Autism: The Importance of Early Detection and Treatment

Published on 04 Feb 2015

General Article

Written by: Dr Shen-Li Lee

Autism

There is a concern among parents that we may be over-diagnosing our children with medical conditions that they do not have. I understand that concern. I, myself, have also raised concerns about the over-diagnosis of ADHD because it seems a convenient diagnosis for normally active children. But as much as we do not want to label our children out of a real or imagined fear of what it might mean, it is also a concern when parents refuse to acknowledge the possibility that their child may have a disorder. Burying our heads in the sand and refusing to acknowledge a problem exists is harmful for our children’s development. One such condition that I want to bring attention to is Autism Spectrum Disorder, also referred to as ASD.

ASD is a case where early diagnosis can have a significant impact on your child’s life and any intervention will be beneficial. Even in the event of a misdiagnosis, no harm is done. In this case, it makes absolute sense to “get in early”.

WHAT IS AUTISM?

Autism is a complex developmental disability resulting from a neurological disorder effecting normal brain function. It affects the development of the individual’s communication and social interaction skills. It presents in the first three years of life and has a genetic link.

WHAT CAUSES AUTISM?

What the research indicates:

there is no one cause of autism – it is usually a combination of gene mutations (which increase the risk of developing autism) and environmental factors

when autism risk genes are present, the following environmental factors further increase the risk of developing autism:
- older parents, especially older fathers
- when Mum is sick during the pregnancy
- difficulties during birth (particularly those that involve oxygen deprivation to the baby’s brain)
- air traffic pollution during pregnancy
family history of bipolar disorder or schizophrenia

it is very unlikely to be linked to vaccinations

Just as there are factors that increase the risk of developing autism, there is research to suggest that autism risk can be reduced by prenatal vitamins containing folic acid taken in the months before and after conception. (JAMA – February 2013)

SIGNS OF AUTISM

A definitive diagnosis of autism is usually only made around 18 to 24 months, but you can observe signs in a child as early as 8 to 12 months old. What to look for:

No big smiles or other warm, joyful expressions by six months or thereafter

No back-and-forth sharing of sounds, smiles or other facial expressions by nine months

No babbling by 12 months

No back-and-forth gestures such as pointing, showing, reaching or waving by 12 months

No words by 16 months

No meaningful, two-word phrases (not including imitating or repeating) by 24 months

Any loss of speech, babbling or social skills at any age

You can also take the M-Chat to help you decide if you need to see a specialist about your child. The general rule is that the earlier your child is diagnosed, the better your chances are for improving your child’s outcomes.

DEBUNKING THE MYTHS ABOUT AUTISM

It is a fallacy that autistic individuals have no feelings – THIS IS NOT TRUE! Autistic individuals feel emotion like any other person – they just do not express them in the same way that most people do. Although a number of children with autism do not like being hugged or touched like most children generally do, not all are like that. They can hug relatives and derive great enjoyment from the contact. The important thing is to make sure the child is prepared for contact. Not all individuals with autism are savants who have an incredible talent for numbers, art or music, but a sizeable proportion do have high IQs and a unique talent for computer science.

MANAGING CHILDREN WITH AUTISM

I won’t pretend that I can grasp or comprehend what it is like to raise a child with ASD. As difficult as it is to raise a child with ASD, it is important to remember that there is a lot we can do to help children with this condition. With the right care and attention, children with ASD can go on to lead normal lives. Growing evidence suggests that a small minority of persons with autism progress to the point where they no longer meet the criteria for a diagnosis of ASD. You may also hear about children diagnosed with autism who reach “best outcome” status. This means they have scored within normal ranges on tests for IQ, language, adaptive functioning, school placement and personality, but still have mild symptoms on some personality and diagnostic tests. We also know that many people with autism go on to live independent and fulfilling lives, and that all deserve the opportunity to work productively, develop meaningful and fulfilling relationships and enjoy life. – Autism Speaks There are some helpful guides here:

Managing challenging behaviour in children with autism spectrum disorder

Helping Children with Autism

Autism – management of autism in children and young people

Behaviour strategies for individuals with ASD

Early detection of autism is extremely important. The best outcomes for a child with ASD require intensive early intervention. With ASD, the earlier you seek help for your child, the better it will be for your child.

THE RISKS OF NOT TREATING A CHILD WITH AUTISM

What happens to the child with ASD who is not treated? Depending on severity, undetected or untreated autism may lead to:

Daily routine functioning and self-care at a low level

Cognitive and language limitations

Problems with school adjustment

Poor social relationships

Inability to live independently

Even if you have a child with high-functioning ASD, your child will still benefit from having a diagnosis and being provided with the care to help your child cope with this condition. For an individual suffering from ASD, it is a very lonely and isolating experience – one that our children might be spared from if we can recognize it and help them from an early age. The important thing is to recognize that it exists and to get help. I think Debbie Page, a mother of a child with ASD, said it best: “My message to other parents is this: Just listen to your instinct and gut. No help you get for them is going to hurt them. Erring on the side of caution and getting early help will not bite you. There is nothing wrong with trying this, even if you don’t yet have a diagnosis. If your child’s communication is not developing, get help for that. You don’t need for everyone to agree on a diagnosis to start getting help for your child.”

GETTING HELP FOR YOUR CHILD

Autism Speaks is a great website for finding information on Autism. For support groups and organisations that help families and individuals with ASD in Malaysia, you can start here:

Early Autism Project provides individualized intervention treatment programs for people on the autism spectrum.

Hua Ming is a non-profit organization focusing on providing special education, training and therapy for autistic children, as well as counseling to their parents.

Autism Link provides comprehensive Applied Behavior Analysis (ABA) therapy to individuals with ASD.

Autism Aspergers Help Association (AAHA)

IDEAS Autism Centre

You can also follow Spectrum Mum in Malaysia who shared her journey with her two daughters. Also available are these centers for children with special needs: