Detecting Autism in Infancy, Starting Treatment EarlyWritten by: June Print This Article
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What is Autism?
Autism is a set of child developmental delays and disabilities. It includes impaired social interaction and communications, delayed and impaired verbal and language skills, and focus on repetitive activities. Autism is just one of several related disorders in the Autism Spectrum Disorders (ASD) classification. Asperger’s Syndrome is the second most common ASD illness after autism and generally differs from autism because language development is not affected as severely.
Early Detection of Autism Provides More Time for Intervention
Early detection of autism can provide parents, doctors, and therapists the time to intervene early in a child’s development, before autism becomes more severe. Although doctors recommend screening for autism starting at age 18 months, it is difficult to screen kids under the age of 2 (sometimes even older) because of typical developmental variations between children that are apparent in the verbal, language, emotional, and motor skills tests used to identify autism.
Nancy Wiseman is a mother of an autistic child who started the non-profit advocacy group First Signs to help other parents with autistic kids. She has written Could It Be Autism?: A Parent’s Guide to the First Signs and Next Steps to help parents identify autism early, starting at age 4 months. The earlier an autistic spectrum disorder is identified, the more time there is for intervention. But it’s particularly difficult to detect autism in infants, especially if parents do not have experience with autism and even more so for first-time parents for whom almost everything about their child is a new experience.
Early detection of autism seems to depend primarily upon absence of behaviors and interests that are demonstrated by typical children without autism. For instance, most babies are intensely interested in human faces and emotions. “Peek-a-boo” and similar games can provide endless delight for them. But an autistic child may have little interest in such things, preferring to watch non-human objects rather than people. As a child gets older, around a year of age, failure to respond to his or her name is another sign of autism. So is not pointing at items of interest and making requests or expressions to people about these items. For instance, a child who often points at a treat or toy and looks at parents or siblings with happy or “help me” expressions accompanied by sounds asking for attention are signs the child does not have autism.
It’s not until later, when children begin to develop more verbal and language skills, that it becomes much easier for medical experts to diagnose autism. But by then, years of opportunity to help the child develop socially and emotionally may have passed.
In 2007, the American Academy of Pediatrics recommended that doctors begin screening babies for autism at 18 months, but researchers have yet to refine the tools for making a reliable diagnosis at that age. One issue, says Catherine Lord, director of the University of Michigan Autism & Communication Disorders Center, is that there is so much individual variability in how babies develop. Another challenge is that many of the signature signs of autism — delayed speech, repetitive movements or fixations on particular toys or objects — involve language and motor skills that babies have not yet acquired. That’s why identifying the signs of autism before age 2 often involves the absence of typical behavior as opposed to the presence of aberrations.
First Steps After Detection or Diagnosis
Nancy Wiseman’s latest book, The First Year: Autism Spectrum Disorders: An Essential Guide for the Newly Diagnosed Child, focuses on what parents and relatives should do after a child has been found to have an autistic spectrum disorder. This is a particularly confusing time for parents as they are understandably upset about the situation and worried about the well-being of their child.
Wiseman’s approach in this second book is to walk the family through what to do during the first year after diagnosis. This includes learning more about autism, finding medical specialists (many doctors know little about autism), getting a second opinion from an expert, developing a treatment plan for your child, and advocating for your child in medical and school settings.
Her book has been well-received and rated by parents who are going through a new diagnosis of autism and ones who have been through it previously. Even parents who have been trying to help an autistic child for years say there are things they have learned from this book.
Wiseman’s works focus more on the detection of autism and behavioral treatments to help autistic children learn emotional skills than on the causes of autism itself. These are definitely important areas with which parents need a lot of help because the parenting skills appropriate for an autistic child are likely to be quite different from what they observed from their own parents and friends with children who don’t have autism.
From what I’ve learned about autism, there is a growing body of autism research that makes it appear there are things parents and society can do to reduce the risks for development of autism in the first place. Some of these may also be useful for treating kids who have an autistic spectrum disorder. I’ll be writing about such topics in future articles.