McLEOD REGIONAL MEDICAL CENTER 12 DECEMBER 2011

(12/12/11) –
Autism is a developmental disorder characterized by: delay in developing language & communication skills, abnormalities in language, abnormal social interactions, narrow range of interests and repetitive behavior. One of these findings alone does not identify a child as having Autism. Having a collection of the findings makes the diagnosis of Autism. Children with Autism have varying degrees of difficulty with language, repetitive behavior & social interactions. Because individuals with Autism have such varying difficulties, it has been termed Autism Spectrum Disorders (ASDs). Children with ASDs are as alike as the leaves are alike in autumn. The spectrum can include those who are nonverbal to those who have small abnormalities in language and communications. Intelligence is generally not affected in individuals with an ASD.

What causes ASD?
No single cause has been found.
Let me also state that there has been no validated connection between vaccine administration and ASD. Studies have failed to prove a cause and effect relationship. The evidence favors rejection of a casual relationship between thimerosal-containing vaccines and ASDs. With that being said it is the recommendation of the American Academy of Pediatrics that children be immunized. Immunizations have helped children stay healthy for many years.

What are some of the signs of ASDs?
Many people with ASDs have different ways of learning, paying attention, or reacting to things. ASDs begin during early childhood and last throughout a person’s life.

A child or adult with an ASD might:
• not play "pretend" games
• not point at objects to show interest
• not look at objects when another person points at them
• have trouble relating to others or not have an interest in other people at all
• avoid eye contact and want to be alone
• have trouble understanding other people’s feelings or talking about their own feelings
• prefer not to be held or cuddled or might cuddle only when they want to
• appear to be unaware when other people talk to them but respond to other sounds
• be very interested in people, but not know how to talk, play, or relate to them
• repeat or echo words or phrases said to them, or repeat words or phrases in place of normal language (echolalia)
• have trouble expressing their needs using typical words or motions
• repeat actions over and over again
• have trouble adapting when a routine changes
• have unusual reactions to the way things smell, taste, look, feel, or sound
• lose skills they once had (for instance, stop saying words they were using)

Screening and Diagnosis
If you think that your child has an ASD, talk with their pediatrician. Early detection and intervention is key to improved outcomes. Diagnosing ASDs can be difficult, since there is no medical test, like a blood test, to diagnose the disorders. Doctors look at the child’s behavior and development to make a diagnosis. ASDs can sometimes be detected at 18 months or younger.

By age 2, a diagnosis by an experienced professional can be considered very reliable. However, many children do not receive a final diagnosis until much older. This delay means that children with an ASD might not get the help they need. The American Academy of Pediatrics strongly believes in the importance of early and continuous surveillance and screening for ASD to ensure that children are identified and receive access to services as soon as possible.

Diagnosing an ASD takes two steps: a developmental screening is a short test to tell if children are learning basic skills when they should, or if they might have delays. During developmental screening the doctor might ask the parent some questions or talk and play with the child during an exam to see how she learns, speaks, behaves, and moves. A delay in any of these areas could be a sign of a problem.

All children should be screened for developmental delays and disabilities during regular well-child doctor visits beginning at 2 months through 18months, as well as 2 year old through 5 year old visits. Additional screening might be needed if a child is at high risk for developmental problems due to preterm birth, low birth weight or other reasons.

In addition, all children should be screened specifically for ASDs during regular well-child doctor visits at 18 months and 24 months. Additional screening might be needed if a child is at high risk for ASDs (e.g., having a sister, brother or other family member with an ASD) or if behaviors sometimes associated with ASDs are present. It is important for doctors to screen all children for developmental delays, but especially to monitor those who are at a higher risk for developmental problems. If your child’s doctor does not routinely check your child with this type of developmental screening test, ask that it be done.

If the doctor sees any signs of a problem, a comprehensive diagnostic evaluation is needed. This thorough review may include looking at the child’s behavior and development and interviewing the parents. It may also include a hearing and vision screening, genetic testing, neurological testing, and other medical testing.

In some cases, the doctor might choose to refer the child and family to a specialist for further assessment and diagnosis. You can also contact your local early intervention agency (for children under 3) or public school (for children 3 and older). To find out who to speak to in your area, you can contact the National Information Center for Children and Youth with Disabilities by logging onto www.nichcy.org or call 1-800-695-0285.

For links to information for families, visit the Centers for Disease Control and Prevention Autism Information Center web page at www.cdc.gov/ncbddd/dd/aic/resources.

There is currently no cure for ASDs, however, children with an ASD can progress developmentally and learn new skills. Right now, the main research-based treatment for ASDs is intensive structured teaching of skills, often called behavioral intervention. It is very important to begin this intervention as early as possible in order to help your child reach his or her full potential.

References: American Academy of Pediatrics, Centers for Disease Control and Prevention

Dr. Danté N. Lewis, FAAP, is Board Certified in Pediatrics and a Fellow of the American Academy of Pediatrics. Dr. Lewis prides himself in the specialty areas of preventative medicine, asthma and other related respiratory illnesses, allergies, atopic dermatitis (eczema), gastrointestinal illnesses, learning difficulties and obesity. Dr. Lewis is also fluent in Spanish.

McLeod Pediatrics Dillon provides excellent care and offers a dedicated and professional staff. Come celebrate your child’s health with Dr. Lewis and his staff at McLeod Pediatrics Dillon – Dr. Danté Lewis, 207 E. Monroe Street, Dillon, or call (843) 841-2816.