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Knowledge of normal development key in diagnosis
Deviations signal need for exam and intervention
Early intervention is important for children with autism. To make sure this early diagnosis occurs, every pregnant woman should be given a chart on childhood development so she knows what is considered typical behavior.
"It is important for all families to know what the typical developmental patterns of a child is, so if things are starting to go wrong, they can start asking questions early," says Sheila Wagner, MEd, assistant director of the Emory Autism Center, Emory University School of Medicine in Atlanta.
It is impossible for parents to learn the warning signs of all the various disabilities including autism, but if they know what is normal they can seek medical attention when there are deviations, she explains.
If children are diagnosed at an early age, they can be taught normal patterns for play, communication, and language, which brings them more in line with typical development patterns.
"It doesn't mean you are getting rid of autism, but you are starting to shape those behaviors. If that child was not identified and traveled along this atypical pathway for years and years, those learned behaviors become cemented and it becomes much more difficult to retrain learned behaviors," says Wagner.
According to the Autism Society of America based in Bethesda, MD, this developmental disability is a neurological disorder that interferes with the normal functioning of the brain and typically appears during the first three years of life. People with autism usually have difficulty with verbal and non-verbal communication, social interaction and leisure or play activities.
Some of the traits often exhibited include the use of gestures or pointing to express needs, not responding to verbal cues, a preference for being alone, little or no eye contact, odd play, tantrums, and resistance to change.
While people with autism may exhibit certain traits, each is unique. According to the ASA, autism is a "spectrum disorder" and, therefore, affects each child differently and in varying degrees.
With early diagnosis and intervention, the cost of lifelong care for adults with autism can be reduced by two-thirds, according to ASA.
For a successful intervention what do parents need to know? Education should start even if a toddler has not had a firm diagnosis but is only considered at risk, says Wagner. At the Emory Autism Center, children can be placed in the early childhood program at the age of one. The majority of children who graduate from this program are placed in a regular kindergarten classroom.
Include parents in intervention
It is a good idea to include parents in the intervention, training them to do what the therapist does with the child. Children with autism have difficulty generalizing information, so parents can transfer what has been learned from setting to setting and person to person, says Wagner.
Without parental involvement, the child will only be learning in a school setting. Education needs to be on a 24-hour basis so he or she can learn to use the skills in different environments.
There is a broad spectrum in the disability range for people with autism. While some may need support and supervision all their lives, others, with mild characteristics and behavior, are fully independent. Many are professionals and have full-time jobs, some earn a PhD degree, and others get married and have children.
While the cause of autism is not yet known, researchers believe there is often a genetic link but something in the environment triggers it. "It is a mystery in many areas and all that we know about autism at this point is nothing compared to what we don't know about the disability," says Wagner.
A child may be developing language and starting to babble, saying a few words and then for some reason stop all progress.
"Developmentally, it is like they are going along a pattern of development and for some reason they hit a pothole and they can't jump over it to progress. What makes that pothole nobody knows; research has not been able to discover the reasons why some children with this disability seem to appear to be doing fine in language and in social skills and then for some reason that stops," says Wagner.
Some children never go through a regression in language or social skills but show delays and deviance in language and social development all along.
What is known is that families need a lot of support when they have a child with autism. Physicians need to provide families with a resource packet when a child is diagnosed that has the names of agencies that can help as well as web sites and books that provide good information.
The divorce rate is high in families who have a child with autism so couples must build a support system. Children with autism are extremely vulnerable — families must find people they trust fully to care for their child.
"It is important for families to have outside interests beyond autism. I often tell couples they need a date night once a week to have dinner and go to a movie," says Wagner.
On date nights she gives parents two rules to follow. One is not to talk about autism and the second is to avoid conversations about their children.
It is also a good idea to spend time alone with other siblings who do not have the disability. "Many times siblings feel left out because all the focus is on the child with autism so they need some care and attention and loving and nurturing as well," explains Wagner. There are support groups in which siblings of autistic children can participate as well.
"Autism is a very complicated thing and our families get pulled in a lot of directions. These kids tend to be very challenging for families and finding that balance is very difficult," says Wagner.
For more information about providing information to parents to aid in autism diagnosis and intervention, contact: