The challenge of treating autism lies in identifying the disorder at an early age.
"The sooner the diagnosis, the better outcome you are going to have," said Lewes pediatrician Dr. Jay Ludwicki.
He said parents should rely on children's well checks to diagnose symptoms, which generally present themselves by 15 and 18 months and as early as 12 months. Those symptoms can range depending on the degree of the neurological disorder, which affects the functioning of the brain.
Ludwicki, who's formerly of Pittsburgh and moved to the area in 1997, said autism is characterized by three main factors: the lack of social interaction skills, the lack of communication skills and the presence of repetitive activities, such as walking circles around a room and banging utensils.
He said there are several chromosomal defects that come together to show characteristics of autism. There are different types of impairment from mild, commonly diagnosed as Asperger's Syndrome, to severe.
"It is very diverse. That is probably the biggest problem," Ludwicki said.
He said he uses the Denver Developmental Screening for children at well checks, or routine visits when children are healthy.
One indicator would be "Is the child pointing, indicating things they want," he said. If several indicators show abnormal development, then he said, physicians can use more intense screenings designed to identify disorders.
"Not every kid is going to articulate real well at 15 to 18 months, but they will pick up nonverbal communication with parents and others around him," Ludwicki said, therefore absence of pointing may be a sign.
Other indicators may be not making eye contact, not showing reciprocal emotion and not being able to follow simple tasks like 'Throw this in the trash.'
"They don't play with toys. They line up toys. Later, they count toys. They don't make transitions easily from one activity to another," Ludwicki said, further explaining characteristics of the disorder.
He said his first step after determining a child is autistic is to refer the family to a pediatric neurologist and a pediatric psychologist. Some children with autism have co-morbidities, Ludwicki said, or other health problems such as anxiety disorder, depression, ADHD or obsessive compulsive disorder. Those problems can be treated with medication. For autism, there is no cure.
"My job is to get them to the neurologist and make sure they don't have other co-morbidities they could be treating," Ludwicki said.
He said more evidence points to genetic factors as causing autism and related disorders, classified as an autism spectrum, than environmental factors. He said vaccines are often blamed for causing autism, but studies have disproved that theory. (For information on that, visit the American Academy of Pediatrics Web site at www.aap.org.)
"It presents at that age" when vaccines are given, Ludwicki said, "so people always look back at a vaccine and say, 'It must have been the vaccine that caused it.'"
"It has a lot to do with brain disorganization," Ludwicki said.
He compared the development of an autistic child's brain to a tree that wasn't pruned. Research shows that autistic children lack the protein glutamate that prunes the brain, or organizes white matter.
Early diagnosis key to treating autism - Delaware Coast Press - delmarvanow.com
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