Evaluation, Diagnosis and Treatment of Autism Spectrum Disorder in Children
Our pediatric providers at RWJBarnabas Health focus on quality of life
for children with autism spectrum disorder (ASD). To help children and
their families, we provide:
- Comprehensive evaluations
- Treatment
- Community education
- Research
With an emphasis on family-centered care, we partner with parents and their children to provide access to the services needed for children to thrive and reach their highest potential.
Because it’s important to identify ASD early, we focus on early detection and treatment, noting important developmental differences in social, language and behavioral skills that can often go unnoticed.
Although autism is typically lifelong, early intervention can dramatically improve a child’s quality of life and functional abilities at home, school, and community settings. As a child develops, their needs may change over time, and RWJBarnabas Health offers specialized developmental and psychological services to help our pediatric patients with ASD navigate life’s challenges.
What Is Autism Spectrum Disorder?
Autism is a complex developmental disability. It is called a spectrum disorder because it is defined by a certain set of behaviors and affects individuals differently and by varying degrees. Autism is characterized by a combination of the following:
- impaired socialization
- impaired communication
- restricted/repetitive behaviors or interests
Among those diagnosed with an ASD, there is a wide variety of skills and abilities, and each child has their own strengths and difficulties.
Early Signs of Autism Spectrum Disorder
While children with autism may vary across the spectrum and need varying levels of support, early potential indicators of autism may first be noticed in the areas of socialization, communication, play, behavior and sensory reactions.
Examples of social, communication and behavioral differences among children with autism include:
- Social. The child may have reduced eye contact and less response to others’ facial expressions. The child may show reduced sharing of interests with others such as not looking where someone is pointing or showing toys to others. They may use fewer gestures.
- Communication. Language milestones may be delayed such as no single words by 15 months or 2-word phrases by 24 months. Children with autism may repeat what others say without grasping the meaning of the words. Some children show reduced response to their names. Regression or loss of communication or social skills occurs for some children with autism between the ages of 15 and 24 months. Children may have an exceptionally good memory for numbers, letters, songs or specific subjects.
- Play. Children with autism may demonstrate repetitive play such as lining up toys. They may engage in less pretend play and may tend toward playing alone or near but less interactively with other children.
- Behavior. Children with autism often have repetitive behaviors and special interests which may result in a strong preference for routine, orders, and rituals. While this may lead to difficulty with change or transition from one activity to another, special interests can also be a strength on which to build.
- Sensory. Autistic children may be particularly sensitive to smells, sounds, touch, and tastes. This may lead to sensory “overload” and difficulty regulating emotions and behavior. For some autistic children, repetitive or “stereotypic” behaviors like rocking or spinning may be a response to this overload and represent an attempt to self-calm.
Does My Child Have Autism?
Your child’s pediatrician or nurse practitioner will screen for ASD at well-child visits between 18 and 24 months and at routine follow-up appointments. Your provider will observe how your child communicates both verbally and nonverbally, such as looking at their parent for reassurance and responding to their name and may ask you to complete screening questions.
At the end of the day, you know your child best. Although it can be difficult to tell the difference between age-typical behavior and what may be signs of autism, a pediatrician or nurse practitioner can evaluate your child and give you further insight as to what is typical behavior and what is not.
If you are a parent with concerns about the way your child plays, learns, speaks, moves, acts or anything you consider concerning, make sure to communicate them to your child’s pediatrician or nurse practitioner. If you are unsure or uneasy about your provider’s advice/suggested treatment, seek a second opinion.
Most people with ASD receive a diagnosis from a medical specialist (developmental pediatrician or neurologist) or a licensed mental health professional (psychiatrist, psychologist, clinical social worker). There are currently no specific laboratory test for ASD. However, several behavioral and developmental evaluation and assessment tools may provide data helpful in making the clinical diagnosis of an ASD.
An autism diagnosis begins with an initial neurodevelopmental evaluation. Doctors will examine whether a child is achieving developmental milestones. When indicated, developmental pediatrics specialists may refer children for psychological testing as well.
My Child Was Diagnosed with Autism. What’s Next?
Intervention for ASD has several components and will begin once a full assessment or evaluation has been made. A pediatrician may recommend medically necessary therapies for your child to address speech, behavioral and social challenges.
It’s important to address these issues to build strengths, reduce problems in school and difficulty learning. Early and effective services can promote daily living skills and quality of life.
There is no one-size-fits-all treatment for ASD. Pediatric providers seek to maximize their patients’ functional abilities and support healthy development and learning so your child can learn the important skills they need to thrive. There is a range of home- and school-based interventions your child’s pediatric provider may recommend to meet their needs.
Treatment Options for Children with Autism
Many therapies can successfully help children with autism learn social, communication, functional and behavioral skills needed as they grow. Treatment options may include:
- Speech/language, occupational, physical, behavioral, psychological, social skill and developmental therapies
- Educational services
- Family supports
- Augmentative and alternative communication (AAC) and technology
- Medications to address specific behaviors which interfere with progress or safety
Philosophy of Care
It is important to recognize that autism spectrum disorder is a form of neurodiversity. Everyone has things that they are good at as well as areas in which they may need help. In addition to focusing on areas in which a child may have challenges and need help with building skills, we also identify and build on child and family strengths.
We work closely with patients and their family to identify ways that the home, school and community environments can be modified to support, welcome and accept autistic people.
