by Lisa Cavanaugh, MD, FAAP
Autism is a communicative
disorder of unknown cause that
interferes with both social and
behavioral development. It affects
many parts of the brain and
manifests in the first few years of
life. The hallmark of autism and
autistic spectrum disorders (ASD) is
impaired social interaction.
Symptoms include difficulties with
communication (both verbal and non
verbal) and obsessive, repetitive
behaviors. These deficiencies may
be mild enough to allow the child to
lead a productive life or severe
enough to make independent living
impossible.
Children with autism and ASD often
will develop normally in other ways,
but have trouble connecting socially
with others. At a very early age
they seem withdrawn and make limited
eye contact. As they grow, they have
trouble with normal play and do not
develop intuition about the subtle
parts of communication such as
facial expression and body language.
Their early words are often
repetitive and echoing instead of
responsive to those around them.
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Repetitive behaviors may follow.
Examples of these are, rocking,
hand flapping and twirling.
Obsessive regimented play develops
involving straightening, stacking
and arranging objects in a
particular way. Autistic children
become rigid and inflexible and have
great difficulty with transitioning
from one situation to another
which leads to tantrums and
sometimes self injurious behavior.
Many toddlers are obsessive and/or
have difficulty with transitions,
but when there is a constellation of
symptoms, it makes sense to discuss
your concerns with your
pediatrician.
Since there is no cure for autism,
early diagnosis and intervention
offer the best hope for improving
communication and alleviating some
behaviors. Your child's
pediatrician is specially trained to
recognize early signs of autism and
ASD. This involves a
comprehensive history and thorough
physical examination and often
a screening tool as well. The M-CHAT
(Modified Checklist for Autism in
Toddlers) is a checklist designed to
screen children aged 16 months to 30
months. It is a 23 item
questionnaire for parents requiring
YES or NO responses that takes under
10 minutes to compete and score.
If a child is identified as "at
risk", the pediatrician will refer
the child for a more comprehensive
evaluation, usually through the
Early Intervention Program. Early
Intervention is a government program
that provides, at no charge, testing
and treatment for children with
developmental concerns.
Parents may also refer themselves
directly to the EIP. Many agencies
will help parents navigate the EIP
(see below) or parents may contact
the agencies directly.
Early Intervention Programs:
NYC - Totline
1-800-577-baby (2229)
Nassau County -
516-227-8661 Suffolk
County - (631)
853-3100
Dr. Lisa Cavanaugh is a member
of Allied Pediatrics. She practices
at Neighborhood Pediatrics in
Greenvale, NY.
