Expert: Trey McGowan - 12/21/2008

Question
QUESTION: Hi Trey, I was wondering if you have ever come across any links between taking effexor ( SSRI anti-depressant) during pregnancy and links to autism or PDD in the developing child. Thanks very much, Julie

ANSWER: Hi there, Julie!

None.

Sincerely, T-....

Well, I suppose that would be an unsatisfying answer, just in itself. And I don't know if the AllExperts list would even let an answer be that short. :) Therefore, I did a skim through the ites that I usually use about the drug you're mentioning. And not once in the read-through of those links did I come across a single link between the two. Effexor, when taken in pregnancy, does seem to cross the placenta (in other words, the drug will get into the baby's system), but in trials, there has been some sign of various difficulties in the child, likely caused more by withdrawal than by the actual drug itself. However, the difficulties do not seem to be a lasting 'birth defect', so much as reactions: hypertension, trembling, difficulty feeding, and the like.

Hopefully that helped answer your question and reassured you at least a little bit! Or if not, educated you. Questions, comments, feedback, follow-ups, are quite welcome!

Trey

---------- FOLLOW-UP ----------

QUESTION: Hi again Trey, I have another quick question regarding my daughter who is PDD diagnosed. I hope that is O.K. She is 4 and ahalf years old and has about 6 words in her vocabulary,which she uses rarely. Do you know of anything that would heip her talk?She does speech therapy already,but doesnt seem to be progressing and has terrible tantrums because she cant communicate. Thanks,Julie

ANSWER: Hi there, Julie!

With your daughter in speech therapy, that will hopefully be at least a little bit of help in later years. I'm not certain how long she has been in therapy, of course, so I may well be overstepping that.

However, my big suggestion here is for you to try some other methods of communication with your daughter as well as speaking. If she at least understands what's being said, and just can't make herself repeat them (which is often the case in higher functioning autism and a *big* cause for frustration tantrums), you might try some sign language. See if you can start learning some important signs in ASL, or even make up a few of your own. The problem with making up your own, of course, is that outside the home, other people won't know it.

If sign isn't a good way, say she doesn't have the coordination or your own hands and brain won't wrap around it, try with symbols, or other typing. At four years old, she probably won't be able to get the hang of straight English typing, but if she manages to get the hang of symbols, then there are special keyboards out to help people who have communication difficulties and English lettering might work later on. Many autistic individuals have used these keyboards over the years, and have found them a great relief.

One thing I can't stress enough, though: if you are indeed working with a speech therapist, you might want to bring up the methods for communication you are using at home. After all, if your child starts signing or reaches for a keyboard in the middle of 'class', they're going to want to know. And if your child finds a new method of communication easier than speech, whatever method it is that you use, they may want to gravitate to that rather than struggling with verbal speech.

Above all else, though, try and be persistent in the therapy. Don't pull her out because of the lack of visible progression just yet, especially if she hasn't been doing it for very long. Sometimes, it just takes a small breakthrough or a little maturation on the part of the child for something to work. Speech therapy obviously won't work in all cases, but if she hasn't been going for very long, definitely try and give it its due, and remember that for a lot of children, progression is not an instantaneous thing, but a long, hard haul. Plus, also remember that if one therapist is definitely not working, you can always look around for another one and see if different methods will help.

Hopefully that helped give a couple of suggestions there. I'd like to think that one or more of them will be helpful to your daughter! Further questions, comments, feedback, follow-ups, are always welcome!

Trey

---------- FOLLOW-UP ----------

QUESTION: Hi Trey,thankyou so much for this information. I'm facinated and so happy that my daughter is trying to communicate but that the wiring between brain and mouth is'nt working properly. ( her older brother also had a severe speech delay;no autism though, and talks nonstop now ,but has trouble with forming words and some concepts.)She was diagnosed with a 'possible intelectual disability',but I cant see that this is the case. She is quite smart! She can write her own name, knows the alphabet( to put in order and tries to sound it out) and loves the written word(tries to read). I am wondering if it is best to learn asl or get a keyboard with symbols( where an earth do you get them?) If she learns asl ,but other people around her ( teachers,other kids)dont know how to use it , would the keyboard be better ? She has been in speech 1x per week for a year and a half. Most of that time was spent learning pecs ( picture exchange  communication) but she hardly seems to ever use it and it seems very impractical to sift through a folder of pictures to try and find the drink one etc. We also live in a remote country town in Australia and dont have a lot of options. Jamilla is a half aboriginal girl ( white mother ,me,and aboriginal father.)We love her very much and think she has an amazing future! Thanks so much for your imput. I have learnt more off you in 2 days than I have in a year, Julie

Answer
Hey there, Julie!

Now, don't take my word about your child as gospel. I said *often* the case, after all. :) I'm not a doctor, and even if I was, making any sort of diagnosis without direct observation is a big bad no-no.

Now that I've got that out of the way, you can find information about these 'type-to-talk' keyboards in a few places. Most of them are made for people with linguistic difficulties.

Some examples I have been able to find (note: I do not work for any of these people; this is not taken as direct advertising, but rather for information and directing you to the type of thing I was refering to)

http://www.textspeak.com/aactalkingdevice.htm
http://www.assistireland.ie/index.asp?docID=-1&locID=135 (this is for Ireland but the examples are solid)
http://www.abledata.com/abledata.cfm?pageid=19327&top=158137&deep=2&trail=10836, (symbols and telephone aids are included here as well; just glance around the 'communications' area)

The question of which would work better, for me, depends mostly on what the child's aptitudes are. If I had to make a choice, I would suggest trying the typing first, as the written language is understood by a lot more people than a few, and you won't need to have a 'translator' around while your child is potentially talking to other people. On the other hand (no pun intended), sign language is good because you don't need to have a special device around. just her own two hands. And I'm not going to deny that some of the type-to-speech programs are quite expensive, though your medical may pay for it if you can get a note from a doctor. *May* being the operative word, of course.

I am happy to hear that you have assistance for your girl, even if it's very difficult for her to get through it. :) I really wish the best for you and yours, particularly in this holiday season! As per usual, questions, comments, et cetera, are welcome. But please pardon slowness on my part during this busy holiday season.

Trey