Autism is in the news frequently nowadays. Newspapers, televsion and the Internet are full of stories about autism; most of them are unfounded. For example, there is no relationship between the measles immunization (or any other immunization for that matter) and autism. A mercury preservative, thimerosol, has been blamed for autism. Not so. Even though thimerosol was removed from routine immunizations many years ago, the prevalence of autism remains the same. Despite many studies that clearly show no relationship between immunization and autism, many parents continue to worry and often are hesitant to immunize their children. There is absolutely no reason to be concerned. It is essential for your child to receive all the recommended immunizations on time. Postponing or refusing immunizations makes no sense and can place your child in danger.
What causes autism? Can it be prevented? Can it be treated? Nervous parents often ask me these types of questions.
This is what I tell them.
Autism actually is a spectrum of diseases, ranging from a milder form, called Asperger's syndrome, to the most severe form, true autism. Often the diagnosis is difficult to make and usually takes months of careful observation before a true diagnosis can be established. It usually requires a team approach--parents, pediatrician, psychologist and pediatric neurologist.
What causes autism? As I write this article, there are many theories, but the answer remains the same: we do not know. Despite a great deal of research, the cause of autistic spectrum disorders still is a mystery.
Can autism be prevented? Unfortunately, it cannot. Can it be treated? Absolutely, and the earlier it is recognized the better the chances of effective intervention and improved outcome. Many children diagnosed with some form of autism do well with proper support and treatment.
At what age do signs or symptoms appear that can alert parents or the doctor to suspect autism? Some studies have suggested that by one year of age there may be hints of autism spectrum disorder. In my experience, I have not found this to be true.
Somewhere between 18 months and two years of age there are usually a number of signs or symptoms that should alert you to the possibility that your child may be autistic. These "red flags" include the following:
1. Not making eye contact
2. Not taking any interest in other children
3. Preferring to always play by himself
4. Repetitive motor mannerisms, such as rocking back and forth or handflapping
5. Delayed language development (should be using single words by age one and two-word phrases by age two)
6. Intense temper tantrums
7. Unable to cope with changes in regular routine
However, even if your toddler does demonstrate one or more of these behavior patterns, it does not mean that he is autistic. As pointed out previously, the diagnosis is difficult to make and requires professional evaluation. The problem is that there is no specific diagnostic test to establish the diagnosis. The final diagnosis can only be made after careful and complete evaluation. and examination by a team of experienced physicians and other health care providers expert in this disorder. Although the earlier the diagnosis is made, the better the outcome, there is no emergency about it. Careful evaluation is essential before a diagnosis is made.
If you suspect that your child may be autistic, then it is important to discuss your concerns with your child's doctor as soon as possible. Most of the time your suspicions will turn out to be without merit. But, as with pretty much everything else, it's better to be cautious than negligent.
The bottom line is that the earlier the diagnosis is established, the greater the chances for improved outcome.
By Alvin N. Eden, M D
Dr. Eden is the chairman of the department of pediatrics, Wyckoff Heights Medical Center, Brooklyn, New York and a clinical professor of pediatrics, Weill Cornell Medical Center, New York, NY. His latest book, Positive Parenting, is now available.
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