Shaheen Akhter

Autism Barta — A smart device based automated autism screening tool for Bangladesh

Autism is a neurodevelopmental disorder which is not fully curable. However, early intervention can improve the condition of the children which requires early detection of autism. For this purpose, screening tools have been immensely used in developed countries. Whereas in developing countries, people are not getting such benefits. In this paper, a new automated approach, Autism Barta is proposed to screen autism in children using smart devices. The application integrates the questions of Bengali version of M-CHAT screening tool with pictorial representation. Therefore, parents can easily understand the interactive questions and use it effectively. The app will automatically screen autism in children, inform the user, store the responses in an online database and will suggest nearby Autism resource center for confirmation and intervention. It is expected that, this system will help to identify and streamline autism for improving the condition in developing countries like Bangladesh.

Smart autism — A mobile, interactive and integrated framework for screening and confirmation of autism

Smart Autism is a cloud based, automated framework for autism screening and confirmation. In developing countries, due to lack of resources and expertise, autism is detected later than early ages which consequently delays timely intervention. Therefore a mobile, interactive and integrated framework is proposed to screen and confirm autism in different age group (0 to 17 years) with 3 layers of assessment process. Firstly, it screens by evaluating the responses of pictorial based screening questionnaire through mobile application. If autism is suspected, then in virtual assessment process, the child watches a video, its reaction is recorded and uploaded to the cloud for remote expert assessment. If autism is still suspected, then the child is referred to the nearest Autism Resource Center (ARC) for actual assessment. Analyzing these results, the integrated framework confirms autism automatically and reduce users ARC visit. It is expected that the proposed framework will bring changes in autism diagnosis process and create awareness.

Prevalence of Autism Spectrum Disorder (ASD) among the children aged 18-36 months in a rural community of Bangladesh: A cross sectional study

Background: Autism spectrum disorder (ASD) refers to a group of complex neurodevelopment disorders characterized by repetitive and characteristic patterns of behavior and difficulties with social communication and interaction. In Bangladesh, autism in children is a significant burden of disease. Early identification of ASD could improve quality of life. The study has explored at the prevalence of ASD among rural community children aged between 18-36 months. Methods: A cross sectional study was conducted among the 5286 children aged between 18-36 months in a rural community. Household level data was collected using screening tool MCHAT. Primarily screening positive 66 children were invited for final diagnosis in a health camp. Diagnosis was made by different staging started from primary screening, followed by validation using MCHAT and flash card. Final diagnosis was made by the paediatric neurologists, child clinical psychologists and development therapist using diagnostic tools (DSM-IV & ADOS). Results: 04 children were diagnosed with autism spectrum disorder (ASD). Prevalence of the ASD in rural community was found 0.75/1000 children. Among the four ASD cases three were boys and one was girl and age range was between 20- 30 months. Whereas, the highest prevalence rate found was for the cerebral palsy which was 5.6/1000 children and Developmental delay (2.6/1000) was the next to that. Conclusions: Age specific autism (18-36 months) in children is found higher in rural community of Bangladesh. In order to get more comprehensive information on autism in other age groups of children in rural community, further study is required. Early detection in rural community could help the policy makers to decentralization of health services among the ASD children in rural community.

Neuroimaging Findings as a Predictor of Choice of Antiepileptic Drugs for Seizure Control in West Syndrome

Background: West syndrome (WS) is a severe form of encephalopathy that typically affects young infants ranges from 2-3.5/10,000 live births. Approximately 50% causes of Infantile Spasm are associated with prenatal factors that includes congenital CNS malformations, intrauterine insults, neurocutaneous syndromes such as Tuberous sclerosis complex, metabolic disorders or genetic syndromes and have poor prognosis. For early identification of underlying etiology a proper neuroimaging is essential that will also help to predict the outcome. For this reason my study aimed to correlate the presence of neuroradiologic abnormalities and its impact on seizure control in the children with West syndrome. Methodology: This retrospective cross sectional study was carried out in Institute of Pediatric Neurodisorder and Autism (IPNA) in BSMMU. All patients those who were diagnosed as a case of West syndrome in between age of 3 months to 3 years according to ILAE (International League against Epilepsy) during period of June 2013 to May 2015 were included in this study. Results: Thirty one (31) children with West Syndrome were studied, their mean age of presentation was 18±10.48 months, mean age of onset of seizure was 6.68±3.9 months, 67.7% of them were male. Patients with normal neuroradiologic findings had early remission of spasms and with anomalies, atrophy and calcification were associated with poor response to drug (p=0.03). ACTH was the most commonly used drug with good seizure remission where neuroimaging finding was normal and in cerebral atrophy as a consequence of perinatal asphyxia (p=0.06). Vigabatrin showed good seizure remission in WS due to Tuberous Sclerosis Complex. Conclusion: Seizure prognosis of West Syndrome differ greatly according to the type of brain lesion so in every suspected cases of West Syndrome early neuroimaging should have to be performed for choosing an appropriate antiepileptic drug.