Why diagnosing autism spectrum disorder is essential for treatment
By Lauren Glendenning/Sponsored by Memorial Regional Health
About one in 68 children in the United States is diagnosed with autism spectrum disorder, but some parents delay seeking an official diagnosis, which can limit the services available to these children.
Services via the school system, health insurance and other programs increase once a diagnosis has been made. Such services include occupational therapy, speech and language therapy, behavioral therapy and more.
Each year during April — Autism Awareness Month — health care providers work to educate communities across the country about this complex and often misunderstood disorder.
That awareness includes educating parents about the disorder so they are not afraid to seek an official diagnosis from a medical doctor, said Susan Jones, an occupational therapist at Memorial Regional Health.
Causes and screenings
Autism Speaks, an organization that raises money for autism research and awareness programs, says autism is caused by different combinations of genetic and environmental influences.
“The term ‘spectrum’ reflects the wide variation in challenges and strengths possessed by each person with autism,” according to Autism Speaks. “Autism’s most-obvious signs tend to appear between 2 and 3 years of age. In some cases, it can be diagnosed as early as 18 months. Some developmental delays associated with autism can be identified and addressed even earlier. Autism Speaks urges parents with concerns to seek evaluation without delay, as early intervention can improve outcomes.”
Diagnosing this disorder can be difficult, because there is no medical test, such as a blood test, that provides a definitive answer. Instead, doctors must perform developmental screenings to see if children are learning basic skills when they should, according to the Centers for Disease Control and Prevention.
“During developmental screening, the doctor might ask the parent some questions or talk and play with the child during an exam to see how she learns, speaks, behaves and moves. A delay in any of these areas could be a sign of a problem,” the CDC says.
The second step in arriving at a diagnosis is a comprehensive evaluation, which reviews the child’s behavior and development, as well as interviews with parents.
The CDC says this could include a hearing and vision screening, genetic testing, neurological and other medical tests. Doctors who commonly do these evaluations include developmental pediatricians, child neurologists and child psychologists or psychiatrists.
Children are then often referred to occupational therapists, who also evaluate each child’s individual needs. Because autism varies in severity and symptoms across a broad spectrum, each child’s needs are different.
“Perhaps it’s sound that really bothers them, or they need academic support,” Jones said. “We’ll work with executive functioning, fine motor skills — maybe handwriting or buttoning.”
Jones said some children on the spectrum may need help identifying the severity of problems –a small problem versus a large problem — and determining how to gauge their reactions to those problems.
Treatment also involves the entire family, said Tracy Perish, an occupational therapist at Memorial Regional Health. Therapists want to know what’s going on in the home and which skills the family wants the child to be doing on his or her own, such as brushing teeth.
“It’s a family effort,” Perish said. “We take what they say very seriously.”
Families can help identify triggers for children with autism, too, Jones said. Therapists often ask parents to keep a log to identify what triggers certain behaviors and reactions.
Regardless of where a child falls on the spectrum, Perish and Jones agree that occupational therapy can play a huge role in developing an appropriate treatment plan.
“From birth, all the way to getting ready for college, we can play a part,” Perish said.
Imagine that there’s a town next to a raging river, with a waterfall just five minutes downstream. One day, the residents of this town notice people caught in the river and many are going right over the waterfall’s edge. What can the townspeople do to save these people?