Practical Advice Astrid Heathcote

Autism spectrum disorders (ASD) have increased dramatically over the past few decades, the U.S. Center for Disease Control and Prevention (CDC 2012) recently established the prevalence to be 1 in 88 American children and estimated 1 out of 54 boys being diagnosed with autism. ASD affects over 2 million individuals in the U.S. and is one of the fastest growing mental health concerns.

As of today, nobody can explain the exponential increase; there is stipulation that there is strong genetic involvement, due to the fact that it affects boys much more frequently than girls and tends to run in families. There is also speculation about risk factors that include advanced parental age (fathers and mothers) and maternal illness during pregnancy, however, not one single factor has been determined to “cause autism.”

Autism is a neuro-developmental condition and establishes its pathway early during fetal development and may alter parts of the developing infant brain. Recent research has concluded that the brain of the child with autism is larger and that parts of it develop faster (e.g., amygdala, which helps control emotions).

Symptoms of autism can range from the inability to articulate wants and needs (limited or no language skills) to subtle difficulty with social situations; people with autism often have many strengths, including the ability to excel in visual skills, music, math and art.

Early diagnosis and intervention are the key and may improve quality of life and social adjustment, including success in school, college and place of employment.

Check-ups with the pediatrician should include assessment of gross and fine motor skills, language development, social interaction with care takers and children, and play skills. If your pediatrician recommends further assessment, or the parent seems concerned about the child’s development, an evaluation by a pediatric psychologist who specializes in autism may be indicative and helpful to rule out a diagnosis.

Some signs of autism are not noticed until a child enters school, as early development appeared normal and often precocious (early language development and reading skills); once a child enters preschool or kindergarten, specific signs of autism may be: intense focus on a specific subject (unusual knowledge of planets, dinosaurs, etc), very formal language skills (I do not want to sleep during the day, for napping); deficit in perspective taking (I don’t understand why other kids are not interested in planets); preferring mature and solitary activities to play; seeking out familiar adults to spend free time activity with; excelling academically but showing difficulty with timed math or writing activities; sleep rhythm difficulties.

A diagnosis of autism is often a relief to the child and the parents who have wondered for a while “what’s wrong.”

I also suggest that we need to stop focusing on “deficits” of the individual and all the things that a child cannot do and shift our paradigm to “Neuro-diversity.” This means that we start viewing the individual with autism through the eye of human diversity. Each child with autism is as unique as the rest of us and requires acceptance for a blend of cognitive strengths and weaknesses (language, sensory procession and motor skills). Early identification and subsequent treatment should focus on autism presenting contextual difficulties that could be avoided by giving each individual with autism unique and individual goals that will help him or her succeed. Sensory demands, social ambiguities and information complexities are some of the barriers that individuals on the autism spectrum have to conquer, however, they need help from society.

As parents, professionals, fellow human beings, educators, and politicians the success of individuals with autism lies in accepting neuro-diversity and providing each of them with acceptance and tolerance, setting unique goals and teaching tools that help them succeed from early childhood into later adulthood (come to think of it, that would include attention-deficit disorders as well).

• Dr. Astrid Heathcote is a longtime resident of Ahwatukee and clinical psychologist in private practice who specializes in assessment, diagnosis and treatment of autism spectrum disorders.

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