All About Autism Spectrum Disorder

A Special love

Cristina Munarriz noticed something was wrong when her son Henry, then six months seemed like he couldn’t hear anything. She observed that her son was shy, but thought Henry would eventually come out of his shell. The boy had skills, like lining up animal toys by species and size. Still, when test results for his hearing came back negative, Cristina felt something was off. When Henry started attending day care classes at three years old, she noted some of these observations: “He never spoke about his classmates, and he would use my finger to point to things he wanted instead of pointing them out himself.”

When a relative who studied Special Education (SPED) suggested that Henry might have autism, a serious disorder in which children can seem unresponsive to others and tend to have significant problems in communication with others*, Cristina looked out for more signs. While watching a television show that talked about symptoms of autism, Cristina’s instinct became stronger. “I knew right then and there that it wasn’t just my eldest who had issues. His brother, Derek, who was then almost two years old, had it, too,” she recalls. “Since I was working for a multinational [company] in Singapore at that time, I asked my sister to have the kids checked. A trip to a developmental pediatrician confirmed Christina’s hunch. Henry was assessed with Asperger’s Syndrome while Derek had Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS). Autistic Disorder, Asperger’s, and PDD-NOS all fall under the Autism Spectrum Disorder (ASD).

Being miles away from home made finding out about her sons’ conditions more difficult for Cristina, who has since stayed with her kids in the country. “I couldn’t go home right away,” she says. “I just wanted to hug my kids. I couldn’t get myself to cry or be angry. I’m not the one who’d be having a hard time, it would be my kids.”

 

In Denial

Lisa Santos** recalls feeling the same way when she found out last year that her four-year-old son, William**, had mild autism. The first-time mom noticed William’s hyperactivity when he was only two years old. “He had severe tantrums, and we couldn’t get his attention every time we talked to him,” shares Lisa, a fulltime wife and mother.

An appointment with a developmental pediatrician made Lisa hear the words she had been dreading all along. “I was in denial,” she admits. “While at the doctor’s office, I already had a feeling William was indeed autistic, but I was still hoping my speculation would turn out wrong.”

Unlike Lisa, Cristina did not go through denial. “Dealing with autism was never my problem,” she says. “I didnít know then what autism would mean for my kids or for me as a parent, but I kept banking on their strengths. For some reason, I knew everything was going to be okay.” Although being in denial is a common reaction, a parent has to make a decision to accept his child’s condition before facing it head-on.

“Nothing can ever be possible until the parent can resolve that he can love the child for whatever he is,” says Edilberto I. Dizon, M.D., Ph.D., pediatrician, a SPED diagnostician and counselor at Child Find Therapy Center and a professor at the College of Education in University of the Philippines in Diliman, Quezon City. “You need to ask yourself, ‘CanI love this child?’ You have to decide first to love your child and take him for what he is; accept him and care for him whatever happens.” Cristina and Lisa’s kids are fortunate that their condition was detected early, but parents can actually look out for symptoms of autism even earlier. “Some children may already exhibit signs as early as 15 to 18 months,” says Lourdes C. Sumpaico-Tanchanco, M.D., a developmental-behavioral pediatrician at The Medical City and faculty member of the Ateneo School of Medicine and Public Health. “Speech delay is a common presentation. Some children respond to name-calling selectively. Repetitive behaviors may be prominent already.”

 

Click here to read about signs of autism to watch out for.

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Here are other signs to watch for if you suspect your child to have autism:

● Impairments in language and communication skills: has speech delay , talks in jargon or echolalia (repeating words he hears); doesn’t turn when his name is called.

● Impairments in social skills: has poor eye contact, doesn’t play with other children, prefers staying or playing by himself, poor index finger-pointing, poor joint attention (doesn’t look at objects being pointed at by caregiver).

● Stereotypic or repetitive behavior: lining of toys, spinning of wheels, gets upset when there are changes in routines at home.

 

Dr. Tanchanco notes: “You don’t need to see all of these signs in one child for him to be diagnosed with autism. Each child has unique symptoms, thereby warranting early developmental assessment.” The experts stress the importance of early detection, which makes way for early

intervention. “You will not lose anything with early consultation with professionals,” shares Dr. Tanchanco. “Early intervention gives you the opportunity to improve your child’s later outcome.” She adds that early intervention will help determine whether your child needs occupational, speech, behavioral, or educational therapy. “All interventions will rely on diagnoses and  assessment results,” explains Dr. Dizon. “The assessment results can tell us what the child can and cannot do. Based on that, we’ll be able to design a program which will help determine where to put the child, what to teach him, and how to teach him. Without assessment results, we will

not know how to tackle it because each child is unique.”

 

Special Education

Unlike in regular school where a lone teacher teaches a large group of kids the same lessons, Dr. Dizon expounds that, in special education, not one design can be the same for all children. He says, “Each child has unique special needs, even if they are twins. So, each one is individualized.”

It is this highly individualized program that can sometimes lead parents to think that having their children go into therapy and a special school are always costly. Dr. Dizon says that parents should have an honest relationship with their doctors. They should inform them if they don’t have

the financial capabilities to cover the high cost of consultations and treatments. “It’s good to tell

diagnosticians what you can only afford,” he says, adding that there are doctors who opt to waive their consultation fees and just ask the parents to defray the cost of the materials used for  herapy. “Just be honest. Some parents give up easily thinking the treatments are expensive. Same goes for the school tell them your situation and make arrangements to cover the cost of other expenses your child may incur.” Dr. Dizon suggests that parents volunteer at their children’s school. You can teach or impart your skills to the students. If you are a good baker, ask the  school if you can teach the students how to bake, and in turn have them cut off some of your child’s tuition. This way, you not only get to manage your finances, you get to spend more time with your child as well.

 

Click here to read on about how parents can make time for their kids with autism and about information on autism spectrum disorder.

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Making The Time for Kids with Autism

Lisa offers this advice to other parents of children with autism: Make time for them. She relates how in her son’s non-sectarian school in Laguna, she sees children accompanied by their nannies, without the parents in sight. “When I spoke with them, they told me that they not the  parents are the ones who mostly take care of the kids,” she recalls. “I believe it’s very important that you give time for your special child no matter how busy or rich you are,” she offers. “You should play a big role as parents of a special child.” She has also seen a significant improvement in William, who has now memorized the alphabet and shown talent in drawing. Dr. Dizon notes that while schools can charge large fees, enrolling your child in an expensive school doesn’t necessarily translate to a better output. “There’s a wrong notion that if a school charges a lot, it must be good,” explains Dr. Dizon, who has 38 years of experience teaching SPED. “I have seen schools that charge exorbitantly! Some charge six- figure fees and turn out to be the worst. And then there are those who charge, say, P2,000 a month, and they turn out to be very good.” Parents should also know that their children are not limited to special schools.

 

AUTISTIC SPECTRUM DISORDER (ASD)

There are the three main forms of ASD:

AUTISTIC DISORDER. When there is qualitative impairment in nonverbal behaviors,  communication skills, and repetitive behavior.

ASPERGER’S SYNDROME. The signs and symptoms resemble those of autistic disorder, only

there is no significant delay in language development. Link to Melody’s blog.

PERVASIVE DEVELOPMENTAL DISORDER-NOT OTHERWISE SPECIFIED (PDD-NOS). This

category is used when there is a severe and pervasive impairment in social interaction and verbal or nonverbal communication skills but the criteria are not met for a specific order.

 

Source: Diagnostic and Statistical  Manual of Mental Disorders (4th, text revision (DSM-IV-TR) ed.) published by American Psychiatric  Association (2000).

 

Click here to read on about how to interact with an autistic child and organizations parents can join to learn more about autism.

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WHAT YOU CAN DO IF YOU INTERACT WITH AN AUTISTIC CHILD:

• Have him look you in the eye when talking to him.
• Assign simple tasks like asking him to sit when he’s hyper or to pronounce a book’s title.
• Give simple rewards like praising him when you ask him to hand you a certain object.

 

IF YOU’RE A PARENT OF AN AUTISTIC CHILD:

• JOIN AN ORGANIZATION. “Parents who first hear of the diagnosis of autism often grieve over the ‘loss’ of their child,” explains Dr. Tanchanco. The Autism Society of the Philippines (ASP) is an organization of parents who give support through meetings. They help the family learn more about the condition, give pointers on how to address certain concerns, and accompany families on their journey with the condition. “Everyone needs a support system whatever their problems may be,” says Cristina, who serves as one of ASP’s trustees. “Most people are just too proud to admit they need help, as if asking for help is a sign of weakness.” Though most people mean well, they do not know where you are coming from. Speak to others who are in the same situation you’re in, and tell them what kind of support you need.Join a group that is positive and uplifting. Avoid the ones who get together only to vent and complain endlessly.
• EMPOWER YOURSELVES AND OTHERS. Dr. Tanchanco encourages parents to engage all members of the household to help out with interventions. Ask a family member or your nanny to volunteer as a teacher aide in neighborhood schools. Dr. Dizon takes it a step further by asking parents to share their knowledge with other less fortunate parents whose children suffer from this condition. “You can form a group of parents with special children who can do outreach programs in other communities. Each one can volunteer to teach one day a week. We need to empower people who can’t afford expensive treatments to think of ways to bond together and use their resources and manpower to maximize their potentials,” he says.

 

IF YOU SEE A CHILD WITH AUTISM OUT IN PUBLIC:

• BE TOLERANT AND RESPECT HIM. Do not laugh or stare at him. When he is having a tantrum, do not gather around him and mock him or his parents. “You don’t need to love them, just respect them,” says Dr. Dizon. “They are special.”

 

*Autsim as defined by Atkinson & Hilgardís Introduction to Psychology 14th edition, by Smith et al.(2003)

 

**Names have been changed. Models used are for illustrative purposes only and are in no way related to the stories.