Autism

Answers to Your Questions About Autism (part 3)

Q: My 3 year old is autistic. Will his symptoms get worse as he gets older?

Posted by: Janice

Dear Janice,

Without intervention, the symptoms will undoubtedly get worse over time. The earlier the intervention begins, the better the outcome will be. The first few years in a child’s life are critical. The brain is developing its capacity for everything from vision to speech to muscle control. And, just as important, it is developing the ability to think and feel deeply. The child who, for whatever reason, is not attending to the social and emotional world around him is not learning all the things children must learn by imitating and interacting with other people. He is missing the foundation for basic social skills and the building blocks for broader learning. The long-term effects can be devastating.

With the appropriate intervention, the symptoms can be reduced significantly and potentially disappear altogether. Current treatment approaches offer real hope and real improvement, and even the possibility of recovery, as autism is treatable.This treatment should take a comprehensive integrative approach, consisting of appropriate clinical, educational, and biomedical treatments.

Sincerely,
Nancy D. Wiseman

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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

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Answers to Your Questions About Autism (part 1)

PREGNANT AND ANXIOUS

Q: A few of my wife's friends who are pregnant or have newborns are really anxious about all the news they read about the increase in autism in America. Should they be worried? What can I say to reassure them?

Posted by: Jerry L.

Dear Jerry:

In general, there has been a dramatic increase in the prevalence of childhood diseases and disorders over the past 10 years, including autism, asthma, allergies, AD/HD, bipolar, and learning disabilities. One in every six children is at risk for a developmental, behavioral, or learning problem. This is very worrisome. The question we must ask is: is this due to genetics, exposure to toxins found in the environment (such as water, air, food, and vaccines), failures in the functioning of various bodily systems (immunological, gastrointestinal, and metabolic), or a combination of the three? Until we know conclusively what causes autism (or any of the other diseases and disorders) parents should be prudent in what they put in (or on) their bodies, homes, and lawns. This is particularly important for children who are far more vulnerable while their brains are developing.

Instead of worrying and doing nothing, parents should be forewarned and armed if they have young children or are planning to get pregnant. They should become more knowledgeable about the ingredients in all products and the potential harm to their body or baby; be vigilant about monitoring their baby’s key social, emotional, and communication milestones from birth through school age; have their child’s development screened beginning at 4 months and for autism at 18 and 24 months; and when in doubt, they should check it out!

Sincerely,

Nancy D. Wiseman

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WHERE CAN I TURN FOR HELP?

Q: I have a 6 year old son that no doctors will help with. We have tried to get Adam help since 3 when easter seals was done with him. I finally got Adam in pre school by the grace of god watching us and running into a old friend who helped. Adam has never slepted a whole night in his whole life. He ws found that at 9 months he had acid reflects and that helped for a while. He didn't speek till around 4 from 2 to 3 we did sign lanuage which we learned from easter seals. He is in kindergarden now and doing exceptionally well considering I didn't knowif he could do it he is reading and comumeticationg well with his teacher. I am very proud we need basically how to control tempers and outbursts. Is there a book with ideas and help to work around all these things

Posted by: kathy bell

Dear Kathy,

I can imagine how upsetting and frustrating this must be for you when you know in your heart something is wrong with your child and no one will step up to the plate and help. Whether it is autism or a related disorder, my new book (The First Year: Autism Spectrum Disorders) can give you the information and tools you need to get started. It will teach you how to assemble a team of professionals that can identify what is wrong with your child and recommend the types of treatments, supports, and program you need for your son. It will also help you to navigate your local school district and insurance company to get the supports and services you need.

Ideally, your son should have a multidisciplinary evaluation consisting of a developmental pediatrician, gastroenterologist, child psychologist, speech and language pathologist, social worker, and educational specialist. The team approach to diagnosis and treatment is vital, as autism can manifest itself in a wide variety of ways (behavior, speech, ability to learn and relate, etc.). The reason I am suggesting a gastroenterologist is because of your son’s reflux, sleeplessness, outbursts, and temper tantrums. Often this can be due to food allergies, yeast overgrowth, or immune dysfunction. Once the team is able to identify the reason for your son’s problems, they can recommend the most appropriate course of treatment. Then you can take an active role in advocating for his needs. Best of luck to you!

Sincerely,

Nancy D. Wiseman

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ARE VACCINES OKAY?

Q: I'm pregnant now and thinking ahead about vaccines my baby will need, but I've read a lot of conflicting information about the link between vaccines and autism. Can you help me navigate through the arguments both for and against vaccines? I want my baby to be as healthy as possible, but I'm not sure whose advice to follow.

Posted by: Karen B.

Dear Karen,

Congratulations on your pregnancy! You are smart to be thinking about this issue now so you can plan ahead. As I’m sure you’ve seen all over the news, there is a great deal of controversy over whether or not vaccines are safe and it’s very unsettling. As I said in an earlier response, until we know conclusively what causes autism, you should be prudent in what you put in (or on) your body, home, and lawn.

The fact of the matter is, no vaccine is completely free of risk. We know that many children with autism are physically ill and once tested, they are found to have compromised immune systems, abnormal detoxification systems, and imbalanced gastrointestinal systems. Evidence shows that families of children with autism also have higher rates of autoimmune disease. This suggests that children with autism may have a genetic predisposition for immune system weakness. Immunizing a child with a weakened or dysfunctional immune system can lead to more serious health and developmental problems. One thing you should look at is your family history (and that of the baby’s father). Are there any neurological, immunological, or other health problems that run in either families (including allergies, asthma, AD/HD, and autism)?

Vaccines can be administered safely to children who are healthy. You can space them out in a way that will not overload your child’s immune system. And when it comes to boosters later on, you can conduct a simple blood test to check your child’s titers. If the test indicates your child is immune to measles, mumps, rubella, chicken pox, or other diseases, there is no need for a booster. This is a personal decision you will have to make, but I suggest you read the book, What Your Doctor May Not Tell You About Children’s Vaccinations by Stephanie Cave, MD, so you can make an educated decision.

Sincerely,

Nancy D. Wiseman

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JUST GOT DIAGNOSED

Q: I am a mother of a child that was diagnosis with autism within the last month. It has not only been a struggle for us to hear the news but also the support and services available for children with Autism. The doctors give their diagnosis and recommendations and we were on our own from there. I am well educated within the Autism Spectrum and yet I am having difficulty finding answers to all my questions. Where do we turn? What do we believe? Does the diets of autistic children really have an effect on their learning capacity? What can I do for my child besides therapies and diets.

Posted by: Abbey Turner

Dear Abbey,

I encourage you to read my new book (The First Year: Autism Spectrum Disorders: An Essential Guide for the Newly Diagnosed Child), as it will answer many of your questions and walk you through the most essential steps that will lift you out of your confusion and frustration, including understanding and accepting the diagnosis, how to become informed and well-connected, establishing your professional team, understanding your child’s unique profile, putting the proper supports in place, knowing and exercising your legal rights, obtaining key evaluations and reports to get the supports and services you need, learning which treatments are most appropriate for your child, and how to advocate. This journey can be very overwhelming for families. I wrote this book for parents, like yourself, who are just starting out.

Parents often ask: “how do I know which treatments will work for my child?” Well, you won’t, unless you first understand your child’s individual profile (since no two children are alike), know the issues to target, the pros and cons of each treatment, and the potential side effects. Some parents put all their eggs in one basket thinking that one method will provide the total solution, while others try everything at once. Unfortunately, there is no magic bullet. What seems to be most effective is finding the right balance of approaches (medical, therapeutic, and educational) that work for your child and family, and then trying them slowly and methodically.

For many children on the autism spectrum, dietary interventions can be very effective. As Kenneth Bock, MD, says: “It’s a mistake not to treat the underlying biomedical problems…to do what we can to help the neurons function so they respond to all the therapies.” I highly recommend his book, Healing the New Childhood Epidemics: Autism, ADHD, Asthma, and Allergies.

Best of luck to you!

Sincerely,

Nancy D. Wiseman

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Autism Q&A With Early Detection Expert

Parent & Child magazine welcomes parent advocate and autism expert Nancy D. Wiseman. Nancy will answer your questions during April (National Autism Awareness Month) about early detection of autism in children and intervention efforts.

Nancy_wiseman

Nancy D. Wiseman has been advocating for improved awareness of early autism detection among parents and medical professionals since 1999.

  • Founder and president of First Signs, a national nonprofit organization that educates parents and professionals about the early warning signs of autism and related disorders

  • Author of The First Year: Autism Spectrum Disorders: An Essential Guide for the Newly Diagnosed Child (2009)

  • Recipient of the 2006 American Academy of Pediatrics’ Dale Richmond/Justin Coleman Award for outstanding achievement in child development

  • Mother of Sarah, diagnosed with autism at 2, now thriving at 13

Do you have a question for Nancy? Submit it in the comments section below. Nancy will post answers to select questions twice during the month of April.

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