Children’s Specialized Hospital battles ASD, autism

April is National Autism Awareness Month.

According to autismspeaks.org, autism spectrum disorder (ASD) and autism are both general terms for a group of complex disorders of brain development. These disorders are characterized, in varying degrees, by difficulties in social interaction, verbal and nonverbal communication and repetitive behaviors. With the May 2013 publication of the DSM-5 diagnostic manual, all autism disorders were merged into one umbrella diagnosis of ASD. Previously, they were recognized as distinct subtypes, including autistic disorder, childhood disintegrative disorder, pervasive developmental disorder-not otherwise specified (PDD-NOS) and Asperger syndrome.

Statistics from the U.S. Centers for Disease Control and Prevention (CDC) identify about one in 68 American children as on the autism spectrum.

Dr. Malia Beckwith, who practices in Developmental & Behavioral Pediatrics at Children’s Specialized Hospital, 150 New Providence Road in Mountainside, responded to questions about ASD and the current autism program at the hospital.

QUESTION: What is Autism Spectrum Disorder?

ANSWER: Autism Spectrum Disorder is a developmental disability that is characterized by a combination of the following: impaired socialization; impaired communication; restricted/repetitive behaviors or interests. Autism is called a “spectrum disorder” because it is defined by a certain set of behaviors, however, these manifest in varying degrees for each individual. Even though people may be diagnosed with ASD, there is a wide variety of skills, with each child having his/her own strengths and difficulties.

Q: What are the most common forms of ASD?

A: There isn’t a common ASD … every child is unique. In fact, two children with the same diagnosis can act completely different from one another — no two people with ASD have the same exact symptoms. Many of the behaviors that are exhibited also interfere with learning or function in the home or community. It is important to take the time to understand how the behaviors of autism manifest in each child to ensure they receive the most appropriate treatment.

Q: ​What are the symptoms of ASD?

A: Some behavioral characteristics of autism might include:

• Delay or lack of verbal and nonverbal communication
• Failure to develop peer relationships appropriate to developmental level
• Impairment of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture and gestures to regulate social interaction
• Preference to be alone, difficulty interacting/socializing with others
• Lack of social and/or emotional reciprocity, meaning a give and take in relationships
• Impairment in the ability to initiate or sustain conversation
• Lack of “play” or make-believe play
• Obsessive attachment to objects, persistent preoccupation with parts of objects
• Spinning, rocking, hand flapping or twisting and/or other self-stimulating behavior
• Over or under sensitivity to sensory input, such as avoidance of noise or seeking out deep pressure input or touch.

Q: How is ASD diagnosed?

A: Autism is usually diagnosed during the early years of childhood, however, may be diagnosed later in high functioning individuals when social demands start to exceed limited capabilities. Diagnosis is based upon the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) which is the main diagnostic reference for mental health/developmental disorders in the United States. The diagnosis is typically based on clinical observation, caregiver report and history. Certain structured assessments that pull for characteristics typically associated with autism may assist in making the diagnosis, however, these are not required for diagnosis when a skilled clinician assesses for the presence of DSM-5 criteria. There is no specific laboratory test for ASD. However, several behavioral and developmental evaluation and assessment tools may provide data helpful in making the clinical diagnosis of an ASD.

Q: What are the causes of ASD?

A: There is not a known single cause for autism. Researchers are investigating a number of areas including genetics, environmental factors, and the interaction of genetics and environment.

Q: How is ASD treated?

A: Early diagnosis is the key to optimal outcomes for children with ASD, as therapeutic interventions for children with ASD are most effective when started in early childhood. The first step is to recognize when a child’s development is veering off the typical course; this may be recognized by parents, or by the general pediatrician.  Interventions can be started right away, through contacting the State’s Early Intervention program, even before a diagnosis is obtained.

Evaluation should then be completed by a specialist to determine the diagnosis.  A comprehensive approach is needed, that will include multiple forms of therapy – applied behavior analysis, feeding and nutrition, medical care, occupational and physical therapy psychology as well as speech and language.

Q: What are the specific goals of the current autism program at Children’s Specialized Hospital?

A: Children’s Specialized Hospital continues to be the leader in autism treatment, education and research in New Jersey. We were one of very few organizations to receive a New Jersey Governor’s Council for Medical Research and Treatment of Autism grant which will allow our Pediatric Primary Care practice at Children’s Specialized Hospital to provide a medical home to children with ASD, creating a clinical model and usable tools for caring for these unique children and their families. Medicine has made tremendous strides in identifying comprehensive treatments for children with autism. With advancements come complexities in delivering that care.  The autism medical home allows for unified coordination of care and is a game changer; not only for the healthcare industry, but more importantly for the children and families we treat. Through Pediatric Primary Care ASD Medical Home, we are laying the foundation to improve life for these children and families, now and in the future.

For more information, you may contact Children's Specialized Hospital at 1-888-CHILDREN (1-888-244-5373).

Jay Jefferson Cooke is columnist/senior reporter for the Courier News, Home News Tribune and MyCentralJersey.com. Phone him at 908-243-6603; email: jcooke@gannettnj.com or write to: 92 E. Main St., Somerville, NJ 08876. Twitter: @JayJCookeCNHNT. Facebook: www.facebook.com/jayjefferson.cooke