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With world Autism day just around the corner, Dr Toju Chike-Obi, Consultant Paediatrician at the Tabitha Health Centre Maitama, Abuja, explains what autism is and debunks myths that the ailment is caused by witchcraft or immunization. These she says are fallacies as research findings have proved them wrong. Tell us more about autism? Autism is a brain disorder in children. It is usually noticed between the ages of two or three years. It is a disorder that has no known cause. Autism might have multi-factorial causes, which means there could be a brain defect that we have not narrowed down to which is also affected by genetic pre-disposition as well as environmental impact on that genetic predisposition. This means there is a genetic problem already and then something in the environment during the child�s development impacts the child�s basic genetic make-up that caused autism. What are the symptoms? Autism has three major symptoms. The three hallmarks of autism are abnormal communication often in speech and language. They communicate abnormally. The second is in abnormal social interaction. They cannot relate socially with people in their environment. The third is that they have abnormal behaviours. There are certain things you look out for to help you make a diagnosis. Is there a blood test that can be done to detect autism? There is no blood test. It is not like malaria which you can test for. Autism is a diagnosis of evaluation. You evaluate the child to see if they fall into these three criteria. Then, you make the diagnosis. What should a parent do if she discovers this? First, every child from birth should be followed by a pediatrician who monitors their growth and development. It is not enough to just get your child immunized. That is very important, but in addition to that, your child should be evaluated by a pediatrician regularly. This means at birth, within the first week of life, at two months of age, four months, six months, nine months, 12 months, 15 months, 18 months, two years and two and a half. If you have a good pediatrician monitoring your child, they should be able to pick up any signs of autism between the ages of 15 months to two years, if any. The problem for parents is that children with autism behave normally in their developmental milestone. They sit at the right time, crawl at the right time, they walk at the right time, so because those things are in place, parents don�t focus on the fact that the child�s speech ,communication, speech and language development is not what it needs to be. They also do not focus on the fact that the child interact abnormally with the other siblings in the family or other kids who come by the house to play. Are there any early interventions in existence? The ideal time to make a diagnosis for autism is before the age of three because you can start to do the interventions. The interventions fall into the categories of the three hallmarks of autism. The first is communication-speech and language development. Often, these children are delayed. Even those that are not delayed are hyper communicative. For instance, a two year old can be able to pronounce big words. But they don�t use those words properly or end up repeating it. So you can do a speech and language evaluation. Access where the child is and begin to do the necessary intervention usually in the form of speech therapy. The second area is in communication. You put the child in a therapy where you help them with their social interaction. For instance, when talking to a child with autism, they sit down and not look at you. They are in their own world or may just be fiddling with the pen. It is not that they cannot hear you, but they cannot interact with you. So the purpose of early intervention is to teach them how to interact with others. For instance, a therapist would tell an autism child, when you hear your name, look at me. By this he/she is teaching �Joseph� to make eye contact with those that are communicating with them. So you begin to teach them this and when Joseph is six or seven years he can interact. This is better than him being in the room with people and still feels totally isolated. They have all kind of behaviours, so you also do some behaviour modification. Studies show that a child diagnoses with autism before age three should have 20-25 hours of therapy per week. What is the prevalence rate of autism in Nigeria? I don�t have Nigeria�s statistics here. But in the world, it is 4 to 6 in every 1000 children. What will you say to those that believe autism is caused by witchcraft? For someone that has spent most of my professional life in the US, we don�t have witchcraft in the US yet, we still have 4 to 6 in a 1000 having autism of which boys are more affected than girls. It is not witchcraft but a condition. What advice do you have for parents with an autistic child? The first is public education on what autism is and not just autism but mental health in general. It is what is swept under the rugs in Nigeria. We hide our relations who have any form of mental disorder. First, there should be a public awareness programme. The second is to support a mechanism for parent with autistic children. Solicit support from groups with other parents, then support from the government to help them with the cost of taking care of the child who is autistic. The stigma of being a parent of an autistic child is hard to eradicate. We need advocacy from prominent people who the society look up to help educate the public about autism. That is where the government comes in, by having schools for children with special needs. A mildly autistic child can function in a regular school but they need to be pulled out for speech therapy. They need to be pulled out for an hour behavioural therapy. But a moderately to a severely impacted autistic child need to be in a special school for children with special needs. Would a child with autism grow up to live a normal life? It depends on the level of autism. If they are mildly autistic, they can get by with help. They can hold down simple jobs but a job that requires a lot of interaction is not what someone with autism will do. They will do well at behind the scene jobs. They can be filing Clarks in the library. Is there hope for parents of children with autism? I can encourage them in one thing. Be an advocate for your child. Get access to a computer go on the internet and look up information on autism. There are resource areas devoted to children with autism. Learn as much as possible about the disease don�t get mired in old wives tales and cultural myths of what autism is. Educate yourself about what autism truly is. Knowledge is power. Some people say certain immunization cause autism. I want to say categorically that it is not true. There are various researches finding to that effect that no immunization causes autism.