Helping families dealing with autism spectrum disorders
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Assessing very young children for Autism Spectrum Disorders

Posted by Patricia Harkins in Uncategorized - (Comments Off)

I saw a 2-year-old in follow-up this week.  I first saw him at 18 months, and he looked very autistic.  He showed no joint attention, eye contact, or shared joy.  He was nonverbal.  He was nearly impossible to engage.  His mother reported he watched TV very intently all day.  I discussed starting speech and OT, a hearing test, and Floortime.   Since they were moving in 2 weeks, I suggested they “lose” the TV in the move.

 

When I saw the 2 year old this week, the transformation was amazing.  He used glorious eye contact and shared enjoyment.  He played peekaboo with me, and anticipated my interactions.  He used a mix of words and jargon.  He had a few little stims, and echoed a bit, but otherwise looked so much better.  We are planning to do an ADOS, but I doubt he will score on the spectrum.

I am seeing many more very young children for assessment for Autism Spectrum Disorders (ASDs).  With pediatricians screening at 18 and 24 months, they are more aware of developmental differences.  Also parents are more aware of signs of autism.  It is difficult to be certain of an ASD in children under 2.  Having the Toddler module for the ADOS 2 will help, but the ADOS is only about 80% accurate  (no test is perfect).  Also, autism is not an absolute, hence the term “spectrum”.  It unfolds over time.  I attended a conference with Amy Wetherby recently.  She showed amazing videos of young children at risk for ASDs at 14 to 17 months, and then at 2 to 3 years.  The autism was there in the early videos, but it was subtler.  By 2 to 3 it was obvious.

When I get these very young  patients who look like they have an ASD, I usually give a “provisional diagnosis”.  I tell them the child will declare himself over time.  In the meantime, nothing we would do based on that diagnosis will harm the child – Speech and occupational therapy, Floortime, educational interventions, hearing tests and possibly an EEG (especially if they regressed before 18 months).   I tell the parents I have no ego, and I’m happy to say down the road I was on the wrong track.  This seems to work with most families.  There are a few who are still in denial, and don’t accept the possibility, but as I say, over time, the child will prove himself.

Sports and Autism

Posted by Patricia Harkins in Behavior | Stories - (1 Comments)

Mother’s Day, and I am going to the local AA baseball game with my 2 kids.  When I was pregnant and found out I was having a boy, I thought “Oh no, I’ll have to go to baseball, football, and soccer games in the cold!”  We lived in Pittsburgh then, so you can see why I was worried.  Then I ended up with a son who had no interest or ability in sports.  Then one summer, he discovered computer versions of several sports – Backyard Baseball, Backyard Football, Backyard Soccer, and Backyard Basketball.  He could make up teams with “little kid” versions of famous sports stars – Mia Hamm, Michael Jordan, etc.  He then played “tournaments” on the computer.  When the summer was over, he knew how the games were played, all the rules, and all the scoring.  He still had no interest in sports, but when they played the games in PE, he was the perfect umpire!  He knew the rules, and applied them evenly (because he has Asperger Syndrome).  He can have a good conversation about the sports with people, and they have no idea he never watches or plays the games.

What’s the point?  One, these kids can learn anything on a computer.  Two, just signing them up for a sport usually backfires.  They can learn the game on the computer.  Then you can work on the skills needed separately.  Then they may be more able and interested in actually playing the game.  If not, they can always be the umpire or referee.  Happy Mother’s Day, and PLAY BALL!

Resources for sensory processing problems (sensory integration disorder)

Posted by Patricia Harkins in Behavior | Uncategorized - (1 Comments)

The following is an excellent compilation of resources and information about sensory processing problems (aka sensory integration disorder).  This causes a great deal of distress to nearly all people on the autism spectrum.  I liken it to having a migraine all the time.  It is difficult to socialize and communicate when you are that uncomfortable in your skin.  Ideally, all people with these problems would get good, sensory based occupational therapy.  FOr those who can’t, this link can lead to good activities and apps that can help.

http://www.oneplaceforspecialneeds.com/main/library_sensory_processing.html

 

I consider the occupational therapy our son had to be one of the the greatest gifts we could have given him.  I had my own sensory problems, and wish I could have had the same kind of therapy.  Then I might not have always been picked last in PE, and would have had better writing mechanics, and less misery from teachers making fun of my handwriting.  Many people with other disorders, such as ADHD, also have sensory problems.  It rarely travels alone, and it can lead to problems with motor, attention, social, and learning skills.  Treating it appropriately can change a child’s life.