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How do you know my child is autistic?
There are no medical tests for autism. Autism is diagnosed by the presence or absence of certain behaviors both by history and examination. As noted, a child must exhibit behaviors in four areas. The first is the way a child develops. For example, in the first year of life a normal child learns to walk, talk and interact with you, so that by the end of the first year you have a "little person" on your hands. A child who is slow, learns those skills, but learns them at a slower rate. A child with autism has very inconsistent development. He/she may start to develop normally and then seem to stop; may start to talk and stop; may have very good motor skills or be very good in some areas and very poor in others. It is this inconsistency in development that is important to making the diagnosis of autism.

The second area in which the children have problems is the way they see the world around them. People with autism perceive the world like an FM radio station that is not exactly on the station when you are driving down the freeway. Sometimes the world comes in clearly and at other times it does not. Therefore, people with autism tend to respond very inconsistently. For example, sometimes they will appear to hear you and at other times not to hear you. Autistic persons will at times appear perfectly normal but at other times appear very withdrawn. "Inconsistency" is a hallmark of autism. Persons with autism may or may not at anytime exhibit the behaviors we think of as indicative of the syndrome.

The third area in which a child has problems is in speech, language and non-verbal communication. The problem in autism is not that children do not talk (though some people with autism never develop speech), but rather that they do not communicate. Even people with autism who have relatively normal language development, have difficulty initiating conversations and volunteering information. Thus, another "hallmark" of autism is a lack of an ability to communicate. Often times what we see in young children is that they do not use the speech and language that they have. A child may repeat everything heard but never use words to request things.

The final area of symptoms is in the way that children relate to people/objects and to events in the environment. Persons with autism have difficulty initiating and sustaining relationships with children of a similar age. Often times, relating to adults is not a problem. As adults, we figure out what a child wants and needs. It is wanting to communicate and interact with other children that is critical to development. It is not that autistic people do not relate, it is that they relate in peculiar ways. It is not that people with autism do not want to make friends, but often times they do not know how. Thus, it becomes critical to teach social skills. However, social problems remain throughout life even in autistic persons who do the best. These social deficits are the most difficult to overcome.


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