Why Pediatricians Miss the Signs of AutismOur pediatrician is a good friend, and a highly experienced doctor. But when we brought our son in for his regular three-year checkup, he saw no developmental red flags.
Our son was diagnosed with Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS) six months later. This time, he was seen by an evaluation team including a psychologist, speech therapist and occupational therapist.
Of course, we went back to our pediatrician and asked why he hadn't seen any problems. He apologized to us, but noted that our son's physical development (height, weight, skeletal structure)was right on schedule. Tommy had also used two-three words phrases to express himself, once again right on schedule.
How Caregivers Pick Up on Signs That Pediatricians MissThe signs of our son's autism were brought to our attention by his preschool director. Unlike our pediatrician, she saw Tommy in action every day. Though he used language, it was repetitive and "echolalic" (that is, he was repeating phrases from videos). Though he had no obvious physical problems, he did have significant delays in fine and gross motor skill development.
Our experience is not unusual. Most pediatricians are not highly trained in picking up developmental red flags. And they see a lot of kids who have slight or brief delays and then develop normally. Parents, nannies and daycare or preschool providers, though, see your child every day. Where your pediatrican may see shyness or a mild delay, you may see a pattern.
Getting the Information You Need About AutismPediatricians' lack of knowledge about autism spectrum disorders is a problem because research shows that the earlier autism is diagnosed, the more likely it is that treatment will be effective. For autism to be diagnosed, primary care pediatricians need more and better information and training.
Nancy Wiseman created First Signs, a non-profit corporation, to provide medical professionals and the general community with the tools they need to diagnose Autism Spectrum Disorders as early as possible. Her website, First Signs, is a terrific resource for parents who are concerned about their child's development. It includes developmental guidelines, red flags to look out for, and content to share with your medical practitioners. Wiseman's new book, Could It Be Autism? is a more in-depth guide to what to look for - and what to do if you find it.
One lesson we learned from our experience is -- don't be afraid to share information you find on the web or on bookstore shelves. At worst, you may find your worries were unnecessary. At best, you may able to help a child get the treatment he needs.
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Early Diagnosis of Autism Spectrum Disorders Pinto-Martin and Levy, Current Treatment Options in Neurology 2004, 6:391-400