A mom sits in my exam room frantic with questions about her daughter. She is overwhelmed after searching every internet site and getting multiple opinions from friends and family. Her 20 month daughter doesn’t behave like her cousins. She prefers to play alone. She doesn’t respond to her name when called. She has few to no words. She is clingy and has difficulty with loud places and resistant to changing her routine. Having her later in life, mom had been very protective and accepted her tantrums and behavior as being different. She asks, ‘Is my child autistic?’
These are difficult discussions with parents that require more time than a blog can do justice. Families have mixed feelings of sadness and relief with a diagnosis as it validates their concerns. The process of finding a cause, diagnosis and treatment can be frustrating since there is no blood test or scan. But here are some guidelines that may help parents decide if they should broach the topic with their doctor. The DSM-5 describes Autism Spectrum of Disorders (ASD) as a group of neuro-developmental disorders that include Aspergers, autism, childhood disintegrative disorder and pervasive developmental disorder not due to another condition.
What to look for?
- Usually symptoms appear before the age of 3.
- There can be poor social interaction and loss of social cues- does he or she make poor eye contact, have you noticed he or she doesn’t smile, they cannot recognize facial expressions or emotions and he or she has trouble making friends
- Have you noticed a regression of milestones and speech, impaired communication- he or she doesn’t babble, doesn’t point, seems to ignore you when you call his or her name, was saying words now has lost those words, keeps repeating words or phrases, trouble with communication that leads to aggressive behavior and tantrums.
- Often a child may resist change or engage in repetitive behavior- this may be hand flapping, head rolling, or body rocking. They may be hyper-fixed on one toy, game or show for an extended time. You have to manage your day around their insistence of daily routine as they have difficulty with change. There can also be self-harming behavior, self-biting, or hitting their head.
Children on the spectrum are unique and have their own special gifts. It is important to not only look for problems but to focus on their strengths as well. These strengths can lead to abilities that foster long term success like seeing and hearing things in concrete terms, content with being alone, they can focus for a long period of time on the same task, and may be good with computers and technology.
Why is a diagnosis important? A thorough and detailed evaluation can identify challenges and direct effective intervention from school programs, Early Intervention and Special Education services. A multi-disciplinary approach with your developmental pediatrician, neurologist, psychiatrist, psychologist, physical/occupational therapist and speech therapist is essential in early identification of strengths and needs. Remember you are not alone, start with a conversation with your pediatrician and love your child and all their gifts.