Dear Dr. Garner,

My grandchild is two years old and seems different from my other grandchildren.

He is not talking, and frequently makes different movements of his body, which I don’t understand. He doesn’t look at me when I hold him. He seems to want to be by himself.

We are all very worried about autism. Could you please explain how to know if a child has autism?

I would like to know what symptoms to look for, and to tell you the truth, exactly what autism is.

Worried About Autism
In Astoria

Dear Worried,

This is a frequently asked question and is of great concern to all.

The word autism comes from the Greek word for “self.”

This describes the main part of being autistic. The child with autism is locked into his own world, with an inability to communicate or interact with others.

For unknown reasons, the number of children diagnosed with autism is rising. Children with autism will usually exhibit problems in three areas of development:
1. Social interaction — This is the hallmark of autism. As early as infancy, a baby may be unresponsive to people.
2. Language skills
3. Behavior — This may be the result of abnormal cell connections in the brain. They often avoid eye contact.

There is a wide spectrum of autism. In the extreme, autism is demonstrated by a complete inability to communicate or interact with other people. On the other end of the spectrum, the children exhibit autistic behavior, but have well-developed language skills (Asperger Syndrome). They might have social challenges and unusual behaviors or interests, but may be quite successful in life.

The age at onset varies with some children under one year of age exhibiting abnormal development and others regressing after a normal infancy period in which the child who previously did well, may begin becoming aggressive or losing language skills already acquired.

Some symptoms are: lack of eye contact; not babbling by age two; failing to respond to his name; not liking to be held; and not smiling.

The baby with autism usually starts talking later than two years of age. He may perform repetitive movements such as rocking or spinning. There may be preoccupation with certain objects. The slightest change in routine may make the child angry. Young children with autism have a hard time sharing experiences with others.

Causes/Risk Factors
What causes this dreaded disease? There is no known cause at this time. There is no link between vaccines and autism.

Some risk factors include having an older father, being a boy and having a sibling with autism.

Certain genes appear to be involved with autism. Some believe they make a child more susceptible to environmental factors, such as pollution.

There is no way to prevent autism.

With early intervention, there can be improved language and social skills. It is important to develop a treatment strategy with your doctor.

There is no medical test to make a diagnosis of autism.

To be diagnosed with autism, your child must have six or more of the following symptoms (agreed upon by a psychiatric organization):
• Avoids eye contact
• Plays alone
• Doesn’t share emotions with other people
• Is unaware of others’ feelings
• Starts talking later than two years old
• Can’t start a conversation – repeats words or phrases over and over again
• Repeats words or phrases as he hears them (has delayed speech and language skills)
• Doesn’t play make believe games
• Develops intense interests in objects
• Becomes disturbed at the slightest change in routine
• May be fascinated by parts of an object, such as the spinning wheels of a toy car
• Flaps his hands, rocks his body, or spins in circles

Treatment Options
There are several treatment options:
1.  Behavior and communication therapy
2. Education therapy. Pre-school children who receive intensive behavioral interventions show good progress.
3. Medications to control symptoms. (20-30% have associated epilepsy.)
4. Creative therapies, such as art or music therapy.
5. Special diet — fat-free diet, gluten-free diet, vitamin A, vitamin C, vitamin B6, magnesium, and folic acid supplements

Even if a child has not been diagnosed with autism, he may be eligible for early intervention treatment services.

The sooner the intervention, the better the chance of success of leading a normal life.

I urge you to bring your grandchild to the pediatrician as soon as possible to see if he does in fact have autism, and develop a course of action to help him lead a normal and productive life.[hr] Dr. Steven Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on The NET, Tuesdays at 8 p.m. on Channel 97 Time Warner and Channel 30 Cablevision.