Recognizing Autism

Learn the signs of this mysterious disorder

A twin celebration

Thomas and James Garrou of Allentown celebrate their ninth birthday with the family. Pictured here (l-r) are Thomas, 4-year-old Daniel, Sheri Miltenberger Garrou and James.

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“Parenting a Child With Autism”
Jan. 10
(will be available as a podcast after the live event on Jan. 10.)

How to Recognize Autism

An autistic child may…

• Laugh or giggle inappropriately
• Have trouble expressing needs
• Have unusual or repetitive patterns of play, such as spinning
• Avoid eye contact
• Be uninterested in cuddling
• Prefer to be alone and have problems interacting with others
• Insist on sameness in surroundings and routine

If you notice some of these signs in your child (usually by age 3), talk to your pediatrician or family doctor immediately. Early care makes a big difference.

Sheri Miltenberger Garrou’s 9-year-old twins, James and Thomas, were born eight weeks premature, so she expected some delay in development. But when the twins were around 18 months, Garrou and her then-husband became concerned about Thomas. “He didn’t interact with us in the way James did, and he’d spin around in circles over and over again,” she says.

The couple suspected autism, and ultimately their fears were confirmed. “My immediate reaction was to fix the problem,” she says. Unfortunately, this problem wasn’t something that could be fixed.

Autism is a brain development syndrome that sets in before 3 years of age. Its key characteristics are difficulty communicating verbally and nonverbally, problems with social interaction and certain behavior patterns (see box at right). “These symptoms don’t develop overnight,” says pediatric neurologist Shu-Gang Xu, M.D. “Often the family starts to sense something’s not right. The child doesn’t play or talk like other kids, or spends hours alone lining up his toys.”

Autism ranges in severity. Some children have mainly social problems. (One example is Asperger syndrome, a type of autism in which language develops in a normal timeframe.) Others have more serious cases including evidence of mental retardation. “We have no clue as to why this variation occurs,” says developmental pediatrician Karen Senft, M.D.

Because symptoms are so varied, Garrou didn’t realize that her other twin had autism, too. “He was diagnosed at age 3 with a milder form,” she says. James isn’t at grade level, but “he’s a great speller and can read and do math.”

Autism transcends all racial, ethnic and socioeconomic groups, but is four times more common in boys. Research points to multiple genetic factors, with possible environmental triggers. A few years ago, the question arose of a link between autism and childhood vaccinations containing mercury. The mercury was removed, yet the rate of autism continues to rise—statistics range from 1 in 1,000 to 1 in 166 children. “Public awareness has a lot to do with the increase in diagnoses,” Xu says. “Developmental screening is becoming routine.”

“One thing we know for sure, parenting skills do not in any way cause autism,” says child-adolescent psychiatrist Dhanalakshmi Ramasamy, M.D.

Parents typically bring their suspicions of autism to the doctor when the child is about 18 months old, says pediatrician Mary Stahl Levick, M.D. “We ask simple screening questions like, ‘Does the child make eye contact?,’” she says. The pediatrician may refer the family to a neurologist, developmental pediatrician or other resource. “Diagnosis is based heavily on observing the child and listening to what the parents have to say about his or her development,” Xu says.

“While no pill or therapy can cure autism, there is hope for helping these children reach their full potential,” says adolescent psychiatrist John Campion, M.D. “The key is getting an early diagnosis so treatment can begin as soon as possible.”

To treat autism, specialists use a range of approaches including speech, occupational and behavioral therapy to help the child learn to communicate, play and interact with others.

Clearly, this disorder presents challenges for the entire family—from coping with the autistic child’s behavior to impact on siblings, child care options and choices of schooling. “Seek support,” Senft counsels families. Whether that’s respite care, assistance from the extended family or a support group, “it’s important to take help when you can get it.”

“You have to redefine your dreams for your child,” Sheri Garrou says. “Even though my sons will never be cured, they are slowly getting better.”

All the specialists in this article are with Lehigh Valley Hospital and Health Network.

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