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Decoding autism spectrum disorders

Published by , on Jun 29, 2018

Autism used to be considered rare, but today approximately one in 60 children is diagnosed with an autism spectrum disorder. What’s causing the increase and what does it mean for kids and families?

World Autism Awarenss Day.Autism and related conditions are in the public eye more than ever before. Celebrities are sharing their personal journeys with autism or Asperger syndrome, which is now grouped into the encompassing diagnosis of autism spectrum disorder. Meanwhile characters on the big and small screens, from Dustin Hoffman in Rain Man to Sheldon Cooper in the Big Bang Theory, are also bringing society’s attention to autism spectrum disorders.

What are the common signs?

The autism spectrum is exactly as the name implies – a continuum with wide variability in the type and severity of symptoms. Parents may first notice poor eye contact, disinterest in cuddling or delays in speech. As children get a bit older, they may exhibit problems with social interaction, trouble with transitions, sensory issues (e.g. being particular about clothing and touch) and unusual behaviors such as hand flapping or spinning.

What’s the first step?

If parents begin to notice a few of these signs, the recommended first step is to check in with their child’s regular pediatrician for a developmental assessment. Based on this assessment and a thorough conversation with the parents, the doctor may determine that these behaviors are a normal part of the developmental process.

If there is a concern, the pediatrician will likely make a referral for the Autism Diagnostic Observation Schedule (ADOS). This standardized test is administered by a professional who has been specially trained and focuses primarily on social communication, social interaction and behavior patterns. A diagnosis is not made based on the test alone, but the results are a valuable component of the overall evaluation process.

What happens after the diagnosis?

Once it’s determined that a child has an autism spectrum disorder, parents often wonder “now what?” It’s important to remember that their child is the same person they’ve always known and loved. A formal diagnosis is simply the first step in developing an action plan to help the child moving forward.

Research shows that early intervention is effective in helping children with autism improve language ability and social skills. Diagnosis often occurs during the preschool years, and many public school systems offer special education preschool programs geared toward kids with specific needs related to autism.

Mental health professionals can work with children of all ages through applied behavior analysis, which includes techniques for increasing helpful behaviors and minimizing those that may be detrimental or interfere with learning. Speech and language therapy and occupational therapy can also be helpful in improving social interaction and building developmental skills.

At times children with autism spectrum disorders have episodes of aggression which may range from mild to severe. A pediatrician or child psychiatrist can help parents in determining why the aggression is occurring and whether or not medications may help. Considerations to use medications are based on whether the aggression is connected to impulsivity, the child not wanting to change what they are doing or their misperception/paranoia about the environment or the people in it.

Where do I turn next?

As awareness of autism spectrum disorders has increased, so too has the breadth of resources for kids and families. Right inside our Virginia Treatment Center for Children, family navigators at the Children’s Mental Health Resource Center help families understand the options available and assist them in finding therapists, psychiatrists and other appropriate services. Several other community resources, including Commonwealth Autism Services, Autism Society of Central Virginia and the REACH program through the Richmond Behavioral Health Authority provide information, advocacy and support.

Are immunizations to blame? NO!

Clinical research has led to improved awareness of the causes and treatments of health conditions, as well as enhanced prevention efforts in the form of immunizations for some of the most troublesome and harmful diseases.

At the same time, health professionals and parents have become increasingly aware of the signs and symptoms of autism and the screening process has become more thorough and readily used. Pair this with the wide spectrum, which identifies individuals with varying degrees of the disorder, and more people are receiving an autism spectrum disorder diagnosis than in the past.

This rise in diagnoses has coincided with improved and increased vaccinations in young children. While this correlation in time has raised concerns for some, we firmly believe that there is no causation between immunizations and autism spectrum disorders and that vaccines are essential in protecting both children and adults from life threatening diseases. Learn more about vaccine safety.

What does the future hold?

There is no doubt that autism spectrum disorders come with challenges, but proper management can help individuals follow their strengths and interests, achieve their goals and live full and satisfying lives.

Some adults with autism are very skilled in their careers and need only minor support with communication and social interactions. Those with more severe impairments may do better with specific vocational training, a more supervised environment and significant support over time. Similarly, many adults with autism spectrum disorders live independently and raise families, while others may live with caregivers or in a group home setting long term.

The beautiful thing is that there is a wide variety of career and living options, just as there is a wide variety of people to fill those roles and homes. With more resources available than ever, families can find support and build their own perfect futures.

By Neil Sonenklar, MD, child and adolescent psychiatrist, Virginia Treatment Center for Children

Medical executive editor for mental health blog series: Bela Sood, MD

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