A Pediatrician’s Guide to Understanding the Signs, Symptoms and Diagnosis of Autism
Over the weekend, my heart was touched when I read a story about a mom named Alexa Bjornson sending her 7-year-old boy, Landon, alone on a flight from Las Vegas to Oregon to see his dad.
This would be stressful for any mom, but Alexa's son has high-functioning autism. She was worried about who would be sitting next to him on the flight and would they be tolerable of her son.
The story had such a happy ending because of a wonderful man named Ben Pedrazza, who even messaged Alexa with a photo of the two of them on the flight.
"He did ask if we were there yet several times but he was a great travel buddy," he wrote.
Isn't that awesome?
With this story in the news, I thought it would give us a chance to talk about autism. I often get asked about it in my office. Some parents want to know if their child should be tested or how they would know if their child has autism. So let's take a look at what pediatricians look for as far as the signs and symptoms of autism spectrum disorder.
Not one single test can diagnose autism. This is not surprising given the complexities of the neurodevelopmental condition, some of those we do not understand fully. What is known is that the earlier it is diagnosed the earlier interventions can be started and the outcomes tend to be more positive.
So what do you look for? What are the signs?
The real answer is it can vary depending on the child, key to early diagnosis requires a partnership between the parent and the child’s doctor. Any concerns a parent has about development should be looked into further. In other cases, concerns may arise after standard developmental screening which occur at each well-child visit. Standard autism screening should occur between 18-24 months of age.
Autism, or ASD (Autism Spectrum Disorder), is a neurodevelopmental condition that may include difficulties with social skills, behaviors of repetitive nature and difficulties with verbal and nonverbal communication. It’s estimated that 1 in 59 children are affected by autism in the United States today. ASD is a complex disorder that presents with varying degree symptoms ranging from mild to severe. There is no single cause, and at this time both genetic and environmental factors are thought to contribute. More importantly no reliable studies to date have shown a link between ASD and vaccines.
Some early signs include:
- Delays in development like delayed babbling or cooing
- Lack of social smile by age 6 months
- No pointing or waving by age 12-14 months
- No single words by age 15 months
Having a pediatrician recognize these signs is one of the reasons it’s important to keep your child up to date with well-child visits. The visits typically include questionnaires about development and this is an opportunity to identify any of these delays early.
Some children may have delays only in one area and no other difficulties. Standard screening tools exist to help your doctor identify other problems which may indicate autism as a possible diagnosis.
One of the most widely used screening tools is MCHAT-R (Modified Checklist for Autism in Toddlers, Revise). This checklist is a series of 20 yes/no questions. The scoring of this screening tool gives a low, medium or high risk for ASD. All children with medium/high risk results should have appropriate follow up which may include referral to a developmental pediatrician or a trained psychologist for formal ASD testing.
What if the screening is negative, but the parent has concerns?
A detailed history regarding the concerns also may lead to referral for further testing even if the screening is negative. The reason for this is because ASD has such a wide presentation of symptoms it may eventually be diagnosed when symptoms are more subtle.
Since every child with autism is different, the treatment recommendations will vary for every child depending on the difficulties they are having. The current evidence supports the following effective treatments for autism: ABA (Applied Behavior Analysis), speech therapy, occupational therapy and treatment of any other co-existing condition of course.
We know early diagnosis leads to early intervention, which has been shown to improve behavior, skills and language development. Early intervention helps with the outcomes of children diagnosed with autism. It’s important to bring up any concerns to your child’s primary care provider as soon as you have any worries or concerns.
An early diagnosis may also start you on an incredible journey with a child as interesting and amazing as Landon.
For more on this Topic:
- Cook Children's Child Study Center
- New Self-Defense Class Empowers Teens with Intellectual Disabilities to be a 'Hard Target'
- The Autism Spectrum: A Pediatrician's Explanation
- Avery's Journey: An Autism Spectrum Disorder
- Autism Spectrum Disorder: The Need to Wander or Elope
- Julia Brings 'Sunny Days' to Kids with Autism
- Living with Autism
- What Is Autism?
Get to know Bianka Soria-Olmos, D.O.
Dr. Soria-Olmos is a Cook Children's pediatrician in Haslet. She was born and raised in Fort Worth, Texas, so Cook Children's has always had a special place in her heart. She came to know Cook Children's when she was just a kid herself. She went to the medical center a number of times with her active younger brother, who needed care following several mishaps with broken bones. The visits inspired her to decide, "I want to be a Cook Children’s doctor one day."
In pursuit of her dream, Dr. Soria-Olmos attended Texas Christian University (TCU) for a degree in biology and to fulfill the pre-medical school requirements. After graduating from TCU, she chose to stay local and attended medical school at University of North Texas Health Science Center/Texas College of Osteopathic Medicine in Fort Worth. She completed part of her pediatric clerkship at Cook Children's, learning about pediatric medicine by attending rounds with pediatric hospitalists. It was then she knew she wanted to be a pediatrician.
She began her career with Cook Children's in 2014 as a pediatric hospitalist caring for sick children admitted to the hospital. Today, she works at Cook Children's primary care office in Haslet. Her special interests include child safety, child development and asthma.
The term autism covers broad range of neurological disorders known as autism spectrum disorder (ASD), and symptoms can be mild to severe. Many people with ASD can lead very productive lives. In fact, some very successful and famous people have ASD. And, as new therapies are introduced, even those with severe cases of ASD are finding ways to communicate and unlock much of their potential.
Children with ASD have differences in the way their brains develop and process information. They might have language delays or trouble communicating with others, perform certain unusual or repetitive behaviors, or have difficulties learning in school. ASD may include pervasive developmental disorders and Asperger syndrome. ASD can be diagnosed by a physician, psychologist or diagnostician.
No two cases of autism are exactly alike. Depending on your child's condition, symptoms can be severe and interfere with everyday tasks or they can be mild and cause few problems. Doctors and scientists call this range of symptoms a "spectrum." Asperger syndrome and pervasive developmental disorders (PDD) are conditions that fall within the autism spectrum.
Without appropriate treatment, these disorders can have lasting effects on a child's physical, social, and emotional development. Cook Children's Occupational Therapy program is designed to address these problems and to each child realize his or her optimal growth and development.