Several decades ago, I worked as a supervisor of a residential treatment facility for dually-diagnosed developmental disabled adults in New York. The job was both challenging and rewarding in myriad ways. In particular, there was one gentleman that left an indelible impression on me; his name was Joel and he was autistic.
Joel’s autism was medically renowned because his symptoms were quite profound and greater awareness of this disorder was on the rise (the first case labeled Autism was in 1943).
The word “autism” derives from the Greek word “autos” which means “self.” It is an intricate neurobehavioral disorder comprised of a wide range and multiple levels of impairment (mild to severe) affecting a person’s social interactions, language and communication abilities, as well as, causing inflexible repetitious behaviors to occur.
When I was first introduced to Joel it was evident that he had been accurately diagnosed because he presented every classical sign of the disorder. He avoided eye contact, was hypersensitive to touch, obsessed over numerical calculations (he was a mathematical genius); given any date and year he could unfailingly tell you the exact day of the week it fell on, as well as, other remarkable qualities. He lived in a mystifying world of his own design, unable to be a part of others except fleetingly, and only if something held his interest. He was both confounding and brilliantly captivating; he was certainly one of the most interesting men I have had the honor of knowing and working with.
While Joel’s diagnosis was clearly identifiable, autism is definitely not a one size fits all type of disorder. Autism may actually look totally different from person to person. In some people it is unmistakable, while in others, symptoms may be imperceptible. In fact, according to the DSM-5 (the Diagnostic and Statistical Manual, published by the American Psychiatric Association used to diagnose mental health conditions in the U.S.), Autism as well as Asperger’s syndrome and several other disorders are now under the broad umbrella of Autism Spectrum Disorder (ASD). There are also three different levels (1 being the highest and 3 the lowest) determined upon, how much support a person with ASD requires to function adaptively — from minimal to substantial.
As you can imagine, diagnosing Autism in very young children can be quite tricky and bears intensive professional investigation. Parents may notice some unusual behaviors or just have a funny feeling that something is not quite right, and question, “Could it be Autism or something else entirely?”
One thing is for certain; early and reliable detection of symptoms is paramount because specifically targeted interventions can be very impactful in developing or strengthening areas of the brain to improve language, behavior, social interaction, and other crucial skills. Young children’s brains are very receptive to learning; therefore, the earlier intervention strategies begin, the greater the possibility for developmental advancement.
According to the National Institute of Neurological Disorders and Stroke, early indicators that require evaluation by an expert include: “No pointing or babbling by age 1; no single words by 15 months or two-word phrases by age 2; no response to name; loss of language or social skills; poor eye contact; no smiling or social responsiveness; excessive or repetitive behaviors.”
There are six areas of early childhood development that should be assessed by a professional: Social, communication, emotional regulation, intelligence and sensorimotor. Additionally, other factors such as persistence (or lack thereof) of symptoms over time, medical conditions, the environment, parenting style, culture, etc. should also be taken into account before a solid diagnosis can be made; all of which can make it complicated for professionals to diagnose and for parents to comprehend.
So where does a parent begin in their quest to uncover what may be going on with their child? Start with your child’s pediatrician or early childhood intervention specialist. Bring a list of concerns that you may have, specific behaviors that you have observed, and for what length of time. Your pediatrician may then suggest that your child receive a formal assessment usually conducted by a specialist that has extensive experience diagnosing and treating autism. Several different diagnostic tools, checklists and direct observations are employed in order to gather objective information.
In many instances, multi-disciplinary teams work together to determine diagnosis and to recommend appropriate treatment. Teams are generally made up of several professionals including but not limited to, a clinical psychologist, a psychiatrist and a speech and language therapist. Parents may go through an array of emotions when a diagnosis of Autism is made; fear for the future of their child, sadness, frustration, and even relief in finally knowing and understanding what is going on with their child. After diagnosis it is imperative for parents to educate themselves about this disorder and follow the recommended treatment strategies in order to, maximize all levels of their child’s potential for success.
In fact, some of the most innovative, talented and amazing people on earth are functioning on the autism spectrum disorder. Temple Grandin, PH.D., a professor of animal science at Colorado State University and one of the most renowned autistic woman in the world once said, “Autism is part of who I am…I have read enough to know that there are still many parents, and yes, professionals too, who believe that ‘once autistic, always autistic.’ This dictum has meant sad and sorry lives for many children diagnosed, as I was in early life, as autistic. To these people, it is incomprehensible that the characteristics of autism can be modified and controlled. However, I feel strongly that I am living proof that they can.”
Some helpful websites are:
Laura Eldridge is with Action for Children, a source for early learning and child care in Madison County. She can be reached at (740) 852-0975, ext. 15 or email firstname.lastname@example.org.