treated a neurological condition, but he was subsequently diagnosed with autism.
A remarkable turn came when the family temporarily returned to Kashmir. There, immersed in a more socially engaging environment, the boy showed significant improvement. Though he remains introverted after returning to the USA, the positive impact of that period of increased social interaction was undeniable.
The younger brother, now 12, also lives with autism, manifesting through symptoms like stammering and social interaction challenges. He currently attends a specialized school in the USA that provides targeted support for his needs.
This family’s experience underscores a crucial insight: while professional interventions and therapies are essential, the power of healthy social interactions cannot be overlooked in supporting individuals with autism. The most effective approach appears to be a combination of both – structured therapeutic support and natural social engagement.
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