University of South Alabama

“Don’t worry about the numbers. Instead, look for symptoms,” said Dr. Hanes Swingle when asked about a new report released by the Centers for Disease Control and Prevention that said the number of children with autism – a developmental disorder – is “significantly” higher than previously thought.

Dr. Swingle, who serves as associate professor of pediatrics at the University of South Alabama College of Medicine and director of the USA Autism Diagnostic Clinic, said that although the numbers for autism have increased during the past 20 to 30 years, they are not increasing at a dramatic rate.

Regardless, Dr. Swingle said it is important for all parents to be aware of the symptoms.

“An early diagnosis is the best diagnosis because you can change a child’s developmental trajectory and dramatically improve outcomes,” he said.

In this particular study, many of the cases involved mild forms of autism. Dr. Swingle said a child with a mild form of autism is not intellectually impaired, but may be significantly withdrawn.

“They go to school but tend to be loners, not wanting to interact with their peers,” he said. “They often have trouble regulating their emotions and exhibit a lot of obsessive behaviors.”

Dr. Swingle said it is common for children with mild forms of autism to be obsessed with a specific topic – astronomy, for example. “The child collects facts and has a high degree of interest in that one topic,” he said. “A positive of this is that they might become an astronomer one day and be highly regarded in that field.”

However, he said the child can also be socially rigid. “They may get upset when other children are not interested in the same topic, and it’s hard for them to be flexible. The older they get, the harder it is to maintain relationships.”

In the wake of the Sandy Hook Elementary School shooting in Newtown, Conn., news stories implied that the actions of one mentally ill individual were due to autism, portraying individuals with autism as violent and dangerous. Dr. Swingle said such reporting is both insensitive and incorrect. “The fact is that there are no studies implicating individuals with autism as being at higher risk of committing premeditated acts of violence."

“To the contrary, older children and adults with autism tend to have strong moral character and are more likely than the general population to rigidly follow the law,” Dr. Swingle said. “Children and adults with autism are much more likely to be the victims of bullying, harassment, and violence than the perpetrators of such behaviors.”

Dr. Swingle said about 80 percent of young children with autism present with language delay and about 20 percent present with behavioral issues.

“Language delay and social interactions are intertwined,” he said. “As a result, it’s important to focus on communication, not just language. Communication helps their behavior and increases the opportunity to interact with other children.”

In addition, Dr. Swingle said children with autism often need to be taught things that come naturally to others – such as social distances and the differences between appropriate and inappropriate comments.

To diagnose autism, a multidisciplinary evaluation can be done by a psychologist, speech therapist, and a physician at the USA Autism Diagnostic Clinic. The test, called the Autism Diagnostic Observation Schedule (ADOS), is the gold standard for diagnosing this developmental disorder. During the test, the child’s social skills and communication abilities are observed during a play session.

“Not every child who has behavior or language problems has autism,” Dr. Swingle said. “This test can narrow it down.”

Dr. Swingle said treatment for mild forms of autism involves treating the behaviors first.

“Parents are more likely to reward the wrong behavior,” he said. “If your child is screaming for you to turn the TV on, many parents will turn the TV on to stop the child from screaming. They are rewarding the bad behaviors instead of the good behaviors.”

If you are worried about your child’s behavior or development, Dr. Swingle said to first talk to your child’s primary care physician. If they are in school, listen to the teacher’s concerns – they know if your child is not interacting with others in the room.

Most importantly, Dr. Swingle said parents need to model behaviors they want their children to display. “Children learn from watching,” he said. “They do as we do, not as we say.”

The USA Autism Diagnostic Clinic sees patients with referral from a physician or other medical/educational professional. To learn more, visit http://www.usahealthsystem.com/autism-diagnosis.

 

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