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Dr. Fred Volkmar of the Yale Child Study Center Answers Common Family Questions

Fred R. Volkmar, MD, Director of the Yale Child Study Center, recently shared his comments on some frequently asked questions from parents of children on the autism spectrum:

Q: What type of patients do you see at the Developmental Disabilities Clinic in Greenwich?

A: We have seen a range in terms of age and levels of functioning but mostly school age and most frequently with a request for either second opinions about diagnosis or review of recommendations.

Q: How can you help my child at school? A: For the individual child we can review the child’s testing and current program and make recommendations for intervention and program changes. Speaking more broadly there are a number of excellent resources for teachers, teachers aides, and others involved in working in schools that are now available – our web site maintains an active list of these resources.

Q: At what age should my child start speech services?

A: Basically as young as possible. An evaluation should be done initially to see what the child needs.

Q: My daughter has funny body movements. She often jerks her head back. She has autism, but is it also possible that she has a tic disorder? Are there treatments for this?

A: Tics can sometimes develop in children with autism – these can be only motor tics (jerky movements typically of head and neck but sometimes of body). Occasionally these come to include vocal tics (throat clearing sounds, noises or, sometimes, words). When both motor and vocal tics are present for a period of time the diagnosis of Tourette’s disorder is made. There are medications that can be used in treating tics.

Q: Are ABA services the only type of therapy that is appropriate for children with ASD?

A: A range of services can be useful – including ABA but other approaches as well. The report from the National Research Council on Educating Children with Autism talks about the range of programs which have been shown to work for children with autism. Many, but not all, have a strong ABA base.

Q: My child doesn’t sleep well at night. How can I get him on a better sleep routine?

A: There are some excellent resources for parents – notably a series of books by Mark Durand. The issues vary from child to child but often establishing a sleep routine is essential. Keeping a “sleep diary” is a place to start.

Q: My child is 5 years old. He is very destructive and aggressive. Should I consider medication for my son’s autism?

A: Without knowing a specific child it is, of course, not possible to say for sure, but this is the kind of thing that medications can help with.

Q: My autistic son will be a teenage soon. Are there special things to look for at this age? Is there an increased risk of seizures?

A: Some children with autism get better at this time in terms of their behavior, others get worse. There is an increased risk for children with autism to develop seizures during adolescence.

Q: We have one child with autism, but we desperately would like to have another child. How much risk is there that a second child will have autism? Is a second child likely to have another disorder? A: There is some increased risk – somewhere between 2 and 10% of another child with autism and up to 20% that the child may have some other problems, e.g., in language.

Q: I have a son who has always been a good student, but he has been painfully shy and socially awkward He is now at a local college. Recently, he was diagnosed with Aspergers. Is it too late to get help for him? How can I help him meet friends and transition better into an independent adult life? A: More and more individuals on the autism spectrum – particularly those with Asperger’s and higher functioning autism, are going to college or other post-secondary schools and becoming independent adults. An entire series of books/resources is available (visit the child study center web site – autism page -www.autism.fm for a list).

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