Early intervention can have a big impact on your child’s development.
Seeing your young child miss expected milestones, lose a previously acquired skills, or struggle to connect socially or emotionally can be one of the most challenging issues to come to grips with as a parent. But current understanding and treatment of autism spectrum disorders can help you find comprehensive and high-quality support.
“Autism is a social, behavioral, and emotional disorder, and it has a range of symptoms from mild to much more severe,” says New York City-based psychologist Jennifer Harstein, PsyD. Because severity falls on such a wide range, autism is now referred to autism spectrum disorder, which includes Asperger syndrome and Rett syndrome.
Symptoms of Autism
Typically, symptoms of autism can begin to appear in children around 12 to 18 months, though they can set in earlier or later. Children with autism will have challenges with communication, social interaction, and stereotypical behaviors, according to Susan Samuels, MD, psychiatrist with NewYork-Presbyterian Hospital and Weill Cornell Medicine in New York City.
The earliest signs of autism include:
Not babbling or pointing by age 1
Not speaking single words by 16 months
Not responding when name is called
Loss of previously acquired skills
Poor eye contact
And repetitive behavior patterns.
It’s helpful to be on the lookout for these signs of autism spectrum disorder, but your pediatrician will be closely watching your child and asking you questions at well visits to assess their risk. Around 18 to 24 months, your child’s pediatrician should screen for autism using a questionnaire called an M-CHAT, according to Preeti Parikh, MD, a pediatrician at The Mount Sinai Hospital and chief medical editor at HealthiNation.
If your child’s pediatrician has concerns based on the M-CHAT, they may refer you to a psychologist who specializes in diagnosing autism for a more comprehensive evaluation.
What to Do If Your Child Has Autism
Treating autism begins with what experts call early intervention. This approach uses different types of therapy to address your child’s specific autism symptoms and help them reach developmental milestones. These may include occupational therapy, speech therapy, or even physical therapy, according to Dr. Samuels.
One common treatment during early intervention for autism is addressing sensory-processing deficits. For example, some children with autism might be overwhelmed by certain textures or tactile sensations, according to Yamalis Diaz, PhD, a psychologist at NYU Langone Health. Desensitizing them at a young age can reduce challenges later in life.
Another common therapy for autism is called applied behavioral analysis (ABA). This therapy teaches important behavioral skills using positive reinforcement.
“We have seen some phenomenal outcomes with early intervention in children with autism,” says Alok Patel, MD, a pediatrician at New York Presbyterian-Morgan Stanley Children’s Hospital. “We’ve seen parents that are just blown away themselves by how well they do with their children.”
Dr. Hartstein is the owner of Hartstein Psychological Services, a group psychotherapy practice in New York City.Susan Samuels
Dr. Samuels is an assistant professor of clinical psychiatry and clinical pediatrics at Weill Cornell Medicine and an assistant attending psychiatrist at NewYork-Presbyterian Hospital.Preeti Parikh
Preeti Parikh, MD serves as the Chief Medical Officer of HealthiNation. She is a board-certified pediatrician practicing at Westside Pediatrics, is an Assistant Clinical Professor at the Mount Sinai School of Medicine, and is an American Academy of Pediatrics spokesperson. She holds degrees from Columbia University and Rutgers Robert Wood Johnson Medical School and has completed post-graduate training at the Mount Sinai School of Medicine.Yamalis Diaz
Dr. Diaz is a psychologist at NYU Langone Health.Alok Patel
Dr. Patel is a pediatrician at New York Presbyterian-Morgan Stanley Children's Hospital.
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So autism is a social, behavioral,
and emotional disorder, and
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it has a range of symptoms,
from mild to much more severe.
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So people with autism spectrum
disorders will have challenges with
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communication, with social interactions,
and with some stereotypical behaviors.
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So some of the challenges children
with autism might have in terms of
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communication involve not being
able to make great eye contact,
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not actually knowing
the right words to use, and
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not being able to get their points
across to the other person.
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There are lots of theories on
what might cause autism, but
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we do think about it as
a genetically-based disorder
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that is not caused by anything in
particular in the environment.
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Autism is most commonly
diagnosed around two to three, but
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symptoms can be seen as early
as six months, and really,
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kind of that 18 months to three-year
period is when it's most diagnosed often.
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My son, Zachary, was diagnosed with
autism around age of three years old.
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He used to attend play dates.
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However, even when I took him to play
dates, he wouldn't really socialize with
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you'd see him drifting off to the side.
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So it was like almost
anything that I tried,
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I would still see another
symptom popped up.
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And after a while,
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as you begin to put together the list of
symptoms, I knew eventually what it was.
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But I didn't even wanna call
it autism at that time.
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Pediatricians, at every check-up
that you go to, will be observing and
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talking to you about maybe
early signs of autism.
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Some of the things that pediatricians will
be looking at, and you can look at home,
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that can be early signs of autism,
is if your child isn't babbling or
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pointing by age 1,
no single words by age 16 months,
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or 2 word phrases by age 2, they don't
respond to their name when you call them.
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Loss of language or social skills that
previously, they may have acquired.
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They make poor contact with
you in terms of eye contact.
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And if you're starting to see certain
repetitive patterns, like excessive lining
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up of toys or objects, those can also be
signs that your child may have autism.
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The real time, in terms of
actual objective questionnaire,
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where we do screening is
around 18 to 24 months of age.
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Your pediatrician should be giving
you something called an M-CHAT,
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which is a questionnaire that screens for
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So if you go to your well child visit,
and the pediatrician has concerns,
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they might refer you to a psychologist
to have a more comprehensive evaluation.
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Treating autism is
really gonna be tailored
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to what deficits the child has and
what milestones they need to try to meet.
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Behavioral strategies are really
the first line approach.
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At the very, very young age, there
is something called early intervention.
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That involves treatments like
occupational therapy, speech therapy,
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sometimes physical therapy,
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that really address some of these
symptoms of autism and help kids adjust.
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A lot of children with autism also
have some sensory processing deficit, so
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they might really struggle with specific
textures or tactile sensations,
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and it kind of overwhelms them to
the point of frustration or anger.
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So working to desensitize them from some
of their sensory difficulties might also
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be really helpful.
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So when they're a little bit older,
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they might be engaged in a type of therapy
call ABA, or Applied Behavioral Analysis,
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that teaches almost sort of positive
reinforcement for positive behavior.
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When parents learn their
children have autism,
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a lot of parents ask about their
child's long-term kind of prognosis.
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Hey, is my child gonna grow up to be,
I hate using the word normal.
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But is my child gonna grow up
to have a normal, happy life?
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Is my child gonna get married?
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Are they gonna have friends?
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And we always try to reassure parents and
say, we have seen some phenomenal outcomes
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with early intervention
in children with autism.
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We've seen parents that are just
blown away themselves by how
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well they do with their children.
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Autism. Jacksonville, FL: KidsHealth. (Accessed on January 9, 2021 at http://kidshealth.org/en/kids/autism.html.)Early intervention. New York, NY: Autism Speaks. (Accessed on January 9, 2021 at https://www.autismspeaks.org/family-services/tool-kits/100-day-kit/early-intervention.) Frequently asked questions. New York, NY: Autism Speaks. (Accessed on January 9, 2021 at https://www.autismspeaks.org/what-autism/faq.) Signs of autism. Portsmouth, RI: National Autism Association. (Accessed on January 9, 2021 at http://nationalautismassociation.org/resources/signs-of-autism/.) Symptoms. New York, NY: Autism Speaks. (Accessed on January 9, 2021 at https://www.autismspeaks.org/what-autism/symptoms.)