First, Autism Spectrum Disorder has got to be a major concern for every new parent. For everyone, in fact – grandparents, neighbors, and schoolmates – we all know someone who might be autistic. That sort of takes care of the “Is it really happening more?” question, doesn’t it?

The next question – what is the cause?  There is some combination of environmental factors and family conditions (genetic influences) that affect the manner in which certain infants and children interact, behave, and develop. That combination either leads to, or is a result of, other chronic or recurring medical problems.

So, when evaluating children under the age of three, socialization is initially expressed with facial expressions and eye contact. First there is smiling, then sounds and finally words. Accompanying that awakening is a widening interest in the baby’s own body, then the outside world, and finally interest in other people. Reaching and pointing are the indicators of that developmental landmark.

As children mature, they need to achieve certain motor milestones. Late crawling or children who “almost walk before they crawl” are at risk for developmental issues. Additionally, there is sometimes a fine line, especially for new parents, about evaluating seemingly ‘cute’ behaviors (such as spinning or lining up objects) that might indicate repetitive movements or restricted interests.

There should be reason for concern when children speak later than one year, plus demonstrate motor activities such as flapping of the arms or toe-walking.

Old-time pediatricians (I’m one of them) who used to say, “He’s a boy, he’ll grow out of it” have had to change our thinking about that. Such advice is not warranted in the face of this autism epidemic. Even more alarming are the toddlers who lose words or phrases that were previously spoken. My advice, seek help right away!

A combination of these signs plus a medical history that includes prematurity, repeated ear infections, multiple formula and food intolerances, reflux, chronic diarrhea, frequent constipation, severe eczema, or persistent crying ought to alert any parent and professional. Such a child needs close observation, a thorough medical and developmental evaluation, and appropriate interventions. That could mean language or behavioral therapies as soon as problems arise.

Medical issues such as skin problems, G-I concerns, repeated ear infections, or significant allergic symptoms need to be addressed. In our modern, polluted world, a healthy diet can’t help but improve any outcome. Just in case there are parents or professionals who may have overreacted to a developmental concern, and the child develops normally, no one will care.

And don’t forget, the chances are 98 in 100 that your child is going to be free of autism. With a parent’s vigilance and appropriate intervention, the other 2% have hope, too. But that’s another blog.

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      Pediatric Special Needs Medicine
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      Address – Brian D. Udell MD
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