Autism Spectrum Book

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AwURg †¯úKUªvg wWRAW©vi (Autism Spectrum Disorder) wK?

AwURg nj gw¯Í‡®‹i ¯^vfvweK weKvkRwbZ Amyweav, hv‡K mgwš^Zfv‡e ÔAutism Spectrum DisorderÕ ev
ASD ejv nq ÒSpecturmÓ ej‡Z AwURg _vKv wkïi bvbv jÿY, `ÿZv Ges cÖwZeÜKZvi ch©vq A_ev
mxgve×Zvi e¨vcKZv‡K eySvq hv GKwU AwURg AvµvšÍ wkïi gv‡S _vK‡Z cv‡i| GUv ¯^í gvÎv †_‡K ¸iæZi
gvÎvq n‡Z cv‡i|
Diagnostic and Statistical Manual of Mental Disorders Fourth Edition- Text Revision (DSM-IV-TR)
Gi MvBW jvBb Abyhvqx GKwU wkï AwUR‡g AvµvšÍ wKbv Zv wbY©q Kiv nq| Manual wU m¤úªwZ cuvP ai‡bi
cÖwZeÜKZvi msÁv wba©viY K‡i‡Q| †hLv‡b A‡bK mgq AwURg‡K Pervasive developmental disorder Gi
mv‡_ GKxf‚Z K‡i ejv nq|
• AwURg wWRAW©vi (K¬vwmK AwURg)
• G¨vmcviRvi wWRAW©vi (GmcviRvi wm‡Ûªvg)
• cvi‡fwmf †W‡fjc‡g›Uvj wWRAW©vi bU Av`viIqvBR †¯úwmdvBW (PDD-NOS)
• †iUm& wWRAW©vi (†iU wm‡Ûªvg)
• PvBìûW wWmBw›Uª‡MÖkb wWRAW©vi (CDD)
Z‡_¨i GB cyw¯ÍKvwU †iU wm‡Ûªvg I CDD Gi Dci mswÿß Av‡jvPbv mn AwURg, G¨vmcviRvi wm‡Ûªvg,
PDD-NOS Gi Dci g~jZ Av‡jvKcvZ Ki‡e| AwURg Gi jÿYmg~n G‡KK wkïi †ÿ‡Î G‡KK iKg nq|
wKš‘ mvaviYfv‡e G‡`i‡K wZbwU fv‡M fvM Kiv hvq|
• mvgvwRK cÖwZeÜKZv
• †hvMv‡hvM ¯’vc‡b mgm¨v/cÖwZeÜKZv
• cybive„wËg~jK I GKB AvPiY evievi Kiv (Repetitive and Stereotyped)
AwURg Av‡Q Ggb wkï‡`i mvgvwRK I †hvMv‡hvM ¯’vc‡bi `ÿZv ¯^vfvweK wbqg Abyhvqx e„w× cvq bv|
AwffveKivB me©cÖ_g wkïi g‡a¨ A¯^vfvweK AvPiY jÿ¨ K‡i| GKB eq‡mi Ab¨vb¨ wkï‡`i mv‡_ wKQz
AvPiY Zzjbv Ki‡j AmsMwZUv mn‡RB †Pv‡L c‡o| wKQz wKQz †ÿ‡Î AwURg _vKv wkï‡`i cÖv_wgK ch©v‡q
e¨wZµg e‡j g‡b nq| A‡bK wkï Zv‡`i 1 eQi eqm c~Y© nevi Av‡MB †Kvb GKwU e¯‘i cÖwZ AZ¨vwaK
Avm³ nq, †Pv‡L †Pv‡L ZvKvq bv Ges Av`vb-cÖ`vb g~jK †Ljvq Ask wb‡Z Pvq bv| evev gv‡qi mv‡_ Av‡av
K_v ejv †hgb ev, ev-ey-ey-`v`v, gv gv e‡j bv| wKQz wKQz wkï cª_g 2/3 eQi ¯^vfvweKfv‡e †e‡o I‡V| wKš‘
Gi ci †_‡K Ab¨‡`i wel‡q AvMÖn nvwi‡q †d‡j, wbie n‡q hvq Ges mvgvwRK DÏxcbvi cÖwZ AvMÖn nvwi‡q
†d‡j A_ev cÖwZwµqvnxb _v‡K| ¯^vfvweK weKvkaviv K‡g Avmv ev m¤ú~Y©iƒ‡c nvwi‡q hvIqv‡K Ôwi‡MÖkbÕ
(Regression) bv‡g AwfwnZ Kiv nq- hv AwURg Av‡Q Ggb wKQz wkïi gv‡S †`Lv hvq|

bb KwgDwb‡Kej wWwRR K‡›Uªvj †cÖvMÖvg


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mvgvwRK cÖwZeÜKZv t
AwURg Av‡Q Ggb AwaKvsk wkï Zv‡`i ˆ`bw›`b mvgvwRK †hvMv‡hvM ¯’vc‡b Amyweavi m¤§yLxb nq| GB
wb‡`©wkKv Abyhvqx AwURg Av‡Q Ggb wKQz wkïi jÿYmg~nt-
†hgb t
• Lye mvgvb¨ †Pv‡L †PvL iv‡L
• Zv‡`i Av‡k cv‡k Dcw¯’Z †jvK‡`i K_v ïb‡Z AvMÖn †`Lvq bv Ges Ab¨‡`i K_vi mvov †`qbv|
• Zviv mnmv wb‡R‡`i Avb›` A‡b¨i mv‡_ fvM Ki‡Z cv‡ibv A_ev cQ‡›`i wRwbm Av½yj w`‡q †`Lvq bv|
• Ab¨iv ivM, `ytL ev †¯œn cÖ`k©b Ki‡jI †Kvb cÖwZwµqv †`Lvq bv ev wbwj©ß _v‡K|
• mv¤úªwZK M‡elYvq †`Lv hvq AwURg Av‡Q Ggb wkïiv mvaviYZ mvgvwRK †hvMv‡hv‡Mi †ÿ‡Î e¨eüZ
¯^vfvweK mvgvwRK Av‡eMxq Bw½Z¸‡jv eyS‡Z cv‡ibv| KviY- Zviv ¯^vfvweK wkï‡`i gZ mvgvwRK
DÏxcK¸‡jv jÿ¨ K‡ibv| D`vniY¯^iƒc ejv hvq- AwURg Av‡Q Ggb wkïiv Zv‡`i mvg‡b †KD K_v
ej‡j Zvi †Pv‡Li w`‡K bv ZvwK‡q Zvi gy‡Li w`‡K ZvwK‡q _v‡K hv mvaviY wkï‡`i †ÿ‡Î e¨wZµg|
GB msµvšÍ Ab¨ M‡elYvq †`Lv hvq AwURg _vKv wkïiv cybive„wËg~jK k‡ãi cÖwZ AvK…ó nq| †hgbt
nvZ Zvwj †`Iqv| AwURg Av‡Q Ggb wkïiv mvaviYZ cÖPwjZ mvgvwRK Bw½Z¸‡jv †Lqvj K‡i bv ev
fzj †ev‡S| GB welq¸‡jv eyS‡Z cvi‡j GB wkïiv mvgvwRKfv‡e †hvMv‡hvM ¯’vc‡b mÿg n‡Zv| GB
ai‡Yi wkï‡`i †ÿ‡Î †Kvb cªkœ †hgbt Zzwg wK 1 wgwbU A‡cÿv Ki‡e? memgq GKB A_© enb K‡i|
AwURg Av‡Q Ggb wkïiv Mjvi ¯^‡ii IVvbvgv eyS‡Z e¨_©
nIqvq Ab¨‡`i A½fw½, gy‡Li fve, Awfe¨w³ Ges Ab¨vb¨
A‡gŠwLK †hvMv‡hvM eyS‡Z cv‡i bv Ges mwVKfv‡e mvov
w`‡Z cv‡ibv| Ab¨‡`iI Zv‡`i A½fw½ eyS‡Z Kó nq|
mvaviYZ Zv‡`i K_vi mv‡_ gy‡Li fvefw½ ev A½fw½i
wgj Lyu‡R cvIqv hvq bv| Zv‡`i Mjvi ¯^‡ii g‡a¨ Zv‡`i
mwZ¨Kv‡ii Abyf‚wZi wgj cÖKvk cvq bv| AwURg Av‡Q
Ggb wkïiv A¯^vfvweK ¯^‡i K_v e‡j hv ïb‡Z A‡bKUv
†ive‡Ui gZ, Mv‡bi my‡ii gZ| AwURg Av‡Q Ggb wkïiv
Ab¨‡`i `„wó fw½ eyS‡Z mgm¨vi m¤§yLxb nq| D`vniY¯^iƒc
AwaKvsk ¯‹z‡j hvIqvi Dc‡hvMx wkïiv Ab¨‡`i Av‡eM ev
wfbœgZ ev D‡Ïk¨ eyS‡Z cv‡i| hv GB wkïiv †Kvb eq‡mB wkï GKv GKv _vK‡Z cQ›` K‡i
cv‡ibv|
†hvMv‡hvM ¯’vc‡bi mgm¨v t
Av‡gwiKvb GKv‡Wwg Ae †cwWqvwUªK †W‡fjc‡g›Uvj gvBj‡÷vbm& (American Academy of Pediatrics
Developmental Milestones) Gi M‡elYv g‡Z GK eQ‡ii ¯^vfvweK wkï GKwU `ywU kã ej‡Z cv‡i, †KD
Zvi bvg a‡i WvK‡j †m †mB k‡ãi w`‡K ZvKv‡Z cv‡i| wb‡Ri cQ‡›`i †Ljbv Av½yj w`‡q †`Lv‡Z cQ›`
K‡i, †Kvb wKQz cQ›` bv n‡j Zv‡`i gy‡Li fw½gvq ÔbvÕ †evaK welqwU cÖKvk K‡i| AwURg Av‡Q Ggb
wkï‡`i weKv‡ki avc¸‡jv avivevwnKfv‡e bvI Avm‡Z cv‡i| D`vniY¯^iƒc t G ai‡bi wkïiv Zv‡`i bvg a‡i

bb KwgDwb‡Kej wWwRR K‡›Uªvj †cÖvMÖvg


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WvK‡j ev Ab¨ †Kvb kã K‡i Zvi `„wó AvKl©Y Ki‡j †m nq DËi †`q bv A_ev †`wi‡Z mvov †`q|
• KvD‡K †Kvb wKQz †`Lv‡bvi †ÿ‡Î Zviv e¨_© A_ev Lye ax‡i I †`wi‡Z G KvR K‡i|
• cÖ_g eQ‡i wkïmyjf AvIqvR ev kã Ki‡jI cieZx©‡Z GUv Kiv eÜ n‡q hvq|
• †`ix‡Z fvlv †k‡L|
• GKwU kã ev ev‡K¨i Ask evievi e‡j, cÖvq mgq Zviv A_©c~Y© evK¨ ˆZwi‡Z e¨_© nq|
• GKwU kã ev evK¨ ï‡b, †mB kã ev evK¨‡K Zviv ûeû e‡j| G‡K B‡Kvjvwjqv (echolalia) e‡j|
• AcwiwPZ I AcÖvmw½K kã e¨envi K‡i hv ïaygvÎ GB wkï‡`i mv‡_ mswkøóivB eyS‡Z cv‡i| GgbwK
AwURg Av‡Q Ggb wkïiv hv‡`i g‡a¨ fvlvi `ÿZv fvj ZvivI cÖvq K‡_vcK_‡b †LB nvwi‡q †d‡j|

bvg WvK‡j mvov †`qbv †Pv‡L †PvL †i‡L ZvKvqbv

D`vniY¯^iƒct GmKj wkïiv mvgvwRK Bw½Z/ms‡KZ¸‡jv eyS‡Z cv‡ibv| ÒG¨vmcviRvi wm‡ÛªvgÓ G AvµvšÍ
wkïiv Zv‡`i wcÖq welq m¤ú‡K© cÖvq GK bvMv‡i K_v e‡j| Zviv Ab¨ KvD‡K K_v ejvi my‡hvM w`‡Z Pvq bv
A_ev A‡b¨i cÖwZwµqvq fve‡jknxb _v‡K| AwURg Av‡Q Ggb wkï‡`i g‡a¨ fve cÖKv‡k A_©c~Y© fw½ M‡o bv
IVvq nVvr K‡i Zviv wPrKvi K‡i| A_ev †Kvb wKQz †Rvi K‡i ai‡Z cv‡i| hZw`b Zv‡`i wb‡R‡`i cÖ‡qvRb
†evSv‡bvi mwVK Dcvq †kLv‡bv bv nq, ZZw`b GB Ae¯’v Pj‡Z cv‡i| GmKj wkï‡`i eqm evovi mv‡_ mv‡_
Zviv Zv‡`i mxgve×Zv eyS‡Z cv‡i| GB m‡PZbZv Zv‡`i‡K DwØMœ ev welbœ Ki‡Z cv‡i|

cybive„wËg~jK AvPiY (Repetitive and Stereotyped Behaviors) t


AwURg Av‡Q Ggb wkï‡`i cÖvqB A¯^vfvweK AvPiY Ges GKB wRwbm eivei Kivi cÖeYZv †`Lv hvq| G
mKj AvPiY gv‡S gv‡S AwZgvÎvq †Pv‡L covi g‡Zv| †Kvb †Kvb †ÿ‡Î GUv mvgvb¨ ev †Pv‡L covi g‡Zv
bv| D`vniY¯^iƒct †Kvb †Kvb wkï ev‡iev‡i nvZ bvov ev we‡kl fw½‡Z nuvUv ev †Pv‡Li mvg‡b ev nvZ Dc‡i
Zz‡j †Nviv‡bv, wb‡Ri Av½yj¸‡jv bv‡o hv †`L‡j Bkviv g‡b nq| Avevi †KD †KD Av½yj w`‡q †PvL Nyiv‡bvi
†Póv K‡i| GB AvPiY¸‡jv evievi Kiv‡K Ò†÷wiI UvBcÓ (Stereotype) AvPiY e‡j|
AwURg Av‡Q Ggb wkï‡`i g‡a¨ A‡bK mgq †Kvb GKwU wel‡q AwZgvÎvq AvMÖn †`Lv hvq| AwURg _vKv
wkïiv Pjgvb †Kvb wKQz †`‡L D‡ËwRZ ev AvKwl©Z n‡Z cv‡i, †hgb PjšÍ Mvwoi PvKv| †Kvb †Kvb mgq Zviv
Zv‡`i †Ljbv¸‡jv‡K wb‡q h_vh_fv‡e bv †L‡j †ijMvwoi gZ GKUvi †cQ‡b Av‡iKUv jvBb K‡i mvRv‡Z
_v‡K| Gmgq †KD GKUv †Ljbv mwi‡q †dj‡j †m Lye D‡ËwRZ n‡q hvq| cybive„wËg~jK AvPiY GKwU wkïi

bb KwgDwb‡Kej wWwRR K‡›Uªvj †cÖvMÖvg


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mKj g‡bv‡hv‡Mi †K›`ªwe›`y n‡Z cv‡i| †hgb- Rb¥w`‡bi ZvwiL, †Ljvi mgqm~wP I †Uª‡bi mgqm~wP g‡b ivLv|
AwURg _vKv wkï‡`i g‡a¨ msL¨v, wewfbœ ms‡KZ I weÁvb wel‡q AvMÖn cwijwÿZ nq| AwURg Av‡Q Ggb
wkïiv Zv‡`i ˆ`bw›`b Rxe‡bi Kvh©Kjvc wbqg gvwdK fvjfv‡e Ki‡Z cv‡i, Z‡e A‡bK †ÿ‡Î gvivZ¥K
mgm¨vi m„wó Ki‡Z cv‡i| Zviv GKB Lvevi LvIqvi Rb¨ A_ev GKB c‡_ ¯‹z‡j hvIqvi Rb¨ †R` Ki‡Z
cv‡i| ˆ`bw›`b Kvh©Kjv‡ci mvgvb¨Zg cwieZ©b Zv‡`i D‡ËwRZ Ki‡Z cv‡i| bZzb cwi‡e‡k wKQz wKQz wkïi
g‡a¨ Pig D‡ËRbv ev nZvkv †`Lv w`‡Z cv‡i|
†Kvb `ywU wkïi g‡a¨ GKB ai‡Yi jÿY, aiY I gvÎv GKB nqbv| cÖK…Zc‡ÿ ¯^vfvweKfv‡e †e‡o IVv
wkï‡`i g‡a¨I AwURg _vKv wkï‡`i wKQz jÿY †`Lv †h‡Z cv‡i| Avcwb hw` Avcbvi wkïi g‡a¨ AwURg
msµvšÍ GK ev GKvwaK †Kvb jÿY †`L‡Z cvb Zvn‡j AwZmZ¡i mswkøó we‡kl‡Ái Kv‡Q civg‡k©i Rb¨
†hvMv‡hvM Ki‡eb|

AwUR‡gi mv‡_ mswkøó Amyweavmg~n t


Ô†iU wm‡ÛªvgÕ (Rett Syndrom) Ges PvBìûW wWmBw›U‡MÖmb wWRAW©vi (CDD), AwURg Gi `ywU `yj©f cÖKvi
hv gvbwmK weKvk‡K e¨nZ K‡i| cÖwZ 10 †_‡K 22000 †g‡qi g‡a¨ gvÎ GKR‡bi †iU wm‡Ûªvg †`Lv hvq|
Aci w`‡K GK jÿ AwURg _vKv wkï‡`i g‡a¨ me©vwaK 2 R‡bi g‡a¨ PvBìûW wWmBw›U‡MÖmb wWRAW©vi †`Lv
hvq| Ô†iU wm‡ÛªvgÕ mvaviYZ †g‡q‡`i g‡a¨ †`Lv hvq| Ô†iU wm‡ÛªvgÕ _vKv wkïiv mvaviYZ 6-18 gvm eqm
ch©šÍ ¯^vfvweKfv‡e †e‡o I‡V| Gici AwUR‡gi jÿY †`Lv †`q| Ô†iU wm‡ÛªvgÕ G AvµvšÍ wkï‡`i g‡a¨
K_v ejvq RoZv ev PjvP‡ji mgš^qnxbZv cwijwÿZ nq| wdwRK¨vj, AKz‡ckbvj I ¯úxP †_ivcx mvnvh¨
Ki‡jI Ô†iU wm‡ÛªvgÕ Gi wPwKrmvi †Kvb wbw`©ó c×wZ †bB|
BDwbK †K‡bwW wkÖfvi b¨vkbvj Bbw÷wUDkb Ae PvBì †nj_& GÛ †W‡fjc‡g›U (Eunice Kennedy Shriver
National Institute Child Health and Human Development) Gi A_©vq‡b cwiPvwjZ M‡elYvq weÁvbxiv
†`‡L‡Qb GKwU GKK Rxb Gi iƒcvšÍi AwaKvsk Ô†iU wm‡ÛªvgÕ Gi mv‡_ RwoZ| GB Avwe®‹vi Ô†iU wm‡ÛªvgÕ
Gi cÖwµqv‡K evo‡Z bv †`Iqvi †ÿ‡Î mvnvh¨ Ki‡Z cv‡i| GKBfv‡e mswkøó wPwKrmK‡`i †iv‡Mi Drm
AbymÜv‡b Zv‡`i `ÿZv e„w× Ki‡Z cv‡i| G‡Z mvgwMÖKfv‡e AvµvšÍ wkï‡`i Rxebgvb e„w× †c‡Z cv‡i|
PvBìûW wWmBw›U‡MÖmb wWRAW©vi †h‡nZz Aí msL¨K wkï‡`i AvµvšÍ K‡i ZvB M‡elK‡`i GB wel‡q
Z_¨ msMÖ‡n mgm¨v nq| PvBìûW wWmBw›U‡MÖmb wWRAW©vi Gi jÿY ïiæ nq mvaviYZ 3/4 eQ‡ii g‡a¨
AvµvšÍ nIqvi c~e© ch©šÍ wWmBw›U‡MÖmb wWRAW©vi _vKv wkïiv ¯^vfvweKfv‡e †hvMv‡hvM ¯’vc‡bi `ÿZv AR©b
K‡i| ¯^vfvweK e„w×i mgqKvj PvBìûW wWmBw›U‡MÖmb wWRAW©vi Ô†iU wm‡ÛªvgÕ †_‡K c„_K K‡i| PvBìûW
wWmBw›U‡MÖmb wWRAW©vi Gi cÖKvk †g‡q‡`i †P‡q †Q‡j‡`i g‡a¨ †ewk| PvBìûW wWmBw›U‡MÖmb wWRAW©vi
Av‡Q Ggb wkïiv c~‡e© AwR©Z fvlv I mvgvwRK `ÿZv nviv‡Z ïiæ K‡i| kãfvÛvi K‡g hvIqvi cÖeYZv
ÔK¬vwmK AwURgÕ †_‡K PvBìûW wWmBw›U‡MÖmb wWRAW©vi Gi g‡a¨ †ewk †`Lv hvq| PvBìûW wWmBw›U‡MÖmb
wWRAW©vi Gi Ab¨vb¨ jÿY n‡jv gjg~Î Z¨v‡Mi wbqš¿Y nviv‡bv|

bb KwgDwb‡Kej wWwRR K‡›Uªvj †cÖvMÖvg


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AwURg wKfv‡e wbY©q Kiv nq ?
AwURg †¯úKUªvg wbY©q GKwU `yB avc cÖwµqv| cª_g av‡c GKRb wkï wPwKrmK ev ¯^v¯’¨ Kgx© Øviv my¯’ wkï
†PKAv‡c wkïi ¯^vfvweK weKvk ch©‡eÿY Kiv nq| †h mKj wkïi weKvkMZ mgm¨v mbv³ nq Zv‡`i‡K
AwaKZi ch©‡eÿ‡Yi Rb¨ cvVv‡bv nq| wØZxq av‡c we‡klÁ wPwKrmK I Ab¨vb¨ cÖ‡dkbvj‡`i mgš^‡q GKwU
c~Yg~©j¨vqb Kiv nq| GB ch©v‡q wkïi AwURg ev Ab¨ †Kvb weKvkRwbZ mgm¨v Av‡Q wKbv Zv wbY©q Kiv
hvq| `yB eQi eq‡mi g‡a¨ wkï‡`i AwURg †¯úKUªvg wWRAW©vi wbf©i‡hvM¨fv‡e wbY©q Kiv hvq hw`I M‡elYv
e‡j †h wKQz mbv³KiY cixÿv 18 gvm ev AviI Aí eq‡m mbv³ Ki‡Y mnvqZv Ki‡Z cv‡i| mgeqmx‡`i
AbymiY K‡i wk‡L †dj‡e GB wek¦v‡m wkï wPwKrmK, cvwievwiK wPwKrmK, wkÿK I AwffveK - A‡b‡KB
cÖv_wgKfv‡e AwURg †¯úKUªvg wWRAW©v‡ii jÿY¸‡jv †QvU K‡i †`‡Lb| Avcbvi †QvU mšÍvbwU‡K AwURg
†¯úKUªvg wWRAW©v‡ii †j‡ej †`Iqvi e¨vcv‡i Avcbvi D‡ØM _vK‡jI hZ `ªæZ GB mgm¨vwU wbY©q Kiv
hvq ZZ `ªæZ h‡_vchy³ e¨e¯’vcbv MÖnY Kiv †h‡Z cv‡i| `ªæZ e¨e¯’vcbv MÖn‡Yi gva¨‡g AwURg †¯úKUªvg
wWRAW©v‡ii mv‡_ mshy³ AviI cÖKU cÖwZeÜKZv¸‡jv‡K Kgv‡bv ev cÖwZ‡iva Kiv m¤¢e| `ªæZ e¨e¯’vcbv MÖnY
Avcbvi mšÍv‡bi ey×vsK, fvlvMZ I ˆ`bw›`b e¨envwiK `ÿZv evov‡Z cv‡i|

mbv³KiY t
Av‡gwiKvb GKv‡Wwg Ae †cwWqvwUªK‡mi mycvwik µ‡g 18 Ges 24 gvm eq‡m my¯’ wkï †PKAv‡c mywbw`©ófv‡e
AwURg †¯úKUªvg wWRAW©vi mbv³KiYmn weKvkMZ mbv³KiY _vKv DwPr| AwURg †¯úKUªvg wWRAW©vi
mbv³KiY I WvqvM‡bvwmm GK bq| mbv³KiY Uzjmg~n cª_gavc wn‡m‡e e¨eüZ nq|

AwURg †¯úKUªvg wWRAW©vi mbv³Ki‡Yi Uzj mg~n t


KLbI KLbI wPwKrmKiv AwURg †¯úKUªvg wWRAW©vi mbv³ Kivi Rb¨ AwffveK‡`i wkïi jÿY¸‡jvi
e¨vcv‡i cÖkœ K‡i _v‡Kb| Ab¨vb¨ mbv³KiY Uzjmg~n‡Z AwffveK‡`i KvQ †_‡K cvIqv Z‡_¨i mv‡_
wPwKrm‡Ki wbR¯^ ch©‡eÿ‡Yi mgš^q _v‡K| ¯‹z‡j hvIqvi Av‡Mi eq‡mi wkï‡`i Rb¨ cÖ‡hvR¨ Uzjmg~nt
• †PKwj÷ di AwURg Bb UWjvm© (CHAT)|
• gwWdvBW †PKwj÷ di AwURg Bb UWjvm© (M-CHAT)|
• w¯Œwbs Uzj di AwURg Bb Uz Bqvi IjWm (STAT)|
• †mvk¨vj KwgDwb‡Kkb †Kv‡ð‡bqvi (SCQ)|
• KwgDwb‡Kkb GÛ wm‡¤^vwjK we‡nwfqvi †¯‹j (CSBS)|
GB eq‡mi †P‡q eo wkï‡`i g„`y gvÎvi AwURg †¯úKUªvg wWRAW©vi ev G¨vmcviRvi wm‡Ûªvg mbv³ Kivi Rb¨
wPwKrmKiv wb¤œwjwLZ mbv³KiY Uzjmn Ab¨vb¨ Uz‡ji Dci wbf©i K‡ibt
• AwURg †¯úKUªvg w¯Œwbs †Kv‡ð‡bqvi (ASSQ)
• A‡÷ªwjqvb †¯‹j di G¨vmcviRvi wm‡Ûªvg (ASAS)
• PvBìûW G¨vmcviRvi wm‡Ûªvg †U÷ (CAST)
AwURg †¯úKUªvg wWRAW©vi mbv³Ki‡Y †m›Uvi di K‡›Uªvj GÛ wcÖ‡fbk‡bi I‡qe mvBU (http://cdc.gov/
ncbddd/autism/screening.html) G D‡jøwLZ †Rbv‡ij †W‡fjc‡g›U w¯Œwbs Uzjmg~n Ges AwURg †¯úKUªvg
wWRAW©vi †¯úwmwdK w¯Œwbs Uzjmg~n mnvqK wi‡mvm© n‡Z cv‡i|
bb KwgDwb‡Kej wWwRR K‡›Uªvj †cÖvMÖvg
5
AwURg †¯úKUªvg wWRAW©vi mbv³Ki‡Y mnvqK wi‡mvm© †m›Uvi di wWwRR K‡›Uªvj GÛ wcÖ‡fbk‡bi I‡qe
mvB‡U D‡jøwLZ †Rbv‡ij †W‡fjc‡g›U Uzjmg~n Ges AwURg †¯úKUªvg †¯úwmwdK w¯Œwbs Uzjmg~n wkïi
AviI cixÿv wbixÿvi cÖ‡qvRb Av‡Q wKbv Wv³vi‡K Zv eyS‡Z mnvqZv K‡i| Avcbvi wkïi wPwKrmK hw`
iæwUb gvwdK mbv³KiY bv K‡i Zvn‡j Zv‡K Zv Ki‡Z ejyb| Awffve‡Ki Rb¨ Zv‡`i mšÍv‡bi weKv‡ki
e¨vcv‡i wb‡R‡`i AwfÁZv Ges D‡ØM mbv³KiY cÖwµqv AZ¨šÍ ¸iæZ¡c~Y©| Avcbvi wkïi weKv‡ki Z_¨¸‡jv
wj‡L ivLyb| cvwievwiK wfwWI, d‡Uv I †ewe G¨vjevg †`‡L g‡b Ki‡Z †Póv Kiæb cÖwZwU AvPiY †m KLb
cª_g K‡i‡Q Ges KLb weKv‡ki wewfbœ avc¸‡jv‡Z †cŠu‡Q‡Q|

Kw¤úª‡nbwmf †ivM wbYv©qK g~j¨vqb t


Ab¨ †Kvb mgm¨vi Kvi‡Y wkïi g‡a¨ jÿY¸‡jv †`Lv hv‡”Q wKbv Zv †ei Ki‡Z wØZxq ch©v‡qi mbv³KiY
cy•Lvbycy•Lfv‡e nIqv `iKvi| we¯ÍvwiZ Z‡_¨i Rb¨ ÔAwURg †¯úKUªvg wWRAW©vi ˆewk‡ó¨i wkï‡`i Avi wK
mgm¨v _vK‡Z cv‡iÕ AskwU †`Lyb|

AwURg †¯úKUªvg wWRAW©vi mbv³Ki‡Y AwfÁ mvB‡KvjwR÷, wbD‡ivjwR÷, mvBwKq¨vwUª÷, ¯úxP †_ivwc÷ ev
Ab¨ †ckvRxexi GKwU Uxg-B g~j¨vqb Ki‡Z cv‡i| GB g~j¨vqb wkïi KM‡bwUf †j‡fj (wPšÍvi `ÿZv),fvlvMZ
`ÿZv Ges e¨envwiK `ÿZv (ˆ`bw›`b KvR¸‡jv wb‡R wb‡R Kivi eqm Dc‡hvMx `ÿZv¸‡jv †hgb- LvIqv,
Kvco civ I Uq‡j‡U hvIqv) ch©‡eÿY Kiv nq|

AwURg †¯úKUªvg wWRAW©vi GKwU RwUj wWRAW©vi hv gv‡S gv‡S Ab¨vb¨ †ivM ev wkLb mgm¨vi mv‡_
†`Lv †`Iqvi Kvi‡Y gw¯Í‡®‹i B‡gwRs, wRb cixÿv, ¯§„wZkw³, mgm¨v mgvavb I fvlvMZ `ÿZvi cixÿv
Kw¤úª‡nbwmf g~j¨vq‡bi AšÍf©y³ Kiv n‡q _v‡K| GB Kw¤úª‡nbwmf g~j¨vq‡bi Ask wn‡m‡e weKv‡k †cuxQv‡bv
wkï‡`i‡K kÖeY cixÿv I †jW cqRwbs cixÿv Kiv DwPZ|

AwURg †¯úKUªvg wWRAW©vi nIqvi cvkvcvwk wkï‡`i kÖe‡Yi mgm¨vI †`Lv w`‡Z cv‡i| AwURg †¯úKUªvg
wWRAW©v‡ii mvaviY jÿY¸‡jv †_‡KI (†hgb bvg WvK‡jI ZvKvq bv) g‡b n‡Z cv‡i Zviv ïb‡Z cvq bv
wKš‘ Zviv Avm‡j ïb‡Z cvq| GKUv wkï hw` A‡b¨i K_vq we‡kl K‡i Zvi bvg WvK‡j †Kvb mvov bv †`q,
Zvn‡j Zvi kÖeY mgm¨v Av‡Q wKbv Zv cixÿv Kiv AZ¨šÍ Riæwi| g~j¨vqb cÖwµqv cy‡iv Ux‡gi Kv‡Q cÖkœ Kivi
I civgk© cvIqvi Rb¨ DËg mgq| g~j¨vq‡bi djvdj Avcbvi mšÍv‡bi wPwKrmv I e¨e¯’vcbvi cwiKíbvq
mvnvh¨ Ki‡e| d‡jv-Avc cÖkœ wb‡q Kvi mv‡_ †`Lv Ki‡eb Zv Aek¨B wR‡Ám Ki‡eb|

bb KwgDwb‡Kej wWwRR K‡›Uªvj †cÖvMÖvg


6
AwURg _vKv wkïi gv‡S Av‡iv Ab¨vb¨ wKQz cÖwZK‚jZv/Ae¯’v _vK‡Z cv‡i t
Bw›`ªqMZ mgm¨v t
AwURg _vKv A‡bK wkïB †`Lv, †kvbv, MÜ, ¯^v` I ¯ú‡k©i cÖwZ AwZ mwµq/ms‡e`bkxj ev cÖwZwµqvnxb
_vK‡Z cv‡i|
• nvév ¯úk© A_ev Zv‡`i Kvc‡oi ¯ú‡k©i Abyf‚wZ Zvi Kv‡Q A¯^w¯ÍKi AcQ‡›`i A_ev Abvivg`vqK
n‡Z cv‡i|
• we‡kl †Kvb kã Zvi Rb¨ †e`bv`vqK/hš¿Yv`vqK n‡Z cv‡i, †hgb: f¨vKzqvg wK¬bv‡ii AvIqvR,
†Uwj‡dv‡bi wis‡Uvb A_ev nVvr S‡oi AvIqvR; A‡bK mgq †m Zvi Kvb Xv‡K Ges wPrKvi K‡i|
• M‡elKMY Abyf‚wZi eûwea ai‡bi Z‡_¨i mgš^q †_‡K GB Abwf‡cÖZ cÖwZwµqv¸‡jv wbY©q Kivi
†Póv Pvwj‡q hv‡”Qb|

Ny‡gi Amyweav/mgm¨v t
AwURg _vKv wkï‡`i Nyg Avmv ev Nywg‡q _vKvi A_ev Ny‡gi mgm¨v _v‡K| GB mgm¨vi Kvi‡Y Zv‡`i g‡bv‡hvM
K‡g hvq A_ev Kv‡Ri cÖwZ I Zv‡`i mÿgZv K‡g hvq Ges Zvi AvPi‡Y cÖfve †d‡j| Av‡iv D‡jøL¨, GB
Ny‡gi Amyweav; AwURg _vKv wkïi wcZv-gvZv m‡e©vcwi cy‡iv cwievi‡K wePwjZ/`ywðšÍvMÖ¯Í K‡i Ges Zv‡`i
mvwe©Kfv‡e (fMœ ¯^v¯’¨) Amy¯’ K‡i †Zv‡j| Ny‡gi mgm¨v Dck‡g AvPi‡Yi cwieZ©b KL‡bv KL‡bv mydj G‡b
†`q, †hgb: Ny‡gi mg‡qi iæwUb AbymiY Kiv A_ev weQvbvq hvevi iæwUb ˆZwi Kiv| wKQz wkï-Ny‡gi Jla
e¨envi Ki‡j fvj Nygvq, Ô†gjv‡UvwbbÕ GKwU ni‡gvb hv kix‡ii Nyg I RvMi‡Yi mvB‡Kj‡K wbqš¿Y K‡i | †h
†Kvb Jl‡ai gZ, Ô†gjv‡UvwbbÕ Gi I AcÖZ¨vwkZ cvk¦©cÖwZwµqv _vK‡Z cv‡i| ZvB Ny‡gi Amyweav wPwKrmvq
Ô†gjv‡UvwbbÕ e¨env‡ii c~‡e©B Avcbvi wkïi wPwKrm‡Ki mv‡_ K_v e‡j m¤¢ve¨ SuywK Ges DcKvi wel‡q †R‡b
wbb| AwURg _vKv Avcbvi wkïwUi mwVK AvPiY I Kv‡Ri DbœwZi Rb¨ AwURg _vKv wkïi Ny‡gi mgm¨vi
wPwKrmv Kiæb; G‡Z cwiev‡ii `ywðšÍvi cÖkgb n‡e|

eyw×cÖwZeÜKZv t
A‡bK AwURg _vKv wkïi gv‡S wKQz gvÎvq eyw× cÖwZewÜZv Av‡Q| Afxÿv cÖ‡qvM Ki‡j wKQz †ÿ‡Î ¯^vfvweK
mvg_© _vK‡jI, we‡kl K‡i eyw×e„Ëxq (wPšÍvg~jK) Kv‡R Ges fvlvi †ÿ‡Î Zviv `ye©j n‡q _v‡K| D`vniY¯^iƒc-
GKwU wkï hvi AwURg Av‡Q- †`‡L KvR Kivi †ÿ‡Î †hgb (GK‡Î cvRj †gjv‡bvi †ÿ‡Î) fvj K‡i wKš‘
fvlvi e¨envi K‡i †Kvb mgm¨v mgvav‡bi Kv‡R fvj bvI Ki‡Z cv‡i| wKš‘ hv‡`i G¨vmcviRvi wm‡Ûªvg
Av‡Q Zv‡`i KLbI ¯^vfvweK ev ¯^vfvwe‡Ki †P‡q †ewk fvlvMZ `ÿZv _v‡K Ges eyw× I fvlvi e¨env‡i †Kvb
wej¤^/†`wi nqbv|

wLuPzwbi mgm¨v t
AwURg _vKv wkï‡`i PviR‡bi g‡a¨ GKR‡bi wLuPzbx Av‡Q| Kv‡iv wLuPzbx ïiæ nq wkïKv‡j, Kv‡iv ïiæ nq
ˆK‡kv‡i| gw¯Í‡®‹i Af¨šÍ‡i Zwor cÖev‡ni A¯^vfvweK Kvh©µgB wLuPzbxi KviY:-
• LyeB ¯^í mg‡qi Rb¨ A‡PZb nIqv ev AÜKvi †`Lv|
• wLuPzbx nIqv wbqš¿Ynxbfv‡e mviv kix‡i SvKzwb Abyf‚Z nIqvq A_ev A¯^vfvweK bovPov|
• Starting spells.
bb KwgDwb‡Kej wWwRR K‡›Uªvj †cÖvMÖvg
7
KLbI KLbI Nyg Kg nIqv ev A‡bK R¡‡ii Kvi‡Y wLuPzbx n‡Z cv‡i| GKwU B‡j‡±ªvGb‡mdv‡jvMÖvg (BBwR),
†iKW© gw¯Í‡®‹i ˆe`y¨wZK Zi‡½i Kvh©µg cixÿv K‡i hv wkïi gv‡S wLuPzbxi Ae¯’v Rvb‡Z mvnvh¨ K‡i _v‡K|
wKQz wkïi A¯^vfvweK BBwR †iKW© _vK‡jI, wLuPzbxi mgm¨v bvI _vK‡Z cv‡i| wLuPzbx cÖwZ‡ivaK Jla w`‡q GB
wLuPzbxi wPwKrmv Kiv hvq| wKQz wLuPzbx cÖwZ‡ivaK Jla wkïi AvPi‡Y cÖfve †dj‡Z cv‡i; AwURg _vKv wkïi
AvPiY cwieZ©‡b wbweofv‡e bRi w`‡Z n‡e| †ewkifvM †ÿ‡Î, wPwKrmKMY
Kg gvÎvi Jla cÖ‡qvM K‡i Kvh©KvwiZv jÿ¨ K‡ib| wLuPzbx cÖwZ‡ivaK Jla
wLuPzbx nevi cÖeYZv‡K Kwg‡q †`q wKš‘ mevi †ÿ‡Î Zv cÖwZ‡iva Kiv hvq bv|
†d«RvBj G· wm‡Ûªvg t
†d«RvBj G· wm‡Ûªvg GKwU †R‡bwUK Amyweav Ges †ewkifvM eyw×cÖwZewÜZvi
mvaviY aiY| hv eskMZfv‡e cÖKvwkZ, jÿY¸‡jv AwUR‡gi mv‡_ wg‡j
hvq| GB bvgwU G·‡µv‡gvR‡gi GKwU Ask †_‡K G‡m‡Q †hLv‡b ÿwZMÖ¯Í
AskwU cÖKvwkZ n‡q‡Q Ges hv LyeB bvRyK| (†d«RvBj gvB‡µv‡¯‹v‡ci
mvnv‡h¨ †`Lv hvq)| †d«RvBj G·‡µv‡gvRg cwiewZ©Z nq, hv‡K wgD‡Ukb
e‡j hv GKwU wR‡b _v‡K| Rwo‡q aiv ev ¯úk© Kiv cQ›` K‡ibv
wKQz e¨w³i mvgvb¨ AvKv‡ii GKvU wgD‡Ukb nq hvi †Kvb jÿY _v‡K bv| Avevi Ab¨ hv‡`i eo AvKv‡ii
GKwU wgD‡Ukb nq Zv‡`i ¸iæZi jÿY cÖKvwkZ nq| AwURg wkï‡`i cuwPkR‡bi gv‡S GKR‡bi GB
wgD‡Ukb _v‡K hvi KviY †d«RvBj G· wm‡Ûªvg|
AwURg _vKv wkïi †d«RvBj G· wm‡Ûªvg cixÿv Ki‡Z n‡e| we‡kl K‡i evev-gv hw` cieZ©x mšÍvb wb‡Z
Pvb| cwiev‡ii Ab¨vb¨ m`m¨iv hvivI mšÍvb †bevi cwiKíbv Ki‡Qb ZvivI †d«RvBj G· wm‡Ûªvg cixÿv
K‡i wb‡Z cv‡ib| Av‡iv Rvb‡Z The Eufice Kennedy Shriver National Institute of Child Health and
Human Development Gi I‡qemvBU †`L‡Z cv‡ib| http://www.nichd.nih.gov/health/topics/ fragile-
X-syndrome.efm.

wUD‡eivm †¯‹‡j‡ivwmm t
GwU GKwU `yj©f †R‡bwUK Amyweav hv gw¯Í‡®‹ ev Ab¨ A‡½ bb K¨vbmvivm wUDgvi ˆZwi K‡i| 1 †_‡K 4%
AwURg _vKv wkïi gv‡S GB wUD‡eivm †¯‹‡j‡ivwmm _vK‡Z cv‡i| Gi KviY n‡”Q, †R‡bwUK/eskMwZ
wgD‡Ukb; eyw×cÖwZewÜZv, wLuPzbx, Ab¨vb¨ kvixwiK I gvbwmK ¯^v¯’¨MZ mgm¨vi mv‡_I Gi m¤ú„³Zv _vK‡Z
cv‡i| wPwKrmv wb‡q m¤ú~Y© Av‡ivM¨ jvf Kiv bv †M‡jI Gi A‡bK¸‡jv jÿ‡Yi wPwKrmv Kiv m¤¢e|
†c‡Ui mgm¨v t
AwURg _vKv wkï‡`i AwffveKMY cÖvqktB Zv‡`i wkï‡`i nR‡gi Amyweav, †c‡Ui e¨v_v, Wvqwiqv, †KŠôKvwVb¨,
M¨v÷ªvBwmm (†c‡Ui M¨vm), ewg A_ev Bloating wel‡q Awf‡hvM K‡ib ev Rvbvb| AwURg _vKv wkïi Rb¨
†Kvb Lvev‡ii cÖwZ GjvwR© Gi GKwU KviY| wkïi †c‡Ui mgm¨vq welqwU h‡_ó cwi¯‹vifv‡e Rvbv bv _vK‡j
GKRb †c‡Ui †ivM we‡kl‡Ái civgk© wbb, wZwb Avcbv‡K Gi KviY I mwVK wPwKrmvi civgk© w`‡Z cvi‡eb|
wKQz mgxÿvi cÖwZ‡e`b †`Lv †M‡Q †h AwURg _vKv wkï‡`i †c‡Ui mgm¨vi jÿY _vK‡jI GUv me AwURg
_vKv wkïi Rb¨ cÖ‡hvR¨ bq| †hgb: wg‡b‡mUvi mv¤úªwZK GKwU M‡elYvq †`Lv †M‡Q AwURg _vKv wkïwUi
kvixwiK I AvPiYMZ Amyweavi mv‡_ Zvi Lvev‡ii m¤ú„³Zv Av‡Q (D`vniY j¨vK‡UvR MÖn‡Y Amyweav A_ev
wKQz wbw`©ó Lvevi MÖnY/Bbwm÷) hv Zvi Rb¨ †KŠôKvwVb¨ ˆZwi K‡i| GB M‡elYvwU civgk© †`q †h, AwURg
_vKv †hme wkï‡`i †c‡Ui gv‡S mgm¨vwU A¯úó (AvÛvi jvBwqs) Av‡Q, wKš‘ Zv‡`i AvPiY †c‡Ui mgm¨vi
jÿY cÖKvk Ki‡Q †hgbt hviv GKwU wbw`©ó ai‡Yi Lvevi Lvq hv h‡_ó cwigv‡Y Avukhy³ bq A_ev Zij Lvq-

bb KwgDwb‡Kej wWwRR K‡›Uªvj †cÖvMÖvg


8
GwU wKš‘ Zvi †KŠôKvwV‡b¨i jÿY|
wKQz evev-gv Av‡Qb hviv Zv‡`i wkï‡`i †c‡Ui mgm¨v ev AwURg‡K wbqš¿‡Yi Rb¨ we‡kl Lvevi w`‡q _v‡Kb|
KLbI wKQz GB mxwgZ ai‡Yi Lvev‡ii wkïwU DcK…Z n‡Z cv‡i| Z‡e we‡kl Lvev‡i AwUR‡gi jÿY Kgvq
G wel‡q †Rvov‡jv †Kvb cÖgvY †bB|
†Kvb we‡kl Lvevi w`‡Z PvB‡j cÖ_‡gB †c‡Ui †ivM we‡klÁ I cywówe‡`i mv‡_ civgk© K‡i wb‡Z n‡e I wkïi
cywói Pvwn`v c~iYI wbwðZ K‡i wb‡Z n‡e|
D™¢‚Z-gvbwmK Amy¯’Zv/Ae¯’v t
AwURg _vKv wkïi gv‡S DwØMœZv, G‡Ubkb †WwdwmU nvBcv‡iKwUf wWmAW©vi (GwWGBPwW) A_ev welbœZv
_vK‡Z cv‡i| M‡elYvq †`Lv hvq- AwURg _vKv e¨w³iv ¯^vfvweK e¨w³‡`i †P‡q gvbwmK Amy¯’Zvi †ÿ‡Î †ewk
SzuwKc~Y© nq| GB D™¢‚Z gvbwmK Ae¯’v †_‡K DËi‡Yi Rb¨ Jla A_ev AvPiY wPwKrmv w`‡q Zv‡`i‡K Zv‡`i
wb‡Ri AvPiY wbqš¿Y †KŠkj †kLv‡bv hvq I AwUR‡gi Pig Ae¯’vi wbqš¿Y K‡i jÿY¸‡jv Kgv‡bv hvq| GB
Ae¯’vi wbqš¿Y K‡i AwURg _vKv wkïi AvPiY e¨e¯’vcbv †bIqv hvq|

bb KwgDwb‡Kej wWwRR K‡›Uªvj †cÖvMÖvg


9
AwUR‡gi wPwKrmv wK?
hw`I A`¨ewa AwUR‡gi m¤ú~Y© wbivgq †hvM¨ †Kvb wPwKrmv c×wZ cÖgvwYZ nqwb, Z_vwc AwUR‡gi `ªæZ
wPwKrmv, h‡_vc‡hvMx ¯‹zj wkÿv cÖwkÿY Kg©m~wP MÖnY Ges mwVK ¯^v¯’¨ †mev GKwU wkïi AwUR‡gi mgm¨v¸‡jv
A‡bK n«vm K‡i, wkïi mwVK fv‡e †e‡o IVv I bZyb `ÿZv e„wׇZ mnvqZv K‡i|

cÖviw¤¢K cÖwkÿY †KŠkj (Early Intervention) t


M‡elYvq †`Lv †M‡Q †h, wbweo e¨envwiK cwiPh©v (Intensive behavioral therapy) wkï eq‡mi Ges
cÖvK-cÖv_wgK ¯‹zjMvgx AwUR‡g AvµvšÍ †QvU wkï‡`i fvlv I eyw×gËv weKv‡k Afvebxq DbœwZ Av‡b| mKj
AwUw÷K wkïi Rb¨ GKK †Kvb †kÖô wPwKrmv †bB| m¤úªwZ Av‡gwiKvb GKv‡Wwg Ae †cwWªKwUª· cÖvK-
cÖv_wgK cÖwkÿY †KŠkj wbwY©Z nIqvi ci h_vm¤¢e kxNªB Zv‡K cÖwkÿ‡Yi AvIZvq Avbvi mycvwik K‡i‡Q|
1. GKwU wkïi AwURg wbwY©Z nIqvi ci h_vm¤¢e kxNªB Zv‡K cÖwkÿ‡Yi AvIZvq Avbv|
2. cÖ‡Z¨KwU wkï‡K Zvi h‡_vc‡hvMx weKvkMZ Ae¯’vb Abyhvqx wbweo, †K›`ªxf‚Z Ges P¨v‡jwÄs
wkÿvi Kvh©µ‡g m¤ú„³ Kiv hv mßv‡n 25 N›Uv K‡i mviv eQi a‡i Pj‡e|
3. †QvU †QvU K¬v‡m 1:1 QvÎ wkÿK ev †_ivwc‡÷i wfwˇZ cÖwkÿ‡Yi e¨e¯’v Kiv Ges †QvU †QvU
`jxq wkÿv Kvh©µ‡gi e¨e¯’v Kiv|
4. AwffveK I cwiev‡ii m`m¨‡`i Rb¨ we‡kl cÖwkÿ‡Yi e¨e¯’v|
5. mywbw`©ó wKQz wkÿv cÖwkÿ‡Yi D‡Ïk¨‡K mdj Kivi j‡ÿ¨ Ggb wKQz Kvh©µg‡K DrmvwnZ Kiv
hv‡Z ¯^vfvweK weKvkcÖvß wkï‡`i AšÍfz©³ Kiv hvq|
6. cÖ ‡ Z¨KwU wkïi Dbœ w Z cwigvc Kiv Ges wjwce× Kiv Ges †mB Aby h vqx Kvh© µ g‡K
cÖ‡qvRb‡ev‡a cybweb¨vm Kiv|
7. cwiKwíZ Kvh©µ‡g wkï‡K AwaK gb‡hvMx Kivi j‡ÿ¨ wb¤œwjwLZ welq¸‡jv mywbwðZ Kiv:-
• D”P gvÎvi mymsNwUZ Kvh©µg (high degree of structure)
• Kvh©µ‡gi iæwUb
• Qwe Øviv (visual cues) †hgb cÖwZwU Kvh©µ‡gi Qwe m¤^wjZ iæwU‡bi e¨envi Ges cÖ`k©b
• cÖ‡Z¨KwU Kvh©µ‡gi mywbw`©ó ¯úó `k©Yxq mxgvbv.........|
8. AwR©Z `ÿZv/`ÿZv¸‡jv‡K bZyb bZyb cwi‡e‡k I cwiw¯’wZ‡Z Kv‡R jvMv‡bvi †ÿ‡Î Ges eRvq
ivL‡Z w`K wb‡`©kbv I cÖwkÿY †`Iqv|
9. cvV¨m~wP‡Z wb¤œwjwLZ welq¸wji Dci AwaK g‡bv‡hvMx nIqv-
fvlv Ges †hvMv‡hvM t
• mvgvwRK `ÿZv †hgb R‡q›U G¨v‡Ubkb (Ab¨ †Kvb e¨w³i w`‡K ZvwK‡q Zvi g‡bv‡hvM AvKl©Y K‡i
†Kvb AvKl©Yxq ev cQ‡›`i wKQz †`Lv‡bv Ges AwfÁZv Share Kiv)|
• AvZ¥wbf©ikxj Ges cÖvZ¨wnK Kv‡Ri `ÿZv †hgb Rvgv Kvco civ, cwi¯‹vi cwi”QbœZv|
• P¨v‡jwÄs e¨envi †hgb AvµgYvZ¥K AvPiY I wPrKvi †PuPv‡gwP (Tantrums) Kgv‡bvi j‡ÿ M‡elYv
wbf©i c×wZi e¨envi|

bb KwgDwb‡Kej wWwRR K‡›Uªvj †cÖvMÖvg


10
• ÁvbMZ `¶Zv (Cognitive skill), †hgb wg‡QwgwQ †Ljv ev A‡b¨i wPšÍvaviv‡K (point of view) †Lqvj Kiv|
• mvaviY ¯‹z‡j hvevi `ÿZv †hgb eY©gvjv †Pbv, msL¨v MYbv Kiv|
e¨vcKfv‡e cÖPwjZ Ges MÖnY‡hvM¨ GKwU wkÿv c×wZ n‡”Q cÖ‡qvwMK e¨envwiK we‡kølY (Applied
Behaviour Analysis) A_ev GweG|
GweG Gi D‡Ïk¨ n‡”Q bZzb e¨envi‡K mwVKfv‡e M‡o †Zvjv I cyi¯‹…Z Kiv, †hgb K_v ej‡Z †kLv, †Lj‡Z
†kLv BZ¨vw` Ges AcÖKvwkZ AvPiY‡K Kgv‡bv|
GweG c×wZ‡Z AZ¨šÍ wbweofv‡e 1:1 QvÎ wkÿK Abycv‡Z wµqv cÖwZwµqvi gva¨‡g mßv‡n 40 N›Uv cÖwkÿY
†`Iqv nq| GweG c×wZ mvaviYZ Ab¨vb¨ GKB ai‡Yi wkÿv cÖwkÿY hv AwUR‡g AvµvšÍ wkïi DbœwZ I
m¤¢vebv‡K weKwkZ K‡i Zv‡`iI AbycÖvwYZ K‡i|

GweG wfwËK wKQz wkÿv cÖwkÿY t


†gŠwLK e¨envi (Verbal behavior)
• fvlv †kLvi Dci ¸iæZ¡ Av‡ivc|
• K_vi cÖwZaŸwb (echoing) †_‡K ïiæ K‡i GKwU wkï‡K avivevwnKfv‡e cvV¨m~wP AbymiY K‡i
µgvš^‡q e¨envwiK I A_©c~Y© †hvMv‡hvM †kLv‡bv|
• ÎæwUnxb wkLb Ges cÖ¤úwUs †KŠkj AbymiY Kiv|

wc‡fvUvj †imcÝ †Uªwbs (Pivotal Response Training)


GB c×wZi g~j D‡Ïk¨ n‡jv t
• wkïi wKQz ¸iæZ¡c~Y© AvPiY‡K mbv³ Kiv †hgb ¯^-D‡`¨vMg~jK AvPiY Ges ¯^-e¨e¯’vcbvi mÿgZv
hv Ab¨vb¨ AmsL¨ AvPiY‡K cÖfvweZ K‡i|
• GB cÖwkÿ‡Y AwffveK Ges cwiev‡ii wkÿv‡KI AšÍf©y³ Kiv nq| hvi D‡Ïk¨ n‡”Q Ggb wKQz
`ÿZv cÖ`vb Kiv hv‡Z GKwU wkï GwKf‚Z cwi‡e‡kI KvR Ki‡Z cv‡i|
Av‡iv wKQz cÖviw¤¢K wkÿv cÖwkÿY †KŠkj t
†W‡fjc‡g›Uvj, BwÛfwRy¨qvj wWdv‡iÝ, wi‡jkbkxc-†eRW (DIR)
†d¬vi UvBg g‡Wj t
• GB cÖwkÿY †KŠkjwUi D‡Ïk¨ n‡jv GKwU wkïi mv‡_ ¯^vfvweK Av‡eM Ges AvMÖn‡K AbymiY K‡i
wkïwUi mv‡_ ¯^vfvweK Ges A_©c~Y© m¤úK© ˆZwi Kiv|
• Gi GKwU Ab¨Zg D`vniY n‡jv EARLY START DENVER MODEL (ESDM) hv GKwU wkïi
†hvMv‡hvM, wPšÍvkw³, fvlv Ges Ab¨vb¨ mvgvwRK `ÿZvi cÖwZ bRi †`q Ges AcÖZ¨vwkZ AvPiY‡K
Kgv‡Z †Póv K‡i| †h‡nZz GB cÖwkÿY GKwU wkïi weKvk Ges Zvi mv‡_ cvi¯úwiK m¤ú‡K©i Dci
wfwË K‡i iwPZ nq, GB †KŠkj¸‡jv Ab¨vb¨ cÖvK…wZK cwi‡e‡k †hgb evwo‡Z A_ev cÖvK-cÖv_wgK
we`¨vj‡qI PP©v Kiv hvq|
bb KwgDwb‡Kej wWwRR K‡›Uªvj †cÖvMÖvg
11
wUP [Treatment and Education of Autistic and related Communication
Handicapped Children (TEACCH)] t
wUP wb‡¤§v³ welq¸‡jvi Dci †Rvi w`‡q _v‡K-
• wkï‡K Zvi PZzc©v‡ki cwi‡e‡ki mv‡_ Lvc LvIqv‡Z|
• Qwei e¨envi (h_v, K¬vmiæ‡gi QvÎ/QvÎx‡`i Rb¨ h‡_vc‡hvMx, ¯úó wkÿv DcKiY e¨envi Ges Zv
Ggb ¯’v‡b Uvbv‡bv ev ivLv †hb cÖ‡Z¨KwU QvÎ-QvÎx cÖ‡qvRb‡ev‡a wb‡RivB e¨envi Ki‡Z cv‡i|
• cÖ‡Z¨KwU wkïi e¨w³‡Kw›`ªK wkÿv cwiKíbv (IEP) e¨envi K‡i wUP wkïwUi Kg©ÿgZv Ges m`¨
cÖKvwkK `ÿZv‡K GwM‡q wb‡Z mn‡hvwMZv K‡i|

AvšÍte¨w³K m¤ú©K wbf©i cÖwkÿY †KŠkj (Interpersonal Syncrony) t


GB cÖwkÿ‡Yi jÿ e¯‘ nj wkïi mvgvwRK weKvk Ges Abyiƒc `ÿZvi Dci Ges GB cÖwkÿY †KŠk‡j GKwU
wkï wKfv‡e A‡b¨i mv‡_ m¤úK© ¯’vcb Ki‡e I Zv eRvq ivL‡Z cvi‡e Zvi Dci ¸iæZ¡ Av‡ivc Kiv nq|
3 eQ‡ii wb‡P wkï‡`i mvaviYZt GB cÖwkÿY¸‡jv evwo‡Z wKsev wkï †mev †K‡›`ª †`Iqv nq| hw`I D³
Kvh©µ‡gi Dci h‡_ó M‡elYv `iKvi, BwZevPK mvgvwRK Av`vb-cÖ`vb, †bwZevPK welq‡K Gwo‡q Pjvi
†ÿ‡Î GB wkï‡`i †h `ÿZv¸‡jv evov‡bv I DbœwZi `iKvi, †mB †ÿ‡Î GB mvgvwRK `ÿZv weKvk cÖwkÿY
†KŠkj A‡b‡KB cÖ‡qvRb e‡j g‡b K‡ib| D`vniY¯^iƒc GB wkï‡`i ÔeÜzZ¡ KivÕ †kLv‡bvi cÖwkÿY wkï‡`i
K‡_vcK_b Ges cvi¯úwiK wµqv cÖwZwµqvi `ÿZv evovq Ges wKfv‡e eÜzZ¡ Ki‡Z nq, gRv Kiv hvq Ges
wKfv‡e †Kvb wZi¯‹v‡ii Dc‡hvMx cÖwZDËi w`‡Z nq ZvI GB wkïiv †k‡L|

Avcbvi wkïi ¯‹z‡ji mv‡_ Kvh©µg t


• Avcbvi wkïi ¯‹z‡ji wkÿK, ¯‹zj KvD‡Ýji, ¯‹z‡ji QvÎ mnvqZv MÖæ‡ci mv‡_ K_v ejyb Ges
Avcbvi wkïi AwUR‡gi Ae¯’vi mwVK g~j¨vqb (evaluation) Kivi wel‡q Avjvc Kiæb|
• hy³iv‡óªi cÖ‡Z¨KwU iv‡R¨ (state) ÔAwffveK cÖwkÿY Ges AbymÜvb †K›`ªÕ Av‡Q Ges ÔwbivcËv
Ges A¨vW‡fv‡Kwm G‡RwÝÕ i‡q‡Q hviv Avcbv‡K Avcbvi wkïi g~j¨vq‡b mn‡hvwMZv Ki‡e|
• we‡klÁ‡`i GKwU MÖæc bvbv ai‡Yi weÁvbwfwËK DcKiY I gvcKvwV w`‡q Avcbvi wkïi
AwUR‡gi Ae¯’vi g~j¨vqb Ki‡eb| GB g~j¨vq‡b Avcbvi wkïi †hvM¨Zvi Ges Pvwn`vi me¸‡jv
w`KB hvPvB K‡i †`Lv n‡e|
• g~j¨vqb †kl n‡j, Zvi we‡kl Pvwn`v Abyhvqx Zvi mvg‡b A‡bK¸‡jv my‡hvM _vK‡e|
• hw` Avcbvi wkïi we‡kl wkÿvi Pvwn`v _v‡K Zvn‡j †m ÔBwÛwfRy¨qvj BD_ wW‡RwewjwUm
GWz‡Kkb G¨v± (IDEA) Gi AvIZvq ci‡e| ¯‹zj KZ…©cÿ (A_ev miKvwi ms¯’v hviv GB Kg©m~wP
cwiPvjbv K‡i) Aek¨B 30 w`‡bi wfZi Avcbvi wkïi Rb¨ Zvi e¨w³‡Kw›`ªK wkÿv cwiKíbv
(IEP) ˆZwi Ki‡e|
• IDEA webvg~‡j¨ Rb¥ †_‡K 3 eQ‡ii GKwU wkïi AwURg mbv³KiY Ges cÖviw¤¢K cÖwkÿ‡Yi
e¨e¯’v K‡i _v‡K|

bb KwgDwb‡Kej wWwRR K‡›Uªvj †cÖvMÖvg


12
• IDEA 3 †_‡K 21 eQ‡ii wkï‡`i we‡kl wkÿv Ges Gi mv‡_ m¤úK©hy³ Ab¨vb¨ †mevI w`‡q
_v‡K| Av‡iv Z_¨ Rvb‡Z BDGm wkÿv wefv‡Mi I‡qemvBU †`Lyb http://idea.ed.gov|
• me AwUw÷K wkïi we‡kl wkÿve¨e¯’vi cÖ‡qvRb c‡o bv Z‡e †m webv †eZ‡b miKvwi mvaviY ¯‹z‡j
Zvi Pvwn`v Abyhvqx †mev cv‡e|
• GB †mev mKj ¯‹zjMvgx cÖwZeÜx wkïi Rb¨ (cÖwZewÜZvi aiY Ges ZxeªZv wbwe©‡k‡l) cÖ‡hvR¨|
(aviv 504, winvwewj‡Ukb A¨v± 1973)
• Rbmvavi‡Yi AwaKvi msµvšÍ hy³iv‡óªi wkÿvwefvM aviv 504 †K Kvh©µ‡g m¤ú„³ Kivi Rb¨
Kvh©Kix c`‡ÿc wb‡q _v‡K hv †K›`ªxq miKv‡ii A_©vq‡b cwiPvwjZ nq| aviv 504 m¤ú‡K©
Av‡iv Z‡_¨i Rb¨ I‡qemvBU †`Lyb www.ed.gov/about/offices/list/ocr/504faq.html. cÖwZeÜx
wkï‡`i Rb¨ hy³iv‡óªi wkÿv wefv‡Mi Kvh©µ‡gi wel‡q Av‡iv Z_¨ cvIqv hv‡e www.ed. gov/
parents/ needs/speced/edpicks.jhtml?src=in. I‡qemvB‡U|
Avcbvi wkïi gva¨wgK I D”P gva¨wgK ¯‹zj PjvKvjxb mgq ¯‹zj wkÿK wKQz e¨envwiK welq wb‡q Av‡jvPbv
Ki‡eb †hgb KvR Kiv, gv-evevi Kv‡Q bv †_‡K Ab¨ RvqMvq _vKv, wbR¯^ kL BZ¨vw` wel‡q|
GB Kvh©µ‡g Av‡iv _vK‡e Kv‡Ri AwfÁZv AR©b, mvaviY hvbevnb e¨envi Ki‡Z cviv, mgv‡R emevm Kivi
Rb¨ Riæwi †h `ÿZv cÖ‡qvRb Zv †kLv|

Jl‡ai e¨envi t
wKQz wKQz Jla Avcbvi wkïi wKQz DcmM© Kgv‡Z mvnvh¨ K‡i hv Zv‡K evwo‡Z ev ¯‹z‡j A‡bK mgm¨vq
†dj‡Q| Av‡iv A‡bK Jla †me‡bi civgk© †`Iqv nq †h¸‡jv‡K Ad †j‡ej (off-label) Jla e‡j hvi A_©
n‡jv †h Jla¸‡jv BDGm dzW A¨vÛ WªvM GWwg‡b‡÷ªkb (FDA) KZ…©K †Kv‡bv we‡kl Kvi‡Y ev †Kv‡bv we‡kl
e¨w³e‡M©i e¨env‡ii AbygwZ †`Iqv nqwb| wPwKrmKiv mvaviYZt Ad †j‡ej (off-label) Jla †me‡bi
civgk© w`‡q _v‡Kb hLb ASD Gi mv‡_ mswkøó Av‡iv wKQz AvPiY _v‡K hvi Jla¸‡jv Aby‡gvw`Z| A_ev †hB
Jla¸‡jv cÖvß eq¯‹ Ges eo AwUw÷K wkï‡`i †ÿ‡Î e¨envi K‡i Kvh©Kix djvdj cvIqv †M‡Q| wPwKrmKiv
Ad †j‡ej Gi Jla Aí eqmx †ivMx‡`i A‡bK mgq w`‡q _v‡Kb| GB Jla¸‡jv ASD wkï Ges wK‡kvi‡`i
†ÿ‡Î KZUzKz wbivc` I Kvh©Kix †mB wel‡q wbwðZ nIqvi Rb¨ Av‡iv cÖPzi M‡elYvi cÖ‡qvRb| A`¨ewa, †h
Jla¸‡jv AwUw÷K e¨w³‡`i †ÿ‡Î e¨envi Kivi Aby‡gv`b †c‡q‡Q Zv nÕj A¨vw›U mvB‡KvwUK&m wim‡cwiWb
Ges G¨vwi wcÖcvRj| D³ Jla¸‡jv 5-16 eQ‡ii AwUw÷K wkï‡`i weiw³Ki AvPiY h_v AvµgYvZ¥K
AvPiY, wb‡RK AvNvZ Kiv, wPrKvi †PuPv‡gwP Kiv, BZ¨vw` wbqš¿‡Y mvnvh¨ K‡i| wKQz wKQy Ad †j‡ej Jla
†h¸‡jv AwUw÷K wkï‡`i Rb¨ e¨envi Kiv nq †m¸‡jv n‡jvt

Gw›UmvB‡KvwUK Jla t
mvaviYZt Zxeª gvbwmK Amy¯’Zv †hgb wm‡Rvwd«wbqvq e¨eüZ nq| GB Jla¸‡jv mvaviYZ: AwUw÷K wkïmn
Ab¨vb¨ wkï‡`i AvMÖvmx AvPiY, Ab¨vb¨ Zxeª e¨envwiK mgm¨v wbim‡b mnvqZv K‡i| GQvov GB RvZxq
Jla¸‡jv cybive„wËg~jK AvPiY, AwZ PvÂj¨Zv, gb‡hv‡Mi mgm¨v wbevi‡YI mnvqZv K‡i|

welbœZv †ivaKvix Jla (Gw›UwW‡cÖ‡m›U) t


†hgb d¬z‡·wUb (†cÖvRvK) A_ev mviUªvwjKb (RjdU&) mvaviYZt welbœZv †ivM Ges `ytwðšÍvMÖ¯Í mgm¨vq
e¨envi Kiv nq| Avevi gv‡S gv‡S cybive„wËg~jK AvPiY †iv‡aI e¨eüZ nq|

bb KwgDwb‡Kej wWwRR K‡›Uªvj †cÖvMÖvg


13
wKQz wKQz †ÿ‡Î AwUw÷K wkï‡`i AvMÖvmx AvPiY I `ytwðšÍvMÖ¯Í mgm¨v †iv‡aI Gw›UwW‡cÖ‡m›U e¨eüZ n‡q
_v‡K| Z‡e M‡elKiv GLbI GB Jla¸‡jvi Kvh©KvwiZv I DcKvwiZv m¤ú‡K© wbwðZ bv| AwZ m¤úªwZ
Gw›UwW‡cÖ‡m›U wmUv‡jvcÖvg wb‡q GKwU M‡elYvq †`Lv wM‡q‡Q †h AwUw÷K wkïi cybive„wËg~jK AvPiY
†iv‡a wmUv‡jvcÖvg Ges cøvwm‡evi (wPwbi `vbv) f‚wgKv GKB| (cÖeÜwU †`Lyb http://www.nimh.gov/
sciencenews/2009/citalopram-no-better-than-placebo-treatment-for-childrenwith-
autism-spectrum-disorders. shtml.)

DÏxcK Jla (w÷gy‡j›U) t


†hgb wg_vBj †dwb‡WU (wiUvwjb) A¨v‡Ubmb †WwdwmU nvBcvi GKwUwfwU wWRAW©vi (ADHD) wPwKrmvi
Rb¨ GKwU wbivc` Ges Kvh©Kix Jla| wg_vBj †dwb‡WU AwUw÷K wkï‡`i I AwZ PvÂj¨Zv Kgv‡bvi †ÿ‡Î
Kvh©Kix e‡j ejv n‡q _v‡K| wKš‘ Kvh©‡ÿ‡Î †`Lv hv‡”Q, Lye †ewk msL¨K AwUw÷K wkïiv GB Jl‡a mydj
jvf Ki‡Q bv| Ges hviv DcK…Z n‡q‡Q Zv‡`i cvk¦©cÖwZwµqv ADHD wkï‡`i †_‡K †ewk n‡”Q| cÖ‡Z¨KwU
Jl‡aiB cvk¦©cÖwZwµqvi SzuwK _v‡K| gvbwmK †iv‡M e¨eüZ cÖPwjZ Jla cvk¦©cÖwZwµqvi e¨vcv‡i Av‡iv
we¯ÍvwiZ Rvb‡Z n‡j NIMH Gi I‡qemvBU †`Lyb “Medications” http://www.nimh.nih.gov/
health/publications/mental-health-medications/index. shtml.

Gw›UwW‡cÖ‡m›U Jl‡ai wel‡q FDA Gi mZK©Zv t


Gw›UwW‡cÖ‡m›U mvaviYZt wbivc` I RbwcÖq Jla| wKš‘ wKQz wKQz cixÿv wbixÿvq †`Lv †M‡Q †h †Kv‡bv †Kv‡bv
e¨w³i †ÿ‡Î we‡kl K‡i wK‡kvi I ZiæY‡`i wfZi GB Jla A‡bK mgq weiƒc cÖwZwµqvi m„wó K‡i|
ZvB FDA mZK© K‡i w`‡q‡Q †h mKj eq‡mi †ivMx hviv GB Jla †meb K‡i Zv‡`i Lye wbweofv‡e ch©‡eÿY
Kiv DwPZ, we‡kl K‡i wPwKrmvi cª_g K‡qK mßvn| m¤¢ve¨ †h cvk¦©cÖwZwµqv¸‡jvi cÖwZ bRi w`‡Z n‡e
†m¸‡jv n‡jv welbœZvi AebwZ nIqv, AvZ¥nZ¨v Kivi wPšÍvfvebv ev Z`iƒc e¨envi, A¯^vfvweK e¨envwiK
cwieZ©b h_v Ny‡gi mgm¨v, Aw¯’iZv, ¯^vfvweK mvgvwRK cwi‡ek †_‡K wb‡R‡K ¸wU‡q †bIqv BZ¨vw`| †ivMxi
cwievi Ges hZœKvixiv GB ai‡bi †Kv‡bv cwieZ©b †`L‡j Aek¨B wPwKrm‡Ki civgk© †b‡eb| mv¤úªwZK Z_¨
Rvbvi Rb¨ FDA Gi I‡qemvBU †`Lyb http://www.fda.gov.

• AwURg ˆewkó¨m¤úbœ wkïiv mvaviYZ: Ab¨vb¨ ¯^vfvweK wkï‡`i g‡Zv GKBfv‡e Jl‡a cÖwZwµqv K‡i bv|
• Avcwb Avcbvi wkïi Rb¨ †mB me wPwKrmK‡`i mv‡_ †hvMv‡hvM Ki‡eb hv‡`i AwUw÷K wkï‡`i
wPwKrmv Kivi AwfÁZv i‡q‡Q|
• Avcbvi wkïi mgm¨vMÖ¯Í DcmM© wbqš¿Y Kivi †ÿ‡Î Jla †`evi cÖ‡qvRb n‡j wPwKrmK‡K memgq
Jla Kg gvÎv †_‡K ïiæ Kiv DwPZ|
• Avcbvi wkïi wPwKrmK‡K Aek¨B wkï‡K †meb Ki‡Z †`Iqv Jl‡ai cvk¦©cÖwZwµqvi K_v wR‡Ám
Ki‡eb Ges Avcbvi wkïi Jla †me‡b wK cÖwZwµqv n‡”Q ZvI wjwce× Ki‡eb|
• wPwKrm‡Ki DwPZ n‡e Jl‡ai djvdj jÿ¨ Kivi Rb¨ wbqwgZ Avcbvi wkï‡K †`Lv|
• Avcbvi wkïi AwUR‡gi wPwKrmvi Rb¨ Avcbvi Kv‡Q A‡bK¸‡jv my‡hvM Av‡Q|
• Z‡e ˆeÁvwbK cixÿv wbixÿvq cÖgvwYZ n‡q‡Q †h me¸‡jv mgvb Kvh©Kix bq|

bb KwgDwb‡Kej wWwRR K‡›Uªvj †cÖvMÖvg


14
• Avcbvi wkïi e¨eüZ Jl‡ai †ÿ‡Î Avcbvi Rb¨ cÖ‡qvRbxq Z_¨¸‡jv g‡bv‡hvM w`‡q co‡eb|
• A‡bK e¨w³ †ivMxi cÖ‡qvRbxq Z_¨¸‡jv †ivMxi Riæwi KvM‡Ri mv‡_ †i‡L _v‡Kb, hv wZwb †Kv‡bv
cÖ‡qvR‡b mn‡RB †`Lv‡Z cv‡ib|
• G¸‡jv LyeB cÖ‡qvRbxq n‡q c‡o hLb A‡bK¸‡jv Jl‡ai †cÖmwµckb wb‡q KvR Ki‡Z nq|
• Avcwb Avcbvi wkïi wPwKrmvi e¨vcv‡i cÖ‡Z¨KwU‡Z wK wK fv‡jv djvdj Ges m¤¢ve¨ wK cvk¦©cÖwZwµqv
n‡Z cv‡i GB e¨vcv‡i m¤ú~Y© ev¯Íe Z_¨ msMÖn Ki‡eb|
• Avcbvi wkïi e¨vcv‡i bZzb †K‡bv wPwKrmv ïiæ Kivi c~‡e© m¤¢e n‡j G‡Ki AwaK we‡kl‡Ái civgk© †b‡eb|

bb KwgDwb‡Kej wWwRR K‡›Uªvj †cÖvMÖvg


15
AwURg †¯úKUªvg wWRAW©vi GUv wK mPivPi †`Lv hvq ?
AwUR‡gi e¨cKZv m¤ú‡K© cwigvc Ki‡Z wM‡q wewfbœ mgxÿvq †`Lv wM‡q‡Q †h AwUR‡g AvµvšÍ wkïi msL¨v
wewfbœ mg‡q wewfbœ n‡q‡Q| KLb, †Kv_vq GB mgxÿv¸‡jv Kiv n‡q‡Q Ges H mgxÿvq AwUR‡gi msÁv
wK †bIqv n‡qwQj, GB welq e¯‘¸‡jvB wfbœ djvd‡ji Rb¨ `vqx wQj| 2009 mv‡j hy³iv‡óª miKvwifv‡e
AwUR‡gi e¨vcKZv m¤ú‡K© Rwic Kiv nq| †m›Uvi di wWwRR K‡›Uªvj A¨vÛ wcÖ‡fbmb Gi (CDC) GB Rwi‡c
†`Lv hvq †h ASD Gi nvi weMZ eQi¸‡jvi ASD Rwi‡ci nvi †_‡K A‡bK †ewk| CDC mgMÖ hy³iv‡óªi
14wU m¤úª`v‡qi 8 eQi eqm ch©šÍ wkï‡`i ¯^v¯’¨ I ¯‹zj †iK‡W©i Dci wfwË K‡i GKwU Rwic K‡i| CDC
GB Rwi‡c †`Lv hvq †h cÖwZ 110 Rb wkïi wfZi 1 Rb wkï AwUR‡g AvµvšÍ Ges †`Lv hvq †h AwUR‡g
AvµvšÍ nIqvi SzuwK †g‡q‡`i Zzjbvq †Q‡j‡`i 4-5 ¸Y †ewk _v‡K| AwUR‡gi nvi Avm‡jB evo‡Q wKbv G
wb‡q we‡klÁ‡`i gv‡S h‡_ó gZv‰bK¨ i‡q‡Q| c~e©Zb Rwic¸‡jvi ci, AwURg mbv³ Kiv Ges wbY©q Kivi
†ÿ‡Î A‡bK cwieZ©b G‡m‡Q| A‡bK AwffveK Ges wPwKrmKiv ASD m¤ú‡K© Rvb‡Qb, AwffveKiv Zv‡`i
ev”Pv‡`i AwURg wbY©‡qi Rb¨ wPwKrm‡Ki Kv‡Q wb‡q hv‡”Qb| Ges Av‡iv AwaK msL¨K wPwKrmKiv ASD
mwVKfv‡e wbY©q Ki‡Z cvi‡Qb| Dc‡iv³ welq¸‡jv AwUR‡gi nvi e„w× cvevi GKwU Ab¨Zg KviY| GQvov,
CDC mv¤úªwZK Av‡iv wKQz M‡elYvi wi‡cvU© cÖKvk K‡i‡Q, Zv‡Z †`Lv †M‡Q c~‡e©i PvB‡Z AwaKZi wkïi
wfZi ASD jÿY mbv³ I wbY©q n‡”Q| Av‡iv Z‡_¨i Rb¨ CDC Gi AwURg welqK I‡qemvBU †`Lyb www.
cdc.gov/ncbddd/autism|

AwURg †Kb nq ?
we‡klÁ‡`i g‡Z GLbI AwUR‡gi my¯úó †Kv‡bv KviY ev KviYmg~n Rvbv hvqwb| Z‡e M‡elYvq aviYv Kiv
n‡”Q †h GB wel‡q eskMwZ (†R‡bwUKm&) Ges cwi‡e‡ki GKwU ¸iæZ¡c~Y© f‚wgKv i‡q‡Q|
eskMwZ t
Awfbœ hgR‡`i (Identical Twins) †ÿ‡Î hv‡`i †R‡bwUK ms‡KZ (Genetic code) ûeû GK _v‡K,
Zv‡`i GKRb hw` AwUR‡g AvµvšÍ nq, Avi GKR‡bi AwURg nevi SzuwK cÖwZ 10 R‡bi wfZi 9 R‡bi
_v‡K| †Kvb cwiev‡i hw` GKwU mšÍv‡bi AwURg _v‡K, cieZx© mšÍvb‡`i kZKiv 35 fvM †ÿ‡Î AwURg
nevi SzuwK _v‡K| M‡elKiv †hB wRb¸‡jv AwUR‡gi Rb¨ `vqx ev AwURg nevi SzuwK‡K evwo‡q †`q, †mB
wRb¸‡jv‡K mbv³ Kiv ïiæ K‡i‡Qb|
Z‡e GLbI ch©šÍ ˆeÁvwb‡Kiv SzuwKc~Y© wRb¸‡jv mwVKfv‡e mbv³ Kivi e¨vcv‡i c~Y© mdjZv AR©b Ki‡Z cv‡ib
wb| GB wel‡q Av‡iv Z_¨ Rvb‡Z PvB‡j ÒAwUR‡gi mv‡_ Av‡iv wK wK GwKf‚Z Ae¯’v _vK‡Z cv‡iÓ LÛwU
(Chapter) †`Lyb| †hLv‡b Fragile X syndrome Ges Tuberous sclerosis Gi wel‡q eY©bv †`Iqv Av‡Q|

†ewki fvM AwURg ˆewkó¨m¤úbœ e¨w³‡`i cvwievwiK BwZnv‡m Ab¨ †Kvb AwUw÷K e¨w³i mÜvb cvIqv hvq
bv| ZvB aviYv Kiv n‡”Q †h G‡jv‡g‡jvfv‡e ev nVvr K‡i wKQz weij †R‡bwUK cwieZ©b/iƒcvšÍi (mutation)
GKRb e¨w³i AwUR‡g AvµvšÍ nIqvi SzuwK evwo‡q †`q| †R‡bwUK Z‡_¨i †h †Kv‡bv cwieZ©b‡KB †R‡bwUK
iƒcvšÍi ev Genetic mutation ejv nq| GB iƒcvšÍi eskMZ n‡Z cv‡i, Avevi KL‡bv Gi †Kv‡bv KviY
Ly‡R cvIqv hvq bv| †R‡bwUK iƒcvšÍi/cwieZ©b KL‡bv DcKvix KL‡bv ÿwZKviK Avevi KL‡bv Gi †Kvb
cÖfve c‡o bv| A‡bK †ÿ‡Î eskMwZi Kvi‡Y AwUR‡gi SuywK _vK‡jI Zv mKj wkïi †ejvq cÖ‡hvR¨ bq|
wKfv‡e GKvwaK wR‡bi mswgkÖY Ges cwi‡ekMZ Dcv`v‡bi wgkÖ cÖfve AwUR‡gi SzuwK evwo‡q w`‡”Q, GB
welqwU Av‡iv fv‡jvfv‡e †evSvi Rb¨ A‡bK M‡elKiv A‡bK †ewk ¸iæZ¡¡ w`‡”Qb|
bb KwgDwb‡Kej wWwRR K‡›Uªvj †cÖvMÖvg
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cwi‡ekMZ Dcv`vb t
gvbe‡`‡ni evB‡i hv wKQz Av‡Q wPwKrmv kv‡¯¿ Zv‡K ejv nq Òcwi‡ekÓ| evqy †_‡K Avgiv k¦vm-cÖk¦vm †bB,
cvwb cvb Kwi, †Mvmj Kwi, Lvevi LvB, Jla †meb Kwi, Ggb Av‡iv A‡bK wRwbm Avgv‡`i kix‡ii ms¯ú‡k©
Av‡m Gi meB cwi‡e‡ki Ask| gv‡qi M‡f© _vKv Ae¯’vq Avgv‡`i PZzc©vk wQj Avgv‡`i cwi‡ek, †hLv‡b
Avgv‡`i gv‡qi ¯^v¯’¨ Avgv‡`i cÖviw¤¢K MVb I weKvk‡K cÖfvweZ K‡i‡Q| M‡elKiv cwi‡e‡ki bvbv Dcv`vb
wb‡q cixÿv wbixÿv Ki‡Qb †hgb cvwievwiK ¯^v¯’¨MZ Ae¯’v, wcZv-gvZvi eqm, Ges Av‡iv Ab¨vb¨ RbmsL¨v
ZvwË¡K Dcv`vb, welv³ c`v‡_©i ms¯ú‡k© Avmv Ges Mf©ve¯’vq Ges cÖmeKvjxb RwUjZv| aviYv Kiv n‡”Q †h
†R‡bwUK Kvi‡Yi gZB cwi‡e‡ki GKvwaK Dcv`vb AwUR‡g AvµvšÍ nIqvi SzuwK m„wó K‡i| †R‡bwUK Kvi‡Yi
gZB cwi‡e‡ki Dcv`vb GKKfv‡e AwUR‡gi SzuwK m„wó K‡i LyeB Kg| †ewki fvM gvby‡liB cwi‡e‡ki
SzuwKc~Y© Dcv`v‡bi Kvi‡Y AwURg nqbv| b¨vkbvj Bbw÷wUDU Ae Gbfvqib‡g›Uvj †nj_& mvBÝ GB wel‡q
M‡elYv cwiPvjbv Ki‡Qb| Av‡iv Z_¨ Rvbvi Rb¨ I‡qemvBU †`Lyb www.niehs.nih.gov/health/topics/
conditions/ autism/index.com ˆeÁvwbKiv AbymÜvb Pvjv‡”Qb Kxfv‡e wKQz cwi‡e‡ki Dcv`vb wKQz wRb‡K
cÖfvweZ Ki‡Q, Zv‡`i ¯^vfvweK Kvh©µg‡K mwµq ev wbw¯Œq Ki‡Q| GB cÖwµqv‡K ejv nq epigenetics.
GB welqwU Kxfv‡e AwURg nq Ges Kxfv‡e Gi cwieZ©bI Av‡m †mB wel‡q M‡elK‡`i Kv‡Q bZzb Z_¨
Avwe¯‹v‡ii m¤¢vebvi `yqvi D‡b¥vPb Ki‡Q|

bb KwgDwb‡Kej wWwRR K‡›Uªvj †cÖvMÖvg


17
AwURg Ges cÖwZ‡laK wUKv
¯^v¯’¨ we‡klÁiv wkï‡`i Zv‡`i R‡b¥i ci †_‡K gvivZ¥K I msµvgK e¨vwa †hgb nvg †_‡K iÿv cvevi
Rb¨ cÖwZ‡laK wUKv †bevi civgk© w`‡q _v‡Kb| †h‡nZz hy³iv‡óªi wkï we‡klÁiv cÖwZ‡laK wUKv¸‡jv
wkïi wbqwgZ ¯^v¯’¨ cixÿvi mg‡qB w`‡Z ïiæ K‡ib, †m‡nZz wkï‡`i Dc‡iv³ e¨vwa¸‡jv †_‡K Amy¯’Zv,
cÖwZewÜKZv wKsev g„Zz¨i SzuwK cÖvq ï‡Y¨ P‡j G‡m‡Q|
hy³iv‡óª wkïiv mvaviYZt R‡b¥i ci †_‡K 2 eQ‡ii wfZi A‡bK¸‡jv cÖwZ‡laK wUKv wb‡q _v‡K, Ges cÖvq
GKB eq‡m GKwU wkïi wfZi AwUR‡gi jÿY¸‡jv cÖKvk cvq| wKQz msL¨K AwffveK m‡›`n Ki‡Qb †h
cÖwZ‡laK wUKvi mv‡_ Zv‡`i wkï‡`i GB mgm¨vwUi GKwU m¤úK© i‡q‡Q| †KD †KD Avevi †hme wUKvq
w_‡g‡ivmvj msiÿK i‡q‡Q Zv‡KB AwUR‡gi KviY g‡b Ki‡Qb hw`I GUv cÖgvwYZ nqwb| w_‡g‡ivmvj
(Thimerosal) GKwU cvi` wfwËK ivmvqwbK c`v_© hv wKQz wKQz cÖwZ‡laK wUKvi msiÿK mnvqK Dcv`vb
wn‡m‡e e¨envi Kiv nZ| ïaygvÎ wKQz d¬z f¨vKwmb ev‡` 2001 mvj †_‡KB hy³iv‡óª cÖvK cÖv_wgK we`¨vj‡q
AskMÖnYKvix eq‡mi wkï‡`i †Kv‡bv cÖwZ‡laK wUKv‡ZB w_‡gv‡ivmvj e¨envi Ki nqbv| GB cwieZ©b m‡Ë¡I,
ASD AvµvšÍ wkïi msL¨v µ‡gB evo‡Q| wKQz wKQz AwffveK wek¦vm K‡ib †hme wUKvq G‡Ki AwaK Amy¯’Zvi
cÖwZ‡iv‡ai e¨e¯’v Av‡Q †hgb- nvg, gv¤úm Ges iæ‡ejv (MMR) fvBiv‡mi wUKv, Zvi mv‡_ wkï‡`i GB
Amy¯’Zvi †hvMm~Î i‡q‡Q| hw`I D³ wUKvi KL‡bv w_‡gv‡ivmvj e¨envi Kiv nqwb| AwUR‡gi KviY wnmv‡e
cÖwZ‡laK wUKvi f~wgKv wb‡qI e¨vcK cixÿv Pvjv‡bv n‡q‡Q|
2010 mvj Awã †Kv‡bv M‡elYvqB wUKvi mv‡_ AwUR‡gi †Kv‡bv cÖZ¨ÿ m¤úK© cvIqv hvqwb|
e¨vcK ïbvbxi ci †dWv‡ij RR Gi we‡kl Av`vjZ ÒcÖwZ‡laK wUKvi e¨eüZ w_‡g‡ivmvj msiÿK wb‡R
wKsev MMR wUKvi mv‡_ mshy³ n‡q AwUR‡gi SzuwK evwo‡q w`‡”QÓ GB ai‡bi eû gvgjvi wec‡ÿ ivq
w`‡q‡Qb| GB wel‡q Av‡iv Z_¨ Rvbvi Rb¨ ‘U.S court of Federal Claims’ I‡qemvBU †`Lyb www.
usfc.uscourts.gov/ omnibus-autism-proceeding|
AwURg welqK M‡elYv I cÖwZ‡laK wUKv m¤ú‡K© mv¤úªwZK Z_¨ Ô†m›Uvi di wWwRR K‡›Uªvj A¨vÛ wcÖ‡fbkbÕ
Gi I‡qemvB‡U cvIqv hv‡e http://cdc.gov/ncbddd/autism/topics.html I‡qemvB‡Ui Z_¨¸‡jv
†K›`ªxq miKvi Ges wewfbœ ¯^vqZ¡kvwmZ msMVb †_‡K †bIqv|

bb KwgDwb‡Kej wWwRR K‡›Uªvj †cÖvMÖvg


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AwURg †¯úKUªvg wWRAW©v‡ii wPwKrmv Ges mbv³ Ki‡Yi Dbœq‡bi wK wK
D‡`¨vM †bIqv n‡”Q ?
mv¤cÖwZK A‡bK¸‡jv M‡elYvq AwURg †¯úKUªvg wWRAW©v‡ii cÖv_wgK ms‡KZ¸‡jv mbv³ Kivi Dci †Rvi
†`Iqv n‡”Q| GB mKj M‡elYvi D‡Ïk¨ wkï‡`i AviI Aí eq‡m †ivM wbY©‡q wPwKrmK‡`i mnvqZv Kiv
hv‡Z Zviv cÖ‡qvRbxq e¨e¯’vcbv `ªæZ †c‡Z cv‡i| D`vniY¯^iƒc AwURg †¯úKUªvg wWRAW©v‡ii GKwU cÖv_wgK
j¶Y n‡”Q gv_vi `ªæZ ea©b| gw¯Í‡®‹i B‡gwRs M‡elYvq †`Lv †M‡Q wkïi cª_g gvm¸‡jv‡Z A¯^vfvweK gw¯Í‡®‹i
e„w× AwURg †¯úKUªvg wWRAW©v‡ii †¶‡Î f~wgKv ivL‡Z cv‡i| GB gZev` †_‡K aviYv Kiv hvq †h †e‡o
DVvi Dcv`vbmg~n, hv gw¯Í‡®‹i mwVK e„wׇK wbqš¿Y K‡i, Zvi †R‡bwUK AmsMwZ AwUR‡g cwijw¶Z gw¯Í‡®‹i
A¯^vfvweKZv mg~‡ni KviY| wkïi gv_vi AvKw¯§K I `ªæZ e„w× GKwU cÖv_wgK ms‡KZ n‡Z cv‡i hvi mvnv‡h¨
AwURg †¯úKUªvg wWRAW©v‡ii `ªæZ †ivM wbY©q I wPwKrmv ev m¤¢ve¨ cÖwZ‡iva Kiv †h‡Z cv‡i | AwURg
†¯úKUªvg wWRAW©vi wPwKrmvi M‡elYv A‡bK¸‡jv c×wZ‡K wbix¶v Ki‡Q †hgb:
• GKwU Kw¤úDUvi wfwËK cÖwk¶Y Kvh©µg hv AwURg †¯úKUªvg wWRAW©v‡ii wkï‡K gyLgÛ‡ji
fvefw½/Awfe¨w³ mwVKfv‡e m„wó Kiv I mvov †`Iqv †kLv‡bvi Rb¨ ˆZwi Kiv n‡q‡Q|
• d«¨vRvBj G· wm‡Ûªvg AvµvšÍ wkï‡`i Kvh©¶gZv /e¨envwiK ¶gZv evov‡bvi Rb¨ GKwU Ilya|
• †kªwYK¶ I ˆ`bw›`b †¶‡Î e¨envi Dc‡hvMx bZzb bZzb mvgvwRK B›Uvi‡fbkb|
• †h me wkï AwURg †¯úKUªvg wWRAW©v‡ii SuzwK‡Z Av‡Q Zv‡`i wWRAW©vi m¤úwK©Z cÖwZewÜZv
Kgv‡Z ev cÖwZ‡iva Ki‡Z GKUv B›Uvi‡fbkb hv AwffveK AbymiY Ki‡Z cv‡i|

AwURg †¯úKUªvg wWRAW©vi ˆewk‡ó¨i wkï‡K Avwg Kxfv‡e mnvqZv Ki‡Z cvwi ?
Avcbvi wkïwU AwURg †¯úKUªvg wWRAW©vi WvqvM‡bvwm‡mi ci Zvi cÖ‡qvRbxq †mev/cwiPh©v I wk¶v w`‡Z
Avcwb e¨_© ev cÖ¯‘Z bb g‡b n‡Z cv‡i| †R‡b ivLyb, A‡bK¸‡jv wPwKrmv c×wZ, mvgvwRK †mev I Kvh©µg
Ges Ab¨vb¨ wi‡mvm© Av‡Q hv mnvqZv Ki‡Z cv‡i| wKQy civgk© hv Avcbv‡K I Avcbvi mšÍvb‡K mvnvh¨ Ki‡Z
cv‡i:
• ¯^v¯’¨ †mev cÖ`vbKvix I wk¶K‡`i mv‡_ me K‡_vcK_b, mfv Ges Ab¨vb¨ Z‡_¨i Dr‡mi †iKW©
ivLyb| hv wewfbœ wPwKrmv c×wZ g‡b ivL‡Z I Avcbvi mšÍv‡bi Rb¨ mwVKwU †e‡Q wb‡Z Avcbv‡K
mnvqZv Ki‡e|
• Wv³v‡ii wi‡cvU©mg~n Ges Avcbvi mšÍv‡bi g~j¨vq‡bi †iKW© ivLyb| GB Z_¨ Zvi Dc‡hvMx we‡kl
Kvh©µ‡g †h‡Z mvnvh¨ Ki‡Z cv‡i|
• Avcbvi GjvKvq we‡kl Kvh©µg m¤ú‡K© Rvb‡Z ¯’vbxq GW‡fv‡Kmx AwURg cÖæc _vK‡j Zv‡`i mv‡_
†hvMv‡hvM Kiæb|
• GKwU B›Uvi‡fbkb cwiKíbv ˆZwi Ki‡ZI Ab¨vb¨ ¯’vbxq wi‡mv‡m©i mÜvb †c‡Z Ges Avcbvi
GjvKvq GKRb AwURg we‡klÁ Lyu‡R †ei Ki‡Z Avcbvi wkïi wPwKrmK, ¯‹zj KZ…©c¶ ev AwURg
mv‡cvU© MÖæc Gi mv‡_ Avjvc Kiæb|
bb KwgDwb‡Kej wWwRR K‡›Uªvj †cÖvMÖvg
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AwURg †¯úKUªvg wWRAW©vi ˆewk‡ó¨i wK‡kvi‡`i‡K †evSv/Dcjw× Kiv t
wK‡kvi eqmUv AwURg †¯úKUªvg wWRAW©vimn †h †Kv‡bv evošÍ wkïi Rb¨B gvbwmK Pvc I weåvwšÍKi mgq|
ˆK‡kv‡ii mgq wK‡kvi-wK‡kvixiv A‡b¨i e¨vcv‡i Ges Zv‡`i mv‡_ m¤ú‡K©i e¨vcv‡i A‡bK †ewk m‡PZb n‡q
hvq| †ewkifvM wK‡kv‡iiv gy‡Li eªY, wb‡R‡`i RbwcÖqZv, cix¶vi b¤^i/†MÖW/†Q‡j‡g‡q eÜzi mv‡_ m¤úK©
BZ¨vw` wb‡q wPwšÍZ _v‡K| AwURg †¯úKUªvg wWRAW©vi ˆewk‡ó¨i wK‡kv‡iiv Zv‡`i mgeqmx‡`i †_‡K Zviv
Avjv`v GB e¨vcviwU eyS‡Z †c‡i Kó cvq| GB e¨vcv‡i m‡PZbZv wKQy msL¨K wK‡kvi‡`i‡K bZzb K‡i
AvPiY wkL‡Z I Zv‡`i mvgvwRK `¶Zv evov‡Z m‡Pó K‡i| Ab¨‡`i †¶‡Î Abyf~wZ‡Z AvNvZ I A‡b¨i mv‡_
†hvMv‡hv‡Mi e¨_©Zv welbœZv, DwØMœZv ev Ab¨vb¨ gvbwmK mgm¨vi m„wó Ki‡Z cv‡i| wKQy wKQy AwURg †¯úKUªvg
wWRAW©vi ˆewk‡ó¨i wK‡kv‡iiv AwaKZi AwUw÷K ev AvµgYvZ¥K AvPi‡Yi gva¨‡g ˆK‡kv‡i Zv‡`i gvbwmK
Pvc I weåvwšÍ cÖKvk K‡i _v‡K| AwURg †¯úKUªvg wWRAW©v‡ii wK‡kvi‡`iI ˆK‡kv‡i Zv‡`i †h kvixwiK
cwieZ©b I †hŠb cwic°Zv Av‡m Zv †evSvi Rb¨ mnvqZv `iKvi|
Avcbvi wK‡kvi mšÍbwUi mvg‡j/Lvc LvB‡q wb‡Z mgm¨v n‡”Q g‡b n‡j Zvi wPwKrmK‡`i mv‡_ †hvMv‡hvM
Kiæb Ges m¤¢ve¨ †Kv‡bv gvbwmK mgm¨vi Rb¨ wK Ki‡Z cv‡ib Avjvc Kiæb| AvPiYMZ †_ivcx I IlyacÎ
mvnvh¨ Ki‡Z cv‡i|

Avcbvi wkïi ˆkke †_‡K cÖvß eq¯‹ nIqvi Rb¨ cÖ¯‘wZ t


miKvwi ¯‹zj¸‡jvi AwURg †¯úKUªvg wWRAW©vi ˆewk‡ó¨i wkï‡K †mev cÖ`v‡bi `vwqZ¡ 22 eQi n‡jB †kl n‡q
hvq| H mgq A‡bK cwieviB Zv‡`i cÖvß eq¯‹ mšÍv‡bi cÖ‡qvRb Abyhvqx Zv‡`i Rb¨ Kg© ms¯’v‡bi e¨e¯’v
Ki‡Z mgm¨vi m¤§yLxb nb| Avcbvi cwievi hw` wbR evwo‡Z cÖvß eq¯‹ mšÍv‡bi jvjb cvjb bv Ki‡Z cv‡i
Zvn‡j Zvi Rb¨ Ab¨Î evm¯’v‡bi e¨e¯’vI Ki‡Z n‡Z cv‡i|
Avcbvi mšÍv‡bi ¯‹zj Rxeb †kl nIqvi A‡bK Av‡MB Avcbv‡K AwURg †¯úKUªvg wWRAW©vi ˆewk‡ó¨i cÖvß
eq¯‹‡`i Rb¨ fv‡jv Kvh©µg I e¨e¯’vcbvi †LuvR Ki‡Z n‡e| cÖvß eq¯‹ AwURg †¯úKUªvg wWRAW©vi ˆewk‡ó¨i
mšÍv‡bi AwffveK‡`i mv‡_ cwiPq _vK‡j Avcbvi GjvKvq wK wK †mev Kvh©µg Av‡Q wRÁvmv Kiæb| ¯’vbxq
mv‡cvU© I GW‡fv‡Kmx MÖæc Avcbvi GjvKvq Avcbvi mšÍv‡bi Dc‡hvMx wK wK mnvqZv I Kvh©µg Av‡Q Zv
Lyu‡R †ei Ki‡Z mvnvh¨ Ki‡Z cv‡i|
AwURg †¯úKUªvg wWRAW©vi ZiæY‡`i †mjd GW‡fv‡KU nIqv wkLv‡bv wkï †_‡K cÖvß eq‡¯‹ iƒcvšÍ‡ii GKwU
¸iæZ¡c~Y© Ask| Gi A_© GB †h Zviv wb‡RivB wb‡R‡`i wk¶v, Kg©ms¯’vb, ¯^v¯’¨ †mev Ges evm¯’v‡bi `vwqZ¡
AviI †ewk wb‡Z ïiæ K‡i| Kg©‡¶‡Î, D”P wk¶vq, wb‡R‡`i GjvKvq Zv‡`i AwaKvi Av`v‡qi Rb¨I AwURg
†¯úKUªvg wWRAW©vi I Ab¨vb¨ cÖwZeÜx cÖvß eq¯‹ e¨w³iI †mjd GW‡fv‡KU nIqv Riæwi|

bb KwgDwb‡Kej wWwRR K‡›Uªvj †cÖvMÖvg


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AwURg †¯úKUªvg wWRAW©vi ˆewk‡ó¨i cÖvß eq¯‹‡`i evm¯’vb t
AwURg †¯úKUªvg wWRAW©vi ˆewk‡ó¨i cÖvß eq¯‹‡`i Rb¨ wewfbœ e¨e¯’v i‡q‡Q| Avcbvi cÖvß eq¯‹ mšÍvb wK
†e‡Q †b‡e Zv wbf©i K‡i Avcbvi GjvKvq wK Av‡Q I Avcbvi mšÍv‡bi `¶Zv I j¶‡Yi/ˆewk‡ó¨i Ici|
wb‡¤œ †e‡Q †bIqvi Rb¨ wKQy evm¯’v‡bi D`vniY †`Iqv n‡jvt
• ¯^Zš¿ Avevm : AwURg †¯úKUªvg wWRAW©vi ˆewk‡ó¨i A‡bK cÖvß eq¯‹ivB GKv emevm Ki‡Z
cv‡i| A‡b‡K wb‡R‡`i evwo‡Z ev GcvU©‡g‡›U emevm Ki‡Z cv‡i hw` wKQy cÖavb wel‡q mnvqZv
†`Iqv nq †hgb: wb‡Ri Avw_©K e¨e¯’vcbv, cÖ‡qvRbxq ¯^v¯’¨ †mev MÖnY, miKvwi ev mgvR‡mev
G‡RwÝi mv‡_ †hvMv‡hvM| cwiev‡ii m`m¨, cÖ‡dkbvj G‡RwÝ ev Ab¨ †mev cÖ`vbKvix GB †mev
mnvqZv cÖ`vb Ki‡Z cv‡i|
• evwo‡Z emevm: †h me cwievi Zv‡`i cÖvß eq¯‹ AwURg †¯úKUªvg wWRAW©vi ˆewk‡ó¨i mšÍvb‡K
evmvq iv‡Lb Zviv miKv‡ii KvQ †_‡K Avw_©K mnvqZv cvb|
• evwoi Ab¨vb¨ weKímg~n: A‡bK cwievi Zv‡`i AvZ¥xq bq Ggb cÖvßeq¯‹ cÖwZeÜx‡`i `xN©‡gqv`x
†mev cÖ`v‡bi Rb¨ wb‡R‡`i evwoi `iRv Ly‡j †`b| GB me evwo‡Z hw` e¨w³MZ cwiPh©v, M„n¯’vjx
`¶Zv Ges Aem‡i we‡bv`‡bi e¨e¯’v _v‡K Zvn‡j G¸‡jv‡K w¯‹j †W‡fjc‡g›U †nvg ejv nq|
• ZË¡veavbK…Z MÖæc emevm: cÖwZeÜx e¨w³iv cÖvqkB MÖæc †nvg ev GcvU©‡g‡›U _v‡Kb †hLv‡b Zv‡`i
†gŠwjK Pvwn`v¸‡jv c~i‡Y mvnvh¨ Ki‡Z AwfÁ ÷vd _v‡Kb| GB Pvwn`v n‡”Q Lvevi ivbœv Kiv,
M„n¯’vjxi KvR I e¨w³MZ cwiPh©v| hviv †ewk AvZ¥wbf©ikxj Zv‡`i evwo‡Z ev GcvU©‡g‡›U ÷vd
nq‡Zv mßv‡n gvÎ K‡qKevi Av‡mb| Zviv wb‡RivB mvaviYZt Lvevi ˆZwi, Kv‡R hvIqv I ˆ`bw›`b
KvR¸‡jv Ki‡Z cv‡i|
• `xN©‡gqv`x †mev e¨e¯’vcbv: †h AwURg †¯úKUªvg wWRAW©vi ˆewk‡ó¨i e¨w³i A‡bK †ewk I
mve©¶wYK cwiPh©v cÖ‡qvRb nq Zv‡`i Rb¨ GB e¨e¯’vcbv cÖ‡hvR¨|

bb KwgDwb‡Kej wWwRR K‡›Uªvj †cÖvMÖvg


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