1.                   To Start with, What Ayurveda Offers to A Parent with A Child Recently Diagnosed Autistic?

To complete the management circle of autism at 360, two important aspects are to be stressed up on.

·                     Styling the family:

This is the prime step to start with. The prime focus is to tame the family hours in such a way that, the activities of daily living in family is customized to make it maximally beneficial for the child in his growing years.

·                     To compose a biological harmony:

Mistuned physical and physiological settings in body presented either as a co morbid condition or as a cause itself, is usually observed in autistic babies. These include altered metabolism, dysbiosis, allergies, MILD TO Moderate Organogenetic Problems. This is the only space where a medical stream has action that too along with assisted therapies like behavioral therapy, speech therapy, and language therapy etc, very well customized as per the degree of organic involvement. Since the medical side of ayurveda offers better prospectus for such presentations, we can promise far better results in such a spectrum of presentations.

2.                   So It’s Time to Decode the Ayurvedic Language of Autism?

So, I will have to start from history, because ayurvedic understanding of autism parallels the evolution of the so called modern culture. Unfortunately, the wake of industrialization and globalization that followed, had imposed a hegemony up on the culture persisted then and there in the world, which resulted in a receptive change round the globe, creating a new world order. As demanded by this cultural hegemony, the new world order is being set in a way such that, human development is defined in terms of the degree of detachment from nature. More human is detached, more he is cultured as per the new definition attributed. A step ahead, it would be complete if I say that, even the developmental indices like per capita income, health indices etc, were built over this new world order as a tool to mark the development of nation. And thus a highly developed nation means a greatly detached culture in general. If this particular understanding of history is read together with the statistics denoting the increased incidence of autism in developed countries, the root cause of such a developmental disorder will be crystal clear.

The following are few among such:

·                     Industrial revolution has contributed maximally to atmospheric pollution. It won’t be that surprising if I coin that, it is industrialization that gave birth to the real head ache – pollution. The resultant toxin accumulation in human body or the exposure to VISHA is one among the prime cause.

·                     Of course a paradigm shift in traditional culture has generated a strong Aatma Karma Dosha (disturbed transmission of collective consciousness) resulting in a situation such that human body is prone to number of serious assaults resulting from loss of equilibrium with nature.

·                     In an expedition to cope up with such a change, world has witnessed a revolutionary change in life style. Food and related practices have evolved much in a way that does not match our body metabolism. This altered metabolism or Agni derangement at different level in the body is yet another important cause.

·                     The day hours are packed with enough work loads. The rhythm of activities in life like food, sleep, exercise is thus hampered and this has affected the basic rhythm of body. While synchronization of body rhythm with rhythm of nature is perfect health, the converse is disease. Such an absolute mismatch is of course a question to human internal environment which has been set to move with nature.ie. Prajnaparadha.

3.                   What Is the Golden Goal That Every Parent Should Keep in Mind While Managing a Child with Autism?

The golden goal is so simple to quote; it is to tune family and the child such that the child experiences harmonious living with the family and thereby in and out the society.

Hope you can get, why I used “it is simple to quote”, - owing to the practical difficulty

Following may be used as marker for this:

·                     By 11 years of age, if the special child is able to go to normal schools (in children who are diagnosed at 3 years of age and well supported with assisted therapies like speech therapy, behavioral therapy etc.)

·                     Hopefully, by the age of 25, if he is potent enough to turn to a socially economically, culturally and professionally, autonomous citizen.

4.                   Autism Spectrum Disorder Is So Wide So That Sufferers Range from Skilled High Functioning Children to Patients with Number of Co- Morbidities. Can Ayurveda Touch the Ends in Such Cases?

Yes, you are right. Autism spectrum disorder as the name itself indicates is a spectrum of diseases ranging from high functioning individuals to children childhood disintegrative disorder. But assessing autism with such a scale is not the method of ayurveda. Ayurveda sets another graduation to describe and analyze different co morbidities related to autism.

Ayurvedic view is little more composite. The pathology of grahani, vata paithika unmada and dooshi visha can be collectively diagnosed rather than a single one. At times, sira snayu gata vata, mamasa gata vata are also diagnosed as per the condition.

5.                   You Spoke Much About Agni, Aahara Etc. Why No References About Dosha Dooshya – The Soul Part of Ayurvedic Diagnosis?

As I told earlier, the prime focus is nothing but agni.

The presentation is typically related to kapha or pitta aavrtha vata in general.

The primary dhathu involved is rasa and raktha dhathu and srothases involved are anna vaha srothas, rasa vaha srothas, pureesha and moothra vaha srothas in usual clinical practices.

And about diagnosis, I have mentioned earlier, about grahani, vata paithika unmada and dooshi visha, sira snayu gata vata.

So the treatment can head with rakta prasadaka dravyas, visha hara dravyas, agnikara dravyas and aama pachana dravyas.

6.                   What Is Your Line of Management?

The mode of action varies greatly for ayurveda treatment and it is clear for all. In case of autism, it is a lifelong medication with 21 days of procedure based bedside therapies once in every 6 months.

·                     Udwarthana (powder massage), takra dhara, siropichu (oil application on head), dhoopanam (smoking therapy).

·                     Continues use of visha hara (anti toxic) and Rasayana medicines (rejuvenative).

·                     Training the primary care taker (Parent) with the basic Principles and Procedures of Ayurveda Treatment of indications and treatment in ayurveda.

7.                    What Are Signs of Effective Treatment Which Can Be Clinically Screened from A Child Under Treatment? How to Judge and Grade These?

The clinical screening tool to assess the effectiveness of treatment from decade experience is like this. If a parent is able to report at least one clinically observable change like improved IN eye contact, reduction in hyper activity, biological markers of altered metabolism like that of ammonia in the lower side etc in every three months, the treatment can be judged effective.

8.                   You Mentioned About Styling Family Setup. How Far It Can Complement the Treatment?

As I have parted before, family life setting holds great importance in treating autism. I won’t agree with you if you say, it just compliments the treatment. In fact, it itself makes the treatment.

Inability to get set with the social fabric is the prime feature of ‘diagnosis autism’. Since social training starts from family, a family tuning is important to potentiate the child to journey in and out of the society. Few of them are:

·                     To dine together with family

·                     To take part in family and public functions

·                     To indulge in prayers and such religious rituals

·                     To do yoga and other exercises together etc

Will help greatly. Thus autism management is family management to a bigger extend.

9.                   For A Common Man Ayurveda Is Synonymous to Diet Rules. How About the Diet Pattern in Autism? Is There Any Relevance for Gluten Free Casein Free Diet?

Anything that satisfies one’s appetite is not food as per ayurveda. A matter is called food only if that has ability to get converted to the living part in a human body. This ability to get converted depends on the method of intake of food, rather than the nutritional value it has. Ie. A highly nutritious food may not serve its purpose if not taken mindfully at proper time, proper appetite; and so on. This concept makes ayurveda so unique among other streams.

Mindful eating, eating on time, minimum gaping between food and sleep etc are few among these diet rules which decide the fate of food inside. And coming to the hot topic- Casein free diet; of course such a kind of food is ideal for children with autism. Milk and milk products are least or not promoted. Even among medicines, we try to avoid medicated ghee etc which may lead to Agni derangement usually.  

And in cases of gluten diet, pathological analysis is important. If the presentation is of gulma pathology in a child with pitta constitution, diet should be well screened for gluten.

10.               Ayurveda Brain Tonics Seem to Be a First Line Treatment for Children with Autism? How About This Trend in Clinics?

Such a clinical interpretation mirrors an ‘A for Apple analysis’. The ‘autism-brain-medhya drugs’ axis- is not clinically perfect. Ayurveda is so unique in interpreting issues affecting mind. Little deeper to current gut brain theory, ayurveda advocates that, protection of gut is in fact protection of brain. There is a common factor between brain and gut- the rasa dhatu. So, focusing on rasa dhathu, thereby gut is the prime way to address issues to brain. A mere bypass to brain is not found effective clinically

11.               We Have Discussed Much About Clubbing Various Assisted Therapies Together. What If These Seems Contradictory to The Principles of Ayurveda or Health Itself Like That of Risperidone Prescription?

When I say, clubbing together different therapies, it means much more.

·                     Different Therapies should be scaled and administered based on their ability to contribute to complete well being of a patient rather than specific indications for specific presentations.

·                     Beyond the case of autism, second is the thought for whole medical world. Medical systems round the globe should be integrated in such a way that, the commonalities- hopefully that contributes to complete wellbeing of a person- should be identified, studied and administered to patients. Such a unification should be done so that the healing hands of whole medical wealth cuddle patients and of course world becomes a better place to live.

·                     And your question about risperidone is an intelligent one. No doubt, its action up on hyperactivity can give good relief to hyperactivity in some cases. But, once it is withdrawn means, child returns with same presentation. In sense, the medicine is in fact prescribed neither for the child nor against pathology but to address the quest of parents to have their child in normal pace at least for some time. But I do wonder, unless and until such a medicines prove to have a permanent effect, why should we go behind all these?  It’s absurd. Instead I do support the supplements like folic acid, vitamin B12 are all very effective and creates no issues if withdrawn. So, such a careful selection is necessary.

12.               What Ayurveda Can Offer Towards the Scope of Prevention?

Prevention is possible only to an extent. When I say to an extent, it means that. It is not cent percent erasable because the causes I have enlisted before ruined the world once for all.

·                     Pre conception care is one such option. Ideal preconception care should be administered for all. Minimum two months- for cleansing therapies and to tune body as per the ayurvedic protocols- is required for an ideal preconception care to be given. Each and every conception should be preplanned one so that the dangers of accidental conception can be ruled out.

·                     Antenatal care: Judicious and safe gestation period should be ensured through ayurveda.

·                     Postnatal care: Good medical care must be given to the child at least in the first two years of life because it is during this period brain development gets completed.

13.               International Recognition Is the Golden Step in Every Innovation. We Have Heard About International Research Seminar in Ayurveda and The Applause You Gained There. Briefly, What Was the Focus Of Your Research Observations And What Were Your Results?

I.R.S.A- was an International Research Seminar organized by European Academy of ayurveda. It was such a cream crowd that I have centered there - A set of people who look ayurveda as the need of tomorrow, who are well versed in ayurveda and who even sets ayurveda as their life time passion.

The research work was titled Correlation of a Gut Therapy Protocol (Aama Chikitsa) In Changes of Aama and Behavioral Symptoms of Autistic Babies. The very concept of ‘’ aahara sambhavam vasthu’’- The core concept of ayurveda that all diseases and human body itself finds its origin from food- was the topic of discussion. Autism with number of co morbidities related to digestion is never an exception to this.

The prime treatment itself is to tackle digestive issues. And the output was surprisingly promising. Children with Autism when treated for digestive issues presented a highly positive change in behavioral problems; psychological issues etc proving that the back bone of Ayurvedic management is nothing other than agni correction. This was the topic dealt with and won a big applause for dissecting the core ideas in ayurveda.

14.               You Were One of the First Researchers in Ayurvedic Field to Stress Up On the Importance of Incorporating Music Therapy into Ayurvedic Management? What Are Your Current Thoughts About This? How This Can Be Better Understood to Work in A Human Body as A Healing Tool?

As coined before, a collective therapy in which each one can help the kid to evoke his senses is needed in autism. It was with such a motto, music therapy was formulated in ayurveda. Till date, ayurveda therapies account for stimulation of eyes, skin, nose and tongue and the strotrendriya- ears are spared. So keeping in mind the role of senses in nervous signaling and promoting neuronal plasticity, along with influencing other senses, music is used to influence the auditory sense. So that, control over mind and intellect becomes little easier.

As a part of clinical interpretation we have made a AyuCALM (Ayurvedic Centre for Autism and children with Learning Disabilities) protocol for administering ‘DOSE’ of music therapy. For children presenting with obstruction of srothases (channels) as the basic pathology as in the case of diseases like deficient speech, the root cause may be the aavarana (blockage) of kapha dosha over other doshas, especially prana udana and vyana vata. This hampers the functioning of vata dosha. As such, along with medicines that remove this kaphavarana, music that can act as srothoshodhaka is to be selected. That means music that possesses a ‘penetrating power’ can be administered so that this can effectively facilitate the removal of kaphavarana.

For this particular effect, music with a penetration capacity, or simply music that can evoke the patient can be used if patients present with kaphavarana features. Athipravrthi (over activity) of dosas is yet another pathology. The dosha predominance in this condition is vata pitha. This serves as the basic pathology for diseases like hyper activity etc. In such cases of vata pitta predominance, music that can be vata pitha samaka should be selected. This is probably a music which is palliative in nature.

15.                It Might Be Interesting to Share the Current Status – How Far People Approved Ayurvedic Hands in Autism as You Observed?

It’s such a crispy question. As you all know autism is literally incurable. Till this moment neither ayurveda nor any medical stream is proved to be the final word. And this has made a wave such that, parents are ready to go with a ray of hope from any part of the world. This has of course turned a little curiosity towards ayurveda too. I don’t know how far I am right still; I wish to tell that, an ‘inborn soft corner’ towards ayurveda too has enormously contributed to this.

Next is a heart breaking fact. No doubt, ayurveda is an art of living. It’s a medical umbrella that shades whole life with extensive happiness and satisfaction. Ayurvedic classics just torches up own the path way to walk through. In this view, ayurveda is much beyond the current definition given to a medical science. To put it simple, the current definition for a medical science is not big enough for being an apt canvas for ayurveda.

In this regard, while addressing diseases affecting social life like autism, ayurveda is never a simple medical aid. It’s a method lightening a floor to a patient so that, he imparts peace, comfort and satisfaction by maximal use of his own abilities. We don’t have a treatment formula to give a rebirth; instead we have an opportunity to bless a patient to be happy with himself, family and society. Biological correction is just tool from the medical armamentarium of ayurveda and thus it can only be a single stream in management. But adopting a life with ayurvedic suits, can give excellent results and that’s the true spirit Ayurvedic management in autism. Lack of such an understanding about autism (ayurveda too) might have created a negative wave among the beneficiaries of ayurveda. The medical side of ayurvedic management which is only a part of treatment is only conveyed to the parents and this never matches with the pre set hopes of any parent. This hampers the popularity of ayurveda

So understanding autism beyond a six letter diagnosis and understanding ayurveda beyond a medical stream can determine the golden future of children with autism.