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Identifying and managing symptoms of autism

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Dr. Nasir Uddin:
(From previous issue)
If a doctor discovers the following obvious signs of developmental delays, the child should immediately be evaluated:
No babbling, pointing, or other gestures by 12 months
No single words by 16 months
No 2-word spontaneous phrases by 24 months, with the exception of repeated phrases (echolalia)
Any loss of any language or social skills at any age
If there are no obvious signs of developmental delays or any unusual indications from the screening tests, most infants and children do not need further evaluation until the next well-child visit.
But children who have a sibling with autism should continue to be closely monitored, because they are at increased risk for autism and other developmental problems. When socialization, learning, or behavior problems develop in a person at any time or at any age, he or she should also be evaluated.
Treatment
Early diagnosis and treatment helps young children with autism develop to their full potential. The primary goal of treatment is to improve the overall ability of the child to function.
Symptoms and behaviors of autism can combine in many ways and vary in severity. Also, individual symptoms and behaviors often change over time. For these reasons, treatment strategies are tailored to individual needs and available family resources. But in general children with autism respond best to highly structured and specialized treatment. A program that addresses helping parents and improving communication, social, behavioral, adaptive, and learning aspects of a child's life will be most successful.
The American Academy of Pediatrics (AAP) recommends the following strategies for helping a child to improve overall function and reach his or her potential: 5
Behavioral training and management. Behavioral training and management uses positive reinforcement, self-help, and social skills training to improve behavior and communication. Many types of treatments have been developed, including Applied Behavioral Analysis (ABA), Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH), and sensory integration.  Specialized therapies. These include speech, occupational, and physical therapy. These therapies are important components of managing autism and should all be included in various aspects of the child's treatment program. Speech therapy can help a child with autism improve language and social skills to communicate more effectively. Occupational and physical therapy can help improve any deficiencies in coordination and motor skills. Occupational therapy may also help a child with autism to learn to process information from the senses (sight, sound, hearing, touch, and smell) in more manageable ways.
Medicines. Medicines are most commonly used to treat related conditions and problem behaviors, including depression, anxiety, hyperactivity, and obsessive-compulsive behaviors.
Community support and parent training. Talk to your doctor or contact an advocacy group for support and training.
Many people with autism have sleep problems. These are usually treated by staying on a routine, including a set bedtime and time to get up. Your doctor may try medicines as a last resort.
Stories about alternative therapies, such as secretin and auditory integration training, have circulated in the media and other information sources. When you are thinking about any type of treatment, find out about the source of the information and about whether the studies are scientifically sound. Accounts of individual success are not sufficient evidence to support using a treatment. Look for large, controlled studies to validate claims.
Experts have not yet identified a way to prevent autism. Public concern over stories linking autism and childhood vaccines has persisted. But numerous studies have failed to show any evidence of a link between autism and the measles-mumps-rubella (MMR) vaccine.6, 7 If you avoid having your children immunized, you put them and others in your community at risk for developing serious diseases, which can cause serious harm or even death.
Home Treatment
Having a child with autism requires taking a proactive approach to learning about the condition and its treatment while working closely with others involved in your child's care. You also need to take care of yourself so that you are able to face the many challenges of having a child with autism.
Educate yourself about autism
Ask your doctor or contact autism groups to find training about autism and how to manage symptoms. Parent and family education has been shown to reduce family stress and improve a child's functioning. Understanding the condition and knowing what to expect is an important part of helping your child develop independence.
Become informed about your child's educational rights. Federal laws require services for handicapped children, including those with autism. Also, there may be state and local laws or policies to aid children who have autism. Find out what services are available in your area.
Learning about autism will also help prepare you for when your child reaches adulthood. Some adults with autism can live by themselves, work, and be as independent as other people their age. Others need continued support.
Work closely with others who care for your child
Close communication with others involved in your child's education and care will help all concerned. The best treatment for children with autism is a team approach and a consistent, structured program. Everyone involved needs to work together to set goals for:
Education.
Identifying and managing symptoms of autism and any related conditions.
Behavior and interactions with family and peers, adjustment to different environments, and social and communication skills.
Work closely with the health professionals involved in your child's care. It is important that they take time to listen to your concerns and are willing to work with you.
Learn ways to handle the normal range of emotions, fears, and concerns that go along with raising a child who has autism. The daily and long-term challenges put you and your other children at an increased risk for depression or stress-related illnesses. The way you handle these issues influences other family members.
Get involved in a hobby, visit with friends, and learn ways to relax. Seek and accept support from others. Consider using respite care, which is a family support service that provides a break for parents and siblings. Also, support groups for parents and siblings are often available. People who participate in support groups can benefit from others' experiences.  Talk with a doctor about whether counseling would help if you or one of your children is having trouble handling the strains related to having a family member with autism.
(Concluded)