Sunday, May 15, 2016

Autism Is Really a Disorder of Communication and Interaction







The numbers are staggering.  One child in 68 goes on to develop this disease; it is more common in boys.  We do not know the cause and are trying to find the best treatments but progress is slow.  The largest misperception about autism is it is NOT a behavior problem.  It is not something a parent has done wrong; there is no one to blame or judge. 



Autism, in plain and simple terms is a communication and interaction disorder.  Think about that for a few minutes.  Imagine not being able to communicate with your toddler and the frustration that entails.  Think about the way a newborn cries, then consoles in our arms, and smiles; that is interaction.  During that first year, so much communication goes on between a parent and child.  They push the spoon away when they are full.  They watch us clap, copy us, and begin clapping themselves.  Almost nothing in the world was better than that first laugh or giggle.   Then they wave, high five, and learn to “fist bump.”  On to their first words like hi, dada, mama, and ball.  Those single words at 15 months become short phrases by 2 years of age and then full on sentences by age 3.  What if things do not progress that way?



Let us go back to that 2 or 3 year old and flip our point of view.  Think about how hard it must be for that toddler, who cannot get the person he depends upon, to understand his needs. By 18 months of age, a child has a way of letting you know they are hungry, wet, tired, or sick.  They can even convey their moods by crossing their arms and stomping their feet.    Often, if a mother or father has a child with autism, it can be impossible to know what they are thinking, feeling, or trying to tell us.  Maybe they are screaming in public now because it involves more of those big people who do not communicate with them and they feel overwhelmed.  Can you imagine being hungry, uncomfortable, or ill and not being able to get your parent to understand?



I have watched many young autistic children in my office be most comfortable on their mother’s back in a carrier and the moment they are removed from that safe place, they literally fall apart.  They are terrified when being examined or weighed and measured.  Their tiny beautiful faces convey fear;  however, children with autism get ear infections, allergies, and the flu just like any other child yet they cannot tell me what is wrong.



I do not know what it is like to have autism, nor do I have experience raising an autistic child.   Watching these children grow and develop over the years becoming adolescents has been interesting.  Some develop their own way of communicating, especially when I have been caring for them their entire lives.  One of my favorite patients is a teenage girl with autism.  Her and I have never had a traditional conversation, but we definitely communicate.  I look forward to seeing her name on my schedule and she gets a huge grin on her face when I walk through the door.  She gives great hugs, ones that I treasure.   She knows me and has seen me for long enough to understand that I will not harm her.  We trust each other. 



On the other end of the spectrum, I have a teenage boy I take care of, who pretty much hates me.  When I walk in the room, he scowls and tells me his life is miserable and he detests coming to my office. He hates going to school even more, which provides some consolation. I would not exactly say I look forward to his visits, but do value and appreciate his honesty. He is communicating and trying to interact; he is trying to make a connection in his own way.



Social skills at a party might not be a gift of children with autism but they are often bright, capable and eager to learn.  Some of my kids are now attending college and moving toward adult careers.  It is hard to know what any one child will go on and do with their lives. I usually try to ask myself “Is this a future artist, computer programmer, engineer, or scientist who will find the cause of autism or possibly the cure?”



Most importantly, remember that a child diagnosed with a communication disorder at 15-18 months has overcome numerous hurdles and struggled with adversity many of us cannot comprehend.  So have their parents.  It just might change your perspective on things when you realize how much children with autism have to offer the world. 

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