Education Matters: Autism Awareness – The Document.

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April is Autism Awareness Month and the focus of this Education Matters report, specifically the process of identifying autism in children. Having gone through all of my education undiagnosed and unhelped with my autism and having now practiced education law for 10 years, this is a matter of personal, as well as professional, interest to me.

It has been almost 25 years since I graduated from high school and wanted to know about today’s processes and resources to ensure children with autism are identified and served. So I turned to Debra Sugar, LCSW. Debra is a licensed clinical social worker with over 20 years of experience. She was a school social worker in Albuquerque for 12 years, working with district programs for students with Autism Spectrum Disorders (ASD). She has worked as part of an interdisciplinary ASD assessment clinic for the past 10 years, where she has focused on supporting families and individuals before, during and after assessment. Currently, Debra practices at Bosque Mental Health Associates with a particular focus on working with children, families, and adults affected by autism and other developmental disabilities. She is also a professor of social work for the New Mexico Leadership Education Program in Neurodevelopment and Related Disabilities.

The paper.: When should a parent or legal guardian (caregiver) have a child assessed for ASD?

Sugar: There are two categories of ASD problems. First, the absence or delay of developmentally expected social communication skills, such as the use of eye contact and gestures, shared pleasure, two-way conversation and interaction, and the development relationships with peers. The second category is the presence of restricted and repetitive interests and behaviors, such as unusual or intensely focused interests, repetitive play, movement or use of language, difficulty with routine changes or transitions, and an unusual response to sensory inputs such as sounds, smells, tastes and textures. Caregivers can consult with their child’s primary care provider about any developmental issues or ASDs.

Research and studies show that autism in girls has been vastly underdiagnosed and misdiagnosed. Does ASD present differently in girls than in boys?

Girls often have a different presentation than boys and are underdiagnosed. Girls with ASD, compared to boys with ASD, often seem more socially motivated and therefore tend to camouflage/hide well. (Editor’s Note: Camouflaging or masking are the socially acceptable behaviors an autistic person engages in in order to “fit in” and “get by” in public and social settings and in interactions with other people. .). Thus, they can imitate the facial expressions, social behaviors and interests of peers. They can laugh when others laugh, etc. They may have difficulty socializing and come up with somewhat canned questions and answers in conversation. Thus, their relationships may seem quite good on the surface, but be more superficial and lack the level of social understanding typical of their peers.

There are common ASD features [to boys and girls] corn [in girls] they are initially less obvious and often successfully masked, especially in young girls. Camouflaging/masking is exhausting! After a social gathering or after being at school all day, girls may be tired, irritable and need a lot of alone time to recuperate.

How does a caregiver get an assessment?

If a parent or guardian is concerned about early development, they can get an assessment from an early intervention program. The Family Infant and Toddlers Program is a statewide program administered by the NM Department of Early Childhood Education and Care and can provide early intervention services for children up to age 3 who have or are at risk of developing developmental delays.

To get a TSA assessment, caregivers can also ask their doctor or insurer for a list of assessors in their area. An evaluation by a medical provider may result in a medical diagnosis of ASD, which may open the door to services covered by health insurance.

If there are ASD issues at school, the caregiver can request that the school conduct an ASD-specific educational assessment. This can lead to autism school eligibility and open the door to school-based services such as speech and occupational therapy, special education and support, and school social work.

What should a caregiver expect from the assessment?

A school assessment will likely include an interview and/or questionnaires, cognitive and communication tests, occupational therapy tests, classroom observation, and an autism-specific assessment.

A [non-school] Child-based assessment should include an interview with caregivers about the child’s medical and family history, early development, communication, social interactions, interests, activities, and behavior. The assessment may include a standardized assessment of the child’s communication skills and developmental/cognitive skills, as well as daily living skills. The caregiver may be asked to interact with their child in specific ways while the assessment team observes. The assessment team may also interact directly with the child and attempt to engage them with toys, activities and conversations, depending on their developmental status. The team may include a psychologist, pediatrician, speech therapist and others.

Over the past two years, telehealth assessment procedures have been developed that work well for some people, but not for all.

If parents want help finding services or navigating systems, a good resource is the Family Resource Team and Autism Providers at UNM’s Center for Development and Disability. It can be very overwhelming for families when a child is diagnosed with ASD. I think it helps to remember that your child is the same person they were before diagnosis, with their own unique set of strengths and challenges. There is great diversity among people diagnosed with ASD. As the saying goes, if you’ve met an autistic child, you’ve met a autistic child.

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