Autism in India

Autism is a pervasive developmental disorder, that is, it becomes apparent in early childhood and affects all aspects of a child’s development. The word “Autism” was first used as a diagnosis in the year 1943, by Dr. Leo Kanner of Maryland’s Johns Hopkins Hospital, and after studying 11 children he diagnosed them to have early infantile Autism. According to the Center for Disease Control, 1 in 59 children has been identified with an Autism spectrum disorder. Autism is the fastest-growing developmental disability and is four times more prevalent in boys than in girls.

India is a highly populated country of nearly 1.3 billion people with children ≤15 years constituting nearly one-third of the population. Many studies have estimated that more than 2 million people might be affected by ASD in India. Most of the reported studies on ASD are based upon hospital-based data and thus lack information on the prevalence estimates of this disorder in India since the reporting of children with ASD is low.

Prominent Indian psychologists suggest that Indians largely emphasize conformity to social norms and value social relatedness and relationships, and hence, a disorder that is defined by deviant social functioning which has special significance in the country. India saw it’s first reform towards autism in 1943 when A. Ronald, a Viennese pediatrician in Darjeeling, gave an overview of the symptoms, etiology, types, and treatment of ‘difficult children’. For him, a ‘difficult child’ is someone who was not very backward than an average child; who was capable of being trained but showed abnormalities or deviation in the sphere of sensitiveness, inclination, and volition. Though in the article written by Ronald, he did not mention the term ‘autism’, although some of the symptoms described by him matched Kanner’s description of autistic children.

Similar to the western world, there has been an increase in the prevalence of autism in India over the years. The recently estimated prevalence of ASD in India ranges from 0.15% to 1.01% in multiple studies, depending on the screening method used by the researchers, and the areas surveyed by them. In another study, the prevalence of ASD was 1 in 125 in children 3-6 years and 1 in 85 in children 6-9 years of age. The prevalence in rural areas was 0.90%, 0.6% in hilly regions, 1.01% in urban areas, 0.1% in tribal areas and 0.61% in the coastal regions.

Once considered rare, the current understanding through several studies is that autism is, in fact, one of the most common developmental disabilities. The increase in prevalence can be attributed mainly to increased awareness and diagnosis amongst professionals. Changes in case definition, earlier detection, and diagnostic substitution of cases also contribute. However, a true increase in prevalence cannot be ruled out, especially because advanced parental age at conception and perinatal risk factors like prematurity and high-risk infant survival have significantly increased over the years.

Despite such a vast increase in the diagnosis of ASD, a large ratio of the Indian population especially the adults, remain undiagnosed. Hence, it is the need of the hour that we start acknowledging such developmental disorders and create a community that is more accepting and reformed for such individuals.

References:

Juneja, M & Sairam, S. (2018). Autism Spectrum Disorder - An Indian Perspective. http://www.smgebooks.com/autism/chapters/AUT-18-12.pdf

Written by:

-Anjani Sharma (III-YEAR)