What You Need to Know About Autism Spectrum Disorder

Autism is a neurodevelopmental disorder now believed to have a number of causes that manifest in slightly different ways. This range of disorders is known as the autism spectrum. Our autism expert, Dr. Jennifer Keluskar, a child and adolescent psychologist, explains.

How common is autism?
Dr. Keluskar: Recent studies show that as many as one in 68 children are being diagnosed with an autism spectrum disorder (ASD). Research into the causes has centered on neurobiological changes such as genetic factors and brain development. Most biological changes appear to have their origins in prenatal development. However, there is question regarding the degree to which environmental factors may also influence the onset of autism.

What should everyone know about autism?
Dr. Keluskar: ASDs vary greatly, but are chiefly characterized by speech and social difficulties, a tendency toward inflexibility, and repetitive, self-directed behavior. Individuals with ASD might be academically gifted or severely intellectually challenged. They tend to communicate, behave, interact and learn in ways different from their peers, often requiring specialized instruction. Although autism is a lifelong condition, individuals will generally show improvement, which can sometimes be dramatic. In some adolescents and adults, the rate of improvement may be more subtle. Interventions based on the principles of behavior and learning theory are very effective in reducing and even eliminating challenging behaviors, as well as promoting the acquisition of socially appropriate and adaptive behaviors.

What are some early signs?
Dr. Keluskar: In toddlers 18 months and older, delays in language development and the lack of desire to communicate may be reasons to seek a professional evaluation. Early signs may include: not using gestures to show interest in the external world (for example, not pointing skywards at an airplane); appearing unaware when caregivers speak; not playing pretend games; avoiding eye contact; wanting to be alone most of the time; and excessive repitition of words, phrases or actions.

How is ASD diagnosed?
Dr. Keluskar: Diagnosis is based on information from parents and teachers about the child’s developmental progress and an assessment from healthcare professionals using a standardized observation scale. Although generally healthy, as many as a third of children at the time of first diagnosis often have associated medical issues requiring further evaluation. These may include genetic syndromes, gastrointesinal problems, sleep problems, seizures or hyperactivity.

Does early diagnosis help?
Dr. Keluskar: Recognizing ASD early and providing interventions can help a child reach full potential. Early, intensive intervention targets social and communication skills, which is also helpful in reducing challenging behaviors. Children are taught how to learn, play and socialize, allowing many to attend their local schools.

What about when a child with ASD grows up?
Dr. Keluskar: Some adults will attend highly structured day habilitation programs, where they will learn to function with maximum independence. In some cases, residential care is needed. Others will be able to live more independently in the community and attain competitive employment, although they continue to exhibit the core ASD characteristics. Yet others are able to assume independent lives, often completing college or vocational training. These “high functioning” individuals may still experience social or occupational difficulties and may require some support.

What distinguishes Stony Brook’s approach?
Dr. Keluskar: As part of Suffolk County’s only academic medical center, our team of providers is in a unique position to provide children and families with coordinated, expert care. We also provide access to the latest developments in ASD evaluation and treatment, including active research efforts here at Stony Brook. Our team includes psychiatrists, psychologists, neurologists, social workers and behavioral analysts.

• Comprehensive evaluations
• Medication management
• Individual, group, and family therapy, including parent and social skills training
• Crisis/intensive behavioral interventions for children who have been connected with the New York State Office for Persons with
  Developmental Disabilities (OPWWD)
• School consultation services
• College readiness and support programs
• Resource assistance
Note: Some, but not all of our services are covered by insurance. Check with your insurance provider.

For more information about the Autism Spectrum Disorders Clinic, call (631) 632-8850.