Early Behavioral Patterns Of Autism - Good Parenting

Dear Dr. Debbie,

We have a family member whose young daughter seems to many of us to have autism.

The parents are divorced and Mom has custody. The problem is that if anyone asks if she has had her almost three-year-old daughter assessed, Mom gets defensive or changes the subject. Since she won’t talk to any of us about it, we are left to discuss our observations with each other when they’re not around.

Other than her parents’ break up, we all agree there was nothing else to explain what seemed to be a sudden onset of symptoms at about eighteen months. She is easily overwhelmed at family gatherings. She has a few repetitive movements such as rocking herself and patting her leg with her hand. There were some phrases we used to hear, such as “Hello, Cheerio!” (hu-wo jee-wo) and “What’s the fuss?” (wuz-a-vuss) that we no longer hear from her, even if we try to coax her.

I had a friend whose child developed similar symptoms at about the same age, after appearing to be developing normally, and went through school as a Special Education student through high school. He lives at home as an adult. By the way, my friend thought at the time that her son’s autism was caused by vaccines. I believe this was disproven several years ago. Our relative is, unfortunately, an “anti-vaxxer” so that isn’t even a possibility.

What can we do to help this child?

Concerned Family Member

Dear C.F.M.,

You have described some of the quirks associated with autism  – social discomfort beyond a primary caregiver, repetitive movements, and sudden loss of language abilities. And you are correct about the coincidental association between vaccines at around 18 months of age and parents’ awareness of “regressive” behaviors such as social discomfort and loss of vocabulary. The journal that in 1998 printed one doctor’s theory  - based on only 12 children - wrote a retraction after several studies found no correlation between the injections and autism. While some clusters of autistic behavior may seem to appear suddenly – somewhere in the second year of life, there is ongoing research to tease out subtle clues that could help to alert parents even earlier. Resisting eye contact (and therefore not enjoying peek-a-boo) is one such behavior.

Your role as a concerned family member is to gather information and resources to share with the Mom. Then wait for her to take appropriate action. If there is another family member or friend she is more likely to take guidance from, bring that person into the mission. The sooner an accurate diagnosis is made, the sooner this little girl can take part in therapeutic activities to reduce the frustrations this disorder can cause.

You might offer to go along at the next doctor visit, so the doctor can weigh in on whether the observed symptoms warrant further investigation. Another route is to use the free services of Child Find through the public school system. In Anne Arundel County the phone number is 410-222-6911. After initial contact, the next step in the referral process is a scheduled telephone interview or an in-person consultation. Offer to accompany the Mom through any and all of this. The interview can be done in the child’s home. If services are deemed to be appropriate they may include home visits by a member of the Special Education staff, and or enrollment in a therapeutic preschool class. (Under the age of three, the parent goes with the child to the classes.)

Unfortunately the parent of a child with special needs may resist the idea that her child is not developing normally. Acceptance brings on a range of emotions including loss, guilt, and the fear of going down an unknown path. If necessary, contact the child’s doctor or Child Find directly to share your concerns. They may have some advice for getting Mom on board. Is the child attending a preschool or child care program? A preschool teacher or child care provider can begin the Child Find referral process without the parent. At that point Mom either has to go along with accepting the recommended services or take her daughter out of the program. You didn’t mention if the child’s father is involved. He could be the one to access professional services. Eventually the child will be old enough that there won’t be any choice about going to school. (Unless Mom decides to home school!) At that point the child’s ability to cope, and hopefully succeed, will be addressed with the resources and expertise of the school system. Sometimes it takes hearing the message from several different people, including some professionals, before a parent can welcome the help her child may need.

Dr. Debbie

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