Patna: For an autistic child in Patna, the day can begin with challenges most people barely notice. A crowded school assembly, the cacophony of traffic outside the classroom and a timetable altered suddenly. What may seem routine to others can overwhelm a child struggling to process sensory information in a city that offers few accommodations for neurodivergent residents.Experts say more children than ever are navigating these challenges. Autism diagnoses have risen sharply over the past decade, driven by greater awareness and improved screening. While more families are seeking help, schools, public spaces and support systems in the capital have struggled to keep pace.Experts are of the opinion that a decade ago autism prevalence in the country was estimated at around one in 100 children. Today, studies suggest it may be as high as one in 31. According to experts, the increase is largely the result of greater awareness and improved diagnosis.“We have definitely seen a surge in diagnoses over the last few years,” said Dr Ruchi Jha, a neurodevelopmental paediatrician, adding, “People are more aware now, which leads to more diagnoses, but many families still seek support late because of fear, denial and concerns about social judgement.”She says the post-Covid years have also seen more children being assessed, as developmental concerns became more apparent after prolonged periods of limited social interaction.“Before Covid, we would see five to 10 cases a month; now, three to four children are brought for assessment every day, mostly between the ages of two and four. Delayed speech, poor eye contact and repetitive behaviours are among the most common concerns,” says Dr Vinay Kumar, former consultant paediatrician at AIIMS-Patna and currently associated with the State Health Society, Bihar.“We are also seeing more developmental delays associated with excessive screen exposure and limited social interaction, particularly in urban nuclear families where both parents are working. While govt schools are mandated to admit neurodivergent children, many still lack the trained staff, infrastructure and support systems needed to adequately support them,” he says.Experts say Autism Spectrum Disorder (ASD) is predominantly linked to genetic factors.“Nearly 80% of autism cases have a genetic component. There may not always be a family history, but certain genetic variations can lead to the clinical symptoms of autism,” Dr Jha says, adding, one of the most common misconceptions is that increased screen time always leads to autism, whereas genetic factors continue to predominate.For many families, diagnosis is only the beginning.“Parents are often scared of the lifelong nature of the diagnosis. They fear isolation, judgement and the lack of support available for their child,” Dr Jha says.Although admissions in mainstream schools for children with mild to moderate autism are mandated, experts say many schools lack trained special educators, sensory-friendly environments and structured support. As a result, children often struggle academically and socially.According to Dr Shachi, an autism intervention specialist, children who receive timely therapy, family support and appropriate educational interventions are more likely to become independent, though many still begin intervention late.“Inclusive education is improving, but we still have a long way to go,” Dr Shachi said.Beyond classrooms, Patna has few spaces designed for autistic children. There are no dedicated sensory parks, limited recreational opportunities and little specialised support in sports or community activities.“The challenges are multifaceted and complex,” Dr Jha says. “A child may need support from the moment they start getting ready for school. Even simple changes in routine can be destabilising,” she adds.Experts say schools, public spaces, healthcare facilities and transport systems have not kept pace with the growing demand for support services.“The training and facilities available are not keeping pace with the increase in autism diagnoses,” Dr Jha says.Govt hospitals can support families through diagnosis, developmental milestone assessments and Individualised Education Plans (IEPs), but sustained therapy remains a challenge, says Dr Shruti Singh, associate professor of pharmacology at AIIMS- Patna, whose area of interest includes autism and neurodevelopmental disorders.“Providing intensive daily therapy is challenging in public hospitals because of the large footfall of patients. Autism intervention is largely parent-led, and progress depends heavily on how consistently families implement therapy goals at home and return for regular follow-ups. Often, the biggest gap arises when intervention plans are not reinforced outside the hospital setting.Parents need to be empowered because therapy cannot be limited to hospital visits,”she says. Mukta Mohini, mother of two autistic children, said one of the biggest misconceptions surrounding autism is that it is a disease that needs to be cured. “Autism is not a limitation. The challenge is not changing the child, it’s building a society that understands, accepts and includes them,”she says.Parents today are far more likely to recognise developmental concerns and seek help than they were a decade ago. The challenge now lies in making Patna autism inclusive.
