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Is My Child’s Autism Diagnosis Correct?

12/24/2018

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If your child has received a diagnosis of autism, you probably have several questions about what to do next, where to find services to help your child, and what you can do to help your child at home. You may even question the diagnosis and wonder if it could be something else. Does your child avoid eye contact because they’re on the autism spectrum, or are they simply very shy? Are your child’s odd fascinations a symptom of autism, or simply a quirky personality trait? If you find yourself asking these questions, rest assured that you’re not alone.

How Often is Autism Misdiagnosed?

In 2012, researchers ran a study and tracked 1,400 children who were diagnosed with autism. By the time the children reached 8 years of age, 61 of these children were no longer diagnosed with autism spectrum disorder, or ASD. Researchers noticed that most of the children who lost their diagnosis of ASD had been diagnosed before they were only 30 months old.

​However, almost all of these children who were no longer classified as having ASD were diagnosed with at least one other condition, such as a language delay or ADHD. Dr. Blumberg, who conducted a study on older children with autism states: "Our study suggests over-diagnosis of ASD may occur and may be more common than expected. But our study also shows that some children are said to have lost the diagnosis due to treatment or maturity.”

Conditions That May Be Mistaken for Autism

Professor and psychologist Tony Attwood says, ““I would say that between 10% and 25% of children diagnosed with ASD will not be classed as having the disorder as adults.” This can be due to early intervention or treatment, or it could have been a different condition than autism all along. In young children, potential signs of ASD may overlap with symptoms of other conditions and lead to misdiagnosis. Some conditions can include:​

  • Developmental delays. When a child isn’t speaking or interacting similarly to other kids their age, this can be a sign of autism, or it might be caused by another condition such as Down syndrome. Sometimes, developmental delays may have no known cause.

  • Psychological disorders. Obsessive-compulsive disorder (OCD), avoidant personality disorder, and other mental illnesses may cause a child to exhibit behaviors that look similar to symptoms of ASD.

  • Sensory processing difficulties. Children with ASD may be over-sensitive to stimuli and not like loud noises, crowds, or bright lights. However, young children may have trouble processing sensory input without having ASD. 

  • Intellectual disabilities. Sometimes, an intellectual disability may appear to be ASD when a child is very young because it can cause difficulties with language and learning.

  • Genetic disorders. Some genetic disorders such as Fragile X Syndrome, Angelman Syndrome, and Rett Syndrome share many of the same symptoms as autism.

How to Approach a New Diagnosis

Dr. Epstein, a neuropsychologist and specialist in diagnosing ASD, believes that doctors need to have the full picture of the child’s behaviors and symptoms before making a diagnosis. She thinks the process should be a comprehensive assessment including:​

  • Screeners or scales. There are a variety of questionnaires and screeners including the M-CHAT and the Ages and Stages Questionnaire that should be the first step in finding a diagnosis. These results alone shouldn’t be the sole reason for a diagnosis.

  • ADOS. If your child receives a score that suggests it may be ASD, the next step is to have them evaluated by a professional. The ADOS, or Autism Diagnostic Observation Schedule, is a common test that helps evaluate the child’s behaviors.

  • Interviews. It’s helpful for professionals to interview you and others who are close to your child, such as your child’s teacher.

  • Cognitive testing. This type of test helps evaluators learn how a child thinks and solves problems, and can give more insight into that than the ADOS test.

What to Do After Receiving a Diagnosis

If your child is found to have ASD, ask your child’s doctor about early intervention programs. These programs will help your child receive the help they need, and are usually highly successful in teaching children useful skills such as communicating with others, finding coping skills, and managing their behaviors. For more guidance on ASD-related issues, feel free to reach out to Dr. Syras Derksen.

​By:  Dr. Syras Derksen
Registered Psychologist
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How to Help Your Teenager with Autism in Secondary School

12/17/2018

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Secondary school is a whirlwind of changes for all teenagers, but it can be especially overwhelming for those with autism. Getting used to a new environment, different teachers, and all kinds of social rules can cause significant anxiety for teenagers with autism, and you may be worried about how your own child will respond to the stress.

​To help your teen thrive academically and socially, it’s important to allow them to have more freedom, help them ease into the new routines, and make sure they get the resources they need.

Autism During Teenage Years

Chantal Sicile-Kira, author of the book Adolescents on the Autism Spectrum, is also a public speaker dedicated to helping parents raise and understand their children with autism. She reports that many parents tell her that their child’s behavior seems to be getting worse as they reach their teenage years, but Sicile-Kira thinks this is simply a misunderstanding. "The teens are not getting more noncompliant because their autism is getting worse. It's because they're teenagers," she states. 

​Just like every other teenager, your teen will crave independence. They may become more moody due to hormonal changes, and they may not want to talk or listen to you as often. However, unlike their peers, teenagers with autism usually don’t have the same outlets to express their teenage woes. Their moodiness may manifest in different behaviors, such as frequent mood swings or becoming non-communicative at times. 

It’s crucial for parents to remember that those on the autism spectrum tend to have trouble identifying and expressing their feelings, and puberty may cause unfamiliar emotions. During hormonal and physical changes, your teen might not understand why they feel upset or sad. They may also be confused as to why they need to make changes in their routine, so try to clearly explain the reasons to them. Being patient, direct, and encouraging can help your teen get off to a great start.

Challenges of Secondary School

As your teen enters secondary school, they will likely face more challenges than their peers. Most people have common knowledge about how to navigate social situations and know what’s OK to discuss and what should remain private. Teens with autism may have more trouble fitting in because they don’t necessarily understand the social rules that seem like “common sense” to their peers. Along with communicating, teenagers with autism might face other challenges including:​

  • Bullying. One study showed that middle and high school students with autism were bullied nearly 5 times more than their peers. Because children and teenagers with autism may come across as awkward when socializing or have seemingly strange behaviors or rituals, they can be an easy target for bullies. 

  • Isolation. Over 40% of teens on the autism spectrum said that they never saw friends outside of school. Sicile-Kara says, “People think they don’t want to have friends, but they do.” Like most other teenagers, teens with autism to want to be accepted and liked, but it’s often more difficult for them to connect with their peers.

  • Personal hygiene. As your teen begins going through physical changes, they might not understand why they need to shower more often or start shaving. It’s important to explain to them why good hygiene is necessary.

  • More responsibility. Dr. Amy Keefer, a clinical psychologist, says that children with autism usually get the support they need during grade school, but that support can slowly disappear as they advance in their education. However, with the demands of secondary school, such as going to different classes, organizing homework, and following complex instructions, most teens with autism still require support with their education.

What You Can Do to Help

Beginning a new routine can be a turbulent and frustrating time for your teen. To help them transition into secondary school and make sure they continue receiving support, it’s recommended to create a transition plan. Depending on your child’s wants and needs, the plan may be more detailed, but the basic aspects of a plan include:​

  • Discussing the plan with the school staff and teachers before your teen begins secondary school so they have time to accommodate for them.
 
  • Visiting the school with your teen before school begins to show them where each class is held. If possible, have your teen meet their teachers and other school staff as well.
 
  • Communicating to the school what supports your teen needs, and finding out who will provide the supports.
 
  • Establishing how you and the school will communicate when your child begins school.
 
  • Planning simple solutions to ease your teen’s anxiety. For example, if your teen gets overwhelmed in crowds, ask if they can have permission to leave class a few minutes early to avoid the loud, overstimulating hallways.

Secondary school comes with many challenges, but with the right support, patience, and understanding, your teen will excel and thrive. For more guidance, reach out to Dr. Syras Derksen.
​
By:  Dr. Syras Derksen
Registered Psychologist
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The First Signs of Autism in School-Age Students and Teens

12/10/2018

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According to this study, about 90% of parents who have a child with autism noticed symptoms by the time their child reached 2 years of age. Autism spectrum disorder can cause developmental delays or other noticeable symptoms in infants and toddlers, but some children with autism may develop normally and show no observable signs of the disorder. However, because autism is on a spectrum, the severity of symptoms varies and affects every individual differently. A significant number of children with autism may not exhibit any common signs until they begin school.

​One parent of a child with autism mentioned in an article that, “My child is developing behavioral problems. That’s because he can’t communicate well at school.” School can cause numerous difficulties for children on the autism spectrum due to the changes that occur in their environment and routines. The stress of school may increase the severity of symptoms, influencing how a child interacts with others, learns, or behaves.

Signs of Autism in Grade School Students

Signs of autism may become noticeable when a child begins school because they tend to have difficulty with different aspects of socializing with others. A child with autism may have difficulty taking turns in conversations, reading the reactions of others, or having conversations about what others want to talk about. Other possible effects of autism in children include:​

  • Speaking in an overly formal or monotone voice.

  • Having highly specific or unusual interests.

  • Difficulty making eye contact.

  • Trouble “fitting in” with their peers.

  • Not understanding the emotions or expressions of others.

  • Being overly sensitive to stimuli such as loud noises or specific textures.

  • Having repetitive or compulsive behaviors.

Signs of Autism in Teenagers

It can sometimes be difficult to notice autism in children if they appear to be doing well in school and don’t seem to have any symptoms that are typical of those on the autism spectrum. However, the onset of puberty, high school, and increased expectations of their achievements may cause the signs of autism to become more apparent. Some common signs of autism in teens include:​

  • Difficulty understanding social cues.

  • Sensory overload.

  • Trouble expressing or identifying emotions.

  • Being easily upset by change.

  • Repetitive behaviors or compulsions.

  • Being withdrawn or depressed.

  • Difficulty adjusting their behaviors to different social situations.

  • Trouble with sleeping.

  • Anxiety or frustration, which may lead to aggressive behaviors.

Autism in Females

Many people diagnosed with autism may also develop a mental illness, but undiagnosed autism may lead someone to develop mental health issues as well. Psychiatrist Ian McClure has reported that females especially are developing mental health difficulties because they haven’t yet been diagnosed with autism. Girls are most commonly underdiagnosed because the diagnostic criteria for autism is more typical for boys’ behavior and symptoms, while girls may deal with their symptoms differently. 

​Teenage girls are usually better at studying other people’s behavior and copying them to mask their symptoms, and quieter girls are usually thought of simply being shy rather than unfocused or disinterested. If they show signs that are more typical of autism, such as severe anxiety when their routine is changed, they may be misdiagnosed with a mental illness instead. 

One woman wasn’t diagnosed with autism until she was 28 years old, but she had been misdiagnosed with several mental illnesses including bipolar depression and borderline personality disorder. She said that learning she had autism changed her life, and it’s much easier to manage her symptoms now that she finally has an accurate diagnosis.

Advice for Parents

If you think your child may be on the autism spectrum or dealing with a mental illness, it’s important to talk to a child psychologist who does autism assessments and your child’s doctor. The earlier a diagnosis is reached, the sooner your child can learn how to manage their symptoms, succeed in school, and communicate with others.

​If your child or teen is found to have autism, there are some ways you can help them adjust to school and other life changes. Try to go with your child to school about a week before classes begin. Show them where their classroom and bathroom is located, and walk around the school with them so they can be better prepared for the first day of school. Getting involved in your child’s school, such as joining the PTA, can help you get to know your child’s teacher and meet other parents who may also have children with autism. 

​Outside of school, therapy might be helpful if your child or teen is dealing with high levels of stress or anxiety, behavioral issues, or seems overwhelmed. A therapist can help them work through their emotions, find healthy coping mechanisms for stress, and provide an outlet for your child’s frustrations. Scheduling an appointment at Oakville Wellness Center can be simply done online, or you can call for more information.

By:  Dr. Syras Derksen
Registered Psychologist
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First Signs of Autism in Young Children

12/3/2018

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Over the past decade, multiple awareness groups and campaigns have dramatically increased the public’s general knowledge about autism spectrum disorder. There have been changes made to the diagnostic criteria to more accurately identify the signs of autism. As a result, more children are being diagnosed with autism today compared to ten years ago. While there has been some public fear and panic about an “autism epidemic,” autism diagnoses are on the rise simply because autism awareness has made it easier for people to recognize early signs.

So, What is Autism?

Autism, or autism spectrum disorder, is a type of genetic condition that usually causes individuals to have repetitive behaviors and difficulty communicating and interacting with others. The autism spectrum covers a broad range of severity and symptoms, and not all people with autism will have significant impairments. Some people with autism may only have mild symptoms, whereas others may have severe difficulty with communicating, learning, and processing stimuli. 

​In some cases, signs of autism may be recognizable in infancy, and medical professionals can accurately diagnose autism in children at just 2 years of age. The American Academy of Pediatrics recommends scheduling both regular developmental screenings throughout childhood, as well as specific autism screenings when your child is 9, 18, and 30 months old.

Signs of Autism in Infants

Autism can cause some developmental delays in infants, so it Is important for parents to notice if their baby isn’t reaching certain milestones. For example, it is common for 12-month-old babies to laugh, make different facial expressions, and babble. It can be a cause for concern if your child turns a year old and hasn’t been displaying any of these behaviors. Recognizing signs of autism in infants doesn’t involve actively looking for symptoms, but rather noticing a lack of normal behaviors such as:

  • Not making eye contact or smiling at you by the age of 3 months.

  • Not laughing by 6 months old.

  • Not mimicking facial expressions or sharing sounds back-and-forth by 9 months old.

  • Not responding to their name, babbling, or pointing to objects by 12 months of age.
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  • Not speaking any words by 16 months old.

Signs of Autism in Toddlers

Autism can cause a number of social, behavioral, and communication differences by the time your child reaches 3 years of age. Around this time, signs of autism can become more apparent when your child is around other kids their age, as they may not respond to other children at all, or they might have trouble noticing facial expressions. Social and communication differences in children with autism can include:​

  • Not wanting to play “pretend” games.

  • Not making eye contact.

  • Difficulty recognizing emotions of others based on tone of voice and facial expressions.

  • Echolalia, or repeating words or sounds.

  • Being uninterested in making friends.

  • Not wanting to start or continue conversations.

  • Not pointing to objects or not paying attention when someone else is pointing at something.

Children with autism may have some noticeable behaviors by the time they are toddlers. These behaviors tend to be repetitive or obsessive, which can be difficult for parents to understand. Physical manifestations of autism, especially in young children, are typically ways for them to manage anxiety, block out unliked stimuli, or simply to pass the time. Some examples of these behaviors may include:

  • “Stimming,” or self-stimulating behavior, such as rocking, hand flapping, and pacing.

  • Being very sensitive to certain sounds, smells, or textures.

  • Having a specific routine and becoming upset if it changes.

  • Showing intense focus or fascination with specific activities or subjects.

What to Do If You’re Concerned

If you think your infant or child may be on the autism spectrum, you should schedule an appointment with your child’s pediatrician for an autism screening as soon as possible. When it comes to your child’s health, you shouldn’t take the advice to just “wait and see” if the signs improve or disappear. Visiting your child’s doctor will allow them to give their professional diagnosis, as well as recommend early intervention programs for your child. 

​Early intervention has been extremely successful for children by helping them develop social skills and learn how to manage challenging symptoms. If you believe your child needs more assistance with communication, Oakville Wellness Center offers other resources, as well as qualified speech-language pathologists who can help your child become more comfortable with social interactions. 

It is normal to feel worried about your young child and what their future holds, but it should be reassuring to know that autism is becoming widely understood and accepted across the country. People with autism today have more opportunities to speak out about their experiences, find employment, and have better support in their education. With early intervention and support from you, your child should expect a bright future.


By:  Dr. Syras Derksen
Registered Psychologist
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5 Things Everyone Should Know About Autism

11/26/2018

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Awareness and understanding of autism have been steadily improving over the past several years. Groups such as the Organization for Autism Research coordinate events to educate people of all ages about autism and use donations to continue research about autism. This organization also offers resources such as scholarships and employment opportunities for adults with autism and gives self-advocates a platform to speak about their experiences. 

​Although organizations like these do a great job of educating people about autism, there is still a lot of work to be done. Research must continue before we can fully understand autism, but even with the information already available, many people still have misconceptions and questions about it.

1. What is Autism Anyway?

The Centers for Disease Control refers to autism, or autism spectrum disorder, as “a developmental disability that can cause significant social, communication and behavioral challenges.”  The autism spectrum includes a wide range of various symptoms, but people on the autism spectrum typically tend to think, communicate, learn, and behave differently than others. 

​Autism was first recognized in 1943 by Dr. Leo Kanner when he reported on eleven children who all showed similar symptoms of being uninterested in people, but rather highly interested in their environment. There is no single known cause for autism, but research done by various scientists today have proven that it’s a genetically based condition.

2. Symptoms of Autism: They Vary

People need to understand that autism is on a spectrum, and not every person with autism will have the same symptoms. People with mild autism, which used to be referred to as Asperger’s syndrome, may go undiagnosed for years, whereas others on the autism spectrum may be nonverbal or have significant cognitive impairment. While these are some common signs, this is by no means a comprehensive list or representative of everyone on the spectrum. 

Common Symptoms in Infants and Young Children
  • Avoiding eye contact.
  • Stimming, or self-stimulatory behavior, such as rocking or hand flapping.
  • Not responding to their name or ignores others.
  • Having a flat expression.
  • No babbling or pointing within the first 12 months.

Common Symptoms in Adolescents and Teenagers
  • Trouble relating to others, or being uninterested in other people altogether.
  • Difficulty expressing their emotions, wants, or needs.
  • Repetitive or obsessive behaviors.
  • Becoming easily upset by changes in their routine or other stimuli such as certain sounds or textures.
  • Unusual, specific interests.
  • Shows few facial expressions or may speak in a monotone voice.
  • Difficulty noticing and understanding social cues such as body language, tone of voice, and facial expressions.

3. Mental Illness Goes Hand-in-Hand with Autism.

It’s fairly common that those who fall somewhere on the autism spectrum often deal with other challenges or mental illness. Symptoms of autism such as feeling uncomfortable in new places or interacting with others may cause anxiety disorders. Sometimes when people with autism notice how they’re different from others around them and feel unable to communicate, they can feel isolated and depressed. Along with anxiety and depression, other challenges people with autism might encounter include eating disorders, aggressive behavior, insomnia, or other difficulties with sleeping.

4. Many Myths Still Surround Autism.

While the general public knows more about autism than they did ten years ago, there are still misconceptions that people believe. A few myths about autism include:​

  • People with autism don’t feel the range of different emotions. People with autism experience the full range of emotion; they just express their emotions differently.

  • Vaccines cause autism. This misconception was widely believed and spread, but scientists worldwide have proven there is no scientific evidence to this claim.

  • People with autism like to be alone and don’t want friends. Most people with autism want to connect with others, but they often have trouble with social communication and recognizing the emotions of others.

5. Parental Support is Just As Important As Professional Support.

Noticing early signs of autism is extremely beneficial for both you and your child. If you recognize any symptoms of autistic behavior in your infant or toddler, it’s recommended to seek a professional diagnosis. Children can be diagnosed accurately at just 18 months of age, and this early intervention can be the key in helping children develop communication skills and manage stressors. 

However, while professional guidance is important, you must never underestimate the importance of supporting your child and helping him to better understand his symptoms. The most important thing for parents to remember is to be open-minded to how their child communicates. Listen to phrases your child may repeat, or focus on nonverbal cues, and then communicate in their preferred way. This can lessen confusion and misunderstanding, and can bring you and your child closer together.

If your child has been diagnosed with autism and you’re unsure of where to turn, Oakville Wellness Center has several resources available. If your child has delayed speech or trouble communicating, it can be helpful to contact a speech-language pathologist. 

If your child is experiencing a major life change, such as entering school, or you fear they might be struggling with an underlying mental illness, there are resources to help your child. 

​
By:  Dr. Syras Derksen
Registered Psychologist
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Could You Have Autism?

9/12/2018

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Over the past several years, people have become more aware of autism and what it entails. This of course is great news for those who cope with its challenges every day. Parents can take comfort in knowing that they are not alone and that there are abundant resources available to help them best meet their children’s needs after diagnosis. Even teachers can access a wide range of lesson plans that appropriately serve children on the spectrum. But what about adults who think they may have autism? How can they get a proper diagnosis? If you are wondering if you might fall on the spectrum and are not sure what to do next, read on for some information and helpful tips.

​To start, below are some characteristics commonly observed in adults with autism.

You Are Fixated on One Specific Topic

Maybe you know more about birds than anyone you know and are always eager to share interesting facts about geese migration patterns. Perhaps you can drone on endlessly about 19th century poets. Having an obsession with a specific topic to the point of struggling to discuss anything else is a classic symptom of autism and similar disorders. People who manifest this symptom might even see their “obsession” as a safe haven from things that scare them, like large crowds.

Making Friends is Difficult for You

A lot of people struggle to meet new people and maintain meaningful, lasting relationships with them. However, making and keeping friends is notably challenging for those with autism. Even those who do make friends regularly might struggle to relate to them on a basic level, straining the friendship as a result.

Irony, Sarcasm and Figures of Speech Often Fly Over Your Head

So, somebody told you a really funny joke. At least--it was supposed to be funny. Other people are laughing. Many are at least smiling, knowing something you don’t. All you can do, however, is think “huh?” You might face similar confusion when someone uses figurative language or gives a sarcastic response.

You Struggle to Abandon the Familiar

Many people have a daily routine so familiar to them that they perform it without much thought. For people with autism, breaking that routine can be distressing. For instance, the average person probably would probably be just mildly annoyed if they had to wait an extra ten minutes to go to lunch at work. Someone with autism, however, would probably get anxious over this disruption.

You Feel Very Introverted

Because of their difficulty in social situations, some people with autism prefer to forgo those situations altogether. As a result, they keep to themselves. They might spend this alone time doing things that make them feel most at ease, like reading or listening to music.

I Think I Might Have Autism. What’s Next?

If you fit several of these descriptions, you might fall on the autism spectrum. However, there are some steps you should take to get a proper diagnosis. Read on to learn more.

First Up: Get a Proper Evaluation

As with any condition, it is extremely important you seek out a professional’s opinion before looking into treatment. You must understand that most psychologists who specialize in autism and spectrum disorders follow diagnostic procedures best suited for children. Additionally, the parents play a major role in making an accurate diagnosis--something that many adults do not have. With these things in mind, you would be best served finding a psychologist who treats adults with autism and thus knows what to look for. Testing will likely involve a lot of talking on your part and much observation from the psychologist.

Be Forthcoming with the Psychologist about Your History

Once you find a psychologist who suits your needs, go to your appointment ready to both ask questions and to share a lot of personal history. In other words, the psychologist will likely want a detailed account of your childhood and medical history leading up to the present. Understand that he is not trying to prod for the sake of curiosity; he is trying to get a picture of who you are. You are not the first person this psychologist has seen with these problems, and be grateful for that. All that experience means that he knows exactly how to help you, whether you fall on the spectrum or not.
For more information on how to cope with specific psychological conditions, visit Dr. Syras Derksen.
By:  Dr. Syras Derksen
Registered Psychologist
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