A class report by Brent Philpot An Undergrad Senior At University of Central Arkansas April 16, 1997

Autism is not a disease with a common cause. It is a syndrome, which is described by a combination of atypical behavioral characteristics. Some of the syndromes of autism include: slow development or lack of physical, social, and learning skills; immature rhythms of speech, limited understanding of ideas and the use of words with out attaching the usual meanings to them;abnormal responses to sensations such as sight, hearing, touch, pain, smell, taste, balance, and the way a child holds his or her body; any one or a combination of these responses may be effected; abnormal ways of relating to people, objects, and events.

Due to the varying degrees of autism, many care givers fail to realize their child has a problem. If the child happens to be the first child for the care giver, then it is difficult for the parent to compare their child to other normally developing children. Of course, the other end of the spectrum is that the parents may realize that something is wrong but fear that their child may be labled handicapped.

There are different levels of autism. They include mild, moderate to profound, and severe. The child performing at the mild level is considered high functioning in that many of the syndromes of autism do not apply. This child may have some communication problems and a lack of learning skills, but otherwise function somewhat normally. Moderate to profound is another level that care givers have to deal with. A child that is at this level of autism has a deficiency in social skills and often cannot communicate fully his or her needs. Also the child may have deficiencies in many other areas. A child that shows severe characteristics of autism often may be non verbal, non-ambulatory, and shows little to no responses to sound, smell, people or events.

It takes three people, in the medical field to diagnose a child, as having autism. A speech pathologist, a physician, and a psychologist use specialized tests that rate children in fourteen categories to determine whether or not they are autistic. If the child rates high in seven of the fourteen categories,they are labeled autistic.

Autism exists in many facets of being. To one extreme are the children with non verbal and non-ambulatory tendencies. The child that is non verbal with autism is one that might cause problems at first with the care giver. Because the child is non verbal, the parent would not have any verbal cues that the child is in pain, is hungry. A source close to the author gave an example of this. A forty-nine year old mother with a child with autism has a son who is a non verbal, non ambulatory, twenty-six year old. When he was a child, he couldn't tell anyone that cold drinks hurt his teeth. He would instead refuse to drink or to eat anything that was cold. She took her son to the dentist and found out that he had a cavity. She was happy to learn that she read his cues correctly and had been able to get him to the dentist. Now she has a better grasp on things that he needs, because she can read the signs.

The other extreme is the child with verbal, ambulatory tendencies. This child could to some extent tell a care giver what is wrong with them or what they may want. In a source from an autism e-mail list, one parent said, "The best thing about having Phil is that never a day goes by that we don't get a belly laugh from something he's done. The incongruencies in his development are often hilarious. He'll decide out of the blue to make a pan of sauteed mushrooms (asking me to work the stove by saying "turn on cook") and knowing every ingredient, every step of the process, even using a knife appropriately, like someone way past his age. And then he'll turn around and crack open a dozen eggs on the counter top and just leave them there!!! Things like that."

Once the child has been labled, the care giver and the three medical professionals get together to decide what medication, if any, to use. Melatonin, vitamins, and Prozac, are just a few of the medicines that can help. Also, to help the care giver there may be some discussion on methods that can be used to control the behavior of a child with autism and also methods on how to manipulate their behavior.

Modeling, being an example, sometimes will help a child with autism. If he or she sees that it may be safe for a parent or care giver to do something, then they may be willing to try to repeat the behavior. The list server the author joined was of great help, in giving him some examples. "Take the child with you. When going to your dentist appointment." This will help in modeling.

It will show the child with autism, that the dentist is a good person. Just telling the child, "The dentist won't hurt you", may or may not help. The child's limited understanding of ideas might hinder their full understanding of the situation. Modeling might harness their understanding.

Anticipatory response is another method a parent may want to attempt. This method is used on children with autism after a parent finds success in modeling. Anticipatory responses such as, marking things on a calendar and counting down the days, might take away some of the anxiety of a dentist appointment. Another source close to the author suggested letting the child hold the toothbrush or tool that the dentist may use. In doing so the care giver helps your child and your dentist have a more productive visit.

In the first example of the non verbal, non-ambulatory, twenty-six year old,the parent told the author that child had no problems at the dentist. When the dentist says open while holding a toothbrush the child with autism usually responded by opening his mouth. The reason behind this is that before the child went on his first dentist appointment, the parent had always held up the toothbrush to show that she wanted him to open his mouth so that she could brush his teeth. Since the child had been conditioned to this his visit to the dentist was much easier. The care giver said, "However, when the dentist had to do anything extensive, such as, fill a tooth or do a root canal, he usually put my son in the hospital, to give him anesthesia".

There is another method called graded cues. In this method a care giver would guide the child with autism by helping him totally with his anxiety over the dentist's visit by letting the child sit in their lap. The next few visits the care giver may stand by the chair holding the child's hand. Gradually, you would move further and further away from the child and dentist until the care giver is in the waiting room reading a magazine.

A dentist visit for a child with autism may end in happiness or deep despair. The best method for taking the child with autism to the dentist is whatever way one can get them there. One parent, on the author's e-mail list, uses a papoose to restrain her child. The child prefers the restraints for on subsequent visits he walked directly to it when he began to feel nervous. Another parent has found that by lying next to the child on the dentist chair, the child was less nervous and more subdued. But, restraint was not necessary in other cases. One parent stated that once the dentist began cleaning her child's teeth, the soft tip from the rotating tool was pleasurable to him. Therefore, it is often up to the child (and an understanding dentist really helps) and the parent to find a way that will help alleviate the nervousness and the anxiety over the sensory input that the child fears.