Nobody Ever Told Me (Or My Mother) That! : Everything from Bottles and Breathing to Healthy Speech Development
Fills a missing niche in the child rearing world. It explains everything from the basics of nursing, to SIDS, to facial massage; finishing with the secrets to good speech development and your child's best natural appearance. Written by an SLP with over 30 years experience, this book is a wealth of necessary information for any new parent.
WHAT TO LOOK FOR IN BABIES,
TODDLERS, AND CHILDREN
As a parent, you never want to believe that your
precious bundle has a problem. But when it comes to autism, catching it early
makes a huge difference. The younger your child, the greater the impact of
treatment on symptoms of autism and other developmental problems. So watching
for warning signs in babies and toddlers is vital.
If you catch autism in its early stages—ideally by the age of eighteen
months—you may be able to interrupt its development and minimize problems. But
no matter your child’s age, don’t lose hope. Treatment can reduce autism’s
effects and help your child learn, grow, and thrive.
Autism is a spectrum of closely related disorders
with a shared core of symptoms. Autism spectrum disorders appear in infancy and
early childhood, causing delays in many basic areas of development such as
learning to talk, play, and interact with others.
The signs and symptoms of autism vary widely, as
do its effects. Some autistic children have only mild impairments, while others
have more obstacles to overcome. However, every child on the autism spectrum
has problems, at least to some degree, in the following three areas:
▪
Communicating verbally and non-verbally
▪
Relating to others and the world around them
▪
Thinking and behaving flexibly
There are different opinions among doctors,
parents, and experts about what causes autism and how best to treat it, and
much that we still don’t know. But on one fact, everyone agrees: early and
intensive intervention helps. For children at risk and children who show early
signs, it can make all the difference.
Early detection of autism
is up to parents
As a parent, you’re in the best position to spot
the earliest warning signs of autism. You know your child better than anyone
and observe behaviors and quirks that a pediatrician, in a quick fifteen-minute
visit, might not have the chance to see. Your child’s pediatrician can be a
valuable partner, but don’t discount the importance of your own observations
and experience. The key is to educate yourself so you know what’s normal and
what’s not.
▪
Monitor your child’s development.
Autism involves a variety of developmental delays, so keeping a close eye on when—or if—your child is hitting the key social, emotional, and cognitive milestones is an effective way to spot the problem early on. While developmental delays don’t automatically point to autism, they may indicate a heightened risk.
Autism involves a variety of developmental delays, so keeping a close eye on when—or if—your child is hitting the key social, emotional, and cognitive milestones is an effective way to spot the problem early on. While developmental delays don’t automatically point to autism, they may indicate a heightened risk.
▪
Take action if you’re concerned.
Every child develops at a different pace—so you don’t need to panic if your child is a little late to talk or walk. When it comes to healthy development, there’s a wide range of “normal.” But if your child is not meeting the milestones for his or her age, or you suspect a problem, share your concerns with your child’s doctor immediately. Don’t wait.
Every child develops at a different pace—so you don’t need to panic if your child is a little late to talk or walk. When it comes to healthy development, there’s a wide range of “normal.” But if your child is not meeting the milestones for his or her age, or you suspect a problem, share your concerns with your child’s doctor immediately. Don’t wait.
▪
Don’t accept a wait-and-see approach.
Many concerned parents are told, “Don’t worry” or “Wait and see.” But waiting is the worst thing you can do. You risk losing valuable time at an age where your child has the best chance for improvement. Furthermore, whether the delay is caused by autism or some other factor, developmentally delayed kids are unlikely to simply “grow out” of their problems. In order to develop skills in an area of delay, your child needs extra help and targeted treatment.
Many concerned parents are told, “Don’t worry” or “Wait and see.” But waiting is the worst thing you can do. You risk losing valuable time at an age where your child has the best chance for improvement. Furthermore, whether the delay is caused by autism or some other factor, developmentally delayed kids are unlikely to simply “grow out” of their problems. In order to develop skills in an area of delay, your child needs extra help and targeted treatment.
▪
Trust your instincts.
Ideally, your child’s doctor will take your concerns seriously and perform a thorough evaluation for autism or other developmental delays. But sometimes, even well-meaning doctors miss red flags or underestimate problems. Listen to your gut if it’s telling you something is wrong and be persistent. Schedule a follow-up appointment with the doctor, seek a second opinion, or ask for a referral to a child development specialist.
Ideally, your child’s doctor will take your concerns seriously and perform a thorough evaluation for autism or other developmental delays. But sometimes, even well-meaning doctors miss red flags or underestimate problems. Listen to your gut if it’s telling you something is wrong and be persistent. Schedule a follow-up appointment with the doctor, seek a second opinion, or ask for a referral to a child development specialist.
Signs and symptoms of
autism in babies and toddlers
If autism is caught in infancy, treatment can
take full advantage of the young brain’s remarkable plasticity. Although autism
is hard to diagnose before 24 months, symptoms often surface between 12 and 18
months. If signs are detected by 18 months of age, intensive treatment
may help to rewire the brain and reverse the symptoms.
The earliest signs of autism involve the absence
of normal behaviors—not the presence of abnormal ones—so they can be tough to
spot. In some cases, the earliest symptoms of autism are even misinterpreted as
signs of a “good baby,” since the infant may seem quiet, independent, and
undemanding. However, you can catch warning signs early if you know what to
look for.
Some autistic infants don't respond to cuddling,
reach out to be picked up, or look at their mothers when being fed.
Early signs of
autism in babies and toddlers
▪
Doesn’t make eye contact (e.g. look at you when
being fed).
▪
Doesn't smile when smiled at.
▪
Doesn't respond to his or her name or to the
sound of a familiar voice.
▪
Doesn’t follow objects visually.
▪
Doesn't point or wave goodbye or use other
gestures to communicate.
▪
Doesn’t follow the gesture when you point things
out.
▪
Doesn’t make noises to get your attention.
▪
Doesn’t initiate or respond to cuddling.
▪
Doesn’t imitate your movements and facial
expressions.
▪
Doesn’t reach out to be picked up.
▪
Doesn’t play with other people or share interest
and enjoyment.
▪
Doesn’t ask for help or make other basic
requests.
The following
delays warrant an immediate evaluation by your child’s pediatrician.
▪
By 6 months:
No big smiles or other warm, joyful expressions.
▪
By 9 months: No
back-and-forth sharing of sounds, smiles, or other facial expressions.
▪
By 12 months: Lack
of response to name.
▪
By 12 months: No
babbling or “baby talk.”
▪
By 12 months:
No back-and-forth gestures, such as pointing, showing, reaching, or waving.
▪
By 16 months:
No spoken words.
▪
By 24 months:
No meaningful two-word phrases that don’t involve imitating or repeating.
Signs and symptoms of
autism in older children
As children get older, the red flags for autism
become more diverse. There are many warning signs and symptoms, but they
typically revolve around impaired social skills, speech and language
difficulties, non-verbal communication difficulties, and inflexible behavior.
Signs and
symptoms of social difficulties in autism
Basic social interaction can be difficult for
children with autism spectrum disorders. Many kids on the autism spectrum seem
to prefer to live in their own world, aloof and detached from others.
▪
Appears disinterested or unaware of other people
or what’s going on around them.
▪
Doesn’t know how to connect with others, play, or
make friends.
▪
Prefers not to be touched, held, or cuddled.
▪
Doesn’t play "pretend" games, engage in
group games, imitate others, or use toys in creative ways.
▪
Has trouble understanding or talking about
feelings.
▪
Doesn’t seem to hear when others talk to him or
her.
▪
Doesn't share interests or achievements with
others (drawings, toys).
Signs and
symptoms of speech and language difficulties in autism
Children with autism spectrum disorders have
difficulty with speech and language. Often, they start talking late.
▪
Speaks in an abnormal tone of voice, or with an
odd rhythm or pitch (e.g. ends every sentence as if asking a question).
▪
Repeats the same words or phrases over and over.
▪
Responds to a question by repeating it, rather
than answering it.
▪
Refers to themselves in the third person.
▪
Uses language incorrectly (grammatical errors,
wrong words).
▪
Has difficulty communicating needs or desires.
▪
Doesn’t understand simple directions, statements,
or questions.
▪
Takes what is said too literally (misses
undertones of humor, irony, and sarcasm).
Signs and
symptoms of nonverbal communication difficulties in autism
Children with autism spectrum disorders have
trouble picking up on subtle nonverbal cues and using body language. This makes
the "give-and-take" of social interaction very difficult.
▪
Avoids eye contact.
▪
Uses facial expressions that don't match what he
or she is saying.
▪
Doesn’t pick up on other people’s facial
expressions, tone of voice, and gestures.
▪
Makes very few gestures (such as pointing). May
come across as cold or “robot-like.”
▪
Reacts unusually to sights, smells, textures, and
sounds. May be especially sensitive to loud noises.
▪
Abnormal posture, clumsiness, or eccentric ways
of moving (e.g. walking exclusively on tiptoe).
Signs and
symptoms of inflexibility in autism
Children with autism spectrum disorders are often
restricted, inflexible, and even obsessive in their behaviors, activities, and
interests.
▪
Follows a rigid routine (e.g. insists on taking a
specific route to school)
▪
Has difficulty adapting to any changes in
schedule or environment (e.g. throws a tantrum if the furniture is rearranged
or bedtime is at a different time than usual).
▪
Unusual attachments to toys or strange objects
such as keys, light switches, or rubber bands.
▪
Obsessively lines things up or arranges them in a
certain order.
▪
Preoccupation with a narrow topic of interest, often
involving numbers or symbols (e.g. memorizing and reciting facts about maps,
train schedules, or sports statistics).
▪
Spends long periods of time arranging toys in
specific ways, watching moving objects such as a ceiling fan, or focusing on
one specific part of an object such as the wheels of a toy car.
▪
Repeats the same actions or movements over and
over again, such as flapping hands, rocking, or twirling (known as
self-stimulatory behavior, or “stimming”). Some researchers and clinicians
believe that these behaviors may soothe children with autism more than
stimulate them.
Common
self-stimulatory behaviors:
▪
Hand flapping
▪
Rocking back and forth
▪
Spinning in a circle
▪
Finger flicking
▪
Head banging
▪
Staring at lights
▪
Moving fingers in front of the eyes
▪
Snapping fingers
|
▪
Tapping ears
▪
Scratching
▪
Lining up toys
▪
Spinning objects
▪
Wheel spinning
▪
Watching moving objects
▪
Flicking light switches on and off
▪
Repeating words or noises
|
Causes of autism
Until recently, most scientists believed that
autism is caused mostly by genetic factors. But groundbreaking new research
indicates that environmental factors may be just as important in the
development of autism—if not more so—than genes.
It appears that certain babies are born with a
genetic vulnerability to autism that is then triggered by something in the
external environment, either while he or she is still in the womb or sometime
after birth.
It’s important to note that the environment, in
this context, means anything outside the body. It’s not limited to things like
pollution or toxins in the atmosphere. In fact, one of the most important
environments appears to be the prenatal environment.
Prenatal
factors that may contribute to autism
▪
Taking antidepressants during pregnancy, especially
in the first 3 months
▪
Nutritional deficiencies early in pregnancy,
particularly not getting enough folic acid
▪
The age of the mother (children born to
older fathers also have a higher risk of autism)
▪
Complications at or shortly after birth, including
very low birth weight and neonatal anemia
▪
Maternal infections during pregnancy
▪
Exposure to chemical pollutants, such as
metals and pesticides, while pregnant
While more research on these prenatal risk
factors is needed, if you’re pregnant or trying to conceive, it can’t hurt to
take steps now to reduce your baby’s risk of autism.
Reducing the risk
of autism: Tips for expectant mothers
▪
Take a multivitamin.
Taking 400 micrograms of folic acid daily helps prevent birth defects such as
spina bifida. It’s not clear whether this will also help reduce risk of autism,
but taking the vitamins can’t hurt.
▪
Ask about SSRIs.
Women who are taking an SSRI (or who develop depression during pregnancy)
should talk with a clinician about all the risks and benefits of these drugs.
Untreated depression in a mother can also affect her child’s well-being later
on, so this is not a simple decision to make.
▪
Practice prenatal care.
Eating nutritious food, trying to avoid infections, and seeing a clinician for
regular check-ups can increase the chances of giving birth to a healthy child.
Source: Harvard
Health Publications
Autism and vaccines
While you can’t control the genes your child
inherits or shield him or her from every environmental danger, there is one
very important thing you can do to protect the health of your child: make sure
he or she is vaccinated on schedule.
Despite a lot of controversy on the topic,
scientific research does not support the theory that vaccines or their
ingredients cause autism. Five major epidemiologic studies conducted in the
U.S., the U.K., Sweden, and Denmark found that children who received vaccines
did not have higher rates of autism.Additionally, a major safety review by the
Institute of Medicine failed to find any evidence supporting the connection.
Other organizations that have concluded that vaccines are not associated with
autism include the Centers for Disease Control and Prevention (CDC), the U.S.
Food and Drug Administration (FDA), the American Academy of Pediatrics, and the
World Health Organization.
Myths and facts
about childhood vaccinations
Myth: Vaccines aren't necessary.
Fact:
Vaccines protect your child from many serious and potentially deadly diseases,
including measles, meningitis, polio, tetanus, diphtheria, and whooping cough.
These diseases are uncommon today because vaccines are doing their job. But the
bacteria and viruses that cause these diseases still exist and can be passed on
to children who aren’t immunized.
Myth: Vaccines cause autism.
Fact: Despite
extensive research and safety studies, scientists and doctors have not found a
link between childhood vaccinations and autism or other developmental problems.
Children who are not vaccinated do not have lower rates of autism spectrum
disorders.
Myth: Vaccines are given too early.
Fact: Early
vaccination protects your child from serious diseases that are most likely to
occur—and most dangerous—in babies. Waiting to immunize your baby puts him or
her at risk. The recommended vaccination schedule is designed to work best with
children’s immune systems at specific ages. A different schedule may not offer
the same protection.
Myth: Too many vaccines are given
at once.
Fact: You may
have heard theories that the recommended vaccine schedule overloads young
children’s immune systems and may even cause autism. But research shows that
spacing out vaccinations doesn’t improve children’s health or lower their risk
of autism, and as noted above, actually puts them at risk for potentially fatal
diseases.
What to do if you’re
worried
If your child is developmentally delayed, or if
you’ve observed other red flags for autism, schedule an appointment with your
pediatrician right away. In fact, it’s a good idea to have your child screened
by a doctor even if he or she is hitting the developmental milestones on
schedule. The American Academy of Pediatrics recommends that all children
receive routine developmental screenings, as well as specific screenings for
autism at 9, 18, and 30 months of age.
▪
Schedule an autism screening.
A number of specialized screening tools have been developed to identify children at risk for autism. Most of these screening tools are quick and straightforward, consisting of yes-or-no questions or a checklist of symptoms. Your pediatrician should also get your feedback regarding your child’s behavior.
A number of specialized screening tools have been developed to identify children at risk for autism. Most of these screening tools are quick and straightforward, consisting of yes-or-no questions or a checklist of symptoms. Your pediatrician should also get your feedback regarding your child’s behavior.
▪
See a developmental specialist.
If your pediatrician detects possible signs of autism during the screening, your child should be referred to a specialist for a comprehensive diagnostic evaluation. Screening tools can’t be used to make a diagnosis, which is why further assessment is needed. A specialist can conduct a number of tests to determine whether or not your child has autism. Although many clinicians will not diagnose a child with autism before 30 months of age, they will be able to use screening techniques to determine when a cluster of symptoms associated with autism is present.
If your pediatrician detects possible signs of autism during the screening, your child should be referred to a specialist for a comprehensive diagnostic evaluation. Screening tools can’t be used to make a diagnosis, which is why further assessment is needed. A specialist can conduct a number of tests to determine whether or not your child has autism. Although many clinicians will not diagnose a child with autism before 30 months of age, they will be able to use screening techniques to determine when a cluster of symptoms associated with autism is present.
▪
Seek early intervention services.
The diagnostic process for autism is tricky, and can sometimes take awhile. But you can take advantage of treatment as soon as you suspect your child has developmental delays. Ask your doctor to refer you to early intervention services. Early intervention is a federally funded program for infants and toddlers with disabilities. Children who demonstrate several early warning signs may have developmental delays. They will benefit from early intervention whether or not they meet the full criteria for an autism spectrum disorder.
The diagnostic process for autism is tricky, and can sometimes take awhile. But you can take advantage of treatment as soon as you suspect your child has developmental delays. Ask your doctor to refer you to early intervention services. Early intervention is a federally funded program for infants and toddlers with disabilities. Children who demonstrate several early warning signs may have developmental delays. They will benefit from early intervention whether or not they meet the full criteria for an autism spectrum disorder.
▪
You don’t have
to wait for a diagnosis to start helping your child
▪
While autism isn’t normally diagnosed and treated
before the second year of life, there are things parents can do if your child's
social and emotional development doesn't seem to be on course. You don’t have
to wait for an official diagnosis to start targeting developmental delays and
working to enhance the bond you share. This is something you can do even when
your child’s just an infant.
▪ The
attachment bond is the unique relationship between your baby and yourself as
his or her primary caretaker. This instinctual bonding relationship draws the
two of you together insuring that the needs of your helpless and vulnerable
infant will be met. In the 90’s, an explosion of learning uncovered the fact
that this unique relationship, the attachment bond, is a key factor in your
infant’s social, emotional, intellectual and physical development.
▪ The quality
of the attachment bond varies. A secure bond provides your baby with an optimal
foundation for life: eagerness to learn, healthy self-awareness, trust and
consideration for others. An insecure attachment relationship, one that fails
to meet an infant’s need for safety and understanding, leads to confusion about
oneself and difficulties in learning and relating to others.