1. Introduction to Autism
📍 Autism. It's a word that carries a lot of weight—a word that evokes a wide range of emotions, from fear and confusion to curiosity and compassion. But beyond the label, beyond the diagnosis, lies a world of unique individuals with diverse strengths, challenges, and stories waiting to be told. This is the Ananya Child Development Center podcast, and today, we're unmasking autism.
We're going beyond the stereotypes and misconceptions to explore the realities of this complex neurodevelopmental condition. And, most importantly, we are seeking out those sparks of hope—the stories, the insights, and the evidence that reminds us of the incredible potential within every child on the autism spectrum.
2. Meet Dr. Nithya
I'm your host, Madhavi Adimulam, and we are joined today by Dr. Nithya, a leading child and adolescent psychiatrist at Rainbow Hospitals in Hyderabad, who has dedicated her career to understanding and supporting children with special needs, autism, and mental health issues, and their families.
Dr. Nithya, welcome to the podcast!
Dr. Nithya: Yeah, thank you for having me, Madhavi. I'm happy to share what I know from my experience so that it can help these children and their parents. It's an honor and privilege to be on your podcast. Thank you.
Madhavi Adimulam: I'm sure parents will benefit tremendously from the answers you provide because so many parents feel lost and don’t know where to look for answers when their child is struggling.
3. Dispelling Myths About Autism
Madhavi Adimulam: Dr. Nithya, let's begin by tackling some of the common myths and misconceptions surrounding autism. What are some of the most pervasive myths that you encounter in your practice, and how do these myths impact children and families?
Dr. Nithya: Some of the most common myths I encounter include:
- The belief that autism is a purely psychiatric issue or a mental health disorder.
- The idea that autism can be treated or cured with medication.
- The misconception that children will “grow out” of autism if left untreated, leading to delays in seeking help.
- The unfounded fear that vaccinations cause autism.
- And, though rare, I’ve even heard some people believe that autism is contagious.
Madhavi Adimulam: Thank you for addressing those harmful myths, Dr. Nithya. It’s crucial to base our understanding of autism on facts and evidence, not on stereotypes and misinformation. And that brings us to a question that's on many parents' minds:
4. Understanding the Causes of Autism
Madhavi Adimulam: What causes autism?
Dr. Nithya: Unfortunately, we still don't have a definitive answer. Research is ongoing, but it seems that a combination of genetic and environmental factors is involved. While there's a genetic component, we haven't identified a single gene responsible for autism in most cases. In about 10 to 15 percent of children, autism is part of a broader syndrome, what we call “syndromal autism.”
Several environmental factors are being studied, including:
- Preterm births
- Exposure to certain toxins
- Infections during pregnancy
- Low birth weight
- Maternal and paternal age
The research is still evolving, and we don’t have all the answers yet.
Madhavi Adimulam: It’s interesting that you mentioned those environmental factors. Lately, I’ve been seeing more children with autism who were born through IVF. Do you think there's a link between IVF and autism or developmental delays?
Dr. Nithya: It’s a question that researchers are exploring, and there’s a possibility that IVF could be a risk factor for developmental delays. But it’s not conclusive. We don’t yet have the evidence to say that IVF directly causes autism.
Madhavi Adimulam: We know that maternal stress during pregnancy is linked to developmental issues in children. And with IVF, the experience of pregnancy is significantly different. There are hormonal injections, the uncertainty of whether the pregnancy will be successful, and often multiple rounds of IVF before a couple conceives. Do you think those factors might contribute to the risk of developmental delays or autism?
Dr. Nithya: It's definitely possible. While IVF itself might not be a direct cause, the stress and anxiety associated with the process could contribute to the risk. More research is needed in this area.
Madhavi Adimulam: It's a complex issue with many layers. So much of what we know about autism focuses on the challenges, but we want to emphasize hope and potential. It’s important to remember that while there are observable behaviors associated with autism, there's also a rich inner world that we often don't fully understand.
5. Exploring the Inner World of a Child with Autism
Madhavi Adimulam: What can you tell us about the inner world of a child with autism – their thoughts, feelings, and perceptions?
Dr. Nithya: Every child, regardless of whether they're on the autism spectrum, is an individual with their own unique emotions, thoughts, and feelings. It’s just that children with autism might not always be able to communicate those inner experiences in ways that we easily understand.
We have to look beyond their behaviors and try to understand what’s going on beneath the surface. As the saying goes, “Behavior is just the tip of the iceberg.” We need to explore what lies beneath, to understand their unique perspective and provide them with the support they need.
Madhavi Adimulam: It’s about seeing the world through their eyes. And sometimes, a child's passions and interests can provide a window into that inner world.
6. Leveraging Strengths and Interests
Madhavi Adimulam: Many children with autism have deep passions or special interests. How can parents and educators in Hyderabad leverage these interests to support a child's learning, motivation, and overall development?
Dr. Nithya: That’s a very important question. Traditionally, we've often focused on a child's deficits—what they struggle with—and tried to fix those weaknesses. But there's a growing movement towards a strengths-based approach. We’re starting to recognize the importance of identifying a child's strengths, skills, and passions, and encouraging them to do more of what they excel at. This can apply to any child, but it’s especially powerful for children with autism.
When a child is engaged in activities that they enjoy and are good at, their self-esteem blossoms, and they gain a sense of confidence that can carry over into other areas of their lives. It can open up new possibilities and help them discover hidden talents they might not have explored otherwise.
Madhavi Adimulam: It's like they find their spark. My son, who’s on the autism spectrum, found his passion in music, and it’s been transformative for him.
Dr. Nithya: Exactly. And just like parents of neurotypical children expose their kids to a variety of activities to discover their interests, parents of children with special needs should do the same. If a child shows a particular talent, nurture it! It’s not going to blossom on its own. It takes encouragement, support, and opportunities for them to shine.
Madhavi Adimulam: It’s about creating that space for their passions to flourish.
Dr. Nithya: And it's important to remember that autism is a spectrum. Some children may have exceptional talents in certain areas, while others may not. But every child has their own unique strengths and abilities. The key is to identify those strengths, celebrate them, and help children feel confident in who they are.
Madhavi Adimulam: That's a powerful message. Now, social interactions can be a challenge for many individuals with autism. How can we help bridge that gap?
Help Your Child Thrive
7. Building Social Connections
Madhavi Adimulam: Social interactions can be challenging for individuals with autism. What are some strategies that parents, educators, and therapists can use to help children with ASD build meaningful relationships and navigate social situations with more confidence?
Dr. Nithya: It's a common misconception that therapy alone is enough to address social challenges. While therapy provides a foundation, it's crucial for parents to actively participate in their child's social development.
Creating an interactive and playful environment at home, where children can practice social skills in a natural way, is essential. I encourage parents to engage in what we call "more play"—actively playing with their child, making it fun and exciting. This is much more effective than "less play," where a parent is passively present but not truly engaged.
Madhavi Adimulam: So, it's about turning those everyday interactions into opportunities for learning and connection.
Dr. Nithya: Exactly. And it’s not just about staying home. Parents should make an effort to take their children out, to parks, social gatherings, or even just to run errands. These are all valuable opportunities for children to practice those social skills in real-world situations.
Remember, it's about consistency. It’s not enough to do this once a week. Aim for at least an hour of dedicated social interaction every day.
Madhavi Adimulam: It's about making it part of their routine. And what about those parents who constantly prompt their child to “say hi” or “say thank you?” I know it comes from a good place, but sometimes it can have the opposite effect.
Dr. Nithya: Yes, when a child feels pressured, they often withdraw or resist. It’s more effective to model the behavior you want to see. If you say “hello” and “good morning” to others, your child will observe and learn those social graces naturally.
Madhavi Adimulam: So, it’s about “leading by example.” And it's also important to have realistic expectations, right?
Dr. Nithya: Absolutely. Start with small steps, building upon a child's current abilities. Encourage them to interact with one child at a time, then gradually expand their social circle. You can facilitate those interactions initially, but as they gain confidence, you can slowly step back and let them take the lead.
Madhavi Adimulam: It's a gradual process of building social skills. And what about involving other family members in this process?
Dr. Nithya: That's a great point, Madhavi. We often see mothers carrying the primary burden of teaching their child social skills. But it's important for other family members—fathers, grandparents, siblings—to be actively involved as well. This not only lightens the load for the mother but also creates a more natural and enjoyable learning environment for the child.
Madhavi Adimulam: So, it's about sharing the responsibility and making it a family effort. You know, here in India, we don't really have much in the way of respite care for families with special needs children. I remember when we lived in the UK, we had access to respite care workers who could come into our home and provide temporary care for our son, giving us a much-needed break.
Dr. Nithya: Respite care is definitely a need of the hour in India, especially with the rise of nuclear families and working parents. It can be incredibly draining for parents to provide constant care without any breaks. It can lead to burnout, depression, and anxiety.
Madhavi Adimulam: It’s essential for parents to prioritize their own mental health, too. A mother’s well-being is directly linked to her child’s well-being.
Dr. Nithya: Exactly!
Madhavi Adimulam: You've developed a wonderful program at Manaha Clinic called Project Rashmi to support mothers. Could you tell us a bit more about that?
8. Project Rashmi: Supporting Mothers
Dr. Nithya: Project Rashmi is an initiative I started to support the well-being of all mothers, whether they have neurotypical children, children with special needs, or are single mothers. Motherhood is a challenging journey, filled with joy but also with stress, exhaustion, and self-doubt. We see a lot of burnout and fatigue in mothers, especially those who are juggling multiple roles.
For mothers of children with special needs, the challenges are often magnified. They might be dealing with financial strain, lack of sleep, constant worry about their child’s future, and pressure from family or society. They need a space to connect, to share their experiences, and to find support.
Madhavi Adimulam: So, it’s about creating a community for mothers?
Dr. Nithya: Exactly. And it's not just about practical support; it's about addressing their emotional well-being. They need a space where they can talk openly about their feelings, their fears, their struggles, and their triumphs without judgment. And that's what we aim to create with Project Rashmi.
Madhavi Adimulam: I’m curious, though, about your decision to bring together mothers from such diverse backgrounds—mothers of neurotypical children, those with special needs children, and single mothers. Why not create separate groups for each?
Dr. Nithya: Because a mother is a mother, regardless of her child’s abilities or her family structure. Motherhood is a universal experience, with its own set of joys and challenges. And when mothers come together from diverse backgrounds, they can learn from each other, share their perspectives, and realize they're not alone in their struggles. They can support each other, empower each other, and build a strong network of understanding and compassion.
Madhavi Adimulam: That’s a beautiful vision, Dr. Nithya. I know you’re passionate about supporting mothers, and this initiative sounds incredibly valuable. Sadly, we're seeing more and more stories in the news about mothers who are struggling to cope. Just last week, I read about a mother in Bangalore who tragically took the life of her three-year-old son who had autism. It's heartbreaking, and it highlights the desperation that some mothers feel. Maybe she didn't have access to the support she needed.
Dr. Nithya: It's a tragedy, and it underscores the importance of support systems for mothers. We need to create safe spaces where they can talk openly about their struggles without shame or judgment.
Madhavi Adimulam: Have you seen signs of burnout in the mothers you work with in your clinic?
Dr. Nithya: Yes, unfortunately, it's becoming more common. Some of the signs include mood swings, frequent crying, lack of energy, loss of interest in activities they once enjoyed, feelings of hopelessness and helplessness, and even suicidal thoughts.
Depression can distort a mother's perspective, making it difficult to see any possibility of things getting better. That's why support groups are so important. They offer a lifeline, a sense of community, and a reminder that they're not alone.
I urge anyone who is struggling to seek professional help. And if you see any signs of depression in someone you know, especially a mother, please reach out and encourage them to get support. Be there to listen without judgment. Your empathy and support can make a world of difference.
Madhavi Adimulam: How can someone seek help, Dr. Nithya? What’s the first step?
Dr. Nithya: The first step is to reach out to a mental health professional—a psychologist or psychiatrist. Share your struggles openly and honestly. They can then assess your needs and determine the most appropriate course of treatment.
Madhavi Adimulam: It's encouraging to see that the younger generation is more open to seeking help for mental health challenges. We need to normalize these conversations and remove the stigma surrounding mental health care.
Dr. Nithya: I agree. It's essential to prioritize our mental well-being.
Madhavi Adimulam: Now, before we wrap up, I’d like to touch upon a complex aspect of autism: comorbidity.
9. Comorbidities in Autism
Madhavi Adimulam: Autism often doesn't exist in isolation. We frequently see other conditions like ADHD, anxiety, and sensory processing issues occurring alongside autism. This is known as comorbidity. Can you talk about why comorbidity is so common in autism and how it can impact a child's development and overall well-being?
Dr. Nithya: Yes, comorbidity is extremely common in autism. It’s not unusual to see two or three co-occurring conditions in a child. It could be ADHD, learning disabilities, or other developmental delays.
Madhavi Adimulam: Why is this overlap so common, Dr. Nithya?
Dr. Nithya: These conditions often share common underlying factors related to brain development. For instance, difficulties with executive functioning, sensory processing, and emotional regulation can contribute to both autism and ADHD.
We also commonly see children with autism struggling with sleep disturbances, gastrointestinal issues, and even seizures. These co-occurring medical conditions can further impact their development and quality of life.
It’s essential for parents to be aware of these potential comorbidities and to ensure their child receives regular medical check-ups, even if the child seems to be doing well in therapy. Because children with autism often have difficulty communicating their needs, underlying medical issues can sometimes go unnoticed.
Mental health conditions, like anxiety, depression, and OCD, can also coexist with autism. It's important to recognize that the symptoms of these conditions can overlap, making diagnosis and treatment more complex.
Madhavi Adimulam: That complexity highlights the need for a comprehensive and individualized approach to care, doesn’t it?
Dr. Nithya: Absolutely!
Madhavi Adimulam: When a child is diagnosed with both autism and another condition, how do you approach the diagnostic process, and how do you create a treatment plan that addresses all of the child’s needs?
10. A Holistic Approach to Diagnosis and Treatment
Dr. Nithya: It's crucial to adopt a holistic approach, considering all aspects of the child’s life and development. During the evaluation, we look at their developmental history, their current skills and challenges, their family dynamics, their emotional well-being, and their experiences in school and other settings. We then create a diagnostic formulation based on established criteria, such as the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), taking into account both the autism diagnosis and any co-occurring conditions. It's essential to address each condition individually, tailoring the treatment plan to the child's specific needs.
Madhavi Adimulam: That makes a lot of sense, Dr. Nithya. It's about taking a holistic approach and looking at the child as a whole person. At Ananya CDC, we offer a range of therapies, including speech therapy, occupational therapy, and behavior therapy.
11. Therapies for Autism and Comorbid Conditions
Madhavi Adimulam: At Ananya CDC, we offer a range of therapies, including speech therapy, occupational therapy, and behavior therapy. How can these therapies be particularly beneficial for children with autism who are also dealing with other conditions like ADHD or anxiety?
Dr. Nithya: We know that therapy is often the most effective treatment for these children, unless there are specific medical conditions that require medication, such as severe anxiety, self-injurious behaviors, or other health issues.
Here's a breakdown of how each therapy can help:
- Behavior Therapy: Behavior therapy, often using ABA-based approaches, can be highly effective. It helps children develop social communication skills, manage repetitive or rigid behaviors, and reduce challenging behaviors like temper tantrums or aggression, which can be particularly helpful for children with comorbid ADHD.
- Occupational Therapy: Occupational therapy addresses sensory processing challenges, which are common in children with autism. It helps them manage sensory sensitivities and develop skills for daily living, promoting independence and overall improvement in their quality of life.
- Speech and Language Therapy: This therapy targets speech delays and language issues, supporting children in developing their communication skills.
It's truly an integrated approach. All three therapies, combined and coordinated, can have a profound impact on a child's development.
Madhavi Adimulam: We've talked about the complexities of comorbidity, Dr. Nithya, but amidst those challenges, there’s always hope.
12. Hope and Potential in Children with Autism
Madhavi Adimulam: What gives you hope as you work with children with autism who are also facing other challenges? What have you seen in your practice that inspires you and reminds you of their incredible potential?
Dr. Nithya: In my experience, both professionally and personally, I’ve learned that every child, whether they have special needs or are neurotypical, is unique and has their own strengths and abilities. Some children might be easier to work with than others, but they all have immense potential. It’s about our perspective—how we view these children.
Do we see them as a “problem” to be fixed, or do we see their potential to shine if given the right support? When we, as parents, therapists, and educators, approach them with acceptance, understanding, and a belief in their abilities, we create an environment where they can truly thrive.
13. Conclusion and Resources
Madhavi Adimulam: Dr. Nithya, thank you so much for sharing your insights and your passion for supporting children with autism and their families.
Dr. Nithya: Thank you for this opportunity. I wish you and all your families the very best.
Madhavi Adimulam: For our listeners in Hyderabad who are looking for expert guidance from a child and adolescent psychiatrist specializing in autism, we highly recommend Dr. Nithya.
And if you're seeking support for your child's development, including speech therapy, occupational therapy, or help with autism, ADHD, and other challenges, please reach out to Ananya Child Development Center. We have multiple locations across Hyderabad, including Gachibowli and Banjara Hills, and our dedicated team is here to provide personalized care for every child. You can find us online at www.asap.org.in or call us at 98485 13192.
📍 Thank you for joining us today! We'll be back soon with more expert discussions to help families navigate the world of child development. Until then, keep learning, keep supporting, and keep celebrating your child’s unique journey.
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