The noise of children’s voices comes from the first floor of the two- story building. Parents are leaving their children with the kinder-garden’s nurses. It’s 9:55 a.m. At 10 a.m. everyone must go to their classrooms and get ready for breakfast.
Children, washing their hands, want to do everything independently. Many are trying not to let the nurse help them with towels. But Shota, 4, is running around the table, talking to himself in words that are hard to understand. “Shotiko don’t cry, Shotiko, don’t cry,” he says to himself, endlessly repeating the same phrase.
Shota is attending classes at a Tbilisi ordinary state kindergarten. His health certificate describes him as healthy. His parents say that he is just a hyperactive boy without any neurological disorders.
His mother, Natia, says she does not want Shota diagnosed or treated as different from other children.
“Problems start in child’s life when everyone perceives him differently from so-called normal people. If I involve him in neurological disorder treatment program, he may have more problems in adulthood. The problem of stigmatization is the biggest one in our country. He isn’t sick, he needs support, not showing pettiness,” she says.
Last year, Natia took her son to a pediatric neurologist. The doctor transferred Shota to an autism center for farther diagnosis.
Autism spectrum disorder (ASD) and autism are both general terms for group of complex disorders of brain development. These disorders are characterized, in varying degrees, by difficulties in social interaction, verbal and nonverbal communications and representative behavior.
Asperger syndrome is often considered a high functioning form of autism. People with this syndrome have difficulty interacting socially and repeat behaviors. Their motor milestones may be delayed too. But these symptoms do not imply sickness, fragility, or emotional disturbance.
“They told me boy’s symptoms were more like Asperger syndrome, but they needed to do another test, which we didn’t take,” said Natia.
She feared that an official diagnosis could result in her son having to leave the kinder-garden.
According to Medea Zirakashvili, pediatric neurologist at mental health department of the Iashvili Children's Central Hospital, parents shouldn’t isolate their children, but involve them in an inclusive education system.
“Anything done for autistic children’s integration in society has only a positive influence. Parents of children with special needs very often isolate their children from society. Sometimes they concentrate more on specific therapy and keep children from social activities, such as kinder gardens or using public transportation. Doctors advise parents to engage their children in social and physical activities in order to integrate them with their peers”-Zirakashvili says
Although Natia feared that her son might be excluded from kinder-garden if he was diagnosed with a condition, the kinder-garden’s director says any physical or neurological disorder indicated in the health certificate of a child doesn’t cause exclusion from the school.
The only reason for leaving kinder-garden can be parents will, according to the director.
“We had two cases when parents hadn’t found time for kinder-garden and treatment therapy simultaneously and they chose autism center said director of the kinder-garden, who has supported her staff to attend a training course on caring for autistic children.
Natia also was concerned that in case of officially registered diagnosis, many people would feel pity for her child.
However, autism specialists say that parents can still send their children to regular schools and activities, but they should get treatment as early as possible.
“The earlier treatment therapy starts, the better the result will be. In many cases parents don’t involve their children in special program; they think that they may have problems at kinder-gardens or at schools. Participation in the treatment program doesn’t exclude to be involved in other social activities,” said Zirakashvili
Natia was told to make regular visits to doctors, but she didn’t follow the recommendation. She thinks there is a significant stigma in accepting psychological or psychiatric care. Society marginalizes such families, she says.
“This has negative impact on the family reputation and child as well,” she says. According to Zirakashvili, hiding children doesn’t preserve them in from stigma.
”No one can protect their child, until parents care what their neighbors think. Parents may not know that they’re taking away child’s chance of independent life,” Zirakashvili said.
The prevalence of ASD in Georgia is the same as in an entire world. According to a pilot study conducted in Georgia in 2008 Autism Spectrum Disorders in Georgia is approximately 1%. From 1826 children 17 were diagnosed with ASD.
Nana Tatishvili, head of Department of Pediatric Neurology and Psychiatry at Iashvili Central Hospital, said more than 60% of people who are diagnosed with ASD have a chance to live independently in case if they receive the right therapy and social integration.
There is no known cure, but with therapy many children and their families can learn to cope with the problems of ASD. Many adults, especially those with Asperger syndrome, are able to have an independent life, if they have the right kind of support available, says Sopho Kereselidze, director of Autism Centre.
It’s already 11:30 a.m. breakfast in the kinder-garden is over. Shota Is sitting near the window looking outside, not paying attention to anyone, with repeated body movements endlessly and monotonically repeating: “It will snow again, it will snow! They said on TV, it will snow.