Diagnosis: Autism - What Families Can Do

By Patricia S. Lemer
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Skylar is a darling three year old, conceived after eight infertile years, and absolutely adored by his parents. His mother experienced some problems during pregnancy, but thankfully, her doctors pinpointed her low thyroid condition and were able to bring her fibromyalgia under control. Skylar's birth, however, was no easier than the pregnancy: his breech presentation required careful maneuvering. That first year of life presented its challenges, too: colic, reflux, and thrush. His constant screaming following his MMR vaccine was worrisome. Then came the repeated ear infections.

Finally, after endless rounds of antibiotics and several sets of ear tubes, Skylar seemed to thrive. He never crawled but walked so early that his parents were sure he was smart. He began picking up words quickly. Lately, however, Skylar has not added any words to his vocabulary. Sometimes he flaps his fingers in front of his eyes. Grandma noticed, when she visited over Thanksgiving, that he didn't always look at her. His parents are concerned.

"Your Child Is Autistic"
Some families can recall the date and event when their toddlers went off-track, and even have home videos to document the change. For other families, like Skylar's, it is a more gradual process. As their anxiety increased, Skylar's parents sought expert advice. The diagnosis: it could be either pervasive developmental disorder (PDD) or autism.

"That is impossible," Skylar's parents thought, going through the sequential steps of denial, anger, and bargaining. Maybe he was just having a bad day when he went to see the specialist.

One reason that diagnosing autism is so confusing is that there are no physiological indicators, as there are for diabetes or cancer. Doctors may not always find the genetic markers they do with other disorders, because autism has many possible causes. It is only diagnosed when a child exhibits certain behavioral and psychological symptoms.

Other symptoms, like Skylar's, are immunological, dermatological, digestive, sensory, neurological, respiratory, cognitive, psychological, and developmental. If the symptoms are mild, a child might be diagnosed with attention deficit disorder. Moderate symptoms might result in a diagnosis of Asperger's syndrome. If severe, the diagnosis would be PDD or autism. These diagnoses make up what is known as the autism spectrum of disorders.

The autism spectrum includes many labels: attention deficit disorder (ADD and ADHD), Angelman's, Asperger's, dyslexia, hyperlexia, Klinefelter's, Landau-Kleffner, obsessive compulsive disorder (OCD), PDD, Rett's, Tourette's, and autism. Children on the autism spectrum have an important commonality: a huge "total load."

Total load theory describes the cumulative effect of the individual assaults of each problem on the body as a whole.

The cluster of symptoms that eventually leads to a diagnosis of autism arises when many systems of the body are stressed to their limits. Each child has a unique personal load limit, as does a bridge. When that limit is exceeded, a very complex constellation of problems results. Of course, not all children with these symptoms become autistic, but the more symptoms present, the more likely the child will be diagnosed with one of the labels on the continuum.

What Can a Family Do?
After anger, bargaining, and depression subsided, Skylar's parents accepted his diagnosis. They then had to make some difficult choices. His doctors suggested traditional treatments, including medications, behavioral management programs, and a special school that provides intense early intervention in language, motor, and psychological areas. Undoubtedly, these treatments could help Skylar progress.

The problem with these usual interventions is that they focus on ameliorating symptoms rather than addressing the underlying causes of autism. Medications can alleviate behavioral and attentional symptoms, but often with undesirable side effects. Caring special education teachers offer individualized programming which may fail to allow the child's own sensory systems to learn how to modulate and integrate information. The lack of typical peers can also be problematic. Counseling programs help parents cope with issues such as picky eating and sleep problems but, again, don't speak to their causes.