Signs of Autism
If you are concerned that your child might be exhibiting signs of autism, there are a number of checklists available to help you determine whether or not to seek further assessment. Much information about typical child development can be found on the website of the CDC (Centers for Disease Control) as part of their “Learn the Signs. Act Early” campaign.
The American Academy of Pediatrics recommends a number of different screening tools and checklists that can be used by professionals to determine whether a child should be further evaluated. These are tools for professionals, but you may find the information available useful. A particularly easy one to administer is the M-CHAT (Modified Checklist for Autism in Toddlers) developed at UCONN and available in both English and Spanish versions.
What Causes Autism?
No one knows the cause (or more likely, the multiple causes) of autism. Research is being conducted in many areas to determine the cause of autism or the causes of the symptoms exhibited by those who have autism.
While there is no known specific cause of autism, there is some understanding of the reasons for some of the symptoms.
Regardless of causation, we do know that autism is a neurobiological disorder – it is not caused by bad parenting or trauma. We also know that many of autism’s core symptoms can be ameliorated through education, intervention and other therapeutic programs.
How Autism is Diagnosed?
Parents, early childhood caregivers (day care providers, early childhood educators), or teachers may suspect that something is “just not quite right” with a child. This can happen when a child is young, adolescent, or any time in between. Parents then typically share their concerns about development with a pediatrician. Autism can also be diagnosed in adulthood.
Diagnosis begins with ruling out medical causes for any of the symptoms, such as a hearing test or medical tests to rule out other disorders. Diagnosis of autism is based on observation of behaviors and abilities.
A multi-disciplinary evaluation is the best way to determine a diagnosis of autism and help families understand how autism presents itself in their child. Evaluation in speech and language, social skills, sensory processing, and motor skills are important in diagnosis.
There are many different instruments that can be used in diagnosis, depending upon the chronological age and developmental age of the person being assessed. As autism is a “pervasive” developmental disorder, affecting social, communication and behavioral issues, it is important to understand how autism presents itself in the individual, to evaluate across different environments (school, home, day care, community) and to assess strengths as well as weaknesses. Understanding that your child has an ASD is a starting point. You must also assess HOW that person expresses his or her autism to plan for appropriate programming.
Autism may also be present along with other conditions. Just like the rest of us, people with autism may exhibit other medical issues or mental health concerns. Autism may exacerbate some of these or may make it more difficult to isolate and diagnose these other conditions.
There may be medical issues such as epilepsy, food allergies, or gastro intestinal issues. People with autism often have late developing nervous systems and may exhibit sensory processing disorders, lack of muscle tone, apraxia or hyper or hypo awareness of sensory input (hearing, touch, taste, sight). Anxiety or depression may exist. Many people with autism exhibit sleep disorders. Epilepsy or other seizure activity is possible. It is important to check out any physical symptoms understanding that a child with autism may not always be able to pinpoint where something hurts (or that something hurts at all!) which can make diagnosis a challenge. Issues such as anxiety, depression or sleep disorders can often be helped with appropriate medication and/or therapeutic interventions. Sometimes people with autism also have intellectual disabilities and/or other learning disabilities as well. AD/HD, OCD and other mental health issues can also be present.
Autism is a lifelong disability. There is no “cure,” but there are many strategies, programs and interventions that can significantly improve the areas of functioning and enable a person with autism to lead a successful, fulfilling life.
Children with autism can be taught to speak, to learn, to communicate, to participate socially, but all of these skills need refinement and upgrading as we progress through life. Social skills that are appropriate for toddlers and preschoolers look pretty silly in middle school! Issues that are not important in preschool are significant in the real world of independent living. It is important for parents, caregivers and professionals to always be looking ahead as well. Where do we want our child to be in six months, a year, five years, ten years, or when I’m no longer around to provide care?
Formal Life Mapping programs put together a group of people around the person with autism – parents, family, other caregivers, therapists, teachers, community members, and to the extent possible, the person with autism. This group then looks at the current abilities and challenges facing the individual and discusses visions for the future. Then, the group “maps out” the direction to get to that future. It is a formal process that can be very helpful for many families, but can also be done more informally. The basic philosophy is that if you don’t know where you are going, you won’t ever get there!
For example, if the ultimate goal for a child is independent living, it is important to understand that person’s abilities and challenges relating to activities of daily life. Taking the example further, will this person learn to drive or is learning to take public transportation or riding a bike a more appropriate goal? As parents and family members who love someone with autism, we need to keep our expectations both high and yet appropriate. Life mapping is a method of continually adjusting expectations to ability and also of involving a group of people in your child’s success throughout life.