Have you ever wondered if your child is autistic? Autism, or autism spectrum disorders (ASD), is a group of brain-based disabilities that affect a child’s social interactions, communication skills, and behavior. Kids who are autistic classically have developmental problems in one of those 3 areas. Take a look at the list below to see if your child shows signs that are concerning.
The 3 Problem Areas
- Social interactions
- Trouble with non verbal interactions (e.g., make poor eye contact)
- Struggle to make friends their own age (or even interact appropriately with peers)
- Lack empathy
- Not interested in sharing interests or enjoyment with others
- Delayed language skills without attempts to compensate
- Can’t carry on a conversation
- Repetitive use of certain words or phrases
- Have trouble with the concept of “make believe” or social type play (e.g., playing house)
- Behavior-“Restricted, repetitive, and stereotyped”*
- Very narrow range of interests
- Intense focus on those limited interests (e.g., may be seemingly obsessed about trains)
- Routines are not flexible (autistic children can’t “roll with the punches”)
- Stereotypic motor mannerisms (e.g., rocking, hand wringing, etc.)
- Things have to always be the same
If your child has problems in only one of these areas, chances are he doesn’t have autism. However, I recommend you still discuss it with your pediatrician. Here’s the rest of the scoop on autism.
- Autism is on the rise. Prevalence is 1 in 68 (according to the CDC 3/2014 report)
- Rate is much higher in males than females: roughly 5 times more common
- If an older sibling has autism, the risk of recurrence is 5-6%
Screening by Pediatricians
The current AAP recommendation is that all kids get screened at the 18 month and 24 month well child checks. Of course, your pediatrician will be looking at every visit for any other signs of developmental delay or other signs that are concerning. There are a handful of screening tools available. In my office, we use the M-CHAT (Modified Checklist for Autism in Toddlers). The goal of screening is early identification. Studies show that the kids who get diagnosed and started early with intervention programs have better outcomes long term. Your child may qualify for services like early intervention (which addresses specific problem areas, like speech delays).
How do you get autism?
The unfortunate part of autism is that despite its prevalence, there is still a lot that is not known about it. Medically, we know that there is a considerable heritable factor in autism. It runs in families and there is a higher recurrence risk if someone else in the family has autism. There are many genes involved in autism and lots of different variations in the whole spectrum, which make narrowing it to a single cause difficult. We do know that there are a few syndromes that are associated with autism (including Fragile X, Tuberous Sclerosis, Phenylketonuria, Angelman syndrome, Rett Syndrome, and Smith-Lemli-Opitz syndrome). There have been a few convincing studies over the years that show that in some cases there seems to be an environmental factor that plays into the diagnosis or at least the “phenotypic presentation” (meaning how a particular person’s autism symptoms may present). In medicine, we call this a “second-hit” phenomena. The way it works is that you have a genetic predisposition to something and when the circumstances are just right (an environmental insult of sorts), it makes the predisposition actually manifest.
How is it treated?
Unfortunately, there is no cure for autism. All treatments are based on helping modify symptoms and improve quality of life. So if language is a problem, we may get a child early speech therapy. The earlier a child can communicate, the happier the child and parents are. Children who are autistic should have an IEP (or individualized education plan) for their schooling. However, every child is unique and every child presents differently, so each child’s needs are different. A severely autistic child may be in a cluster class with only a few other children (who have similar limitations), while a child with only mild impairment may be in a mainstream classroom and only qualify for a small amount of resource help. Make sure that your pediatrician is aware of your child’s needs. A good doctor can be your best advocate in helping you get the resources your need for your child.
*from the AAP professional resources documents