Expert: Catherine Ridenour - 11/18/2006

Question
I have a wonderful 4-year old son named Alex. We are in the process of getting him diagnosed to see whether or not he has autism. Many of the people at the Autism center here in Chapel Hill, NC as well as our school officials seem to think this is the case. At the least, he is developmentally challenged for sure.
    My question is this. Many times when my wife and I take Alex out to dinner, the store, etc, he tends to start yelling..loudly, very loudly. He screams sometimes for no apparent reason. I wonder whether or not he has the words to express himself. This can be quite embarrassing to us and prevents us from going to a lot of places, simply because we don't want to have to deal with the other people there.
    I get honestly frustrated to the point of my blood pressure going up from hearing from complete strangers on how I should parent my child better, or their stares that basically imply this. How can I deal with Alex's behavior, or if I can't control it, how would you suggest I deal with my frustration in this matter.
    Thanks in advance for your advice.

Keith

Answer
Hi Keith,

I empathize with your frustration. Been there, done that, got the T-shirt. Be patient with the length of this reply, I have much to tell you.

#1, be sure his hearing is normal. Deaf children can exhibit the same symptoms. Fortunately, most children in this country are now screened at birth and well-child visits for deafness. Still, multiple ear infections can wreck havoc on hearing and, therefore, language development.

You may be correct that your son does not have the language skills to express himself. Whether he is autistic or just speech delayed, speech therapy will certainly focus on helping him with that problem. Also, he will receive social skills training to help him understand how outbursts affect other people. They will use "social stories" as a teaching tool. These simple stories help the child look at appropriate behavior in advance and without the pressure of being in the situation.

Most people on the autistic spectrum have a very limited understanding of social interaction. They are "deaf" to tone of voice, facial expression and body language. The stares you find so uncomfortable are invisible to your son.

I can assure you that he will make progress toward more acceptable behavior, it will just take him longer. You should continue to take him out because sheltering him at home deprives him of opportunities to learn and isolation can lead to depression on the part of his parents.

It is sad that people are so intolerant. Four year old kids are seldom socially appropriate. Basically, you and your wife are going to have to develop a thicker skin and rehearse a few ways to inform people that your son is doing the best he can. If you do get a diagnosis of autism, you can explain this, if you feel comfortable sharing the information.

Fortunately, it is now known that autism is NOT the product of poor parenting or child abuse. Some people still believe this, however. Be sure that you, as his parents, take advantage of any education you can get in parenting your special child. Read lots of books by parents of autistic kids, read books by autistic adults. I'll put some links at the end of this message where you can find lots of information.

Now, you also need to know about behavior "triggers". Many autistic people are overly sensitive to stimuli that you and I can screen out. Sudden or high pitched noises, blinking lights, florescent lights, the texture of clothing, wrinkles in their socks, smells, and more can send them into overload. In children, this can take the form of screaming for no apparent reason. Simple things like a hat or ear plugs may help him cope better out in the world.

Also, be aware that there may be a very smart mind behind the delays. Autism does not always mean diminished mental capacity. It's kind of a "wiring" problem. Many famous and successful people, when seen in hindsight, were probably on the autistic spectrum. So, hang in there, love him for his unique self.

http://www.patientcenters.com/autism/news/resources.html (books and resources)

http://www.ninds.nih.gov/disorders/asperger/asperger.htm (the definitions and government links)

http://www.autism.org/temple/meds.html (about medication)

http://www.autism.org/ (many links to information)

http://www.autismasperger.net/intro.htm (Stephen Shore’s web site)

http://www.angelfire.com/pa5/as/asteachersites.html (teaching resources)

http://www.pnas.org/cgi/content/full/95/23/13982#B14 (About movement in infancy)

http://groups.msn.com/TheAutismHomePage/toilettraining.msnw (toilet training)

Best wishes,
Catherine