Early Red Flags and Warning Signs of Autism (cont.)

My child was babbling up until 6 months, but by 10 months, there was no more babbling. Any regression of any skill should be evaluated immediately.

So, then what would you say is the best way to determine if your child has autism?

If a child shows any of the red flags or early indicators, then that child should be evaluated by a developmental specialist - developmental pediatrician, or pediatric neurologist, psychiatrist, or psychologist - who has expertise in diagnosing and treating autism spectrum disorders. No two children are alike and the autism spectrum is very wide, ranging from mild to severe. Some kids may have many of the signs and features, while others may only have a few. Still, for the trained professional, it is easy to diagnose.

To meet the diagnostic criteria, there must be:

  • Impairment in social interactions
  • Impairment in verbal and nonverbal communication
  • Restricted and repetitive patterns of behavior or interests

In addition, most of these kids have severe sensory issues and they may be over- or under-reactive to touch, sound, taste, or any of the other senses.

What advice do you give parents at an early age, as far as behavioral exercises?

Floortime is a wonderful approach that any parent can do at home. It's a child-led, systematic approach developed by Dr. Stanley Greenspan that encourages parents to interact with a child in a way that helps the child to advance developmentally. Floortime is getting down on the floor with your child and interacting and playing in an activity that interests the child. If you have a child who is only interested in banging pots, for instance, you get down on the floor with the child and bang pots until you can connect with that child. Over time you learn how to maximize the number of back and forth interactions by following the child's interests and motivations using gestures, play, and communication. Floortime can help a child climb the developmental ladder, one milestone at a time

All new parents should be taught how to do Floortime, not just those who have children with delayed development. It is particularly effective for children who are difficult to engage.

A 2006 WebMD article states that "too much TV time for toddlers may trigger autism," according to a study by Cornell business professors. Have you heard anything on that?

I don't think too much TV is healthy for any child, especially under 3. Children need to be engaged in activities with peers and adults-that's what's critical. As for TV triggering autism...I cannot give any credence to that study.

Is there a way to explain how drastic the differences are between a child who gets immediate help in the extreme early stages and a child who does not receive any developmental therapy until later?

The difference can be dramatic. Children were not diagnosed before school age and they did not have the kinds of Early Intervention services 10 or 20 years ago that we have today. Today there is tremendous hope for progress, and even recovery. More and more children are losing their diagnosis. That doesn't necessarily mean they've lost every attribute, but they may no longer meet the diagnostic criteria for autism.

While my daughter has incredible communication and social skills, she still has severe auditory processing and attentional issues. She is diagnosed with ADHD, bipolar, and PANDAS, which stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. PANDAS is an autoimmune disorder triggered by strep that attacks the basal ganglia in the brain (which effects movement and behavior) and may prove to be quite prevalent in a sub-set of children who have autism, bipolar, ADHD, tics, and OCD.

The kids who seem to make the best progress are those who are diagnosed early and have an individually-tailored, comprehensive treatment program consisting of biomedical, therapeutic, and educational interventions.

What is one extremely important piece of advice that you often give to parents of children with autism (in regard to any issue related to the disorder)?

Parents need to have a good support system in place, because this is more than a race and bigger than a marathon. It's a series of marathons throughout the years. You must pace yourself, and you need to put good supports in place, whether it's family members who can pitch in and do your grocery shopping or a neighbor who can watch your child while you take a walk or go to a movie, or do something for yourself. Somehow you have to find the time to spend with your spouse and other children. This life is very stressful and it either brings couples closer together or pulls them apart. It's draining on every family member. But, if you can look past the difficult times and focus on the incremental gains your child is making, you can begin to appreciate all the little things in life that you never thought about before.

Do you offer any advice or information on resources for low-income families with autistic children to get the help they need?

The out-of-pocket costs for treatments can be devastating for any family -- ,often costing between $40,000 and $100,000 per year, depending upon on your insurance policy. In my book, Could It Be Autism?, I offer suggestions for how to work with your insurance company. There's tremendous inequity in how insurance companies reimburse families, and often it boils down to how much you're willing to fight. Same with the public school systems. Parents have to know what their child needs and they need to become their child's best advocate. There's a Web site called Wrightslaw.com, which is fantastic. You can plug in your zip code and get a long list of resources for your state. Many states offer supplemental insurance plans based on a sliding scale. Some state agencies offer flexible funding for families in need.

In addition, the ARC of the U.S. has chapters in every state -- many have autism support centers that provide advocacy training, legal support, lending libraries, support groups, and an opportunity to network with other families. Networking is key to your survival. Check with the local autism organizations to see what they offer, attend conferences, contact local support groups, and engage with other parents while your child is having occupational or speech therapy and you are in the waiting room. It just might be the best free support group you can find.

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