National Autism Month

April

In 2021, the CDC reported that approximately 1 in 44 children in the U.S. is diagnosed with an autism spectrum disorder (ASD), according to 2018 data. The disorder is found in all ethnic and socioeconomic groups and is more prevalent in boys than girls – 1 in 27 boys and 1 in 116 girls. According to the organization Autism Speaks, the disorder can be reliably diagnosed as early as age two, but most children aren’t diagnosed until after age four. Early intervention affords the best opportunity to support healthy development and deliver benefits across a person’s lifespan. For that reason, and in honor of Autism Awareness Month, this special section provides information on diagnosing autism, signs and symptoms to watch for, the importance of good nutrition with autism, and tips to manage meltdowns.

Autism

What it is, Signs to Watch for, Diagnosis and Treatment

Autism is a neurodevelopmental disorder characterized by challenges with social communication, and by restricted and repetitive behaviors. It is now considered part of the wider autism spectrum.

In 2013, the American Psychiatric Association released the fifth edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The DSM-5 is now the standard reference that healthcare providers use to diagnose mental and behavioral conditions, including autism. Children can be diagnosed as early age two to three. To meet the criteria for an autism diagnosis, an individual must exhibit six signs/symptoms – two must be related to social interaction, one related to communication, and another related to restrictive or repetitive behavior.

One of the most important things a parent or caregiver can do is to learn the early signs of autism and become familiar with the typical developmental milestones your child should be reaching.

What are the signs of autism?

The autism diagnosis age and intensity of autism’s early signs vary widely. Some infants show hints in their first months. In others, behaviors become obvious as late as age two or three. Not all children with autism show all the signs. Many children who don’t have autism show a few. That’s why professional evaluation is crucial.

The following may indicate your child is at risk for an autism spectrum disorder. If your child exhibits any of the following, ask your pediatrician or family doctor for an evaluation right away:

By 6 months

• Few or no big smiles or other warm, joyful and engaging expressions
• Limited or no eye contact

By 9 months

• Little or no back-and-forth sharing of sounds, smiles or other facial expressions

By 12 months

• Little or no babbling
• Little or no back-and-forth gestures such as pointing, showing, reaching or waving
• Little or no response to name

By 16 months

• Very few or no words

By 24 months

• Very few or no meaningful, two-word phrases (not including imitating or repeating)

At any age

• Loss of previously acquired speech, babbling or social skills
• Avoidance of eye contact
• Persistent preference for solitude
• Difficulty understanding other people’s feelings
• Delayed language development
• Persistent repetition of words or phrases (echolalia)
• Resistance to minor changes in routine or surroundings
• Restricted interests
• Repetitive behaviors (flapping, rocking, spinning, etc.)
• Unusual and intense reactions to sounds, smells, tastes, textures, lights and/or colors

Source: autismspeaks.org

How is autism treated?

Currently there is no cure for ASD. Therapies and behavioral interventions are designed to remedy specific symptoms and can substantially improve those symptoms. Some symptoms can be treated with medication. The ideal treatment plan coordinates therapies and interventions that meet the specific needs of the individual. Most health care professionals agree that the earlier the intervention, the better.

Educational/behavioral interventions: 

Early behavioral/educational interventions have been very successful in many children with ASD. In these interventions therapists use highly structured and intensive skill-oriented training sessions to help children develop social and language skills, such as applied behavioral analysis, which encourages positive behaviors and discourages negative ones. In addition, family counseling for the parents and siblings of children with ASD often helps families cope with the particular challenges of living with a child with ASD.

Medications: 

While medication can’t cure ASD or even treat its main symptoms, there are some that can help with related symptoms such as anxiety, depression, and obsessive-compulsive disorder. Antipsychotic medications are used to treat severe behavioral problems. Seizures can be treated with one or more anticonvulsant drugs. Medication used to treat people with attention deficit disorder can be used effectively to help decrease impulsivity and hyperactivity in people with ASD. Parents, caregivers, and people with autism should use caution before adopting any unproven treatments.

Source: NIH

Encourage Autistic Children to Eat Well

Autistic children are often picky eaters. Parents and schools often struggle to meet these children’s nutritional needs and get them to eat a variety of foods.

Autism Spectrum Disorder (ASD), 

a developmental disorder, is characterized by deficits in communication and social skills and coupled with at least two forms of restrictive or repetitive behaviors and/or interests. Because of the variety of symptoms associated with ASD, children may experience a number of difficulties with varying degrees of intensity.

“Issues with food arise for an assortment of reasons: sensory processing symptoms, allergies, medications, and gastrointestinal complications,” said Connie McIntosh, an associate professor in the College of Health at Ball State University.

Because the prevalence of autism is 1 in 59, it is critical that parents and school nurses become more knowledgeable of eating problems in children with ASD and identify strategies to improve the nutritional status of this population.

Symptoms of autism such as sensory sensitivity contribute to why these children refuse to eat certain foods, but medications, food intolerance, and even financial status can cause this issue to become concerning to a student’s overall health. 

McIntosh offers the following tips:

Refer the child to a Registered Dietitian Nutritionist (RDN) who will screen and assess nutritional needs.

Work with the primary care physician to assess serum blood levels of various nutrients, evaluating other chronic conditions and behavioral issues that may be prevalent. 

Consider a child’s sensory needs and offer foods that are acceptable and tolerated without overwhelming the child’s senses.

Create a quiet and consistent environment that is stress free and model proper eating habits. Understand the importance of consistent and distraction-free mealtimes.

Offer healthy snacks (e.g., dried fruits) rather than candy or sweets at home and at school.

Expand food repertoire by adding items of the same color and introducing new foods one at a time (e.g., vegetables with pasta).

Add extra foods to items the child already likes. For example, add mashed cauliflower to their mashed potatoes.

Include an assortment of varied brands and packaging of foods (e.g., changing brands of the same foods frequently to help prevent a child from getting stuck on one brand’s look or flavor).

Engage in eating as a dynamic process. Encourage a child to use their hands and ask questions about their food (e.g., origin, flavor, nutritional value, color, etc.).

Use reward schedules to encourage a child to eat their meals, like a toy at the end of the week if they eat a variety of foods a certain number of times. For every new veggie or fruit tried, give a reward. 

McIntosh notes that all children with ASD are unique and encourages parents and school nurses to remain flexible in how they adapt these tips to meet children’s needs. 

How to Manage Meltdowns

Meltdowns and upsets can happen at any age, but the younger a child is both in age, or in aspects of development, the more frequent and disruptive meltdowns can be. Understanding what happens in the brain during a meltdown can help you be better prepared to avoid the next disaster.

Learn your child’s signs and cues that things are beginning to escalate: 

Flushed cheeks, a change in the level of activity, shutting down, or becoming hyper. Becoming louder and more agitated are also signs.

Change the environment. Minimize chaos. Remove your child from the scenario – either by moving them or asking others to leave. Think calm, cool, quiet. You can dim the lighting, turn off tv/radio, grab a cool washcloth or iced water to drink. Come under your child’s noises, not over. Get quiet, not loud. While yelling may be your natural instinct so they can hear you, it can further trigger their fight/flight response, sending them into the meltdown faster.

Use fewer words, not more. When your child is on the brink of a meltdown is not the time for a life lesson or reasoning with them. Their brain will not process information well at this point, which can further frustrate them.

Engage large muscle groups in the body to help shift which parts of the brain are activated. Go for a walk, bike ride, or jump on a trampoline. Doing something mindless that provides some sensory input and engages the muscles can help to re-set mood and emotions.

Local Autism Resources

Autism Services of Southwest Louisiana is a 501(c)(3) non-profit agency, founded on the belief that each person with autism deserves a living environment specifically tailored with their disability in mind. Autism Services of Southwest Louisiana (ASSL) provides unique housing and support services for adults on the autism spectrum to help them achieve independence with the assistance of staff specially trained to accommodate them. Twenty-four-hour care/ one-to-one assistance and focus on achievement of individual goals distinguishes our organization’s model from an institutional setting and a residential setting that encompasses all disabilities. ASSL and its partner non-profit provider agency, Direct Care Inc., offer Medicaid waiver services (Children’s Choice, New Opportunities Waiver, Supervised Independent Living) in a warm, family-like community-based setting for adults throughout Southwest Louisiana and beyond. The adults who reside in our homes are at least 18 years of age, have an autism diagnosis, and receive some form of Social Security disability income. The waiver programs provide a portion of the pay for personal care attendants that ensure appropriate monitoring and supervision are in place on a 24/7/365 basis. Social Security disability income is used to pay room, board, and provides a monthly spending allowance for the individual client residing in the household. ASSL plans to expand their reach, increase services, and build two more homes by the end of 2023.  Our provider agency, Direct Care Inc., also provides care to community clients with disabilities. For more information, go to www.autismservicesswla.com or call office at 337-436-5001.

St. Nicholas Center transforms the lives of children with Autism, delays, and disorders by providing therapy and family support. They offer a wide range of services including Applied Behavior Analysis (ABA), Occupational Therapy, Speech Therapy, Social Skills training, and diagnostic testing, all under one roof. Services are provided to children with Autism, developmental delays, and neurological disorders in a fun, loving, and educational environment. They strive to be the state model of an all-inclusive therapeutic facility by providing the best pediatric therapy and affordable services to children and families facing the challenges of Autism, developmental delays, and neurological disorders. Their Outreach Program offers community-based educational opportunities and emotional support to foster understanding, compassion, and confidence. From saying their first word to improving vocational skills, St. Nicholas Center transforms the lives of these children one milestone at a time.Located at 2519 Ryan Street, Lake Charles. For more information, call 337-491-0800 or see their website, www.stnickcenter.org.

Autism Society of SWLA — Since 1965, the National Autism Society has been a leader in serving people on the autism spectrum, their families and professionals. The Southwest Louisiana affiliate is a great source of information and support for individuals and families impacted by autism. Founded in the 1970’s by Geri Landry, they provide support, services, and opportunities to persons with autism and their families throughout the SWLA five-parish region. They organize several social events throughout the year including summer camp and an annual Christmas party. As their primary fundraiser, each year they collect used Mardi Gras beads and recycle them for organizations to resuse. For more informationautismsocietyofswla.com or call 337-855-2068.

Autism Speaks is a national organization dedicated to promoting solutions, across the spectrum and throughout the life span, for the needs of individuals with autism and their families. They do this through advocacy and support; increasing understanding and acceptance of people with autism; and advancing research into causes and better interventions for autism spectrum disorder and related conditions. Founded in 2005, their website offers a wealth of information for those whose lives are impacted by autism. www.autismspeaks.org/