|
|
|
|
Identifying
Children
with Autism
Spectrum
Disorder |
|
|
|
Information
for Physicians
and Primary Health Care Providers |
|
|
|
|
|
|
|
|
| THE STATE EDUCATION DEPARTMENT
/ THE UNIVERSITY OF THE STATE OF NEW YORK |
|
| Dear
Pediatric Primary Health Care Provider:
You have a primary role in the identification of children with developmental delays or disabilities including Autism Spectrum Disorder (ASD). Current research indicates that many children with ASD can be identified as early as toddlers. We are asking that you identify children with ASD early so that appropriate education programs and services may be provided at an early age to support learning and development.
The terms Autism and Pervasive Developmental Disorders (PDD) are defined in the Diagnostic and Statistical Manual IV and are often used synonymously. The literature refers to ASD as a wide continuum of associated cognitive and neuro-behavioral disorders including, but not limited to, three core-defining features: impairment in socialization, impairment in verbal and non-verbal communication, and restrictive repetitive patterns of behavior. There are five disorders associated with ASD or PDD. These include autistic disorder, Asperger disorder, childhood disintegrative disorder, Rett disorder and pervasive developmental disorder - not otherwise specified (PDD-NOS) or atypical autism.
During well-child visits or through parent reported concerns regarding their child’s development, you may determine that a child needs further evaluation. Below are developmental milestones for communication and social skills, two of the developmental areas that define autism. The items listed are developmental milestones that children following a typical developmental sequence should exhibit by the time they reach a specified age. Failure to achieve a developmental milestone is a clinical clue that raises concerns that the child may have autism or some other developmental delay or disability. |
|
15
months developmental milestones
- Makes eye contact when spoken to
- Reaches to anticipate being picked up
- Shows joint attention (shared interest in object or activity)
- Displays social imitation (such as a reciprocal smile)
- Waves “bye-bye”
- Responds to spoken name consistently
- Responds to simple verbal request
- Says “Mama, Dada,” specific
|
18
months developmental milestones
- (Same as 15 month milestones, plus the following:)
- Points to body parts
- Speaks some words
- Has pretend play (such as symbolic play with doll or telephone)
- Points out objects
- Responds to spoken name consistently
- Responds when examiner points out object
|
|
|
| If you are concerned that ASD or another developmental disability may be present in a child and need diagnostic confirmation, referral to a developmental pediatrician, child neurologist, child psychiatrist or child psychologist skilled in issues of ASD would be appropriate. Please share a copy of this brochure and the enclosed resource sheet with the child’s parent(s). Encourage parents to seek a developmental or educational evaluation as soon as possible. For children from birth to two and a half years of age, please assist the parent with a referral to the New York State Early Intervention Program. For children two and a half years of age or older, a referral should be made to the local public school district. |
|
Lawrence C. Gloeckler
Deputy Commissioner
NYS Education Department
Office of Vocational and Educational Services for Individuals with
Disabilities |
Anthony Malone, M.D.
Clinical Associate Professor
of Pediatrics
The Children’s Hospital at
Albany Medical Center
Developmental Pediatrics |
Harold Kanthor, M.D.
Chairperson of the Committee on Children with Disabilities
The American Academy of Pediatrics
New York State Chapter 1
|
|
|
|
|
|
|
|
The critical issue in the identification of ASD in early childhood is recognition of
impairment in
socialization. The child with ASD often has difficulty forming, maintaining and expanding relationships.
- This is reflected by problems in reading social cues including tone of voice, inflection, intensity, facial expression, body language and social setting, and the child being unaware of others and their social circumstances.
A frequent hallmark of ASD is
restrictive, repetitive patterns of behaviors seen in non-functional and poor imaginative play:
- A child with ASD does not play like a typical child.
- Toys are often not used for their intended purpose, but usually for a repetitive, mechanical, tactile exploration with lack of imagination.
- The child's anxiety and need for repetition or ritualistic behavior are frequently evident during play.
Impairment in verbal and non-verbal communication
may be noted when efforts
at communication are different from typical children, for example:
- The child shows poorly developed or inconsistent attention to others. The child may not look to people for approval, look at other people’s faces while trying to communicate or talk, point to objects and look where others have pointed, or acknowledge when spoken to.
- The child does not understand what is said to him/her consistent with what is expected for the child’s age.
|
|
|
|
|
|
| Websites: |
Further information about education services may be found at:
Education Department Website:
www.nysed.gov
Further information about autism may be found at:
Special Education Website:
http://www.p12.nysed.gov/specialed |
|
| Regional
Associates: |
For information relating to special education laws, policies and programs contact:
Regional Associates at: |
| Western Region |
(585) 344-2112 x420 |
| Central Region |
(315)
428-3287 |
| Hudson Valley Region |
(914) 245-0010 |
| Eastern Region |
(518) 486-6366 |
| Long Island Region |
(631) 884-8530 |
| New York City Region |
(718) 722-4544 |
|
|
| Publications: |
| For additional copies of this brochure
a request may be faxed to the Special Education Policy Unit at (518) 474-2219 or mailed to the Special Education Policy Unit, Publications - Room 1624, One Commerce Plaza, Albany, N.Y. 12234. |
|
|
|
|
| For
Children at Specific Ages |
Local
Resource |
Available
Information |
| |
|
|
Infants
and Toddlers,
Birth - 3 years old |
Your county office’s general information number
• Early intervention official |
How to refer your child for a
no-cost evaluation and early intervention services. |
| |
|
|
Children
3 - 5 years old |
Your
local public school district:
- The principal of the public school building your child will attend at school age,
or
- The Director of Special Education,
or
- The Superintendent of Schools
or
- Your county office’s general information number
- Preschool Special Education Municipality Representative
|
How to refer your child to the Committee on Preschool Special Education (CPSE) for a no-cost evaluation and for preschool special education services. |
| |
|
|
Students
5 - 21 years old |
Your local school district:
- School principal of the school where you reside,
or
- Director of Special Education,
or
- Superintendent of Schools
|
How to refer your child to the Committee on Special Education (CSE) for a no-cost evaluation and special education services. |
|
|
|
|
|
| For
Children at Specific Ages |
Local
Resource |
Available
Information |
| |
|
|
Infants
and Toddlers,
Birth - 5 years old |
Early Childhood Direction Centers,
NYS Education Department (SED)
Office of Vocational and Educational
Services for Individuals with Disabilities
Albany, NY 12234
(518) 486-7462
www.p12.nysed.gov/specialed/ecdc |
How to obtain early intervention and preschool special education evaluations and services for a child who may have a disability. |
| |
|
|
Infants
and Toddlers,
Birth - 3 years old |
NYS Department of Health (DOH)
Early Intervention Program
Division of Family Health
(518) 473-7016
www.health.state.ny.us/ |
How to identify the Early Intervention Official in your county of residence and to obtain information about early intervention evaluations, programs and services for infants and toddlers with a disability or developmental delay. |
| |
|
|
Children,
3 - 5 years old |
NYS Education Department (SED)
Office of Vocational and Educational
Services for Individuals with Disabilities
Special Education Policy
(518) 473-6108
www.p12.nysed.gov/specialed/autism/home.html |
How to obtain preschool special education evaluations and services for a child who may have a disability. |
| |
|
|
Students,
3 - 21 years old |
NYS Education Department (SED)
Special Education Quality Assurance
Eastern Regional Office (518) 486-6366
Western Regional Office (585) 344-2112
Central Regional Office (315)
428-3287
Hudson Valley Regional Office (914) 245-0010
NYC Regional Office (718) 722-4544
Long Island Regional Office (631) 884-8530
www.p12.nysed.gov/specialed/quality/home.html |
How to obtain an explanation of special education laws, policies and programs specific to parental questions and concerns. |
|
|
| For
additional copies of this brochure...
a request may be faxed to the Special Education Policy Unit at (518)
474-2219 or mailed to the Special Education Policy Unit,
Publications - Room 1624, One Commerce Plaza, Albany, NY 12234.
The State Education Department does not discriminate on the basis of age, color, religion, creed, disability, marital status, veteran status, national origin, race, gender, genetic predisposition or carrier status, or sexual orientation in its educational programs, services and activities. Portions of this publication can be made available in a variety of formats, including braille, large print or audio tape, upon request. Inquiries concerning this policy of nondiscrimination should be directed to the Department’s Office for Diversity, Ethics, and Access, Room 530, Education Building, Albany, NY 12234. |
