Published in the PRG winter edition 2020
By Debra Gutierrez, PT, DPT, PCS
During my work with children with special needs, I am often asked by parents if their child has autism. This is a complex question about a complex developmental disorder. With autism, the brain functions differently and we don’t know what causes it. While we all have our quirks, it’s the accumulation of several behaviors or quirks that can be significant enough to impact communication and behavior. First 5 Nevada County states it this way: Autism is a developmental disorder because symptoms generally appear in the first two years of life.…it can affect a child’s ability to speak, learn, and communicate with others.” Autism is also a spectrum – a person may be mildly involved or may have significant difficulty with managing normal daily activities. That’s why it’s often referred to as ASD – Autism Spectrum Disorder.
Research presented at a recent conference pointed to gross motor difficulties that are becoming associated with someone with ASD. This includes developmental delay, poor coordination, one side of the body being weaker, and asymmetrical posture in standing. It’s interesting to note that children may actually be using their peripheral vision, which may be why one of the signs of ASD is poor direct eye contact.
As First 5 notes that while “not all children develop at the same rate, some may need further evaluation and special services to help them grow up healthy. Autism, in particular, can be difficult to diagnose because it affects each child differently…At this time, there is no cure for autism, but children who are screened and diagnosed at a young age, and engage in therapeutic intervention services, show significant improvement in learning and communication skills.” Although people with ASD experience many challenges, they may also have many strengths, including being able to learn things in detail, remembering information for long periods of time, and can be strong visual and auditory learners, excelling in math, science, music, or art.
The American Academy of Pediatrics recommends that all children be screened for developmental delays at their 9-, 18-, and 24- or 30-month well-child visits and specifically for autism at their 18- and 24-month well-child visits. Children who show developmental problems during this screening process will be referred for a second stage of evaluation with a team of doctors and other health professionals who are experienced in diagnosing ASD.
The evaluation may assess cognitive level or thinking skills, language abilities, and age-appropriate skills needed to complete daily activities independently, such as eating, dressing, and toileting. Because ASD is a complex disorder that sometimes occurs along with other illnesses or learning disorders, the comprehensive evaluation may also include blood tests and/or hearing tests.
By getting help at an early age when the brain is still developing – from birth to age 3 years – parents can help children reduce the effects of autism by the time they start kindergarten. Some of the most common treatment options include speech therapy, diet, and therapies focused on improving relationships, such as ABA (Applied Behavioral Analysis) therapy.
In recognition of April being Autism Awareness Month, First 5 Nevada County recommends being aware of the following early signs of autism. See a health care provider for further screenings if you notice your child exhibits these indicators:
Early Warning Signs
• Does not coo or smile by 6 months old
• Makes little, inconsistent, or no eye contact
• Does not say simple words like “mama” or “dada” by 1 year old, or if older, has difficulty with back and forth conversations
• Does not respond to noises, sounds, or voices; tends to not listen to people
• Has trouble sitting, standing up, or reaching for objects by 1 year old
• Repeats certain behaviors, such as repeating words or phrases, or does things that are harmful like banging his or her head
• Does not engage in interactive games and activities like peek-a-boo, “pretend,” or pointing and showing things to people
• Any loss of speech or social skills
• Often talks at length about a favorite subject without noticing that others are not interested or without giving others a chance to respond
• Has facial expressions, movements, and gestures that do not match what is being said
• Has an unusual tone of voice that may sound sing-song or flat and robot-like
• Has trouble understanding another person’s point of view or is unable to predict or understand other people’s actions
• Has a lasting intense interest in certain topics, such as numbers, details, or facts, or is overly focused with moving objects or parts of objects
• Gets upset by slightchanges in a routine
• Is significantly more or less sensitive than other people to sensory input, such as light, noise, clothing, or temperature
• Has sleep problems and is irritable.
The Nevada County Infant Program for children birth to age 3 provides services tailored to each child’s special needs. For more information on their services, call 265-0611 x201.
Understanding Autism. First 5 Nevada County at first5nevco.org and first5california.com/parents.
NIMH. Autism Spectrum Disorder. nimh.nih.gov/health/topics/autism-spectrum-disorders-asd/index.shtml.
Autism Spectrum Disorders: Evidence Based Assessments and Interventions. Lovelace-Chandler, V. and Salem, Y.,
APTA Combined Sections Conference 2019.