Worried About Autism – Where to Begin?

Not uncommonly, The Child Development Center receives emails such as this one:
Stumbled upon your website, and I have found it to be very informative. My 3 year old has just been diagnosed with Autism, although I do not really believe that he is autistic, because in some rare moments, I find he displays “normal” for lack of a better word, tedencies. He makes eye contact, he tries to express himself, he doesn’t point, but shows me where he wants to go and what he wants. Although, at the same time, many of the other signs are obviously there. Anyways, my reason for emailing you is that we live <<outside the US>>, and I wanted to know if there are any practitioners that you could recommend that we see in our neck of the woods?

In the past, parents would seek assistance and counsel from their child’s pediatrician or family physician.
Doctors take note: this is a serious shortcoming on our part if we do not understand how to diagnose, work up, treat and counsel families about the most important childhood epidemic of the 21st century.
Specialists take note: giving a parent a ticket for various therapies will not stop the family from seeking other opinions and treatments.

Step 1: Use an online tool, such as the M-CHAT, to learn if the child fits criteria for autism. The diagnosis is imprecise, at best, and misleading, at worst, because families may feel hopeless and believe that Rain Man is their child’s future. The behaviors that rule the diagnosis IN are the important ones, not the activities that do not fit the general perception of this disorder. In the case above, the child is starting to develop more typically by pointing and making eye contact, which is a positive sign toward recovery. What should concern any family (and the doctors) is lack of speech (or loss, even worse), and the “other signs that are obviously there.”

Step 2: If you can, find a knowledgeable practitioner with proven results. At the last meeting of Special Needs Pediatric doctors, there were fewer than 150 participants. Admittedly, there are simply not enough specialists for a condition that affects 1/68 children. The best place to start is the clinician directory at www.medmaps.org. Choosing one of the MAPS members will assure you that the clinician has studied (and been tested on) multiple courses in the most basic and advanced science of ASD.

Step 3: List all of the child’s other medical conditions and work with your pediatrician to address them. Diarrhea, constipation, reflux, asthma, eczema, allergies, recurrent infections may be the primary reasons for behaviors, such as aggression and fog, assigned to the ASD diagnosis. Ask the doctor to check the complete blood count, vitamin D levels, liver, kidney and thyroid function. Get an audiology examination. For the extremely restless, melatonin is a great anti-oxidant and sleep aid.

Step 4: Don’t give your child PPIs for GERD (smaller, frequent feedings and proper positioning), or Miralax for constipation (try probiotics and fiber). Refuse to give antibiotics with every fever elevation or ‘cold’, and question ALL medication advice, such as pre-treatment with Tylenol, or giving vaccinations while the child is ill.

Step 4: In the absence of any other assistance, at least try the gluten free-casein free diet for a few months. What have you got to lose? And, while we’re on the subject of diet, the fewer toxins the better. Try not to cater to the child’s favorite foods, if they are full of sugar or artificial coloring and flavors. Children do not know what is best for them. Especially if outdoor play is minimal, supplement with multivitamins, including C and D3, and fish oil.

Step 5: There is no magic pill, so far. Start appropriate therapies, such as speech and language, OT or behavioral intervention as soon as possible. Your healthier child will progress much faster when proper behaviors are emphasized. Rethinkautism.com can be a valuable tool, particularly when a therapist is not available.

Parents who seek opinions about their child’s unusual development are probably thinking autism, somewhere in the back of their minds. However, after experiencing the denial that is part of the grieving process, the reality of actually believing the diagnosis has to motivate parents to research, ask other parents and take action.

Even for families living in the remotest locale, something can be done to help your developmentally high-risk child.

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Brian D. Udell MD
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Davie
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Email bdumd@childdev.org
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