Autism Spectrum Disorders

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition that affects a child’s ability to communicate, socialize, and process sensory information. It presents with a wide range of symptoms and severity—from mild to profound—making it a "spectrum" disorder. While ASD is often diagnosed through behavioral observation, increasing research reveals links to brain development, structural anomalies, and neurological dysfunctions, especially in cases with severe regression, seizures, or motor delays. In Bangladesh, awareness and understanding of autism are growing, yet many children go undiagnosed or receive inadequate early interventions. Dr. Md. Nafaur Rahman, one of the country’s leading pediatric neurosurgeons, emphasizes the importance of early neurological evaluation and neuroimaging, especially when autism coexists with epilepsy, developmental delay, cerebral malformations, or hydrocephalus. 🌍 Autism in Bangladesh – Current Landscape Bangladesh has witnessed a rapid rise in autism diagnoses in recent years. However: 🎓 Early signs are often missed or misunderstood, especially in rural areas 🏫 Limited access to special education and therapy centers outside major cities 🧠 Few clinicians assess for neurological or structural causes in children with ASD 🧪 Coexisting conditions like seizures, sensory dysfunction, or developmental delay are under-treated ❌ Parents often rely solely on behavioral therapy, missing the role of pediatric neurology or neurosurgery 🔍 Signs and Symptoms of ASD 🗣️ Delayed or absent speech 🚫 Poor eye contact and lack of social engagement 🔁 Repetitive behaviors (hand flapping, lining up toys) ❌ Difficulty understanding social cues or emotions 🧃 Strong reactions to sound, light, textures (sensory dysfunction) 🧠 Regression in milestones after normal development 💤 Sleep problems and feeding challenges ⚡ Seizures or abnormal head size in syndromic cases “Autism is not just a behavioral condition—it can be a reflection of deeper neurological architecture that must be understood for better outcomes.” — Dr. Md. Nafaur Rahman 🧪 When to Refer to a Pediatric Neurosurgeon? Parents and pediatricians should consider neurosurgical consultation in ASD if: 🧠 Child has macrocephaly or microcephaly ⚡ Associated epilepsy, infantile spasms, or abnormal EEG 🔁 Child has developmental regression or sudden motor issues 📉 Failure to respond to intensive behavioral therapy 🔍 MRI shows Chiari malformation, hydrocephalus, or cortical dysplasia ❌ Suspected tethered cord, spinal lipoma, or sensory neuropathy 🧠 Common Neurological Associations with ASD Cortical Dysplasia / Brain Malformations Abnormal brain development may impact social and language centers Hydrocephalus Pressure-related brain dysfunction affecting communication and sensory processing Chiari Malformation / Syringomyelia Can cause motor delay, poor coordination, and sensory overload Tethered Cord Syndrome Causes toe-walking, sensory dysfunction, and behavioral distress Seizure Disorders / Infantile Spasms Common in regressive autism or syndromic ASD Genetic Syndromes (e.g., Tuberous Sclerosis, Fragile X) Often include autism with structural or metabolic brain involvement 🛠️ Multidisciplinary Management of ASD 1. 🔬 Diagnostic Assessment 🧠 MRI Brain and Spine – To detect structural abnormalities ⚡ EEG/Video EEG – To evaluate for epilepsy 🧪 Genetic and metabolic tests in syndromic presentations 🧾 Developmental profiling and sensory evaluation 📋 Autism diagnostic tools (e.g., ADOS-2, CARS, M-CHAT-R/F) 2. 🧒 Therapeutic Approaches Applied Behavior Analysis (ABA) Speech and Language Therapy Occupational Therapy for sensory integration Special Education and parental training Medication for aggression, sleep, or seizures (if indicated) 3. 🧠 Neurosurgical Interventions (in select cases) VP Shunt or ETV for symptomatic hydrocephalus Chiari decompression for associated malformation Spinal untethering for neurogenic bladder, sensory/motor issues Management of associated epilepsy (e.g., focal resection or neuromodulation) 🔁 Importance of Early Neurosurgical Involvement Neurosurgical consultation is not a last resort, but a valuable step in early diagnosis, especially when: Brain imaging reveals anatomical causes of delay There is severe motor, language, or sensory regression Child suffers from autism with epilepsy or spasticity Non-surgical neurological causes have been ruled out 👨‍⚕️ Why Trust Dr. Md. Nafaur Rahman for Autism Evaluation? 🧠 Over a decade of experience in neurosurgical disorders linked with developmental delay 🏥 Works at National Institute of Neurosciences & Hospital (NINS) 🧒 Provides coordinated care through Bangladesh Paediatric Neurocare Centre 🧬 Involved in early detection, imaging, and multidisciplinary referral 🧘 Focused on child-friendly, empathetic consultations ✅ Integrates surgical and non-surgical care in complex neurological autism cases 📞 Get Expert Guidance for Your Child’s Development Dr. Md. Nafaur Rahman Assistant Professor, Pediatric Neurosurgery, NINS Chief Consultant, Bangladesh Paediatric Neurocare Centre 📱 For Serial/Appointments: 📞 01912988182 | 📞 01607033535 🌐 Visit: www.neurosurgeonnafaur.com