The Latest on Autism
What Difficulties Does a Child With Autism Face?
Children with autism have trouble communicating. They have trouble understanding what other people think and feel. This makes it very hard for them to express themselves either with words or through gestures, facial expressions, and touch.
An autistic child who is very sensitive may be greatly troubled -- sometimes even pained -- by sounds, touches, smells, or sights that seem normal to others.
Autistic children may have repeated body movements such as rocking or hand flapping. They may have unusual responses to people, attachments to objects, resistance to change in their routines, or aggressive or self-injurious behavior. At times, they may seem not to notice people, objects, or activities in their surroundings.
Some people with autism are mentally challenged, although most people with pervasive developmental disorder or PDD have normal or even above-average intelligence. In contrast to being cognitively impaired, which is characterized by relatively even skill development, people with autism show uneven skill development. Those with autism may have problems in certain areas, especially the ability to communicate and relate to others. But they may have unusually developed skills in other areas, such as drawing, creating music, solving math problems, or memorizing facts. For this reason, they may test higher -- perhaps even in the average or above-average range -- on nonverbal intelligence tests.
How Is Autism Diagnosed?
The American Academy of Pediatrics (AAP) recommends screening children for autism as part of the 18-month and 24-month well-patient visits in addition to the developmental screening performed at all healthy child wellness visits. This policy helps health professionals identify signs of autism early. Developmental screening tools, such as the Ages and Stages Questionnaire or the Modified Checklist for Autism in Toddlers (M-CHAT), can help assess behavior.
If a health professional discovers the following obvious signs of developmental delays, the child should immediately be referred for a full evaluation:
- No babbling, pointing, or other gestures by 12 months
- No single words by 16 months
- No two-word spontaneous phrases by 24 months, with the exception of repeated phrases
- Any loss of any language or social skills at any age
If your primary care provider does not have specific training or experience in developmental problems, he or she may refer your child to a specialist, usually a developmental-behavioral pediatrician, neurologist, psychiatrist, speech therapist, or child psychiatrist, for additional testing. If there are no obvious signs of developmental delays or any unusual indications from the screening tests, most infants and children do not need further evaluation until the next regular checkup.
However, children who have a sibling with autism should continue to be closely monitored because they are at increased risk for autism and other developmental problems. In addition to the evaluations at well-child visits, these children should undergo testing for language delays, learning problems, poor socialization skills, and any symptoms that might suggest they have anxiety or depression.
When socialization, learning, or behavior problems develop in a person at any time or at any age, he or she should also be evaluated. Most experts believe that if a parent has a "hunch" the child may have autism, they should insist that the child be evaluated. Often, parents know when a child is not connecting with them, whereas a doctor may miss these cues.