Study: When Kids Show Signs Of Autism, Pediatricians Often Fall Short

by Michelle Diament/Disability Scoop 

Pediatricians are conducting routine checks for autism, but new research suggests they frequently fail to act when screenings show cause for concern.

A study looking at medical records for children who visited 290 doctors between 2014 and 2016 shows that the vast majority were screened for autism at ages 18 and 24 months as recommended by the American Academy of Pediatrics.

Dr. Tom Lacy, right, examines a 2-year-old. A new study suggests that most children who fail autism screenings don’t get referred to specialists. (Ricardo Ramirez Buxeda/Orlando Sentinel/TNS)

However, in cases where children were flagged by the screening test, just 31 percent of providers made a referral to an autism specialist, according to findings published this month in the journal Pediatrics.

For the study, researchers reviewed 23,514 screenings conducted with what’s known as the Modified Checklist for Autism in Toddlers, or M-CHAT. Of them, 530 children failed their check at 18 months, 24 months or both.

The researchers then tracked the children for two to four years to find out what types of referrals were made or completed and how the kids fared.

Even when children were referred to an autism specialist, only about half of families followed through, the study found. Ultimately, 18 percent of kids who failed the M-CHAT screening were diagnosed with autism and 59 percent were found to have another neurodevelopmental disorder.

Though autism can be reliably identified at age 2, fewer than half of children with the developmental disorder are diagnosed by age 4, according to the Centers for Disease Control and Prevention. Spotting autism early is considered important because research has shown that intervention is most successful when started young.

“There needs to be action by pediatricians following that failed screening,” said Robin Kochel, an associate professor of pediatrics and psychology at Baylor College of Medicine who worked on the study. “Whether that action is immediately evaluating for autism themselves, or making those appropriate referrals if they are not sure a child meets the criteria for autism.”

Note: The original article was published in Disability Scoop on September 24, 2019

Health with Aspergers: Balancing Your Mind, Body, and Soul

Managing your weight for good health can be a difficult goal to obtain and keep. From counting calories to the numerous diets available to knowing which gym facility to join or what exercises to do, the options can be overwhelming for someone that just wants to get started.

It is even more challenging for someone with a special medical need. You add a whole new layer of obstacles on top of what we already mentioned. Don’t be discouraged before you start, or even after you start, for that matter.

Weight management is a long and hard journey that requires your soul, mind, and body but it will change your life. Before we start I advise you consult your physician concerning changes in your lifestyle that affect your meals and physical activity.

Autism: Effective Treatment Options

By: The Autism Science Foundation

Scientists agree that the earlier in life a child receives early intervention services the better the child’s prognosis. All children with autism can benefit from early intervention, and some may gain enough skills to be able to attend mainstream school. Research tells us that early intervention in an appropriate educational setting for at least two years prior to the start of school can result in significant improvements for many young children with autism spectrum disorders (ASD). As soon as autism is diagnosed, early intervention instruction should begin. Effective programs focus on developing communication, social, and cognitive skills.

sensory

Early diagnosis of ASD, coupled with swift and effective intervention, is paramount to achieving the best possible prognosis for the child. Even at ages as young as six months, diagnosis of ASD is possible. Regular screenings by pediatric psychiatrists are recommended by the Centers for Disease Control and Prevention (CDC). Even if your child is not diagnosed with an ASD before the age of 3, under the Individuals with Disabilities Education Act (IDEA), your child may be eligible for services provided by your state. In addition, many insurance companies will provide additional assistance for the coverage of proven therapies. More information on autism and insurance can be found here.

The most effective treatments available today are applied behavioral analysis (ABA), occupational therapy, speech therapy, physical therapy, and pharmacological therapy. Treatment works to minimize the impact of the core features and associated deficits of ASD and to maximize functional independence and quality of life. In 2012, the Missouri Guidelines Initiative summarized the findings from 6 reviews on behavioral and pharmacological interventions in autism. The consensus paper includes current evidence of what interventions have been studied and shown effective, why or why not, and can be found here.

Applied Behavioral Analysis (ABA) works to systematically change behavior based on principles of learning derived from behavioral psychology. ABA encourages positive behaviors and discourages negative behaviors. In addition, ABA teaches new skills and applies those skills to new situations

Early Intensive Behavioral Intervention (EIBI) is a type of ABA for very young children with an ASD, usually younger than five, often younger than three.

Understanding Comorbidities

Top of the Spectrum News

As many as 85% of children with autism also have some form of comorbid psychiatric diagnosis. ADHD, anxiety, and depression are the most commonly diagnosed comorbidities, with anxiety and depression being particularly important to watch for in older children, as they become more self-aware. Understanding and treating psychiatric comorbidities are often far more challenging than the Aspergers/Autism itself as discussed in this edition of Top of the Spectrum News.

The diagnosis of comorbidities can be challenging because many people with ASD have difficulty recognizing and communicating their symptoms. It takes time to uncover the cause of a meltdown or aggravation but to aid you in your search, we listed the most common comorbidities below:

  • Epilepsy/seizures
  • Sleep disorders/disturbance
  • ADHD
  • Gastrointestinal disorders
  • Feeding/eating challenges
  • Obesity
  • Anxiety
  • Depression
  • Bipolar disorder

Top of the Spectrum News is a product of Aspergers101.

Cognitive Behavioral Therapy for Individuals with Aspergers

Anxiety-related symptoms are frequent concerns in children, adolescents and adults with Aspergers and HFA, which may be treatable with Cognitive Behavioral Therapy.

the pain

Anxiety is commonly found in high functioning individuals on the spectrum in particular because they have an increased awareness of their own social difficulties. This cognitive awareness may intensify their anxiety toward social interaction and promote isolation.

Recent numbers found that 11-84% of children on the autism spectrum experience impairing anxiety, while only 4.7% of all children aged 3-17 years have experienced anxiety.

Cognitive Behavioral Therapy (CBT) is a type of psychotherapeutic treatment that helps individuals recognize how thoughts and feelings influence behavior and cope with these challenges.

CBT is used to treat a wide range of issues, in addition to anxiety, including:

Aspergers, Nonverbal Learning Disorder (NLD), and Families: A List of Resources for You

Parents of any child with differences struggle with feeling isolated. One of the challenges for families with Aspergers Syndrome (AS) and nonverbal learning disabilities (NLD or NVLD) children is that these children don’t look different. They’re bright and verbal; their quirkiness, sensitivities and apparent oppositionalism aren’t easy to understand.

Kid having a tantrum

As a result, parents often feel blamed for their children’s special challenges. I know one mother who was told bluntly by her brother, “You must be doing something wrong. Give me two weeks with that kid in my house and I’d straighten him out.”

Parents are well aware that rigidity meeting rigidity doesn’t work and only leads to meltdowns.

Aspergers and NLD children require unique parenting skills based on understanding, acceptance, and appropriate interventions. Blaming and punishment don’t make family life any better and don’t encourage positive growth in children.

Ultimate Guide: Understanding High-Functioning Autism & Aspergers Syndrome

 The following is an excerpt taken from the documentary: Coping to Excelling: Solutions for School-age Children Diagnosed with High-Functioning Autism or Aspergers SyndromeMedical reports reveal a profound discovery in the brain of those with High-Functioning Autism. Studies with MRI imaging document an actual physical difference in some areas of the autistic brain verses that of a neuro-typical brain.

Neurological pathways fire differently in Asperger patients than that of a typical brain function. It has become clear that individuals who are diagnosed as High-Functioning Autistic or Aspergers receive their gifts and struggles from a physical medical basis not behavioral, as you may have been pressured to believe. Once we understand exactly how the challenges occur, we can begin to lead our loved ones with Aspergers on the path from coping to excelling.

We interviewed experts in the field of Autism to offer you a quick read on understanding High-Functioning Autism and Aspergers Syndrome.

Upcoming Event: Jennifer Allen to Speak at ACU Summit 2019

“The Less Traveled Path to Christ: Families, Autism and the Church Today”

Autism, depression, anxiety, ADHD, and developmental delays often keep kids (and parents) away from church. The Great Commission instructs us to go and preach the gospel to all nations, to all people … and as for those with disabilities, we must put aside our fear of “different” by first understanding the uniquely wired brain and then providing accommodation(s). Jennifer Allen will share her family’s personal journey of having a child diagnosed with autism and how the less traveled path to Jesus, though oftentimes rocky, offers beautiful vistas that neurotypicals seldom witness. This session is for the church to better understand the challenges that face these families along with suggested accommodations and especially for the parent torn about church and their children.

THE FACTS:

When: Tuesday, September 17th

Time: 9:30a – 10:15a

Where: ACU Summit on the Campus of Abilene Christian University 

               ACU Biblical Studies Building 1201850 Teague Boulevard

               Abilene, TX 79601 – Room 120

Cost: Free

Go to ACU Website for full information on ACU Summit 2019  or view the full ACU Summit 2019 Program here. Note: Jennifer Allen’s presentation: The Less Traveled Path to Christ: Families, Autism and the Church Today is listed on page 23.

During a Meltdown

A meltdown is scary and lonely. A change in routine can be enough to tip the scales in sensory input and cause what is titled a “meltdown” where a person with autism or asperger syndrome temporarily loses control due to emotional responses to environmental factors. They aren’t usually caused by one specific thing.

Triggers build up until the person becomes so overwhelmed that they can’t take in any more information. In previous blogs, we have addressed the complex topic of meltdowns. While the main message is to have a plan to PREVENT a meltdown, we must also be prepared if a meltdown does occur.

Portrait of unhappy screaming teen girl

I will start by outlining what NOT to do. I think this is best said coming from someone that has lived through a meltdown with neurological implications.  The following is an excerpt from a message from Mr. John Scott.

Meltdowns: What Not to Do

My meltdowns can be very frightening and confusing for those around me. I work very hard to appear as capable and composed as possible throughout each day, so when I finally lose it, people are shocked to see me act so “autistic.” I cry, scream, break things, flap my hands, and pound my fists against my head. I haven’t found the perfect remedy for my meltdowns, but I do know what makes them far worse… 

If I am having a meltdown… 
– DO NOT become angry with me or raise your voice. 

Autistic meltdowns may be frightening to observers, but at their most intense, they are nothing less than pure psychological torture for the person experiencing them. I feel as if I am caught in a war zone, terrified for my very life. My senses are on fire and I have very little control over myself. I may feel threatened by intense emotional displays. This is very dangerous. 

– DO NOT attempt to restrain me. 
I understand that my tantrums are scary, as I’m well over six feet tall, but you must remember that I am far more frightened than you are. I would never intentionally hurt anyone, but if you approach me in a hostile manner, or attempt to use any force without my permission, I may lose the last bit of self-control I have. 

– DO NOT ask me what is wrong. 
Trust me, when I’m banging my head into the wall I do not want to discuss my emotional triggers. 

– Most importantly, DO NOT tell me to “snap out of it.” 
Trust me, I would if I could. Don’t patronize or belittle me by acting as if I could control myself if I only tried harder. This is a good way to make the situation ten times worse.
You may know me from my column here on WrongPlanet. I’m also writing a book for AAPC. Visit my Facebook page for links to articles I’ve written for Autism Speaks and other websites.

CLICK HERE  for the entire posting.

I would like to add one more . . . this is not the time to say “Use your words.”  As the brain escalates in a meltdown, the ability to be rational and articulate diminishes.

So now for what TO DO?

  • During a meltdown a child most needs the opportunity to relax. Therefore, you should respond patiently and compassionately as you support this process. Offer choices of relaxing activities, perhaps through the use of a choice board. If the person is not able to make a choice, then simply present a pre-determined calming activity. Often, this might be an activity that incorporates a strong interest [e.g. video of SpongeBob or favorite song/music].
  • In some cases, it might be best to offer a way out of the situation through escaping the current stimulation of the environment. Again, a pre-determined location might be another room or other safe place [e.g. chill zone, motor lab, etc.].  However, it might be difficult for the individual to transition to another location if the meltdown is at its peak.
  • If there are others in close proximity, then it should be part of the plan to move them to a safe place.
  • Most importantly, do everything possible to keep the individual safe from him or herself. If they engage in head banging, protect their head by placing a pillow or bean bag between them and the floor or wall.

As you can see, there is little to really do during a meltdown. Again, all efforts should be made to PREVENT a meltdown.

by Lisa Rogers

24 Surprising Physical Symptoms of Anxiety

A woman with her hand on her head, grimacing. Text reads: 24 surprising physical symptoms of anxiety

24 Surprising Physical Symptoms of Anxiety

To learn some of the ways anxiety not only affects your mind — but your body — we asked people in our mental health community to describe what physical symptoms of anxiety they deal with, and what they feel like.

Here’s what they shared with us:

1. “When I get into high anxiety, sometimes out of nowhere, I get GI [gastrointestinal] symptoms. Constantly going to the bathroom. I have cramps and abdominal pain. It’s tough because there is nothing I can do but just try to wait it out.” — Michele P.

2. “Does anyone else find themselves antsy after a big panic attack where you can barely sit still and then for the next couple days, you’re completely mentally/physically exhausted? I feel like everything is just too much and I can’t move.” — Kristen G.

4. “In the aftermath of a panic attack, I often feel bone-chillingly cold. It doesn’t matter what time of year it is, and no jacket or blanket helps. I just have to ride it out until it goes away.” — Monica M.