Answers to Your Questions About Autism (part 2)

YOUR SECRET TO SUCCESS?

Q: I am interested in your profile information that your daughter Sarah is now 'thriving' To what do you attribute her current condition? What therapies helped her reach the point she is at now? What kind of expectations do you hold for her future?

Posted by: Cathy Mealey

Dear Cathy,

I am happy to share with you what worked for my daughter, but please keep in mind that what works for one child may not necessarily work for another. It’s critical that a treatment program be tailored to the individual needs of a child.

My daughter was diagnosed with mild-to-moderate autism at the age of two, and subsequently, with colitis at the age of 6, and PANDAS at the age of 7. PANDAS stands for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and it is a bacteria-triggered autoimmune disorder that can result in a sudden onset of symptoms, including tics, obsessions and/or compulsions, anxiety, irritability, sleeplessness, and a mood disorder. During the first year, we received Early Intervention services for about 11 hours per week with several clinicians who came into our home and in a playgroup setting. I began putting together a strong team of professionals that understood my daughter’s individual needs and could help me build a comprehensive program using the framework of DIR®/Floortime™, a model that I felt would work well for my daughter.

Our program consisted of 6-8 Floortime sessions each day, lasting 20-30 minutes apiece; speech/language therapy, play therapy, and occupational therapy 3-4 times per week; a daily sensory diet; and as many play dates with typical peer models as I could manage. I enrolled my daughter in a full-time specialized school program with lots of structure and opportunities to explore and interact. Her biomedical treatment included dietary and nutritional interventions, medication, and detoxification.

My daughter is 13 now and although she still has a ways to go (medically, we are still treating the PANDAS), she is very connected and social,she can relate to people with a deep sense of warmth and intimacy, and she can argue anyone into the ground on almost any topic. She’s making solid academic progress, is an avid reader, figure skater, rides horseback nearly every day, and has a few good friends.

To see what she has gone through, day in and day out, over the past 11 years with all the educational, therapeutic, and biomedical interventions (not to mention all the invasive tests, blood work, and IVs) and to see how far she has come despite the odds and the many roadblocks she has faced, it is mind blowing. My daughter is my inspiration!

Sincerely,

Nancy D. Wiseman

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SIGNS OF THE DISORDER

Q: What age should I start looking for signs of autism in my baby?

Posted by: Caroline R.

Dear Caroline,

Long before you sense there is something wrong, you should be monitoring your child’s key developmental milestones and watch for early signs of delay, because if you intervene early enough, you may be able to prevent a developmental delay from progressing into a full-blown disorder and get your child back on a healthy developmental path. Please go to the First Signs website at www.firstsigns.org and look for our Hallmark Developmental Milestones. Second, you should begin screening your child’s development with a validated screening tool as early as 4 months. Please see the Screening section of the First Signs website for more information.

To meet the diagnostic criteria for an autism spectrum disorder (ASD), you must have three core features: impairment in social interaction, impairment in verbal and nonverbal communication, and restricted and repetitive patterns of behavior or interests. Some of the early warning signs to watch for in the second year of life (Wetherby & Woods, 2004) are:

• Lack of appropriate eye gaze
  
• Lack of warm, joyful expressions
• Lack of sharing interest or enjoyment
• Lack of response to name
  
• Lack of showing gestures
  
• Lack of coordination of nonverbal communication
  
• Unusual prosody (little variation in pitch, odd intonation, irregular rhythm, unusual voice quality)
  
• Repetitive movements with objects
  
• Repetitive movements or posturing of body, arms, hands, or fingers

I encourage you to check out the ASD Video Glossary, an online video glossary that Amy Wetherby, PhD (Florida State University) and I developed in collaboration with Autism Speaks to help parents and professionals learn more about the early signs and features of ASD. This glossary is linked from our home page at www.firstsigns.org. Here, you will see side-by-side video clips of children with typical behaviors in comparison with children who present red flags for autism. But please understand, there are many presenting features associated with ASD that are depicted in the video clips. Most children do not show all of the features all of the time. Instead, many children have some of the features some of the time. Awareness of these common presenting features may help to heighten your index of suspicion. Individually, these features may not indicate a problem; but in combination, they may indicate a need for a diagnostic evaluation.

Sincerely,

Nancy D. Wiseman

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SHOULD WE TRY MEDICATION?

Q: I am the mother of a 7 year old with autism. He does a lot of running & yelling, I have a hard time getting him to focus on learning when I try to work with him, should I have on some kind of medication like for hyperactivity to help him focus better.

Posted by: Kim Casto

Dear Kim,

When you say “medication for hyperactivity” I assume you mean psychiatric medication. Have you –or your team of professionals– tried to peel apart the issues to understand the underlying cause(s) of the hyperactivity and outbursts? Have you seen a pediatric gastroenterologist or nutritionist who specializes in treating young children with autism? Or a Defeat Autism Now (DAN) specialist? I suggest you pursue this avenue before trying a psychiatric medication, which will only act as a band-aid. Oftentimes, these types of behaviors can be due to gastrointestinal or immune problems. Dietary and nutritional interventions can work well with these types of issues. My daughter was highly sensitive to gluten (protein found in wheat, barley, rye, and other grains) and every time she ate something that was cross-contaminated with gluten, she was so hyper you could peel her off the ceiling within 20 minutes of ingesting it.

Also, does your child get sensory integration (SI) therapy a few times a week? Does he have a daily sensory diet? This can help to improve his sensory processing functions and work towards calming him down in his daily activities (such as school, play, mealtime, sleep, etc.), as well as enhance his social interactions with peers. There are several chapters in my new book (The First Year: Autism Spectrum Disorders: An Essential Guide for the Newly Diagnosed Child) that address your concerns.

Sincerely,

Nancy D. Wiseman