Friday, October 16, 2009

Rehabilitation Can Play a Critical Role in Helping Autistic Children

As a speech language pathologist who works with both children and adults, I see all kinds of diagnoses. As a pediatric therapist, one of the more interesting yet baffling is children within the “Autistic Spectrum Disorder."

Autism is a pervasive developmental disorder which affects social and communication skills but can also affect motor and language skills. It is not unusual for a child with autism to also be treated by an occupational therapist and a physical therapist. Statistics vary, but one in every 150 children may be diagnosed with this devastating disorder.

Boys are more than four times likely than girls to be autistic. Usually diagnosed at 3 years of age, a toddler at 16 months can show signs that are telling. These might include: not using words, not responding when his/her name is called, exhibiting repetitive behaviors, resisting cuddling, not pointing to objects and not engaging in simple interactions/games.

A pediatrician is instrumental in helping parents determine if a child is showing the signs and what services to seek out. One of the first professionals that a family is referred to is a speech language pathologist, as speech and language deficits are most noted. A pediatric SLP is trained in the area of language and social deficits, and is key in helping to determine if a child is in the spectrum.

More specific speech and language skills assessed are the following: understanding what others are saying or following directions without needing cueing; interest in age-appropriate toys and playing with them as intended; methods that are used to communicate wants and needs; interest in other people and wanting to interact. Speech pathologists will also be interested in the child’s eating patterns, as children with autism may be very “picky” eaters with a very limited diet.

Occupational therapists will be interested in a child’s sensory system, specifically the areas of touch/sound/light/temperature. Fine motor skills, gravitational insecurities and attention to task are other areas of interest to the OT’s. Large motor skills, such as learning to walk are not deficits often seen, but reduced body and spatial awareness are often deficits seen by the physical therapist.

Now, it’s not to say that all children with autism exhibit the same lack of skills. That is what is confusing about this disorder. It is a broad diagnosis that can include a high IQ as well as mental retardation. A child with autism may be chatty or silent, affectionate or cold, methodical or disorganized, mildly affected or severely affected.

It is a challenging diagnosis for all therapists involved. But the good news is, the earlier intensive therapies are started the better the prognosis for the child. While a child may always be intrinsically autistic, it is possible for the child to overcome the specific impairments in order to lead a very functional, productive, interactive and independent life.

--Cindy Irish, MS, CCC/SLP
Lead Speech Pathologist

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