Therapies for high-autism-risk-flagged 12mo old?
Dear friends of mine who actually live in Melbourne, Australia have a beautiful 12-month-old son who has recently been flagged for high risk of autism. Between 9 and 12 months they noticed his babbling substantially reduced, he isn't responding to his name anymore, and he's no longer gesturing. They're new parents, and they've been approved for $20,000 of funds from the state disability agency for therapies for him, but they have no idea where to start. Does anyone have advice about where they should begin?
Thank you so much!!
Feb 2, 2023
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That is so kind and thoughtful of you to ask for help on their behalf! Fortunately for them, Australia is a GREAT place to be in their position and I’m sure they will be given all sorts of excellent expert advice on what to do with that $20,000! Early flagging and funding like that doesn’t happen in America! Trust me when I say that there is soooo much support in Australia (and knowledge) around autism. In America, a child of that age would ideally (in my personal opinion) receive speech therapy (with an SLP), Occupational Therapy and DIR/Floortime and/or Early Start Denver Model. I imagine that in Australia they have similar protocols. Again, Australia is the one of the world’s most advanced countries when it comes to autism so they’re in a wonderful place.
I don’t have experience with ASD, but I suggest that your friends take their kid to an ophthalmologist. My kid developed cataracts around that age and experienced similar issues (not responding to name, not pointing). We learned that vision problems are more common in kids with ASD, but also that vision problems are sometimes misdiagnosed as ASD. Our kid was marked as medium risk for ASD based on a questionnaire, but every developmental therapist who has met him says they do not think he has ASD. He is now getting developmental help in addition to his cataracts treatment, and his verbal skills are quickly getting back to his age level as his vision improves. For the developmental help, I don’t have a recommendation in Australia but it seems like something their pediatrician should know- ours referred us to the Regional Center of the East Bay and we’ve had a great experience with all the help they’ve provided, and they connected us to therapists in all the areas where our kid could use a boost.
I would look into music therapy, most often children on the spectrum respond to music greatly - even use singing instead of talking for langaue development. Juliane
I’m not a professional, and they should definitely get professional advice and support. I have spent a lot of time around both neurotypical and autistic babies and kids, though, and I have an opinion about parenting in this situation. Take it with a grain of salt. While waiting for professional guidance, I would practice child-centered, attachment-style, intensive parenting. I normally don’t have a strong opinion about parenting style. Neurotypical babies can thrive with lots of styles, but babies with autism should be lovingly coaxed into as much interaction and communication as possible while their brains are still developing. For example, carrying the baby a lot, rather than leaving him on the floor or in a crib, etc., means he will be close to your face every time you talk. Babies with autism often don’t seek out faces the way neurotypical babies do, so it’s good to cue faces up for them as much as possible. Also, intensive parenting gives you a chance to closely attune yourself to your baby’s every mood, trigger, interest, etc., which might help in finding anchors for communication. Like you might find the baby feels calmest and most open to connection while touching certain things, which could give you a space to meet them where they are: say they love picking up rocks in a gravel pile, you pick up rocks up with them, trying to gently connect and talk while doing so. I would do a lot of clear, deliberate speech, maybe with baby signs. Some kids with autism can learn sign language more easily than speech. But speak too. Not rapid chatter, but things like holding a desired item close to your face while saying & signing “Cup.” “Does Baby want cup?” Say “Baby wants cup” before giving it. Etc. Show them how to point. “Look at the car!” While pointing. “Now Baby shows Mommy the car!” while holding their hand in a pointing position. Etc. Neurotypical babies are wired to attend to speech and social cues, but many babies with autism need more support and encouragement to learn these things. Breaking their reveries to interact may feel unnatural (and exhausting) but they may need more interaction they will seek to learn to talk / sign. At the very least, this super close attention would enable the parents to give the experts more nuanced information about the child when professional intervention starts. Personally, I wouldn’t focus on anything but communication. I think it’s okay to be different, and society should be more accepting of neurodiversity, but if you can’t express yourself and communicate your needs, that’s just plain hard.
Autistic adult and parent to likely autistic kids here--my first and strongest recommendation would be to educate themselves on all the different ways there are to be (happy, healthy, well-adjusted AND) autistic. Not sure about the situation in Australia but I know in much of the world most of the recommended therapies (pretty much anything with 'behavioral' in the name) lean pretty hard into making kids ACT more neurotypical rather than trying to help them with any challenges they might have. I'd strongly encourage that your friends join some social media groups run by autistic adults (Autism Inclusivity is maybe the biggest and most well-known one) and read some books if they're into that. Happy to chat more off-list if it'd be helpful, feel free to contact me.
In addition to pursuing therapies for him, I would also recommend your friends pursue an in-depth genetics evaluation for their son. If an underlying cause is found, it might be helpful in pointing where to concentrate efforts.