Catherine (Moderator) - 12:57 PM:
Welcome! Today’s chat: A closer look at childhood autism and pediatric conditions will begin shortly. Please start submitting your questions and Dr. Sara Wiemer will begin answering them as soon as we get started. While you are waiting for the chat to begin, feel free to visit the
Center for Neurodevelopmental Disabilities to obtain more information about autism. We will do our best to answer all of your questions, but because this is such a popular chat, the physician may not be able to answer all of your questions in the time allowed. Your understanding is greatly appreciated.
Dr. Sara Wiemer (NorthShore) - 1:04 PM:
Good afternoon, my name is Sara Wiemer and I am a pediatrician practicing at the NorthShore Medical Group in Deerfield. Thank you so much for joining our chat today – I am looking forward to discussing a very important topic.
In honor of April being Autism Awareness Month, the focus of our talk today will be on Autistic Spectrum Disorders (ASD).
Nearly everyone has been touched by someone on the autistic spectrum - the number of children receiving the diagnosis of an ASD has increased over the years and the CDC estimates that 1 in 110 American children have the diagnosis. As a general pediatrician we have multiple roles in the diagnosis and treatment of ASDs:
1)Address parents’/caregivers’ concerns
2)Recognize at-risk children through screening tests and health maintenance visits
3)Refer children who show signs of ASD to the appropriate specialists
4)Help caregivers advocate for the child
Dr. Sara Wiemer (NorthShore) - 1:04 PM:
Again, thank you for joining our chat today and please feel free to ask your questions regarding ASD. If you have a pediatric question unrelated to autism, I will gladly address it as well, if time permits.
Terrence (Chicago, IL) - 1:05 PM:
My son talk to everyone in the house,but when we visit family he doesn't talk much. Sits in one spot. When you tell him don't do something, he gets quiet and holds his head down and cry. He is 7yrs old. In school he doesnt talk to the teacher. He is finally coming around to talking to her, but it's the end of the school year. He did this last year as well.
Dr. Sara Wiemer (NorthShore)
If your son is able to have normal conversations and relationships with family members and does not show any other signs of an autistic spectrum disorder then it is possible he would have a different diagnosis (including selective mutism, anxiety, sensory integration disorder, etc).
Some signs of autism include:
- trouble understanding other people's feelings or talking about their own feelings
- delayed speech and language skills
-repeating words or phrases over and over
- Getting upset by minor changes
- Having obsessive interests
- Unusual body movements like flapping his hands, rocking or spinning
-Having unusual reactions to the way things sound, smell, taste, look, or feel
It is very important that you talk to your son's pediatrican about these concerns so that he can refer him to the appropriate specialist who can evaluate him. Getting help early on is very important!
Judith (Arlington Heighs, IL) - 1:13 PM:
How do I go about finding a doctor who will fill out the requested documents to certify that my son (now 22) has Autism, is on the Asperger scale, CP and ADHD to satisfy the requirements of Social Security so that he may atain medical benefits? I don't know where to look, and he stopped seeing his pediatrican at age of 18 yrs. old. This is very important to us as we need the medical care and cannot afford it.
Dr. Sara Wiemer (NorthShore)
Thank you very much for asking this question, Judith. I know that many caregivers of young adults with ASD have concerns about transitioning into adulthood and making sure that their child continues to receive the health care and therapies they need.
Most internal medicine and family medicine physicians will feel comfortable addressing the health needs of individuals with autism and other chronic medical conditions. The first step is to find a good primary doctor - talk to your own physician or to your son's previous pediatrician to see who they would recommend. The primary physician can work with you to complete the paperwork and help your son get benefits. They can also help refer you to programs and specialists to help him get the support he needs as an adult with autism.
Brian (Evanston, IL) - 1:20 PM:
What are the trends in helping a child diagnosed with autism? What would be the earliest intervention approach and how would it be administered? Is there a special training for caregivers or learning facilitators?
Dr. Sara Wiemer (NorthShore)
Most people agree that therapies for autism require a "team" approach: a pediatrician for general health concerns and a “home base”, a developmental pediatrician or neuropsychologist who specializes in ASD, various therapists (occupational, speech, physical, applied behavior analysis), school support (an aid or therapist). Some children benefit from a nutritionist, a psychiatrist or a neurologist depending on their individual needs. And of course the parents/guardians play a huge part in care.
Applied Behavior Analysis has been shown to be effective and is a big part of many ASD therapies. This is an individualized approach to analyzing a child's strengths and weaknesses and uses this analysis to teach the child how to suceed at desired behaviors.
You may encounter alternative treatments for ASDs. Unfortunately there are not good studies to prove if they are effective, and some may even be detrimental to your child's health. Please check with your pediatrician first!
Felicia (Glenwood, IL) - 1:30 PM:
My 8 yr old son has autism and over the past several years has stopped drinking milk and water and now only eats, McDonald fries, cheetos and rippled potato chips. How long can he survive like this and what therapists work with children, autism, or food aversions? He stopped eating regular foods after taking his MMR vaccination.
Dr. Sara Wiemer (NorthShore)
One of the many challenges in caring for autistic children is food aversion, or extreme pickiness. As you mentioned, the concern is that the child is eating unhealthy foods that lack some of the essential nutrition they need to grow and stay healthy.
Typically the therapies for food aversion and feeding disorders involve a registered dietician, a speech-language pathologist and sometimes an occupational therapist. There are some groups in the North Shore and Chicago area who provide these services. Please ask your son's pediatrician if he or she has someone they would recommend.
Lorena (Chicago, IL) - 1:42 PM:
I have an autistic son, who is 20 years old. It seems to me that once a person with autism reaches adulthood, help for them becomes minimal. I'm interested in some kind of help with his weight, which began upon taking respirdal.
Dr. Sara Wiemer (NorthShore)
Unfortunately I think many caregivers of adults with autism feel that their resources are more limited. Autism is not exclusively a childhood disease and it is important that autistic adults continue to receive therapies and life-skills training to help them have a healthy and good-quality adulthood.
There are some good websites and support groups for families of adults with autism, including
www.agingwithautism.org. I encourage parents to join a group or find somelike-minded parents to help with referrals, connections and support.
In regards to your son's weight issues, it is a good idea to have him start seeing a nutritionist or dietician. Ask his physician for someone they would recommend.
Catherine (Chicago, IL) - 1:50 PM:
What options are there for a soon to be 4 year old for schooling and potty training? And where can I locate support groups for the mother?
Dr. Sara Wiemer (NorthShore)
For children over the age of three, contact the child's local public elementary school who will provide you with options for pre-school and beyond. Most of the school districts in our area do an excellent job providing education services to children with autism and other disabilities.
In regards to support groups, some of the ones we refer to include:
- North Suburban Autism Society of Illinois (contact person is Richard Fink 847-583-5080)
-In Deerfield - autism support group (contact person is Kristen Scott 847-945-1418)
I would also refer the mother to the website autismillinois.org to find local support groups
Catherine (Moderator) - 1:57 PM:
Thank you everyone for your great participation, the chat will be ending in approximately 10 minutes. Please submit any final questions you have.
Eunha (Elmhurst, Il) - 2:01 PM:
My son is 4 years old, he was dignosed with Autism when he was 2 1/2 yo. He is receiving ABA therapy at home, goes to school 1/2 day 5 days a week, we are trying special diet GF/CF with mostly organic foods and supplements. He has been making steady progress but he is not near where he should be verbally or socially for a typical 4 year old boy. I know there is no miracle cure but do you have any experience or information about other treatments that may be worth trying?
Dr. Sara Wiemer (NorthShore)
It is wonderful that you are doing so much to help your son and I want to emphasize that "steady progress" is a very positive thing when it comes to autism!
Unfortunately many of alternative therapies that people recommend or try for autistic patients have not been validated in any quality scientific studies. Many of the studies on some of these alternative therapies have shown that there is no benefit compared to traditional therapies, and in some cases there has been a harm to the child. While I completely understand the need and desire to do everything you can to help your child, I caution you to do a lot of research and talk to your son's pediatrician before trying anything.
If you feel that his therapies are not helping, there is nothing wrong with seeking help from another therapist, psychologist etc. and possibly finding someone who is a better fit for your child's individual needs.
Mike (Chicago, IL) - 2:16 PM:
Are there special educational options for pre-schoolers with autism?
Dr. Sara Wiemer (NorthShore)
For children under age 3, you should contact the local early intervention services
in Lake County: 900-585-1953 Cook County: 800-585-1963
For children over age 3, contact the child's local public elementary school. There are of course private preschool options for children with autism and disabilities and the preference between public and private school is entirely up to the parents.
Catherine (Chicago, IL) - 2:21 PM:
Potty training suggestions?
Dr. Sara Wiemer (NorthShore)
Potty training can be another huge challenge for autistic children.
In general it is important not to push or force potty training on an autistic child - as you know they do not respond well to changes, uncomfortable situations or anger.
- Have specific times of day when you try to have the child sit on the potty for several minutes - the best times are usually shortly after meals because that's when the body naturally "needs to go". When they are on the potty, let them do something they enjoy - play with a toy, look at a book, sing a song, etc. If they don't go after the alloted time, don't make a big deal, just try again later. If they do go, there should be some positive reinforcement (this is one time I advocate bribery!)
Autistic children often have issues with constipation due to their medications or restricted diets and that makes it very hard to potty train - do your best to have them stay well hydrated and eat high fiber foods, and take any medications that are prescribed
Dr. Sara Wiemer (NorthShore) - 2:31 PM:
Thank you so much for joining our discussion on autism spectrum disorders today! You had some excellent questions.
If you have any further questions for me or would like to make an appointment please call 847-945-4575.
Have a wonderful day!
Catherine (Moderator) - 2:31 PM:
Thank you again for participating in our chat today. For more information please visit our
Center for Neurodevelopmental Disabilities pages.
Also, a transcript of this chat will be available shortly.