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Autism Spotted at Age 14 Months

Early Autism Detection Widens Window for Effective Treatment

Parent: Child Seemed Normal continued...

Autism clearly has a strong genetic component. But genes aren't destiny, Landa says.

"Your brain development isn't just engineered by your genetics. Your experience plays a role in your outcome," Landa says. "So if a toddler isn't attending to social cues and develops these patterns of behavior that make it hard to engage with others, the child isn't getting learning opportunities. It becomes a vicious cycle. We want to disrupt this cycle, to teach children how to engage with objects in diverse ways. We teach them to have joint interactions with people that are rewarding."

It isn't easy. Maloni says she tries to engage her sons in social play "every waking moment." But the results are more than rewarding.

"Normal kids, when a parent walks out the door, the child is screaming, and when they come back they are glad to see them. But our children didn't even notice we were gone," Maloni says. "Now we walk through the door and they run over to us. They are happy when we are there and know when we are not there. It is very gratifying."

Spotting at-Risk Kids

Landa says every parent with a family history of autism -- or who suspects that a child may not be developing normally -- should have that child screened for autism by age 18 months if not sooner.

"Parents usually just look at whether their child walks on time and talks on time," she says. "They might not pay attention to the kinds of objects a child gravitates toward, or lack of diversity in play, or failure of a child to give and show objects. But if you specifically ask parents about certain behaviors, it can be a wake up call for the parents. That is why I advocate screening."

Autism strikes 1 in every 166 children -- it is not rare. A simple one-page, 23-item questionnaire called the M-CHAT helps identify toddlers who need further testing. The test can be found on the Internet, but Landa warns parents to take the completed test to a health care professional for evaluation. The test is not meant to be scored by the person taking it.

Identifying a 14-month-old child as at risk for autism is not the same as an autism diagnosis, Landa warns. Children vary widely in their speed of development.

"Kids who aren't talking or walking or have developmental delays; children who have problems with social reciprocity, who are not very responsive to having their name called, who are not responsive to silly little teasing games, who are not giving objects to you and giggling with you and playing turn-taking games -- those things are really big red flags," she says. "But developmental fluctuations at this age are not uncommon. So when we talk to parents of children under 24 months of age, we should be talking about social communication delays and risk for autism, rather than laying out a diagnosis at this time."

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