Saritha

Saritha is a 14 year-old girl with autism and severe mental retardation. She is a student in the Pre-Primary class at Asadeepam. Saritha is unable to speak, however her understanding is quite good. Saritha is one of four girls living at Asadeepam, where there are approximately 50 students. It is not surprising that only 1/10 of the students are female, since both autism and mental retardation are more prevalent in males. Autism is 3 to 4 times more common in males, and the ratio of males to females with mental retardation is approximately 2:1. This ratio changes to 1.5:1 when we look only at severe cases, therefore females are overrepresented in the lower ranges of intellectual disabilities. Girls are less likely to be affected by autism, however if they are affected then their intellectual impairments tend to be more severe. If a true male excess exists for these disorders, then it is possible that the cause can be an X-linked genetic disorder, but more research is needed.

According to her family, Saritha appeared to be developing typically until the age when she received several vaccinations. After this, she began to withdraw and develop autistic symptoms. There have been individuals who have attributed the cause of autism to vaccines, however this progression of autism is actually fairly common, even in children who do not receive vaccines. Some children will begin to develop early milestones, and these skills will disappear before age 2. This coincides with the period in which children are typically vaccinated, so some individuals have drawn an illusory correlation between these two independent events.

Like many children at Asadeepam, Saritha comes from a very poor family. Her mother was a single-parent who needed to provide for the family, so during the day she would often lock Saritha alone in a room while she left for work. Whenever possible, Saritha's grandmother would watch her during the day, however she was very ill. This upbringing has definitely had negative effects on Saritha's socialisation and communication skills.

Saritha needs help for eating and toileting, and the staff are working to help her develop skills that will help her become less dependent. Saritha will often collect dust and waste and brush it with her hands into little piles on the floor. This may be a habit that was formed while she was locked alone in a room, and the teachers have worked to decrease this behaviour.

Saritha is learning vocational skills such as colouring, using scissors and glue. She is also learning to write some letters in Malayalam and to identify her written name. It is difficult for me to work with Saritha because children with autism have difficulty understanding non-verbal cues such as gestures, and this is my primary method of communication at Asadeepam since I do not speak Malayalam. When working with Saritha, I must physically guide her hands to show her the task that I would like her to complete.

The one action that Saritha can mimic is a smile. She will always respond with a smile when I call her name or if I first smile at her. She will also maintain eye-contact, which is unusual for children with autism. Children with autism show a difficulty in recognising emotion and relating to others, so perhaps Saritha does not smile because she is happy or recognises that I am happy, but because she has simply learned that by mimicking this action she will be met with positivity.

Unfortunately, Asadeepam does not have the resources to provide adequate care for Saritha and other students with autism. In order to see significant improvement in her language, academic and social skills, Saritha would need about 40 hours a week of individual attention from a trained teacher. Also, the best interventions for autism begin at a very early age and as the child matures it becomes more difficult to teach skills and habits. Looking at Saritha's past assessments, we can see that she is making progress in her personal, social, academic and vocational skills, however the development is slow and minimal.