ORLANDO, Fla. – April has traditionally been known as Autism Awareness Month, but it has more recently shifted toward Autism Acceptance Month. The goal is to take awareness one step further in order to truly accept those with autism as part of the community day in and day out. In order to have acceptance, education and understanding is really important.
So News 6 spoke to Rashonda Musawwir, a pediatric nurse practitioner at Orlando Health Arnold Palmer Hospital for Children. She specializes in developmental and behavioral medicine. We took some of the most-Googled questions on autism to her.
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What is autism?
“Most people have heard of autism. Most people know someone with autism or a family member has autism. But no one really knows like what it is,” said Musawwir. “So I think the simplest way to help others understand what autism is, is to describe it as a neurological disorder that affects development in your communication, socialization, but it also affects your behaviors. So, in a nutshell, you may experience speech and language delays, where the child may have difficulty communicating at an age appropriate level, but also their socialization, how they interact with others, how do they communicate on a social and a social manner, but also how they adjust their behaviors. So they may have difficulties with change and difficulties with things not going the way they planned or how they think it should go. But they are very regimented and sometimes rigid in their routines. So the adjusting to those things may be difficult.”
What causes autism? Is it genetic?
“What we know today, as far as research-wise, is that there is a genetic underlying cause for the disorder,” said Musawwir. “Of course, there may be other things, such as which are currently being studied, including environmental and other influences that may cause higher incidence of autism spectrum disorders, but to date, genetics still remains the primary cause.”
Is autism a disability?
“I’d like to say that autism is not a disability, although you have different levels of function may qualify for disability,” said Musawwir. “But based on what I see now is characterizing it as a disability makes it seem as though that they are unable to do many things, when in actuality they do things very differently. So characterizing as a disability I think would be unfair. However, depending on the level of severity of the symptoms, it can be impairing, which is where the term disability usually is inserted.”
What does ‘the spectrum’ mean? How many levels are there?
“Within that spectrum, there are three levels,” said Musawwir. “Level one, which is mild or the higher-functioning level. And typically speaking, you see milder speech and language delays, you usually see also more social awareness, better abilities to read and understand social cues and language. However, they still have some difficulties in navigating those social nuances, if you will. But they are with me compared to function level, they typically are able to do more self-care and more problem-solving than children that are further down on the spectrum. And then we have level two, which is moderate functioning. And those also have speech and language delays, typically, some difficulties with adjusting to change, they may require more day-to-day assistance in daily living with moderate functioning than maybe the level one would. And then there’s level three, which is what we consider the the severe range of autism spectrum disorder. And this is sometimes where we have children that may have a significant impairment in speech and language communication skills may require a lot more assistance from parents and others to get their daily needs met, including eating and self-care skills, like showering and bathing and things like that.”
Is it possible to get rid of autism?
“So that’s a loaded question,” said Musawwir. “Because it is thought that this is a chronic, lifelong condition. In my practice, have I seen children come in with many symptoms of autism spectrum, go through some years of therapy and then start showing a lot fewer of those symptoms? Yes. However, it’s very difficult to say absolutely, you will lose your diagnosis of autism spectrum eventually because it’s not able to be predicted. It’s not something that we can foresee happening. "
What are some of those therapies?
“With all levels of autism spectrum disorders, we recommend therapies to improve the child’s communication skills, social skills, adaptive skills, which is kind of like your day-to-day problem-solving and self-care and different things of that nature,” said Musawwir. “What we recommend, no matter what your your level of autism spectrum disorders, that you should participate in those therapies. So for a child with what we consider mild autism spectrum disorder, or level one, which many people may see on Google, those are our higher-functioning children with autism spectrum disorder. And contrary to what some may believe, they still do need therapy services to work on social communication so that they are able to display behaviors and communication and social skills at an age appropriate level. And then, of course, your other levels, such as a level two, which is a moderate functioning child on the autism spectrum, they also need the therapies as well, for the same reasons. And in this, as you go further down the autism spectrum, the level of therapies may change, or may not be as intense or maybe more intense, I should say, then children that are higher functioning, but all levels do require some form of therapy services.”
What are some traits that adults that have or haven’t been diagnosed may have?
“Some things that adults may recognize his difficulties adapting to change, difficulties understanding social cues, understanding the social norms and nuances that everyone else understands,” said Musawwir. “Like, for instance, I’ll give you an example. Many times adults will say, ‘I kind of read people around, I think that they are maybe mad at me when they use a stern tone of voice’ or things like that. So they may have difficulties understanding what that voice mean, or they may have a difficult time understanding certain body language, for instance. Sometimes they have a hard time recognizing it for themselves, but they’ll hear other people’s comments that maybe makes them think a little bit different.”
What are some of the traits you may see in children?
“For younger children, I would say, about 15 months to 24 months, they may be start out as speech and language delays, like you think your child may not be speaking as much as another child in the same age group. Or even just using gestures, like waving ‘H’i, and ‘bye, bye’, they may not be doing that just yet,” said Musawwir. “Sometimes we see things like tantrums is a very common concern for parents because of the difficulty of adjusting behavior when we either can’t have what we want or have to wait and be patient, or just a change in routine or a change in the normal way that we do things at home. And sometimes very difficult to console. That’s another thing that we hear. Maybe you’re noticing now that we’re not playing with other children or making friends or even interested, we may see that across all ages as well. or difficulty. Then of course, there’s repetitive behaviors like hand-flapping or walking on tippy toes, lining up objects. Playing with the same toys over and over in the same manner. Those are just type of things that we typically hear. There are several more but those are most common.”
What kinds of things can I tell my child about autism?
“Let’s say, you probably would be discussing with with your child just saying, ‘Your friend in class may have a hard time understanding. So you may have to be either more specific, or simply be patient.’ Because sometimes what we hear more so with kids is that the child with autism spectrum disorder may not want to play, because they’re interested in doing their own thing. So sometimes it’s more about being patient and giving them a chance to warm up to you. But keep trying, you know, don’t stop trying to play with them, include them in your games, include them in your tag, and things like that, so that they feel welcomed and more apt to want to participate in some of those social things,” said Musawwir. “I’ll be honest with you, I’ve heard from many other kids who do not have autism, and they have kids with autism in their class, they actually understand it quite well, which has been very rewarding to know that they’ll say things like, ‘So-and-so in my class doesn’t talk much. So I help them with when they need help, or I let the teachers know that they may help because they can’t talk well’, or things like that. So it’s very rewarding to see that the kids are including them and helping out when they can.”
If I think I or a loved one may have autism, what should I do?
“I would say if you have any concerns about possible autism spectrum, disorders within your child or yourself, to reach out to your primary care physician or reach out to the specialists. You can go directly to the source if you want as well. And then we will be able to help determine if your child needs to be evaluated, or yourself if you contact a psychologist as an adult.”
We’ve come a long way talking about autism, how far do we still have to go?
‘I definitely feel we’ve come a long way to where it’s more widely accepted the diagnosis of autism spectrum and the stigma is slowly fading away,” said Musawwir. “However, we still have quite a ways to go when it comes to the understanding of autism, for those of us who do not have autism and understanding others and the challenges that they may face. But being a partner with them, instead of not really acknowledging we definitely have a long way to go.”