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Parenting

By Anandhi Narasimhan, M.D.

Autism and Your Child

Autism is a subject that has been receiving a lot of media attention lately with celebrities such as Jenny McCarthy and Holly Robinson-Pete going public about their children’s private struggles with the disorder.

Autism is characterized by difficulty in social interactions and responsiveness, language impairment and bizarre motor behavior beginning before the age of three. A diagnosis can be made by a qualified professional with extensive knowledge about the criteria and symptoms. Autism can be detected very early, even at just 18 months.

Medical science theorizes that autism is the result of a variety of factors, including genes and environmental causes. Some believe there is an association between vaccines and autism, but no conclusive scientific evidence has been found thus far.

Autism is on the Rise
The Center for Disease Control has confirmed that the rate of autism has been increasing, with the incidence now at 1 out of every 150 children, consistent across different ethnic groups. Over the last several decades, however, the rates have had a noted increase. Researchers say this is partially due to a few factors: the broadening of the diagnostic criteria, so kids who weren’t diagnosed previously are being diagnosed now, a decrease in the age of diagnosis and the greater efficiency of diagnosis. These factors do affect the number of cases, but there is still a noticeable, unexplained increase.

Knowing What to Look For
As with any disorder or disease, the earlier the symptoms are identified and intervention begins, the better the long-term outcome will be. So how do you identify the signs? Here are some things to keep in mind:

1) If your child is not reaching developmental milestones at the right time, such as smiling, saying first words, looking at you and engaging with you, let your pediatrician know. If there is a delay, this doesn’t mean your child automatically has a problem, but it is a good idea to keep your pediatrician aware of your child’s development. A child usually smiles at the sound of a parent’s voice and watches faces intently at around three months of age. At seven months, children begin responding to their own names, can transfer an object from one hand to another and begin to engage in social play.

2) If your child is experiencing language delays, consider speaking only English at home for some time. Language delays can be tricky, because more than one language is spoken in many South Asian households. This is very important to many people, because children who learn languages at an early age are often more comfortable speaking them as they get older, and language also helps parents pass down their South Asian culture. Also, children do not have a sense of embarrassment or inhibition in learning languages as adults might have, so it is easier for them to absorb this information. However, being exposed to different languages can cause confusion in a child experiencing language delays. Many parents are not educated enough about this issue, so if a child is having trouble, he should only be spoken to in English until he catches up and sustains language development. At a later time, parents can discuss the issue of reintroducing another language with a speech therapist.

If you are noticing delays, inform your pediatrician and have him or her take a look at your child. Child psychiatrists and psychologists familiar with these problems may spend hours of repeated evaluations with a child to make a diagnosis. This is important because the symptoms are less obvious than with other disorders. Large academic hospitals might have autism specialists who may be able perform a comprehensive evaluation at a lower cost or even for free through research studies. It is worth looking into such options.

So, What if my Child has Autism?
If your doctor diagnoses your child with autism, get information on what to do next and ask many questions! In the South Asian community, doctors’ opinions are frequently taken at face value, but this doesn’t mean you have to completely agree with an opinion. If a doctor reassures you that everything is okay and you are not satisfied, you always have the option to get a second opinion.

Because of stigma, South Asian parents often don’t want to seek out mental health professionals, even though they can be valuable resources. Moreover, noticing a child has developmental delays can infuse an enormous amount of panic, grief, disappointment, worry and fear in parents, and a mental health professional can help you deal with these emotions while getting your child the appropriate treatment. In our community, our parents had many dreams and expectations for our future, as we naturally have for our own children, so such problems can be extremely difficult to deal with. Ask around for referrals and recommended professionals. Seeking help for yourself in support groups and therapy can enable you to be a better parent.

The most important thing to understand is that if a problem is identified, you need to act as soon as possible. The biggest mistake I see parents making is avoiding getting the recommended services and interventions that could greatly help their child because of denial or hope that the problems will just go away. Please do not do your child a disservice by avoiding what could really help him or her, even if you are scared. You have the right to be completely involved in overseeing what happens with your child and assessing whether or not a specific intervention is working.

One Family's Journey Into the World of Autism

I am the mother of a three-year-old boy with autism. Our son was born a healthy seven-pound baby who smiled, cooed and hit all his milestones on target, so we never really worried about anything. Then, at 18 months, everything changed. He stopped responding to his name, stopped making eye contact with us, was totally unaware of his surroundings, would spin his toys forever and did not talk at all. Out of sheer concern, we made an appointment with his pediatrician, who advised us to get him evaluated, just in case, at the early intervention centre. We can’t thank him enough for not writing us off with a wait-and-see approach.

When the evaluation took place, we were in for a rude shock. We learned that our son satisfied most of the criteria to be placed on the scale for autism spectrum disorders, but the official diagnosis came much later. After the evaluation, he was eligible right away for speech, behavioral and occupational therapies. Thereafter, an influx of therapists came into our home and lives and changed everything for us. Some were very knowledgeable, and some were clueless about what to do with our son.

This experience sparked our quest to help our son in the most effective way. The answers to our prayers for our son's recovery from this torturous condition came in the form of the applied behavior analysis/verbal behavior approach, Defeat Autism Now! treatments and speech therapy. Early intervention is the key to helping these wonderful children and drawing them away from the grips of autism. Finally, at the age of three, our son can speak a few meaningful words for which we are so thankful.

The best lesson we have learned from this whole experience is to never take anything for granted in life. Also, we have learned to never compare our child with any other child, because each child is unique. We have come to understand that autistic children learn differently, and it is up to the parents and therapists and teachers to understand this and to try, in every possible way, to help teach these children to function more effectively. The everyday struggles are enormous, but we can never give up as parents because we are all they have. We think of our special-needs child as a gift, because he is indeed different and special.

Our advice to other parents is to keep doing research and stay as informed as possible on the latest developments for autism treatment and management. If you cannot be your child's advocate, then no one else will be. Nothing in the world prepared us to deal with this grim diagnosis for our darling son, but we survived. We are now on our way to dreaming big for his future with stronger resolve than ever before. Isn’t that what we, as parents, are supposed to do?

--Relentless parents of a three-year-old with autism

Treatment Options
A doctor may refer your child to an occupational and physical therapist to help with motor delays. Language delays require a hearing test and a speech and language evaluation for speech therapy. There are government agencies that provide services and support for individuals with developmental disabilities, which also means they can fund certain services. Request an “Individualized Education Plan” through your school district so some of the required services can be funded through the school system.

In addition, many parents hire therapists privately. These could include speech therapists or even behavioral therapists who are familiar with applied behavioral analysis, where an individualized plan is built for your child. The more therapy that is undertaken, the quicker you may see improvement in your child’s behavior or speech.

For more information regarding autism spectrum disorders, visit http://www.cdc.gov/ncbddd/autism/

 



Anandhi Narasimhan, M.D. is a Board-Certified Physician, accredited by the American Board of Psychiatry and Neurology, specializing in Adult, Child and Adolescent Psychiatry. Dr. Narasimhan currently serves on clinical faculty at Cedars Sinai Medical Center in Los Angeles, runs a private practice in Los Angeles and serves as a child and adolescent psychiatrist for Aviva Family and Children's Services, a non-profit contract agency with the Department of Mental Health. For more information, visit www.doctoranandhi.com.

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