What is Autism?
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder consisting of difficulties with communication and social interaction, as well as restricted and repetitive behaviors or interests. We want to take a moment to acknowledge how encompassing that definition is. What autism looks like for any one child can be very different from another in terms of skills, challenges, and need for assistance or therapies. Currently, the CDC estimates that 1 in 54 children have autism, and it is more common among boys. Signs of autism are usually present prior to 3 years old, though children may not be diagnosed until an older age. For some children, there is a more gradual but persistent developmental delay. Whereas other children may experience a sudden regression in behavior. There is no clear single cause of autism. Rather, we suspect that it is multifactorial, e.g., genetics, biologic, and environmental. While there is no "cure" for autism, research strongly supports that early intervention leads to improved outcomes and behaviors.
What is your Pediatrician's Role?
We are screening your child's developmental milestones at every well-check exam, starting at 2 months old! Our clinic, like many others, has chosen the Ages & Stages Questionnaires (ASQ's) as our standardized developmental screening tool. We also specifically screen for autism at both the 18 month and 24 month well-checks using the Modified Checklist for Autism in Toddlers (M-CHAT). Notably these are all screens and do not confirm a diagnosis without additional evaluation. If these screens raise any red flags, we will of course talk with you, the parents. We always welcome you to come to us with concerns prior to those well-checks. If there are concerns, additional workup and diagnostic tests can be done at a behavioral center or with a specialist in Early Childhood Intervention, Neurology, Developmental Pediatrics, Psychiatry, or Psychology. Some of these options may require a referral, which you and your provider can discuss.
What Therapeutic Treatment Options are Available?
There are various therapies available depending on your child's needs. Most common therapies include Applied Behavioral Analysis, speech, physical, occupational, behavioral, feeding and nutrition. Many of these therapies may be prescribed for various reasons and do not require a diagnosis of autism. Applied Behavioral Analysis (ABA) therapy is oriented at teaching new behaviors and modifying existing behaviors. Unlike other therapies, ABA may require a diagnosis of autism to qualify for health insurance benefits. Early Childhood Intervention (ECI) is a program in Texas that offers services to children with developmental delays, vision or hearing impairment, or certain medical diagnoses up to 36 months old. The initial evaluation to determine whether your child is eligible for ECI services is at no cost, and if your child is eligible, services are offered on a sliding fee scale. Anyone (including parents) can make an ECI referral at any time. If your child is older than 3 years old, they may also be eligible for services through your local school district.
What Other Support is Available for Families?
Your child's doctor is a resource for evaluating your child's development and helping to determine what your child may need. There are many support groups and informational resources available for families as well. We recommend that you reach out for help in your community, online, and at your child's school or preschool.
Here are three great resources for information and guidance:
Below is a database of recommendations from local parents (thank you everyone for your contributions). There are also many other resources in the Austin area. We always welcome your feedback. Please let us know if you find these resources helpful, and send us any other resources you would recommend so we can share with all of our parents.
Thank you to Dr. Ashley Wilson for the research and information.