What is Autism?
Autistic Spectrum Disorders (ASDs) are a group of neurobiological conditions resulting from a transaction between a biological predisposed individual and a variety of possible environmental influence.
When parents read about classical autism, invariably they report that although many of its manifestations fit the profile of their child, there are also many characteristics that simply do not. Autism affects individuals in a wide variety of ways along a spectrum, which is why we refer to it as ASD. This spectrum can be likened to a rainbow with a wide array of colors. There are those who are on the more severe end and those who are more mildly impaired.
The Diagnostic and Statistical Manual of Mental Disorders (APA, 1994), also known as the DDM-IV, is a manual that attempts to clarify definitions of autism. The DSM-IV classification of pervasive developmental disorder (PDD) includes Autistic Disorder; Asperger’s Syndrome; Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) and other rather rare disorders. The diagnosis of an Autism Spectrum Disorder requires that symptoms be of sufficient severity to result in a marked degree of impairment of function under three domains:
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Impairment in social interaction, including impairment in eye contact, facial expression, body posture and gesture, failure to develop peer relationships, lack of social and emotional reciprocity and obliviousness to the needs of others.
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Impairment in verbal and nonverbal communication, including a delay in or lack of spoken language, and lack of make-believe or pretend play.
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Restrictive, repetitive, and stereotyped patterns of behavior including preoccupation with restricted patterns of interest and routines, repetitive motor mannerisms and other stereotypes, and persistent preoccupation with parts of objects.
Not all of the symptoms need to be present for the diagnosis to be made. Some children fall into a gray zone when a clear-cut diagnosis is difficult to make. PDD-NOS pertains to children who do not meet the symptom number or severity necessary for the diagnoses, such as Multi-System Developmental Disorder, might not entitle a child to educational or developmental interventions.
In the diagnostic process it is important to remember that, just as typical children on the spectrum of autism are also different from each other.
What Is a Developmental Pediatrician?
A developmental pediatrician is a board-accredited pediatrician who has also received sub-specialty training and certification in developmental-behavioral pediatrics. That person should have five years of practice experience, of which at least 50 percent focuses specifically on developmental-behavioral issues.
Why Would a Person With Autism Need to See a Developmental Pediatrician?
Most pediatricians in general practice have little experience with autism spectrum disorders. As a result, they are not ideally qualified to diagnose or treat autism. Developmental pediatricians, particularly those with a subspecialty in the field, are highly trained and experienced in identifying and diagnosing a whole range of developmental and behavioral differences. A developmental pediatrician should be able to look at your child's development overall, provide a diagnosis, and recommend a specific treatment plan.
What Does a Developmental Pediatrician Do for Children with Autism?
At the very least, a developmental pediatrician will spend at least an hour or two with you and your child. He or she is likely to spend a fair amount of that time interviewing you about your child's developmental history, habits, abilities and challenges. In addition, he or she will conduct a thorough evaluation of your child, checking height, weight, coordination, responsiveness, etc. It is unlikely that the pediatrician will conduct psychological or speech tests, though he or she will be aware of possible issues in these areas and will observe how your child moves, interacts, speaks, plays, and so forth. Once the pediatrician has completed the evaluation, he or she may provide you with a full report as well as a specific diagnosis such as Asperger Syndrome, Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS), speech delays, etc. He or she may also recommend specific options for treatment, or refer you to agencies that fund and provide such treatments. Occasionally, if you are very lucky, you will find a developmental pediatrician with the time, knowledge and inclination to help you help your child by finding the right treatments, therapists and educational program.
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