11 month old just diagnosed ASD

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ABA means Applied Behaviuor Analysis. It's a collection of teaching tecniques that rewards the appropriate behaviour and not the wrong one. Language, for example, is treated as a behaviour. When the child wants water, if he says water he is rewarded. In the past they used to punish not desired behaviours (as stimming) punishing the child even physically. It doesn't happen today, but some other not physical punishment should be used. It's not a violence, but I strongly disagree with adversives.
Some other ABA tecniques should cause stress in the children. For example, request to do something once a second. Autistic children may not be able to do so and start stimming or self harming. That was happening to my son.
ABA contains several tecniques so you have to be careful and ask to apply those that enjoy your son. It is possible to learn and play togheter and my opinin is that the child learns better if enjoys therapy. (for instance, operating conditionon tecnique).
That said, I do ABA with my son because it's effective.
You have time to choose the best professionals and to study before the beginning of the intevention. If you do so, you will be able to do the best for your son.
The main book to reas is "teaching indivisuals with developmental delays" by I Lovaas.

i think 11 months is incredibly early to diagnose, and i myself would be hesitant to do intensive therapies unless there was clear and obvious need. certainly some things may be clear at 11 months, such as if PT would be helpful for a child who is not yet crawling or turning over. but many of the issues with autism simply are not going to be measurable at such a young age. there is no way to determine the childs verbal ability, mobility, peer relationships, imaginative pla,y, or cognitive delays... these things simply arent in existence or measurable yet in infants.

some questions to consider:
what exactly are the 40 hrs of intensive therapies that are being recommended?
are these therapies evidence based?
how is your child affected, what issues are you seeing?
is this your first child or subsequent child, and how does their development compare with siblings if not an only child?
is there a history of autism in the family?

in study 1, they look at the infants ability to right themselves while lying down, and conclude that "An autistic baby, ≈5 months old, cannot right by rotation. Instead, he arches the head and pelvis sideways upward, moves the top leg forward, and topples over en bloc, without the sequential segmental rotation in the righting movement characteristic of normal children." of course, then they mention that this conclusion is drawn on the home videos of only *3* autistic children which they then extrapolated to the entire population of autistic infants. this study had no control group.

in the second study, 4 of the 10 autistic children had IQs less than 75, but they did not even test IQ for the control group. the study even states "This type of sample reduces, but does not eliminate, the possibility that the behaviors found to distinguish the two groups are related to cognitive delays and not autism." this study also only really identified 4 behaviors: pointing, showing, looking at faces, and orienting to name (looking at you when you call their name). all of these things are already recognized as autistic deficits, but are not enough to diagnose alone.

also keep in mind these studies were based on home videos and only included 17 and 11 autistic children respectively. not even all the children met the diagnostic criteria for autism. some of the videos were as short as 3 minutes long. overall, not very strong science.


now, i wont disagree that autistic behaviors can be present as early as birth. we certainly knew our youngest was "different" from the first few days, and many of the early signs are still present to this day at the age of 5. most of the early signs were sensory behaviors, altho some were distinctly autistic (lack of smiling, failing to respond to his name, lining up toys). our oldest had signs of sensory issues at 18 months and those also still exist.

but to diagnose at 11 months and, more importantly, start them on 40 hours a week of intensive therapy? that to me is putting the cart before the horse. there is a HUGE amount of development happening in those first couple years, and you just cant say what is going to happen as the child develops, begins talking (or not), learns to interact with others (or not). you just dont know what the child even needs at this age.

There's a sticky at the top of the parent's section for parents of autistic children who don't have Asperger's, if you have a question that pertains to a more profound case of autism you might find a higher concentration of understanding from parents there. My son was diagnosed just before his second birthday, but he lost language at 18 months so he should've had his diagnoses much sooner. I was also surrounded by people (pediatrician included) who'd rather accuse me of being a hypochondriac than see things for what they really are and give me support. There were earlier signs as well, but no one took them seriously (extreme difficulty breast feeding, horrible sleep patterns, constantly needed to be bounced, very late transition to solid food, unaware of soiled cloth diapers, constant shrieking, night terrors, extreme allergic reactions to insect bites and eggs and I'm probably forgetting a few ... everyone thought I was exaggerating even though I've never been one to exaggerate.) Once my son started flapping, spinning, lining up toys, not responding to his name - everything else made sense and I told the pediatrician he was autistic (I'm sure they really thought I was overreacting then) and the only one of those symptoms they took seriously was lost speech. My son is 3 now, so the struggles of the first couple years are still fresh in my mind. I hope you get the support you need and that those around you understand what you're going through.

Last edited by Washi on 08 Jul 2011, 3:48 pm, edited 1 time in total.

I find it very difficult ti believe that a kid can be diagnosed with ASD with young. Most syntoms cannot even be seen in a person this young. My daughter starting showing signs at 2 years old. I think you should try to get a second opinion. In my experience doctors will say anything to get the money out of your pocket. We got the right diagnosus for our daughter after 3 years of visiting different specialists and getting different diagnosis. Unless you kid syntoms are too hard to handle I think you should wait a little. Get a book and read about ASD diagnosis.

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I assume this diagnosis didn't happen in a vacuum? If you brought your baby to a doctor with concerns, and the doctors are confirming them, I say you know your child best. I think all of us who got a late diagnosis suspected something very early: I, myself, don't think the colic we experienced was a traditional colic.

That being said, I would also not put myself in the poorhouse for therapy (having tried a very expensive therapy that did very little for us - it wasn't a standard therapy, though.) I'm no doctor, but I think I'd start with what the insurance will cover or maybe a little more if you're comfortable with that - and see what kind of results you get (the research that shows that 40 hours is the "right" number suggests that there are benefits from as little as 20) . You have time: it's a really, really early diagnosis - keep in mind that the 40 hours of ABA is usually prescribed to 2-3 year old nonverbal children. If you start now, you will be ahead of the game just because of your child's age. Also, make sure you watch and learn from the therapists: there is no reason you can't learn the techniques and apply them yourselves, and make up the gap in hours.

One question: ABA is set up to reward specific behaviors and reduce other behaviors by ignoring them. What behaviors do they want to increase/decrease? I'm curious how they plan to apply this technique to such a young child (not disagreeing, just curious.)

Same here, my kid seems "normal" to those who don't spend a lot of time with him. We didn't see any signs in him till he was around two and wasn't meeting milestones for speech.

Anyway not sure if 40 hrs a week is what a baby not even one year old needs, normally they work on skills that your kid would not have yet anyway, such as speech, or problem behaviors like tantrums and potty training.

My youngest son is part of an infant sibling study in Canada of siblings of children with Autism and they are developing more standardized tests to be able to identify autistic traits at a younger age, right now they are working around a form of ADOS for at 12 months of age. My youngest has been in the study since he was 6 months old. (They studied the kids at 6 months, 12 months, 18 months, 2 years, 3 years, 5 years and now 8 years of age). It is very interesting, was brought to a meeting to hear some of the preliminary results.

I posted a reply in the other thread and I was very angry with parents telling the OP that her son could not be diagnosed so early. That is not true for classic Autism. She should be happy to get the therapy some people get none. Take it and if its too much, back off, simple. If you refuse it you may not be offered again. Thankfully some places are actually moving forward with early diagnosis and early intervention....it is what works people!

Also my son was diagnosed with Asperger's at age 6 and my daughter with classic autism right before age 3 because the doctors had the wait and see approach. Guess what? Shes still autistic....they didnt need to wait and see!

I agree that 40 hours a week sounds like a lot. A woman that that I know started what is called the Denver Model at 18 months. It is play based therapy, mainly used with toddlers. I never used it personally. You can look it up on-line.

I think that you cannot start speech or occupational therapy (if the child has physical ailments--likely with such an early diagnosis) too early. Whatever you do should be fun for the child, though.

My older son, Heath, who has mild ASD symptoms and raging OCD, memorized a box of about 200 flashcards at your son's age. I bought the flashcards at a teacher supply store. They have both words and pictures on them. Many flashcards are available off of Amazon.com. He liked learning the words on the cards.

My older son with classic autism had used the same flashcards and many others, starting when he was three and learning to speak.

I would also recommend getting speech DVDs from BabyBumbleBee.com. My older son learned his first words from these DVDs and from flashcards (be sure to get the ones with both words and pictures).

Also get a bunch of those alphabet videos and DVDs--they usually have vocabulary words on them and can be found cheap used.

I would also advise working with him in small chunks and pushing him to the point that he gets upset.

Both of my kids and the baby who got the Denver model therapy loved flashcards and learning videos. They were eager to learn but needed something visually-based.

I think that my kids both showed early warning signs, but I didn't get either of them diagnosed with anything until much later.