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Autism

Approaching Autism

08/08/2005

Question:

I believe my Grandson is showing the signs of Autism. It is a very touchy situation since they never wanted to vaccinate him for the very same reason. They were concerned about him getting Autism. Because it is my daughter-in-law and son's baby and they both are so sensitive to their first child I find it difficult to approach the subject. I am not quite sure why. However, if you have any suggestions on how to approach two very protective and proud,parents I would love to hear it.

Answer:

Dear Grandparent,

We will try to help get you started.

First, how to broach this subject with the parents? Parents of children with autism spectrum disorders often attribute the first evidence of these issues as mere individual differences in development. One of us (the writers) is the parent of three adult sons, two of whom have autism spectrum disorders to differing degrees. While I spotted individual characteristics that were of some concern, it took me a long time to see the whole picture. Now that I have spent almost five years working in university clinics, it has become clear that early intervention is key regardless of the child's special need.

Accurate assessments of very young children are now possible. The interventions that would be recommended if a child were diagnosed with an autism spectrum disorder would certainly do no harm for typically-developing children, but a "wait-and-see approach" could be harmful to the child who needs intervention. Most parents can relate to the issue of having difficulty seeing normal changes, because they are "so close to the action." That is, we don't see our children growing day-by-day because we are looking daily, and it is hard to take in the tiny changes. Grandparents have the advantage of experience and often the distance to play an invaluable role. Certainly a short list of the behaviors you have observed or developmental concerns you have should be shared (via the parent) with the pediatrician. If the child has demonstrated some of the issues at a family gathering, a videotape of the event could prove an informative and objective sample of behavior for a knowledgeable medical professional.

What should you look for if you are concerned about the possibility of autism or related condition in your grandson? The Center for Disease Control has an excellent web-site that you may want to consult: http://www.cdc.gov/ncbddd/autism/

Here are some key symptom areas related to autism:

1. Individuals with autism often do not interact normally with others. In a toddler, this may show up as (a) lack of eye contact, (b) unusually solitary behavior, (c) a lack of wanting to be held or cuddled, and (d) a lack of desire to play with other children. Some children with autism seem not to hear others when they are addressed by name; often, hearing testing will reveal that there is no hearing loss, indicating that the child is failing to orient normally to his or her name. Young children with autism may find it difficult to participate in simple interaction games, such as the "I'm gonna getcha" hand games some parents play with their children or "Ring around the rosie." Around the age of 2-3 years, we expect children to be starting imaginative play, such as feeding dolls, having action figures carry out activities, "tea parties," and so forth. Absence of this kind of behavior may be cause for concern. Imitation is another normal behavior (e.g., pretending to vacuum the floor with an object.) That may be a sign of difficulty if it is absent in a young child.

2. People with autism experience difficulty with communication. In a toddler or child, some indicators may include (a) the lack of normal babble that babies show as they develop language, (b) a lack of speech when it would normally be expected (say, 2 years), (c) the loss of speech at any time, (d) excessive repetition of words after speech has developed (e.g., repeating the same phrase over and over again). Some children with autism "reverse" their pronouns: They may say "I" when they mean "you" and vice versa.

3. People with autism usually have a need for sameness and routine, sometimes demonstrated as repetitive movement. Symptoms may include repetitive sounds, repetitive body rocking, movements of the hands before the eyes, or repetitive movement of objects. Others are bothered by alterations to schedules, such as changing the order in which activities are conducted. Some children with autism object to changes in placement of objects in the home or to a change in the route from home to the local store.

If you see several of these symptoms (or a lack of the normal behaviors mentioned) you may well want to discuss them with your grandson's mom and dad. Likewise, any slowness to develop the normal milestones (e.g., speech) is well worth discussing with the parents.

For more information:

Go to the Autism health topic, where you can:

Response by:

Jacqueline Wynn, PhD
Clinical Assistant Professor of Pediatrics
Director, Center for Autism Spectrum Disorders
College of Medicine
The Ohio State University

Michael G Aman, PhD Michael G Aman, PhD
Professor of Psychology and Psychiatry
College of Medicine
The Ohio State University

Patricia H Cloppert, BSFS Patricia H Cloppert, BSFS
Faculty Parent Advocate
Program Manager for Parent/Family Support
OSU Nisonger Center
The Ohio State University