Evidence is mounting that autism is caused by the combination of a specific genetic abnormality and environmental factors. In November 2009, Dr. Geraldine Dawson at the University of Washington reported on the results of a two-year study of 48 toddlers. Her work proved that intervention with toddlers can positively affect their outcomes. Toddlers, diagnosed with autism before age two, were given either standard weekly therapy or daily, in-home play therapy. Dawson demonstrated that intensive early intervention can make a significant difference in autistic children's communication and social skills.
The key to accessing early intervention for autistic children is detection and referral. That requires parents know the earliest signs of autism.
Autism in Infancy
Most parents whose infants are later diagnosed with autism recall that their baby did not smile at the typical 6 to 8 weeks of age. The infant may hold their body stiffly instead of cuddling when held, and they did not appear comforted by the parent's cooing sounds. Many also have a difficult time nursing.
Other autistic children may meet their early milestones because smiling, cuddling and nursing don't require the interaction of responses from different parts of the brain. That leads many parents to think there's nothing wrong, until later, when more complex tasks can't be accomplished.
An experienced pediatrician may be able to see subtle differences simply because she's seen hundreds of infants at the same stage of development. Lactation consultants are another valuable resource. Not only can they help reluctant babes to nurse, they can also spot the infant whose total behavior is pointing to autism or another developmental delay.
Autism in Toddlers
The primary task of toddlerhood is connection. Every waking moment the healthy 1-year-old is observing, imitating and communicating with the adults who love her. For this to occur, multiple neurons from different parts of the brain have to work in coordination. This process is what the autistic child can not do.
Autistic 1-year-olds don't babble back and forth with mom and dad. Later, around 16 months, when imaginary play should begin, the autistic child isn't playing with dolls, talking into dad's cell phone or pretending to set the table. Finally, between 18 months and 2 years of age, children should be pointing to things they see, just to show what they've found to their parents. They communicate verbally and non verbally about the plane in the sky or the flowers they find on a walk and they show interest in the parent's reaction. This is called "joint attention" and an autistic child simply can't engage in this important way. That deficit keeps him from learning about the world and is now considered the cardinal sign of autism in toddlers.
Finding Signs by Screening
The American Academy of Pediatrics has called for all children to be formally evaluated for autism at the 18 months and 2 years of age, during those well-child check-ups. To make the doctor's assessment more accurate, parents can use the Modified Checklist for Autism in Children or M-CHAT at home and bring the results to the office visit. The M-CHAT is a set of 23 signs of autism that has a has a high degree of reliability. You can find it for free online.
If you find your child is exhibiting signs of autism, don't keep this thought to yourself. Pediatricians depend on your assessment because you're with the child every day, in a variety of situations.
Finding autism early is the only way to make sure your child can access the intensive interventions researchers like Dr. Dawson believe can make a significant difference in an autistic child's ability to communicate and interact socially.
References
- "Autism Genetic Resource Exchange Study Report"; Ning Lei, PhD et al; conference presentation at the Pediatric Academic Societies (PAS) annual meeting in Vancouver, British Columbia; Canada, May 2, 2010
- "Pediatrics"; Randomized, Controlled Trial of an Intervention for Toddlers With Autism, Denver Model; Geraldine Dawson, PhD, Sally Rogers, PhD, Jeffrey Munson, PhD, Milani Smith, PhD, Jamie Winter, PhD, Jessica Greenson, PhD, Amy Donaldson, PhD, Jennifer Varley, MS; November 30, 2009
