It is estimated that one in 88 children, and one in 54 boys will be diagnosed with an Autism Spectrum Disorder (ASD). Boys are four times more likely to be diagnosed than girls. Autism is a spectrum disorder, meaning that it affects each person in varying degrees. In the most severe cases, it can be detected at an early age, however children that are higher functioning with ASD, may not be diagnosed until they reach school age, or later. There are documented cases of children diagnosed with ASD who “outgrow” their diagnosis, especially when they receive early intervention services. The earlier that ASD is detected and therapies started, the better chance of that happening. At the very least, early intervention services can help children to potentially overcome some aspects of ASD.
Some children with ASD show obvious signs early on, such as missing developmental milestones like talking and walking. However, many others reach all of their milestones on time with no “obvious” signs of ASD, unless you know what to look for. Doctors should screen for ASD at each regular checkup for children 16 to 30 months of age. Most pediatricians use a screening tool called the M-CHAT to determine if there is concern for ASD. Parents fill out a questionnaire and based on their answers, and the child’s doctor may ask further qualifying questions to find out if they are at risk of ASD.
The M-CHAT is a useful tool, however, many things can go unnoticed depending on how you interpret the questions. Consider also that it’s a test. Even though you’re not being “graded”, there is a natural tendency to want to get the “right” answers. Smash that idea and answer as honestly as possible to get the best result for your child.
Some things that are not part of the initial questioning on the M-CHAT, but are reported by parents of kids with ASD are listed below. Have you noticed your child to have any of these red flags?
- Doesn’t respond to their name when called
- Uses very few words
- Regression in speech–started off saying several words, but suddenly says fewer or none at all
- Doesn’t make eye contact or looks only at object when asking for something, instead of making periodic eye contact
- Lines up toys instead of engaging in purposeful play
- Focuses on a part of a toy, such as spinning the wheels on a train
- Obsession with appliances such as a blender, vacuum cleaner, or a fan
- Spins or walks in circles
- Flaps hands
- Bangs head or hits head
- Repetitive behaviors not already mentioned
- Resistant to touch or being held
- Refusal to eat foods based on color or texture, shape or size
- Doesn’t show an age-appropriate interest in other children his age
- Prefers to be alone
- Can entertain him or herself for long periods of time
- Likes things to be in a certain order
- Does not like any change in routine
- Frequent prolonged meltdowns
- Inappropriate reactions such as laughing when anyone else might cry or be angry
If you have an immediate concern that your child may have ASD, there is an online instant-score version of M-CHAT available at www.m-chat.org. The online version is actually quite good and asks follow up questions based on your initial answers. Considering that doctors have varying experience in administering the M-CHAT, it may be a good idea to use the online version, and bring the results with you to your child’s next appointment.
Depending on how your child scores on the M-CHAT, many doctors may recommend the “wait and see” approach. Meaning, let’s not worry about this now, and we’ll talk about it at the next appointment. You are the Mom (or Dad)! Follow your instinct. Regardless of the M-CHAT result, if you have a concern you can ask your child’s pediatrician to make a referral to your local Early Intervention program. Also request a referral for a developmental pediatrician that can make an official diagnosis (if applicable), and look at your child’s development as a whole. If they still want to wait and see, you can make your own referral to early intervention. Ask your child’s pediatrician for a contact number to call at your local Early Intervention office.
Once a referral is made for Early Intervention (EI) services, your child will be tested to see if they have delays in any developmental areas such as speech, fine motor, and gross motor skills. If it is decided your child has a need, they will quickly begin to receive in-home services in areas such as speech therapy, physical therapy, occupational therapy, special education itinerant teacher (SEIT), behavioral therapy, or feeding therapy. Keep in mind that even though your child may qualify for services, Early Intervention does not make an ASD diagnosis. Only a developmental pediatrician, psychiatrist, or psychologist can make an official diagnosis. Don’t waste time waiting for EI to tell you it’s time to see a specialist, set up an appointment as soon as possible, as there is often a long waiting period to get an initial appointment. Having a diagnosis can go a long way as far as getting EI services. If a child is initially denied EI services, but then receives an ASD diagnosis, you may have more luck requesting an early re-evaluation (standard waiting time for re-evaluation is six months). If your child is getting EI services and then receives an ASD diagnosis, it can help to increase services to a more therapeutic level for your child.
April 2nd is World Autism Awareness day and April is National Autism Awareness month. In honor of this, do the M-CHAT for your child and pass this article along to raise awareness of ASD. If you haven’t noticed, Autism Speaks is a sponsor for Marvy Moms. Make a purchase from Autism Speaks to support Autism research. Autism Speaks is more than a store, they are also an incredible resource for all things autism, take a look at www.autismspeaks.org.