Discussing Autism

The American Academy of Pediatrics has created two new reports in an effort to help pediatricians recognize autism earlier and guide families to early and effective interventions.

The first report, Identification and Evaluation of Children with Autism Spectrum Disorders provides pediatricians with the signs and symptoms of ASD so they can recognize them in their patients, which ironically, many do not. Autism is often missed until later ages because children are simply labeled as developmentally delayed. The first main sign is usually language delay but there are plenty of initial signs including:

* not turning when the parent says the baby’s name;
* not turning to look when the parent points says, “Look at…” and not pointing themselves to show parents an interesting object or event;
* lack of back and forth babbling;
* smiling late; and
* failure to make eye contact with people.
Interesting…I remember AJ’s caregivers telling us that he did not smile, speak, or come out of his shell until we had met him. Only then did he seem to have some sort of spark (he was 26 months when we adopted him). And, to this day he had trouble with eye contact.

This particular report specifically tells pediatricians to be aware of the early signs of autism at every doctor visit and to conduct appropriate screening if concerns are valid.

“Red Flags” that are absolute indications for immediate evaluation include: no babbling or pointing or other gesture by 12 months; no single words by 16 months; no two-word spontaneous phrases by 24 months; and loss of language or social skills at any age. Early intervention can make a huge difference in the child’s prognosis. “Autism doesn’t go away, but therapy can help the child cope in regular environments,” said Chris Plauche Johnson, MD, MEd, FAAP, and co-author of the reports. “It helps children want to learn and communicate.”

The second report, “Management of Children with Autism Spectrum Disorders” advises pediatricians to refer the child to early intervention and get them actively engaged in intensive therapies. It also advises pediatricians to allow for nonstandard therapies and to become knowledgeable of those particular alternative and complementary medicines.

Pediatricians who treat children with ASDs should recognize that many of their patients will use nonstandard therapies. The report says it’s important for pediatricians to become knowledgeable about complementary and alternative medicine (CAM) therapies, ask families about current and past CAM use, and provide balanced information and advice about treatment options, including identifying risks or potential harmful effects. They should avoid becoming defensive or dismissing CAM in ways that convey a lack of sensitivity or concern, but they should also help families to understand how to evaluate scientific evidence and recognize unsubstantiated treatments.

Kudos for the AAP for stating that there are other methods to treat Autism besides simply using therapies. ie: biomedical? I just wish my doctor would listen to it.

Both reports will be part of the new practical resource for pediatricians.

A new site, which launched this October, has dozens of video clips of toddlers and preschoolers in the red-flag stage of autism as well as the normal developmental range. Autism Speaks has teamed up with First Words Project and First Signs to bring the public this amazing tool. However, I did have some trouble using it. You do have to log in (no problem) and download a new view tool (if you do not have it). Once you have that down it does skip some and you have to reload the video’s from the gray screen, not the top screen.

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