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Understanding Autism

Diagnosis and treatment

How can you know  -- and how early can you find out  -- if your child falls anywhere on the broad spectrum?

Parents who've noted that their 14-month-old doesn't babble or point, is losing skills, or isn't talking by 18 months should talk to their pediatrician and get a developmental screening. If it indicates a possible problem, you should be referred to a specialist who can evaluate your child further using tools such as the Autism Diagnostic Observation Schedule (ADOS), a workup done by observing and interacting with the child.

That said, getting a qualified medical diagnosis for an infant or a toddler is not the straightforward process it should be. There's "tremendous variability" in the skill that public agencies and private practices bring to the screening process, says Fred Volkmar, M.D., chairman of the Department of Child Study at Yale University. "We've put a lot of money into research but not enough into translating that research into medical practice."

And a sound diagnosis is only the beginning. Treatment is the next step, and there are no fewer than ten types of interventions offered nationwide that work to some degree, says Dr. Volkmar. But usually only one type is available in any one area. Making a choice (if there is one) between or among approaches is not easy on the parent, either, because there aren't clear standards to go by.

But using the wrong intervention for a child with ASD can squander a precious window of opportunity, says Susan Wilczynski, Ph.D., executive director of the nonprofit National Autism Center (NAC), in Randolph, MA. "Learning is lifelong," she says, "but many kids who receive intensive intervention early, in their first five years, do better than those who receive it later." Establishing treatment standards so parents can choose effective programs is the mission of the newly organized NAC. Meanwhile, Wilczynski urges parents to choose approaches backed up by evidence that they work, such as those in Educating Children With Autism, a book that can be read for free online .

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