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Unlocking the mysteries of Autism: Causes, symptoms & interventions
Chandigarh, Updated At : 07:11 PM Sep 24, 2025 IST
Autism and education concept. Autism spectrum disorder. The word autism on colorful cubes with stationery objects on blue background.
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What is Autism (ASD)?
• Autism or Autism Spectrum Disorder (ASD), is a neurodevelopmental disorder characterised by persistent difficulties in social communication and interaction, along with restricted, repetitive patterns of behaviour, interests or activities.
• The term “spectrum” indicates wide variability: some individuals may have mild challenges and live independently, while others may require lifelong support.
• It typically manifests in early childhood (before age 3) though many are diagnosed later.
• The prevalence estimates vary; globally about 1 in 127 persons was estimated to have autism in 2021.
Causes/risk factors
Autism does not have a single known cause. Current understanding is that it results from a complex interplay of genetic and environmental factors.
Key factors studied include:
Factor type | Examples/evidence | Notes/caveats |
Genetic factors | Rare de novo mutations, copy number variants, polymorphisms in multiple genes | Many genes implicated; no single “autism gene.” |
Parental/prenatal factors | Advanced parental age, maternal diabetes, pregnancy complications, prenatal exposure to pollutants | These factors increase risk, but are neither necessary nor sufficient. |
Perinatal/birth complications | Prematurity, low birth weight, hypoxia during birth | These add to risk under vulnerable genetic background. |
Environmental exposures | Heavy metals, air pollution, some medications taken during pregnancy (e.g. valproate) | Association found in some studies; causality is less clear. |
Because of heterogeneity, the “multiple hits” or “brain network” hypotheses are common — that several small genetic and environmental insults combine to disrupt brain development in critical periods.
Symptoms/clinical features
Since autism is a spectrum, manifestations vary. But generally, the features are grouped into two broad domains:
1. Social communication & interaction difficulties
• Challenges in social-emotional reciprocity (e.g., reduced sharing of interests, difficulty back-and-forth conversation)
• Problems in nonverbal communicative behaviours (e.g., limited eye contact, gesture use, facial expressions)
• Difficulty developing, maintaining and understanding relationships (e.g. difficulty adjusting behaviour in different contexts, lack of peer relationships)
2. Restricted, repetitive behaviours, interests or activities
• Repetitive motor movements, use of objects or speech (e.g. hand-flapping, lining up objects)
• Insistence on sameness, ritualised patterns, resistance to change
• Highly restricted, fixated interests (abnormal intensity or focus)
• Hyper- or hypo-reactivity to sensory input (e.g. adverse reactions to sounds, textures, patterns)
Other associated features/co-morbidities:
• Intellectual functioning may vary widely (from intellectual disability to above average intelligence)
• Many have co-occurring conditions — epilepsy, anxiety, depression, ADHD, sleep disorders, gastrointestinal issues, etc.
• Communication delays (e.g. late speech)
• In some, periods of regression (loss of previously acquired skills)
• Behavioural challenges (tantrums, self-injury) in more severely affected individuals
Early signs (in toddlers/infants) may include:
• Lack of babbling or pointing by 12 months
• No single words by 16 months or two-word phrases by 24 months
• Little use of gestures (pointing, waving)
• Poor social engagement (less interest in social games, limited eye contact)
• Atypical play (e.g. repetitive lining of toys)
Diagnosis & assessment
• No blood test or imaging confirms autism. Diagnosis is clinical, based on behavioural criteria (e.g. DSM-5, ICD-11).
• Use of standardised screening tools and diagnostic instruments (e.g. Autism Diagnostic Observation Schedule [ADOS], Autism Diagnostic Interview — Revised [ADI-R])
• Multi-disciplinary evaluation (paediatrics, psychology, speech, occupational therapy)
• Assessment of co-morbidities and functional levels
Early diagnosis is important to allow early intervention.
Treatment/intervention/management
There is no cure for autism. The goal of treatment is to support skills, reduce harmful behaviours, enhance quality of life and promote inclusion.
Major approaches include:
Intervention type | Examples/description | Evidence/considerations |
Behavioural/developmental interventions | Applied Behaviour Analysis (ABA), Early Start Denver Model, Pivotal Response Training, social skills training | Among the strongest evidence base, especially if started early |
Speech & language therapy | To improve communication, pragmatic language, augmentative/alternative communication (e.g. picture exchange) | Tailored to individual needs |
Occupational therapy/sensory integration | To address sensory processing challenges, fine motor skills, daily living skills | Mixed evidence but widely used |
Educational interventions | Individualised Education Programmes (IEPs), special education, inclusive schooling | Essential for academic, social inclusion |
Pharmacological treatment | Used not for core autism, but for target symptoms (e.g. irritability, aggression, hyperactivity) — e.g. risperidone, aripiprazole | Must be carefully monitored; side effects exist |
Supportive/psychosocial interventions | Parent training, counselling, support groups | Important for family resilience |
Assistive technology | Communication aids, apps, educational software | Growing role in augmenting abilities |
In India, research is ongoing. For example, a compound “6BIO” is being evaluated (in mice) for potential to improve learning in autism/ID models.
A holistic approach (health + education + social support) is considered best.
Challenges & issues
• Late diagnosis and underdiagnosis, especially in low-resource settings
• Lack of awareness, social stigma
• Scarcity of trained professionals, especially in rural/remote areas
• Inadequate infrastructure, limited access to interventions
• Language/cultural adaptation of diagnostic tools (in India many tools are not validated in local languages)
• Funding, sustainability of services
• Integration across sectors (health, education, social welfare)
Government/policy/rights (India & international)
International/global
• UN & WHO: WHO has autism as part of developmental disabilities; advocates for integrated services and inclusive society.
• UN General Assembly designated April 2 as World Autism Awareness Day (later called Autism Awareness/Acceptance Day).
India
• Under the Rights of Persons with Disabilities (RPwD) Act, 2016, autism is recognised as a disability.
• Inclusive education/Samagra Shiksha: The scheme encourages inclusive schooling and provides for reasonable accommodations.
• Disability certification: Persons with autism can obtain certificates of disability to access benefits (e.g. financial aid, reservation)
• The National Trust (a statutory body under Ministry of Social Justice & Empowerment) runs programmes for persons with autism and other intellectual disabilities (residential care, skill development, scholarship)
• Health insurance & schemes: Some state/central schemes may help cover therapy/diagnostic costs (e.g. NIRAMAYA, though implementation is uneven)
• In Maharashtra, the state has recognised services for autism (awareness, diagnosis, educational support).
• Several scholars call for a National Programme on Autism (or more structured plan) combining health, education, social sectors.
• The government also emphasises vocational training/skill development for persons with autism to improve employability.
• Judicial activism: courts have upheld rights of autistic children in education (e.g. Delhi HC recently upheld that a child with mild autism must be readmitted in a private school under RPwD Act)
Recent developments/news
• The FDA (US) is poised to approve leucovorin (folinic acid) for treating verbal communication symptoms in children with cerebral folate deficiency and autism-like features — though it is not a cure.
• In India, a robotic interactive gaming system was developed by IIIT Allahabad to support children with autism via adaptive learning.
• The Delhi High Court upheld the right of a child with mild autism to continue education, mandating that private schools must provide accommodations under RPwD Act.
• BTS’s Suga (South Korean artist) pledged to establish a treatment centre for autism care (Min Yoongi Centre) in collaboration with a hospital, combining music-based therapy and research.
• In Nigeria, a 15-year-old boy with autism set a Guinness World Record by painting the world’s largest canvas to raise autism awareness.
• Emirates airline is training staff to become “autism certified,” making it more accessible for autistic passengers via staff training, sensory guides, etc.
These reflect global and Indian-level attention to inclusion, technology, legal rights and therapeutic innovation.
Observance: World Autism Day
• When: April 2 each year.
• Why: To raise awareness, promote acceptance, foster inclusion of autistic persons worldwide.
• Origin: Proposed by Qatar, adopted by UN General Assembly in 2007 (Resolution A/RES/62/139). First observed in 2008.
• Note: Some autistic advocacy groups prefer terms like “Autism Acceptance Day” or “Autistic Pride Day”, arguing that “awareness” is insufficient without true acceptance.
From UPSC/Mains perspective: Key themes & possible questions
When writing a Mains answer or preparing for UPSC, you can use the following structure and themes:
1. Definition & scope
• Define autism/ASD; highlight spectrum nature and variability
• Provide prevalence and global vs Indian context
2. Causes/determinants
• Genetic, environmental, perinatal factors; stress interplay, multicausal model
3. Impact & challenges
• On individual (communication, learning, social inclusion), family (emotional, financial burden), society
• Co-morbidities, need for lifelong support
• Gap in services, stigma, inequality of access
4. Interventions/solutions
• Early detection, multidisciplinary interventions, inclusive education, assistive tech, skill training
• Role of public health, community-based rehabilitation, NGOs
• Role of technology & innovation
5. Policy/legal framework
• RPwD Act 2016, inclusive education policies, schemes, rights of autistic persons
• Challenges in implementation, need for national autism programme
6. Recent developments & future directions
• New therapies/drugs, technology (robots, AI, apps)
• Judicial cases enforcing rights
• Push toward acceptance rather than mere awareness
• Emphasis on neurodiversity movement
7. Conclusion/way forward
• Need for multisectoral coordination (health, education, social welfare)
• Strengthening grassroot/primary care involvement
• Increasing awareness and reducing stigma
• Promoting research, data generation, monitoring
• Fostering inclusive society and livelihood opportunities
Possible Mains/Essay questions:
• “Critically examine India’s policy response to autism spectrum disorder. What gaps remain and how can they be addressed?”
• “Discuss the role of early intervention and technology in managing developmental disorders such as autism.”
• “Autism is not merely a medical issue but a social inclusion challenge — comment.”
• “Evaluate the significance of neurodiversity and autism acceptance in modern societies.”
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