Latest update: December 21st, 2013
Lately, there has been a lot of talk the “spectrum” rather than autism specifically. In order to elucidate what is meant by the spectrum, I have put together a short guide to the different categories that fall under the term.
But, first let me point out some things to look for in very young children in order to identify a one who might have a disorder on the spectrum. These might be difficult to identify in young children, as they are not necessarily abnormal behaviors, but simply the absence of certain normal behaviors.
Autism Speaks, an autism advocacy organization, suggests scheduling a visit to the pediatrician if your child does not meet the following benchmarks:
- No big smiles or other warm, joyful expressions by six months.
- 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.
Helpguide.org, a non-profit resource for those dealing with health challenges, lists the following signs to look out for, especially in older children:
- Doesn’t make eye contact (e.g. look at you when being fed).
- Doesn’t smile when smiled at.
- Doesn’t respond to his or her name or to the sound of a familiar voice.
- Doesn’t follow objects visually.
- Doesn’t follow the gesture when you point things out.
- Doesn’t make noises to get your attention.
- Doesn’t initiate or respond to cuddling.
- Doesn’t imitate your movements and facial expressions.
- Doesn’t reach out to be picked up.
- Doesn’t play with other people or share interest and enjoyment.
- Doesn’t ask for help or make other basic requests.
If you aren’t sure about these symptoms, you can fill out a simple twenty-three question checklist called the M-CHAT (Modified Checklist for Autism in Toddlers). Some of the questions include, “Does your child enjoy being swung, bounced on your knee, etc?” and “Does your child take an interest in other children?” This M-CHAT can help you determine whether your child’s behavior merits a further visit to the doctor.
Once a doctor has determined that your child falls into the autism spectrum, his treatment will vary depending on the type of disorder diagnosed. There are multiple disorders on the autism spectrum.
PDD-NOS stands for Pervasive Developmental Disorder – Not Otherwise Specified. Essentially, it is a diagnosis that means “on the autism spectrum, but not falling within any of the specific categories of autism.”
Within the DSM IV, a manual that practitioners use to diagnose neurological disorders, there are five disorders that fall under the category of Pervasive Development Disorder (PDD): autism, Asperger syndrome, Rett syndrome, fragile X syndrome, and PDD-NOS. A child would be diagnosed with PDD-NOS if he has symptoms of Pervasive Developmental Disorders, but not enough of any of the four specific disorders to receive a diagnosis.
Many of the disorders that fall into the category of PDD have overlapping symptoms. Below, I have explained some of the symptoms that are particular to each (as listed in the DSM IV.)
- Late talking (after the age of two), and other developmental delays by 30 months.
- Chooses to play alone, rather than interact with others.
- Repetitive movements such as rocking, spinning, or hand-flapping.
- Above average verbal capabilities.
- Obsession with complex topics as patterns or music.
- Scripted, robotic, or repetitive speech.
- Half or more of children with Rett syndrom have seizures.
- Normal verbal development until around 12-18 months, then a subsequent loss in the ability to communicate.
- Slowed growth, especially apparent in head size at six months of age.
- In males, a decreased IQ; in females, variable IQ.
- Social anxiety when placed in situations in which they are forced to interact with others.
- Spoken language often characterized by stuttering and omitted sounds in a sentence.
At this time there is no consensus amongst physicians as to when exactly a child should be diagnosed with PDD-NOS, autism or Aspergers syndrome. Therefore, it is possible for the same child to receive different diagnoses from different doctors, even as he exhibits exactly the same symptoms.
Regardless of the diagnosis, research has shown that children with Pervasive Developmental Disorders have significantly better results when treated from an early age. In fact, studies conducted showed that children who began treatment at the age of two had fewer than half of the symptoms as compared to children who began treatment after the age of eight.
Treatments for PDD-NOS vary depending on the range and severity of the symptoms. However, some typical and effective treatments include:
- Play therapy: Through play (a child’s natural mode of expression), children learn to cope with emotional issues. In this way, children can manipulate the world on a smaller scale, something that cannot be done on everyday basis.
- Sensory integration therapy: Through a gradual introduction of averse stimuli, children become used to situations that might have otherwise made them uncomfortable. (For example, some children with PDD might not tolerate the noise scissors make during a haircut. A trained specialist would slowly integrate the scissors noise near the child’s head in order to make haircuts more bearable).
- Social skills training: Coaching in non-verbal communication and everyday interactions can help children gain the essential skills to make friends and pay attention to teacher that do not come naturally because of PDD. This can greatly improve the child’s social experience for the rest of his life.
About the Author: An acclaimed educator and social skills specialist, Mrs. Rifka Schonfeld has served the Jewish community for close to thirty years. She founded and directs the widely acclaimed educational program, SOS, servicing all grade levels in secular as well as Hebrew studies. A kriah and reading specialist, she has given dynamic workshops and has set up reading labs in many schools. In addition, she offers evaluations G.E.D. preparation, social skills training and shidduch coaching, focusing on building self-esteem and self-awareness. She can be reached at 718-382-5437 or at firstname.lastname@example.org.
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