Autism Surveillance and Management – ASM

Collaboration with-

Director ZMT Clinics Network: Dr Anwar Nadeem
Project Director: Dr Azra Rafiq Consultant Pediatrician
Health Education Coordinator: Dr Fauzia Farah

 Objective: Early Diagnosis of ASD (Autism Spectrum Disorder) and Intervention to achieve best potential.

Implementation Plan

  1. Autism awareness programs for Health care Providers and Children care givers.
  2. Training for Autism Screening (M CHAT)
  3. Autism screening of toddlers (16 months-3 yrs.) as part of weekly well baby clinic /daily OPD
  4. Follow up 6 monthlies
  5. Diagnosis
  6. Referral and
  7. Rehabilitation

Autism Spectrum Disorder (ASD)

Autism Spectrum Disorder (ASD) is a lifelong neurological disorder that affects the way a person communicates and relates to the people and world around them. ASD can affect behavior, social interactions, and one’s ability to communicate.

ASD crosses all cultural, ethnic, geographic, and socioeconomic boundaries.

ASD is a spectrum disorder, which means that while all people on the spectrum will experience certain difficulties, the degree to which each person on the spectrum experiences these challenges will be different. It is characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication, as well as by unique strengths and differences.

Whether someone with ASD is affected mildly, severely, or somewhere in between, they might have difficulty verbalizing their thoughts, managing their anxiety, dealing with change, or participating in group activities. This can sometimes result in unintended conflicts with the community at large, lead to engagement with the mental health sector, as well as criminal and family justice systems. Without the proper supports, people on the spectrum can experience joblessness, homelessness, strain and stress. This can have a major impact on their quality of life.

Possible signs of autism in babies and toddlers:

  • By 6 months, no social smiles or other warm, joyful expressions directed at people
  • By 6 months, limited or no eye contact
  • By 9 months, no sharing of vocal sounds, smiles or other nonverbal communication
  • By 12 months, no babbling
  • By 12 months, no use of gestures to communicate (e.g. pointing, reaching, waving etc.)
  • By 12 months, no response to name when called
  • By 16 months, no words
  • By 24 months, no meaningful, two-word phrases
  • Any loss of any previously acquired speech, babbling or social skills

Possible signs of autism at any age:

  • Avoids eye contact and prefers to be alone
  • Struggles with understanding other people’s feelings
  • Remains nonverbal or has delayed language development
  • Repeats words or phrases over and over (echolalia)
  • Gets upset by minor changes in routine or surroundings
  • Has highly restricted interests
  • Performs repetitive behaviours such as flapping, rocking or spinning
  • Has unusual and often intense reactions to sounds, smells, tastes, textures, lights and/or color

The American Academy of Pediatrics recommends autism screening at all 18- and 24-month well-child visits and anytime a parent or doctor has concerns. However, screening at 16 months or even earlier is also recommended by neuro developmental pediatricians.


According to CDC USA the prevalence rate of ASD is 1 in 59 and it is four times more frequent in boys than in girls.
In Ontario, Canada there are an estimated 100,000 individuals with ASD.

Yet most of the public, including many professionals in the medical, educational, and vocational fields, are still unaware of how autism affects people and how they can effectively work with individuals with autism to mitigate challenges faced by the subjects and achieve maximum potential.

The people with autism learn, and the rate at which they learn, can be totally different from others without autism. Therefore, those with autism sometimes need to learn things that we do not consider the part of learning.

Autism is not a mental illness and Autism is not caused by bad parenting. Children with autism are not kids who misbehave

 Why we need this project?

 Early detection 1000 days opportunity window

If a child is diagnosed early with autism, interventions can be implemented which can mitigate several difficulties and prevent some effects which limit the abilities of affected children and nurture some important attributes which many of affected children have. Parents, early childhood educationist and therapists can do a lot to improve the quality of life. Unfortunately, in many cases it happens otherwise due to delays in diagnosis and lack of trained parents and educationists.

Early Autism diagnosis is delayed mainly due to two factors; one not being aware of the autism symptoms and the other because of fear of stigma. Many children with autism are not diagnosed early, put on waiting lists and miss out on early behavioral interventions and other benefits opportunity because health professionals are reluctant to diagnose autism early out of fear of labeling young children. Under these contentions, diagnosis can be delayed for up to five years and sometimes, until the child has reached school age and beyond.

Normally parents contact late when the opportunity window of 1000 days has already been closed.

AWB plans to embark upon the following projects:

1) Mass awareness campaigns in the community for early detection/ suspects identification
2) Train Healthcare Professionals for early detection/diagnosis
3) Train mothers and community health workers on early features of Autism.
4) Establish training of Early Childhood Educationist for early and appropriate interventions.
5) Establish continuing education of educators for various age-related interventions.


Autism without Borders