Once a child is diagnosed with autism, intervention becomes the next — and perhaps the most vital — step. Interventions are tailored strategies and therapies that help children improve their communication, behaviour, motor skills, learning abilities, and daily functioning.
Published Apr 02, 2025 | 2:00 PM ⚊ Updated Apr 02, 2025 | 2:00 PM
Autism and education concept. (iStock)
Synopsis: The earlier autism is identified, the sooner a child can start receiving the support they need. In the first few years of life, the brain is in a rapid phase of growth — it’s more flexible, more responsive, and more open to learning. This period is often referred to as the “critical window” for intervention.
As parents, we’re constantly observing our children — celebrating their first words, watching how they play, and noticing how they respond to the world around them. However, sometimes, certain behaviours or developmental delays can raise questions that are difficult to answer right away.
Autism, or Autism Spectrum Disorder (ASD), is one such condition that often begins to show signs in early childhood. It affects how a child communicates, interacts socially, learns, and behaves. The term “spectrum” is key — because autism looks different in every child. Some may struggle with speech or prefer to play alone, while others may have repetitive behaviours or be highly sensitive to sounds or touch.
What’s important to understand is this: Autism is not caused by bad parenting, vaccines, or anything a parent has or hasn’t done. It’s not an illness or something that needs to be “fixed.” It’s a neurological difference in how a child’s brain processes information. With understanding, support, and the right interventions, children with autism can lead full and meaningful lives.
Knowing this helps lift the burden of guilt or confusion that many parents feel when they first hear the word “autism”.
While global awareness of autism is growing, India is still catching up when it comes to recognition and diagnosis. According to estimates by the Indian Council of Medical Research (ICMR) and other studies, about one in 100 children in India is on the autism spectrum.
That translates to roughly two million children across the country.
However, the actual number may be higher, as many cases go undiagnosed due to limited awareness, stigma or lack of access to trained professionals — especially in rural areas.
Screening is the first step in identifying whether a child may be showing signs of autism. It doesn’t confirm a diagnosis but helps flag potential developmental concerns that may need a closer look. In most cases, autism screening begins during routine paediatric visits, typically when a child is between 18 to 24 months old.
During these visits, doctors may use standard questionnaires or checklists to observe how the child communicates, makes eye contact, responds to their name, games or uses gestures.
One commonly used tool is the Modified Checklist for Autism in Toddlers – Revised (M-CHAT-R), which helps assess early behavioural indicators in children under the age of three. If the responses raise concerns, the child is usually referred to a specialist — such as a developmental paediatrician or child psychologist — for a more detailed evaluation.
This process may sound formal, but it’s essentially about observing behaviours and developmental milestones that every child passes through in early life.
The goal is to catch any delays or atypical patterns before they widen into challenges that are harder to address later.
Today, many paediatric clinics are adopting digital tools that make the process faster and more accurate. Parents might be asked to complete app-based assessments, where short video clips or interactive exercises help assess a child’s attention, reactions, and engagement. These digital methods are especially useful in settings with limited access to trained specialists, and they allow for quicker referrals when needed.
In some parts of the world, researchers are even using artificial intelligence to analyse videos of a child’s natural behaviour — like how they play or react to a parent’s voice. These AI models can detect subtle patterns that may go unnoticed in a regular consultation.
In parallel, studies are exploring the use of biomarkers, such as brain imaging or eye-tracking, to help detect autism at an even earlier stage — these are still being tested and aren’t widely available yet.
What’s encouraging is that screening is becoming more accessible and accurate, helping parents get answers sooner rather than later.
The earlier autism is identified, the sooner a child can start receiving the support they need. In the first few years of life, the brain is in a rapid phase of growth — it’s more flexible, more responsive, and more open to learning. This period is often referred to as the “critical window” for intervention.
Early diagnosis allows for early intervention, and this can be truly life-changing. Whether it’s through speech therapy, occupational therapy, behaviour therapy, or parent-led programmes, early support can help children improve communication skills, reduce behavioural challenges and build stronger social connections.
It doesn’t mean the child will stop being autistic, but it can help them navigate the world with greater confidence and independence.
According to the Centres for Disease Control and Prevention’s (CDC) ‘Learn the Signs. Act Early.’ programme, children who receive developmental support services before the age of three are more likely to achieve better outcomes in school readiness, communication and everyday functioning. These gains aren’t just academic — they impact how a child relates to the world and how much they can participate in it with joy and confidence.
It also makes a difference for parents. Knowing what’s happening gives families a sense of clarity. It connects them to resources, therapists and support groups. It reduces the guesswork and anxiety and replaces it with an action plan — one that is focused on nurturing the child’s potential, not just managing their challenges.
Once a child is diagnosed with autism, intervention becomes the next — and perhaps the most vital — step. Interventions are tailored strategies and therapies that help children improve their communication, behaviour, motor skills, learning abilities, and daily functioning.
Over the years, these approaches have moved beyond a one-size-fits-all model. Today, they are more individualised, evidence-based, and family-inclusive than ever before.
Among the most widely used and effective approaches is Applied Behaviour Analysis (ABA), which uses positive reinforcement to encourage desired behaviours and reduce those that may be harmful or disruptive. While traditional ABA was often seen as rigid, newer versions have become more play-based, flexible, and personalised to each child’s unique strengths and interests.
Early Start Denver Model (ESDM) is another powerful intervention that blends ABA principles with play and relationship-building, designed specifically for toddlers between 12 to 48 months.
Studies have shown that children who received ESDM showed greater improvements in IQ, adaptive behaviour and autism diagnosis scores than those who received standard community care. One randomised trial published in Paediatrics found that children receiving ESDM therapy showed an average IQ gain of 17.6 points over two years.
In India, access to structured interventions is growing, with more therapy centres now offering multidisciplinary programmes — a combination of speech therapy, occupational therapy, sensory integration therapy and parent training modules. Telehealth-based interventions have also become increasingly common, especially post-Covid, allowing families in tier-2 and tier-3 cities to consult with specialists remotely.
A growing trend is Naturalistic Developmental Behavioural Interventions (NDBIs). These are play-based and child-led strategies that integrate teaching moments into everyday routines. NDBIs have been shown to be highly effective in enhancing social communication and cognitive skills, particularly when started early and supported consistently by caregivers.
As families navigate the early stages of a child’s development, one of the most influential allies in their journey is often the paediatrician. They are usually the first professionals to track a child’s growth, behaviour, and developmental milestones — and often the first to notice when something may not be progressing as expected.
In the case of autism or other developmental delays like Global Developmental Delay (GDD), timely identification and action are essential. However, equally important is addressing the preventable causes early on, including proper perinatal care, prenatal testing for genetic disorders, ensuring maternal and infant health, preventing infections, and avoiding nutritional deficiencies in children.
A child’s developmental journey is shaped not only by genetics, but also by the quality of care, safety, and learning opportunities they receive in their early years.
Paediatricians play a central role in this ecosystem. From recognising early signs of delay to establishing a diagnosis, managing comorbidities, and coordinating with speech therapists, psychologists, and special educators — they serve as the connecting thread between families and a multidisciplinary care team.
Their ability to guide prognosis and support parents through each step makes a measurable difference in both medical outcomes and long-term social functioning.
In short, while awareness and intervention are critical, having the right paediatrician — one who listens, observes, guides, and collaborates — is often where progress truly begins.
(The author is a paediatric neurosurgeon at Apollo Hospitals in Jubilee Hills, Hyderabad. Views expressed here are personal.)
