Autistic Spectrum

Disorder (ASD)

Dr. Shivani Sharma Pandey

Agenda

01 Introduction

02 Challenges

03 Oral Health Problems in Autism

04 What needs to be done?

Dr. Shivani Sharma Pandey 2

Introduction
Autistic Spectrum Disorder or ASD refers to a Owing to the impaired social behaviour, autistic
range of conditions characterised by challenges children often appear insensitive, uncaring and
with social skills, repetitive behaviour, speech self absorbed
and non-verbal communication caused by a
combination of environmental and genetic
influences

Devoting a lot of time and energy at the cost of It is important to understand that the in-
social life, career, personal relationship and difference, apparent lack of affection and non
financial conditions can lead to a sense of loss compliance of instructions is not deliberate and
grief for parents and care givers wilful

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Challenges
 Lack of qualified and well trained
therapists and teachers
 Reluctance by schools to integrate
autistic children in the mainstream. They
fill up special needs quota with kids
having physical disability
 If given an admission, often autistic kids
are put in separate classes, specially
those with verbal issues
 Parents are often forced to admit their
kids in special needs schools, which
deprives them of the company of normal
kids who can be their role models,
someone to emulate
 Insensitive approach of unskilled
therapists
 Educational assistants/shadow teachers
are appointed to take care of the
students in the class who are mostly not
trained
Dr. Shivani Sharma Pandey
 The teacher has to focus on other students
in the class and feels that it is the
shadow’s responsibility, hence many times
there is no clarity about who is answerable
for the child’s progress, consequently the
child keeps lagging behind in academics
and other aspects
 Lack of acceptance by other children.
People need to understand that the
behaviour is not deliberate or wilful
 They find it very difficult to put themselves
in another person’s position, to appreciate
that person’s perceptions, feelings and
understanding. As a result their feelings
are not tempered by the usual social
understanding and norms
 Owing to the impaired social behaviour,
autistic children often appear
insensitive, uncaring and self absorbed
 Parents of kids with ASD are denied
permanent residence in many countries
 Insurance agencies do not give health
insurance for autistic children
 For the parent or the care giver,
devoting a huge amount of time and
energy to support the child can often be
at the cost of their own social life,
career, personal relationships and
financial situations, which can lead to a
sense of loss and grief
 The child’s autism impacts daily
routine, interfamilial dynamics and the
relationships of the whole family with
surrounding networks of kin,
neighbourhood and community
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Oral Health Problems in Autism
 Damaging Oral habits – Bruxism, Tongue thrusting, Masochistic habits like picking at the gums and lip
biting (Advised to use mouth guards, if it can be tolerated)

 Dental Caries - Oral hygiene might often be compromised as there is impaired compliance to instructions
and lack of understanding (Advised preventive measures, increased water intake, offer alternatives to
cariogenic foods and beverages, caution about drugs that decrease salivary flow)

 Periodontal Diseases - Advised proper Oral Prophylaxis

 Tooth Eruption – It might often be delayed, drugs like phenytoin that are often recommended can cause
gingival hyperplasia

 Trauma and Injury – To the mouth from falls require immediate attention (Advice to care givers to learn
the procedure to be followed if a permanent tooth is knocked out, locate any missing portions of teeth and
get chest X-Ray done to rule out aspiration of broken tooth fragments)

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 What needs to be done?
Building of Support System – Active associations of parents and care givers

Focus on the child – To fit better in the chaotic world

WE CAN DO IT

Augmentative Communication – Supplementing spoken language with gestures or visual symbols to

communicate the meaning. E.g. PECS Picture Exchange Communication System, visual time tables

Social Stories – Tailoring social stories to make a child more aware of the feelings and intentions of others

Skilled Workforce – Skilled Teachers and therapists to be appointed in schools

Designing IEPs for students – Consider their individual strengths and area to be worked on

Financial Policies - Government to frame policies for the support and healthcare insurance of autistic children

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