Understanding Autism in Children
A 2022 autism study on children in Bangladesh, found that Autism Spectrum Disorder (ASD) prevalence was 17 per 10,000 young children – in other words, one in 589 young children. Boys were found at higher risk of autism (one in 423 boys; one in 1026 girls). In addition, the prevalence of ASD was higher in urban environments than in rural ones – 25/10,000 and 14/10,000, respectively.
Despite the circumstances, children with autism are seldom given any grace for a condition that’s beyond their control. Fortunately, increasing media coverage has enabled continuity of awareness and advocacy interventions. Reminding us that maybe all is not lost. In a conversation with health and education experts, we unpack what it truly means to be “autism-inclusive” across families, institutions and society.
Medical Landscape: Knowledge, Attitude and Practice
Dr Helal, Professor, Child, Adolescent & Family Psychiatry, Faridpur Medical College, says that the benchmark for “normal” or “neurotypical” behaviour is based on whether or not all children function in the same way or share the same pragmatism, within culturally expected ranges.
He says, “there are cultural variations in the autism spectrum. What we recognise as ‘neurotypical’ can be identified as ‘neurodivergent’ in Western countries. Cultural variation refers to the ways different societies interpret, recognise, and respond to traits of autism, influencing diagnosis rates, symptom expression,” he explains. Given the dearth of skilled professionals and country-specific research, our mental health framework leans on Western practices. However, training programs conducted in recent years have led them to identify and diagnose autism, vetted by IPNA, NIMH and NINS.
Watch for signs such as difficulty with communication, limited eye contact, challenges with social interaction, and a preference for routines or repetitive behaviours.
Who’s at risk? Factors may include being born underweight, preterm, or after a delayed birth, having a family history of autism, birth injuries, or nutritional deficiencies during pregnancy. Additional risks include maternal exposure to lead pollution, infections like measles, mumps, or rubella during pregnancy, and advanced parental age. However, these factors do not determine a specific cause, and many individuals with these backgrounds do not develop autism.
Dr Helal shares that social discrimination often influences many parents to hide their children, or even avoid getting treatment for autism. “Prolonged denial of autism eventually leads to delayed acceptance and intervention. By then, the condition becomes more complex. Especially, when these children reach adolescence and need to navigate puberty and sexual health.”
The expert believes that autism management must be tailored in a holistic way, which includes personalised education, sensory communication, behaviour therapy, and a solid support system.
“Teachers must be sensitised to accept variation in students. They must learn how to keep these children calm so that they don’t distract their peers in class. Additionally, parents of neurotypical children need to be accommodating of kids with ASD and understand that they deserve to belong here just as much as the others.”
Dr Helal further stresses that words and phrases surrounding autism must bear pragmatic meanings which are accepting of children’s cognitive differences. When adults accept differences, children and adolescents tend to follow. He reminds us that, “if we can accept our friends despite various differences, we should at least be able to create an environment where a person with ASD can exist at their own pace, without being reminded of what they lack.”
Tailored for Diversity: The Learning Curve
Rejecting the myth of the “normal child,” Insiyah Zohair, Head of Frobel Playschool Dhaka (FPSD) stresses that the education system needs empowerment as opposed to compliance to help neurodivergent individuals navigate mainstream society. FPSD welcomes all types of children with open arms, teaching them skills in leadership, resilience and empathy.
Addressing Special Needs Education (SEN), Insiyah says “we understand that every child learns differently. So, we allow them to touch, move, build and explore. For children with ASD, we rely on visual support, choice words and social stories to help regulate their behaviours, support their learning and establish a routine. This helps reduce their anxiety and gives children autonomy,” she explains.
For the education sector, a few priorities remain non-negotiable: establishing a dedicated SEN department, ensuring all teachers undergo mandatory training, and designing special-needs–centred lesson plans with realistic, achievable goals. Equally vital is the integration of multi-sensory learning approaches and visual schedules to support a wider range of learning needs.
FPSD is cognisant of the different sensory needs of every child. Thus, all forms of communication are valid. Teachers are trained to view sensory behaviours — clapping, pacing, hand-flapping — not as misbehaviour, but as communication and self-regulation. This approach celebrates and accepts diversity, emphasising that teaching and learning does not require stringent rules.
Among other strategies include, sensitisation sessions which demonstrate the uniqueness of each child based on their height, hair and finger print. “Our children understand diversity and have created appropriate rules for themselves for peer-interactions in collaborative ways,” shares Insiyah.
Insiyah observes that children usually don’t hold prejudice against their peers who are atypical. It is the adult interpretation that gives a different meaning. As a result, sensitising parents of diverse children is of utmost priority at FPSD. “My job is to provide parents with the right information that gives them clarity, to make informed choices.
Reassuring them that their child will flourish at their own pace. We recommend parents to focus on symptoms and progress; we also connect them to our team of experts specialised in SEN.” Insiyah leaves behind the wisdom that, “children with autism are not less. They just need empathy and the right support system to thrive.”
Where to Go: State-Approved Diagnoses & Treatment
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- Bangladesh Medical University
- Institute For Paediatric Neurodisorder And Autism (IPNA)
- National Institute of Mental Health and Hospital (NIMH), Child Adolescent and
- Family Psychiatry Department
- Combined Medical Hospital (CMH)
- National Institute of Neuro Sciences & Hospital (NINS)
- Bangladesh Shishu Hospital & Institute
- Medical Colleges (Department of Psychiatry, Department of paediatrics)