Medically Reviewed By Sonam Kothari, Written By Tejasvi Parekh
A complicated neurodevelopmental disorder known as autism spectrum disorder (ASD) impacts a person's behaviour, social interaction, and communication, among other areas of development.
Standardised diagnostic instruments and scales are commonly used to diagnose autism—these aid in determining the degree of symptoms and helping to design effective therapies.
The varied and distinct socio-cultural setting of India made the necessity for a culturally appropriate and standardised method for autism evaluation more and more evident.
As a result, the Indian Scale for Assessment of Autism (ISAA) was created, with the express purpose of meeting these objectives and offering a trustworthy way to identify and gauge the severity of autism in the Indian community.
This article elaborates more on autism and its symptoms, Introduces the ISAA test, its reliability and validity, Issues in the test and future Recommendations
A complicated neurodevelopmental disorder known as autism spectrum disorder (ASD) usually manifests in early childhood and lasts the entirety of a person's life.
It is typified by a wide spectrum of symptoms that mainly disrupt behaviour, social interaction, and communication and can vary greatly in severity. A fundamental feature of autism is difficulty communicating and interacting with others.
Autism spectrum disorders frequently cause difficulties for people with mutual social relationships, making it difficult for them to recognise and react to social cues such as tone of voice, body language, and facial expressions.
This may make it more challenging to establish and sustain connections. Nonverbal communication can also be challenging; people may avoid making eye contact, make few movements, and find it difficult to read other people's nonverbal clues.
Certain people may not acquire spoken language, have a restricted vocabulary, or use language in strange ways, including speaking monotonically or repeating words (echolalia).
Other people may experience delayed language development. It can be difficult for even highly proficient language users to comprehend and use language in social situations.
Autism is characterised by restricted interests and repetitive behaviours in addition to social and communication difficulties. Stereotypical motions like hand flapping, rocking, or spinning can be used by people with autism to help them cope with stress or sensory input.
Many often follow rigid routines and get upset if they are disturbed, showing a need for consistency and predictability in day-to-day activities as well as other areas of life.
People frequently have intense, narrowly concentrated interests in particular subjects or pastimes, devoting a considerable amount of time to learning about or pursuing these pursuits, sometimes to the detriment of other pursuits.
Unusual reactions to sensory stimuli are another common symptom of sensory sensitivity. For instance, some sounds may be too much to handle, or one could want to feel a certain way, like touching a certain texture.
A wide range of cognitive disabilities can be found in people with autism. Some may have intellectual disabilities, while others may be average or above average in intelligence.
A small percentage of people with autism show savant abilities, which are exceptional skills in areas like math, music, or art. Many people with autism struggle with executive functioning, which includes organising, planning, and flexible thinking. They may also have attention issues. Emotional regulation can be problematic
The National Institute for Mentally Handicapped (NIMH) created the Indian Scale for Assessment of Autism (ISAA) in 2009. Because of language and cultural differences, it was discovered that current Western diagnostic tools were less successful when used in the Indian setting. The main objective of ISAA was to develop a tool that would be both practical and culturally suitable.
The ISAA is a forty item scale broken down into six domains: emotions, speech, language, and communication; behaviour patterns; social relationships and reciprocity; sensory characteristics; and cognitive components.
The Autism Spectrum Assessment (ISAA) is a scoring tool that measures the severity of autistic symptoms and impairments. It categorizes autism into no autism (score <70), mild autism (70-106), moderate autism (107-153), and severe autism (>153).
The scale is user-friendly and takes 15-20 minutes to administer. Despite some issues with emotional responsiveness, ISAA has proven reliable for evaluating autism. It has improved therapy targeting and helped people with autism in India.
The Indian Scale for Assessment of Autism (ISAA) is a valuable tool for diagnosing and measuring autism severity, but it has several drawbacks. Its effectiveness in young children, particularly those under nine years, is limited.
The scale's sensitivity and specificity are good for adults and older children, but it cannot accurately reflect how autism symptoms change over time in younger children due to developmental variability.
Additionally, ISAA faces challenges in distinguishing between concomitant neurodevelopmental diseases like ADHD and Intellectual Developmental Disorder (IDD), which may result in inaccurate or false positive results.
Furthermore, ISAA scores may underestimate the severity of autism in situations where core autistic symptoms persist despite improvements in expressive language. Some items, particularly those dealing with emotional reactivity, are difficult to score, affecting the assessment's overall validity and reliability.
The International Autism Spectrum Disorder (ISAA) is a diagnostic tool that can be improved to better represent early developmental signs of autism in young children. This can be achieved by adding new items or changing existing ones, including observations and developmental benchmarks unique to lower age groups.
Aligning ISAA with other diagnostic instruments like CARS can resolve issues with specificity and agreement. Moreover, comorbidity management can be improved by integrating techniques to account for overlapping symptoms and differentiate between autism and other neurodevelopmental concerns.
Revision of scoring guidelines for difficult items, such as emotional responsiveness, can improve dependability by improving descriptions and examples, and providing clinicians with regular training on scoring them.
Including longitudinal data to monitor changes in autistic symptoms over time can also enhance ISAA's efficacy. These improvements ensure that ISAA continues to provide insightful information for the diagnosis and treatment of autism in the Indian setting.
