Early interventionists, physicians and nurses, child care providers, preschool teachers, home visitors, playgroup leaders, family members – you all have the power to help with early identification of autism spectrum disorder. Earlier identification is associated with earlier, appropriate intervention and better long-term positive outcomes for children. It is not an easy topic to discuss with families, and most of you are not able to make a diagnosis.
However, you can have the conversation. Here’s how:
Know the signs – Educate yourself on the early signs of autism spectrum disorder in infants and toddlers. Some early signs include: delays with social smiling; not responding when name is called; delays in communication (ie., delayed vocabulary, lack of joint attention, not using gestures, lack of turn-taking); repetitive behaviors; limited interests and play skills, etc. Read this article for a fantastic overview of prevalence, early signs, and evidence-based practices: Infants and Toddlers with Autism Spectrum Disorder: Early Identification and Early Intervention (PDF, New Window) (Boyd, Odom, Humphreys, & Sam, 2010).
Be honest and supportive – When a parent asks you the question “do you think my child has autism?” recognize this as an opening. While you may be wary to say “yes” because maybe you aren’t sure or maybe you are afraid, you can have an open, honest discussion with the parent. You can ask the parent what she knows about autism and why she is concerned about it. You can discuss the characteristics of ASD and reflect together on whether or not you and the parent seen similar behaviors in the child. You can talk about next steps – screening, a visit to the pediatrician, etc. You can talk about emotions and fears and help link the parent to people who can help. The video, Talking to Parents about Autism, from Autism Speaks, is a great resource to help you with the conversation.
Talk about the impact of early diagnosis and intervention – You can talk with the parent the significant link between early diagnosis and early, appropriate intervention. Talk about the link between early intervention and better long-term positive outcomes for academic and social-communication success. Do not pressure the parent; instead, share information and resources so that she can make the informed decision that is best for her child and her family.
Offer a screening – When a parent is concerned, any of you can offer to help the parent complete the M-CHAT. You can provide the parent with the url to the M-CHAT website where the parent can complete the screening online and review the results in private. You can link the parent to a local specialist for screening or further testing if she is ready for this step.
Coach the parent in how to use intervention strategies – Be sure that your sessions focus on what she can do to help her child learn to communicate and interact during daily routines when you are not in the home. Help her learn how she can make a difference in her child’s development. Autism is not hopeless. Help her see the impact she can have.
Link the parent to resources – Provide information about websites, books, support networks, professionals, and other parents who might be resources. Find out about local community resources for autism interventions within and outside of the Part C system. Explore her family’s insurance to find out if it will pay for autism interventions. Share information in written form too so that the parent has it when she needs it.
Perhaps the hardest question is, “what if I am concerned but the parent hasn’t mentioned autism?” How do you bring it up? Look for that opening when discussing the child’s development. A parent of an older child with ASD once told me that the first person to bring up autism is never going to be someone you will like, meaning that it is natural to be angry with that first person. If you are going to be that first person, be sure to be sensitive and understand that talking about autism is an emotional experience. You can check out this handout, Concerns about Autism: Talking with Families (PDF, New Window), developed by the VA Community of Practice in Autism (CoPA) , that provides guidance on how to talk about autism with families when you have concerns.
Visit our Autism Spectrum Disorder page on the VA Early Intervention Professional Development Center site for links to online learning modules, free articles, and other resources that you and families can access.
Today is World Autism Awareness Day. Think about the role you can play in early identification.
How do you talk with families when you or they have a concern about autism? What do you say? What resources do you share?