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Pediatric Autism Spectrum Disorder

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What is Autism Spectrum Disorder?

Autism Spectrum Disorder affects every child differently. This means that people may present with either very mild difficulties or very severe difficulties, with a wide range of severity between those two extremes. Along with deficits in social communications, individuals with ASD may have restricted, repetitive patterns of behavior, interests or activities. Terms such as Autism, Asperger’s Syndrome and Pervasive Developmental Disability-Not Otherwise Specified (PDD-NOS) have been historically used to describe people under the autistic spectrum. However, these previous diagnoses are included under the broader term Autism Spectrum Disorder.

A couple things to consider:

  • ASD affects everyone differently. Some children may have typical language skills and average cognitive skills, but demonstrate difficulties with peer social interactions. Other children may have limited language skills and have deficits in cognitive functioning, requiring more significant support.  

  • Many times, individuals with ASD exhibit difficulties that result in another diagnosis or a co-occurring condition, such as ADHD or Anxiety.
Signs of Autism

What Signs of Autism Can I Look For in My Child?

Children with ASD often feel frustrated as they struggle to communicate effectively, interact with others, and manage the typical tasks that occur on a daily basis. As a result, the child may pull away from social interactions, become angry or physically aggressive, or exhibit tantrum behaviors. Every child deals with these frustrations in their own unique ways.

Some of the things to look for that may help you identify ASD are:

  • Difficulties in the areas of communication and social interaction
    • Difficulties making eye contact or using it to regulate social interactions
    • Tend to look and listen less to people in their environment or fail to respond to other people
    • Rarely seek to share their enjoyment of toys or activities by pointing or showing things to others
    • Demonstrate difficulty or inconsistency in responding to their name or other verbal attempts to gain their attention
    • May not exhibit or be slow to develop nonverbal communication such as gestures like pointing, waving, clapping etc.
    • Demonstrate delays in language or inconsistent use of language skills
    • Repeat words or phrases that they hear, or what is known as echolalia
  • Restricted, Repetitive Behaviors, Interests, and Activities
    • May demonstrate an intense focus on certain objects or activities
    • Demonstrate motor mannerisms, such as flapping hands or repeatedly bouncing up and down
    • Engage in sensory seeking behaviors
    • Sensitivity to noise or other sensory sensations (touch, auditory, visual, taste)
    • May engage in repetitive play such as spinning the wheels on a toy car instead of using it how is was intended to be used.

Although there is no medicine that can “cure” ASD, through training, practice and support, a children with ASD will learn skills that will help them throughout their life. 

For more information, talk to your pediatrician, school program or a trained Autism evaluator. Does My Child Have Autism: A Parents Guide to Early Detection and Intervention in Autism Spectrum Disorders by Wendy Stone is also a great resource. 

 

Medical vs. School Diagnosis

What is the Difference in a Medical vs. School Diagnosis?

Children with ASD may already have a medical diagnosis or may be diagnosed by the school. Different needs might warrant getting a diagnosis from one, the other or both. 

For example, if your child demonstrates difficulties in the academic environment, the school needs to evaluate your child to determine if they are eligible to receive services under an “educational diagnosis” or educational classification. If deemed eligible this would allow your child to access supports such as speech and language therapy at school or receive education in a classroom with less students and more teachers. However, if you would like your child to see a psychiatrist or receive other support outside of school and potentially use your insurance to cover those appointments, a medical diagnosis is typically required. Since there are no medicines/prescriptions for ASD, many parents sometimes only get their child diagnosed by the school.

 

How is Autism Diagnosed?

How Is Autism Diagnosed?

There are currently no specific medical tests that can diagnose a child with ASD. Diagnoses are made through a combination of formal clinical observation of children and information gathered from parents’ expertise in their child’s development. The Center for Autism and Developmental Disabilities at Children’s Medical Center specializes in the evaluation of children with a suspected ASD and other developmental disabilities.

During the evaluation, the clinician or evaluator will seek information about a child’s cognitive functioning, language and social communication skills, behavioral functioning and adaptive skills. Children will participate in some of the tests, which may resemble school activities. These tests require the child to follow directions, answer questions and/or play. Additional measures to assess child functioning include parent participation in completing a checklist or rating a child’s skills and behaviors. 

These evaluations are often performed by a team of professionals, but may also be performed by a single provider with specialized training in identification of ASD. The length of time and number of appointments will vary, depending upon the age of the child, his or her language level and the complexity of other medical or behavioral conditions the child may have.

A professional trained in this area can identify ASD in children as young as 18 months old. However some children with ASD who have intact language skills but have more subtle difficulties with peer interactions may not be identified until the child goes off to school. That’s when difficulties with social interaction may appear more significant. Many of these children are not diagnosed with ASD until around first or second grade in school. When a teacher first notices signs and symptoms, they talk to the parents and ask for approval to do a full assessment of the child. Additionally, parents can also request that the school perform a full independent evaluation if they have concerns about their child’s academic/behavioral progress. 

 

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