Does Your Baby Have Autism?: Detecting the Earliest Signs of Autism - Softcover

Philip Teitlbaum; Osnat Teitlbaum

Softcover

ISBN 10: 0757002404 ISBN 13: 9780757002403

Publisher: Square One Publishers, 2008

Synopsis

The signs of autism centre on a child's social interaction - from poor eye contact to lack of verbal communication. Unfortunately, these signs usually don't reveal themselves until the age of two or three, at which point, the opportunity for improvement has lessened. But what if it were possible to detect autism within the first six months? That is the basis for Philip and Osnat Teitelbaum's book, DOES YOUR BABY HAVE AUTISM? For nearly two decades, this dedicated husband-and-wife team has worked to develop a pre-screening programme based on physical movement. In DOES YOUR BABY HAVE AUTISM?, the authors first examine the pioneering body movement work of Noa Eshkol and Abraham Wachmann. They then explain how to identify movement disturbances that appear to be the precursors for the development of autism and Asperger's Syndrome, allowing for an 80-percent reduction in diagnosis time. Early diagnosis can make an all-important difference in the treatment of autism. DOES YOUR BABY HAVE AUTISM? provides a key for every parent and carer who is concerned about a child's health.

About this title

About the Author

Osnat Teitelbaum studied movement and movement notation under Professor Noa Eshkol, at Seminar Hakibbutzim College and Tel Aviv University. Since 1989, she has taught movement analysis at the University of Florida.

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Philip Teitelbaum, PhD, completed his doctoral degree in Physiological Psychology at Johns Hopkins University. He has been a professor at Harvard University, the University of Pennsylvania, and the University of Illinois.

Excerpt. © Reprinted by permission. All rights reserved.

Does Your Baby Have Autism?

Detecting the Earliest Signs of AutismBy OSNAT TEITELBAUM PHILIP TEITELBAUM

Square One Publishers

Copyright © 2008 Osnat Teitelbaum and Philip Teitelbaum
All right reserved.
ISBN: 978-0-7570-0240-3

Contents

Acknowledgments........................................ixForeword...............................................xiA Word About Gender....................................xivPreface................................................xvIntroduction...........................................11. What Is Autism?.....................................52. Symmetry............................................153. Reflexes............................................294. The Ladder of Motor Development.....................415. Righting............................................496. Crawling............................................597. Sitting.............................................698. Walking.............................................799. Seeking Help........................................91Conclusion.............................................105Glossary of Terms......................................107Resources..............................................117Suggested Reading List.................................125References.............................................129Observation Journal....................................131Parent Questionnaire...................................145Index..................................................147About the Authors......................................152

Chapter One

What Is Autism?

Autism is not a new condition. Indeed, the word "autism" was coined more than a century ago. Over the years, however, our definition of autism has changed, as has our understanding of this condition.

This chapter first provides a concise history of autism and attempts to describe this disorder. It then looks at how the medical community currently defines, diagnoses, and treats autism. Finally, we briefly introduce you to our own research on this disorder-research that, we believe, offers new hope to infants everywhere.

A BRIEF HISTORY OF AUTISM

Prior to the 1900s, autism as a diagnosis was nonexistent. Those people who had what is now called autism were diagnosed with another disorder-usually, Juvenile Schizophrenia or mental retardation. For this reason, autistic children were often institutionalized.

Eugen Bleuler, a Swiss psychiatrist, first introduced the term autism in 1911, basing the word on the Greek autos, meaning "self." Yet Bleuler did not use the term to describe people that we would now identify as autistic, but applied it to people with schizophrenia who showed an extreme withdrawal from social life.

Several decades after Bleuler's coining of the term, autism was given a new meaning. In the late 1930s, an Austrian-born psychiatrist named Leo Kanner began conducting a case study of eleven children at the Johns Hopkins Hospital in Baltimore, Maryland. This culminated in Kanner's classic 1943 publication "Autistic Disturbances of Affective Contact," in which he described the children in his study as having "extreme autistic aloneness." A year later, Hans Asperger, an Austrian pediatrician working independently of Kanner, published "Autistic Psychopathy in Childhood." In his article, Asperger described several children who, although they differed in some respects from the patients observed by Kanner, shared the trait of seeming remote and uninterested in other people.

Despite the fact that neither Kanner nor Asperger had access to today's medical technology, their observations are fundamental to the field of autism today. Both doctors believed that the children they studied suffered from an underlying disturbance. Most interesting were the features of autistic behavior described by the two doctors. They included:

"Autistic aloneness," meaning a tendency to fixate on one stereotypic (repetitive) activity, shutting out anything, whether a person or a situation, from the outside world. This separation of self from the rest of the world is the cornerstone of what is referred to as autism. In fact, at the time that Kanner and Asperger were writing, many autistic children were at first considered deaf because they seemed completely oblivious to the sounds around them.

A preference of things over people. Autistic children ignore and avoid the people around them, including their parents. In fact, they appear to regard people as "things" that are to be either disregarded or dealt with, without any emotional attachment.

Language difficulties, which can take a variety of forms. Some children with autism do not speak as early as typical children do. Some don't speak until three years of age; a few, not until their late teens. Some children start to "babble" on time, and then regress to a form of speech called echolalia, in which they repeat all or part of what was just said to them. Many never use the first-person pronoun "I," but instead, refer to themselves as "you." For instance, an autistic child might state "You want candy," when she actually means "I want candy." More often than not, it is language difficulties that first draw attention to a child with autism.

Ritualistic and obsessive behavior, which can take a variety of forms. Once an action is carried out in one way, an autistic child will often insist that it always be performed in that manner. In other words, these children insist on "sameness." For instance, when traveling from point A to point B, a child may insist on always taking the route used the first time she went from A to B. Even the smallest of changes in routine can lead to a temper tantrum. Autistic children may also have special systems of arranging favorite objects.

An intolerance of loud noises, some movements, and other specific sensory stimuli. Autistic children have been known to fear elevators, vacuum cleaners, mechanical toys, running water, and even the wind, and to go into a panic when these things are present. Kanner, who was the first to note this phenomenon, felt that the problem was caused not by the noise or movement itself, but by its intrusion into the child's aloneness. Since then, other interpretations have been offered. (See the inset on page 8.)

Remarkable feats of memory and other unusual mental abilities. Although this is not true of every autistic child, some children with this diagnosis have an amazing memory for specific things, such as poems or sports trivia; are able to perform mathematical computations that border on genius; have astounding musical abilities; or exhibit other extraordinary talents.

Lack of smiling during and sometimes beyond infancy, as well as lack of facial expression when speaking. Kanner first reported that many autistic children do not smile, and that their speech is often not accompanied by facial expressions or gestures. Our own observations have shown that some children later diagnosed as autistic did not smile at all as infants. This is sometimes due to a form of paralysis called Moebius mouth, which is discussed on page 20.

It is important to note that both Kanner and Asperger commented on a possible relationship between autism and schizophrenia, but agreed that they are separate conditions. The most significant difference between the two disorders is that even the earliest onset of schizophrenia is preceded by at least two years of average development, while autistic children show evidence of their condition from the very beginning of life. This is why, as we will explain in later chapters, it is possible to detect autism fairly early in infancy.

Perhaps because of World War II, at first, little response was generated by Kanner and Asperger's findings. But during the seventies and eighties, a number of people-Lorna Wing, Michael Rutter, William Condon, Uta Frith, and Edward Ornitz, to name just a few-further explored the nature of autism, searched for its causes, and devised methods of treatment. By the time of Leo Kanner's death in 1981, his findings, as well as those of fellow pioneer Hans Asperger, had worldwide acknowledgment, and autism was recognized as a valid diagnosis.

Interest in autism has continued, and many studies have focused on the disorder, with strides being made in identifying its cause. It should be noted that back in the 1940s, Leo Kanner's observations of autistic children and their families led to the "refrigerator mother" school of thought. Popularized by child psychologist Bruno Bettelheim, the refrigerator mother label was based on the notion that autism is caused by the mother's lack of emotional warmth. This idea was eventually discredited, and other explanations of the disorder have since been offered. Some people have suggested that thimerosal, a mercury-based preservative used in routine childhood vaccines, plays a part in the development of autism. This is a highly controversial issue. There is, however, strong evidence that DNA variants-genetics, in other words-lie at the roots of autism. This would explain why in some families, as many as three or four children have been diagnosed with the condition. Examination of the brains of autistic individuals has revealed abnormalities within the brain stem and cerebellum. (See page 42 for information on the anatomy of the brain.) The mechanism through which the genes can cause atypical brain development is not yet known.

AUTISM NOW

Autism is now considered one of several conditions that fall under the umbrella term Autism Spectrum Disorders (ASD). Opinions differ as to exactly which conditions are covered by this term. Other than autism, many experts include Asperger's syndrome, Childhood Disintegrative Disorder, Rett syndrome, and Pervasive Developmental Disorder-Not Otherwise Specified. All five ASD conditions are characterized by impaired social interactions and communication skills, as well as repetitive patterns of behavior. The inset on page 10 presents the criteria used to diagnose autistic disorders as they appear in the American Psychiatric Association's publication Diagnostic and Statistical Manual of Mental Disorders.

Of the five ASD conditions, autism and Asperger's syndrome are the most common, and it is these two disorders that we explore in this book. What is the difference between autism and Asperger's? Autism is usually defined as a developmental disorder characterized by problems with social interaction, language and other communication, and learning. It can also involve repetitive behavior, the desire for routine, and remarkable mental abilities. People with Asperger's syndrome have many of the same characteristics, but tend to have higher IQs and develop language at a normal age. Yet they often lack the ability to recognize social cues and respond appropriately to social situations. Moreover, people with Asperger's often develop specialized interests and talk about them obsessively using adult language. This is why Asperger's is sometimes referred to as Little Professor Syndrome. Some experts have also observed that Asperger's children are clumsy in their movements, and this clumsiness is used by some as a specific marker for Asperger's syndrome. It should be noted, though, that people diagnosed with autism can be clumsy as well.

In this book, we use the words "autistic" and "autism" as umbrella terms to refer to both autism and Asperger's syndrome. The term "Asperger's" is used to refer to only that specific syndrome.

WHAT TREATMENTS ARE OFFERED FOR AUTISM?

Researchers now agree that autistic behavior indicates some type of neurological impairment. But because the exact nature of this impairment and the severity and presentation of symptoms vary so much from individual to individual, no one specific treatment exists. Instead, a variety of therapies are available. These include but are not limited to the following. (To learn more about the treatments listed below as well as other therapies, see Chapter 9.)

Applied Behavior Analysis (ABA). Based on the work of B.F. Skinner, this method uses positive reinforcement to shape appropriate behavior and promote learning in autistic children. It involves one-on-one interaction between a child and an ABA professional for as many as forty hours a week.

Facilitated Communication. Designed to allow communication by individuals without functional speech, this method involves a facilitator who uses physical contact to help the disabled person express her thoughts through a keyboard, picture board, or speech synthesizer.

Floortime. Developed by Dr. Stanley Greenspan, Floortime is intensive one-on-one therapy in which a child and an adult-either a trained therapist or a parent-engage in imitation play intended to help the child master developmental milestones.

Medication therapy. Medication therapy uses drugs to treat autism's various symptoms, such as hyperactivity, anxiety, and aggressive behavior.

Nutritional therapy. This approach uses supplements and/or a special diet free of gluten (wheat) and casein (dairy) to treat the autistic child.

Occupational therapy. Through the use of real-life activities, occupational therapy develops the practical skills needed for daily living, as well as play and social skills.

Physical therapy. This therapy uses exercises and physical activities to teach motor skills such as walking and running, and to improve general posture, balance, coordination, and strength.

Sensory integration therapy. Based on the work of A. Jean Ayres, this therapy teaches the nervous system to properly interpret sensory input-the five senses, as well as the senses of movement and body position-and respond in an appropriate manner. The result is enhanced concentration, motor skills, and behavior.

Speech and language therapy. This therapy is designed to improve both verbal and nonverbal communication skills.

The Tomatis Method. Based on the work of Dr. Alfred A. Tomatis, the Tomatis Method provides the child with specialized auditory stimuli of different frequencies. The purpose is to decrease hypersensitivity to sound, enhance language and social skills, and otherwise lessen the symptoms associated with autism.

Because it is so difficult to match each child with an appropriate treatment, parents often experiment with multiple therapies at the same time in an effort to deal with their child's various problems. Many concerned parents also enroll their children in vision therapy, music therapy, horseback riding, yoga, and other activities to help them develop weaker skills.

HOW SUCCESSFUL ARE CURRENT TREATMENTS OF AUTISM?

Since autism and Asperger's were first recognized in the 1940s, the search for truly effective treatment has been frustrating to both parents and professionals. While many children have been helped, many others have not.

Let's look at Applied Behavior Analysis, mentioned on page 11. ABA is widely accepted by both parents and doctors largely because it has been highly researched, and because its effectiveness is supported by numerous anecdotal stories. One study published in 1987 stated that by the age of seven, about half of the forty test children undergoing this therapy were able to join mainstream classes, showing an impressive rate of success in comparison with the untreated group. Still, half of the children undergoing ABA were not able to perform like nonautistic children of the same age.

Other statistics support the limited effectiveness of current treatments. For instance, researchers say that with therapy, 25 percent of autistic children are able to score in a normal IQ range and to function in public school. Yet 25 percent of those treated never develop language skills.

The above statistics are not being cited to denigrate the many dedicated professionals who treat autistic children, or to criticize the valuable therapies they provide. Rather, like many of the experts in the field, we believe that the major problem with current treatments is that they are being started too late in a child's life. In fact, one of the few things the autism community agrees on is the value of early intervention. The nervous system-which is at the center of autism and Asperger's syndrome-is most easily shaped during the first few months of life. At that time, the brain is more "plastic" and better able to compensate for areas that are failing to develop properly. According to Dr. Rebecca Landa, Director of the Center for Autism and Related Disorders at the Kennedy Krieger Institute in Baltimore, Maryland, evidence indicates that if children with autism were diagnosed at a younger age, earlier intervention would ultimately lead to far better outcomes than are currently possible, making a tremendous difference in the lives of children and their families.

Why aren't children usually diagnosed with autism or Asperger's during infancy, when they can be most easily helped? If you look at the definition of autism provided on page 9, as well as the inset on page 10, you'll see that the diagnosis of this disorder focuses on social interaction, on language acquisition, and on learning skills. These are all aspects of development that become most apparent when a child is at least two years of age, rather than when she's an infant. The American Academy of Pediatrics recently stressed the importance of early diagnosis by urging that every child be screened twice for autism by age two. But again, they advise pediatricians to look for lack of babbling, no single words by the age of sixteen months, not turning when the parent says the baby's name, and other social and language-related cues-symptoms that are not likely to be helpful during the first year of life. What's needed, then, is a method of detecting this problem as soon after birth as possible.

(Continues...)

Excerpted from Does Your Baby Have Autism?by OSNAT TEITELBAUM PHILIP TEITELBAUM Copyright © 2008 by Osnat Teitelbaum and Philip Teitelbaum. Excerpted by permission.
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Edition details

• Publisher: Square One Publishers
• Publication date: 2008
• Language: English
• ISBN 10: 0757002404
• ISBN 13: 9780757002403
• Binding: Paperback
• Number of pages: 192