According to the Centers for Disease Control (CDC), autism affects one in 54 children in the United States today. Autism Spectrum Disorder (ASD) encompasses a broad range of behaviors ranging from mild to nearly disabling and is often used interchangeably with terms such as Asperger Syndrome and Pervasive Developmental Disorder. In fact, these are separate conditions that all fall within ASD.
In this video, San Diego Health host Susan Taylor talks about ASD with Shirin Alonzo, MD, an internal medicine physician and pediatrician with a specialty in neurodevelopmental disorders at Scripps Coastal Medical Center San Marcos.
ASD has replaced the individual diagnoses of autism, Asperger and others. ASD is not a mental illness; rather, it is a neurodevelopmental disorder that is present at birth.
A person is diagnosed with ASD if they have certain clinical symptoms that develop in early childhood, usually before the age of 8. According to Dr. Alonzo, the diagnosis is based on developmental milestones in three categories:
- Language and communication: By about 6 months of age, babies should be babbling using consonant sounds such as “bah, bah, mah, mah, lah, lah.” By age two they should start putting words together and have age-appropriate conversations.
- Social interactions: The second category assesses how a child interacts with others. While many people believe children with ASD avoid talking, making eye contact or hugging, the opposite also may be true: excessive hugging or not understanding boundaries may indicate ASD as well.
- Unusual behaviors: The third category looks for repetitive or obsessive behaviors, such as saying the same phrase over and over, lining up toy cars for hours on end, rocking back and forth, or opening and closing doors. Sometimes, these behaviors are subtle.
Dr. Alonzo notes that ASD is a lifelong disorder, and symptoms can change over time; for example, a toddler who repeatedly lined up toys may later have issues with social interactions.
If you notice that your child shows symptoms of ASD, the first step is to tell your pediatrician, school counselor or other expert who has training in ASD and can help direct you to the proper resources.
“There is no cure because it is not a disease, but treatment can optimize development and learning,” Dr. Alonzo says. “Treatments will be highly individualized based on the symptoms that the patient is displaying. If they’re not sleeping, we’re going to focus on getting them enough sleep, because that will affect behavior the next day. If they’re aggressive, we’ll try to get them on medicines so that they’re not aggressive, and they can pay attention and learn.”
ASD treatment may include a combination of medication and intensive therapies, such as speech or behavior therapy. Behavioral specialists can guide parents on creating care plans for the day at home.
School-age children with ASD should have an Individual Education Plan (IEP) evaluation by their school district. During the evaluation, various specialists evaluate each child to determine how to best accommodate their needs and provide the proper resources to optimize learning. These evaluations usually take place when a child enters kindergarten, but may be done as early as age 3.
“Our focus is on very early intervention, because the earlier we get resources and therapies for that child, the higher chance they’ll have for a successful life,” says Dr. Alonzo. “Parents who have concerns should not just brush them off or think their child will change. Getting the right help can be complicated, so that's why it’s important to talk to your pediatrician, who will help you maneuver through the system.”
Finally, Dr. Alonzo encourages parents to be advocates for children with ASD by helping to eliminate the stigma. “Start talking about it in an accurate and informative way,” she says. “Don’t focus on the disability. Focus on their abilities, because people with ASD see the world in a little bit different way than you and I might, but that way is special.”