Autism is a complex developmental disability.
The condition is the result of a neurological disorder that has an effect on normal brain function, affecting development of the person's communication and social interaction skills.
Approximately 1 in 88 children in the United States has an Autism Spectrum Disorder – a ten-fold increase over the past 40 years.
Selected Podcast
Autism Awareness – Knowing Can Make A Difference
Featured Speaker:
Gary Feldman, M.D.
Dr. Feldman received his bachelor of medicine and surgery degree from the University of Cape Town School of Medicine in South Africa. He completed his residency in pediatrics at Red Cross Children's Hospital and University of Cape Town in South Africa and worked in primary care pediatrics for five years prior to moving to the United States in 1999. He completed a fellowship in Developmental and Behavioral Pediatrics at Rainbow Babies and Children's Hospital and Case Western Reserve University in Cleveland, Ohio. He is a member of the American Academy of Sleep Medicine and Society for Developmental and Behavioral Pediatrics. Dr. Feldman has been the medical director of the Stramski Children’s Developmental Center at Miller Children’s since 2004.Organization: Miller Children’s Hospital Long Beach
Transcription:
Autism Awareness – Knowing Can Make A Difference
Deborah Howell (Host): Hello and welcome to the show. You are listening to weekly dose of wellness. It’s brought to you by MemorialCare Health System and I am Deborah Howell with today’s guest. He is Dr. Gary Feldman medical director of the Stramski Children's Developmental Center, Miller Children’s Hospital Long Beach since 2004. Dr. Feldman received his bachelor of medicine and surgery degree from the University Of Cape Town School Of Medicine in South Africa. He completed his residency in pediatrics at Red Cross Children’s Hospital and university of Cape Town in South Africa and worked in primary care pediatrics for five years prior to moving to the United States in 1999. He is a member of the Academy of sleep medicine and society for developmental and behavioral pediatrics. Welcome to you Dr. Feldman.
Dr. Gary Feldman (Guest): Thank you. Thank you for having me.
Deborah: You know I could talk to you forever about Cape Town one of my very favorite places to visit, but today’s topic is autism, so let’s get ready and how common is autism.
Dr. Feldman: You know that’s a hotly debated topic and every year the number seems to indicate that it’s becoming more and more prevalent and it is increasing. Right now, you look at from a global perspective, approximately 1% of the world population has autism and if you break it down to what the figures are up in the United States presently about 1 in 88 children will be diagnosed with the condition and if you break it on further you can probably say about 1 in 50 of those will be male and 1 in 250 of those will be female.
Deborah: So, that’s fairly common for sure at least in our country.
Dr. Feldman: Well, that’s those of the figures that we have here. You know, as such it is difficult to ascertain you know around the world into kind of get reliable, but what seems to be happening you know if this is the case, all these numbers increasing because people are just getting better at diagnosing the condition.
Deborah: Right that was my question, yeah.
Dr. Feldman: Or is it because the incidence is actually increasing and the answer is probably a little bit of both.
Deborah: Okay because there was a very rare when I was coming out to you. You just didn’t hear about it and now it’s everywhere. I mean it’s all over the media, so what are some of the signs and symptoms of autism?
Dr. Feldman: You know, Deborah you can basically break it down into two broad categories. The first is a problem or difficulty with social communication. Social communication is weird, unspoken way of how we talk to each other you know the analogy is the young couple that are in love that are now in the restaurant to having the romantic dinner. They are sitting across the table and looking at each other and they are not saying a single word.
Deborah: Nothing.
Dr. Feldman: But, looking at each other and raising of the eyebrows and you know that of the corner of the one side of the mouth, they will mean things.
Deborah: Yes.
Dr. Feldman: And they interpreted and then the partner will respond with something else and that is all kind of nonverbal communication that takes place and we do it all the time, you know when we talk to each other, we are using our hands for gesture because we trying to convey some kind of meaning. We may be watching someone to see what their action is, when we are talking and thinking oh my gosh they interested, may be I should stop talking, looking are they really interested that means I need to talk some more or keep on the topic, so that’s just the tip of the iceberg to explain what social communication is and if we have time we can swing back on this, so that’s the one category, the problems with social communication. The other category is serve an intense interest or need for things that are all the same, so an intense need for rituals, living a great ritualistic life and doing repetitive behaviors and these can be the with people all mostly knows the pacing up and down, walked on the toes, their hand flapping, preoccupation with movement, spinning of wheels.
Deborah: I hadn’t heard that one. I was thinking of more was Rain Man based on an artistic person that movie when you pick up the Dustin Hoffman walking back and forth and needing to see the same show over and over and over and over.
Dr. Feldman: Exactly. So, you know for kids commonly what they all do for the repetitive behaviors, they might have a favorite DVD that they are watching and they will watch either the whole DVD over and over and again or they actually selected section within a DVD and loop that had been played over and over again and these kids will do a lot what we called scripting that they might not afraid. You know an autistic child who likes toy story might keep on saying repeatedly to infinity and beyond and will be talking about the context You know, hi Tony. How are you? And he will say to the infinity and beyond.
Deborah: Right.
Dr. Feldman: Repeatedly and may just repeat words like hi, how are you and child would say hi, how are you, so it’s really just a repetitive what we call echolalia and if that’s just one another example of somebody’s stereotyped patterns of behavior.
Deborah: Which sort of maximum targets at school I would imagine you know.
Dr. Feldman: I think if think about autistic behaviors makes kids targeted, targeted schools, I think you know you can have kids you don’t have these repetitive behaviors and these intense dependencies on routine. They can just have like you can have a child who has got high functioning autism, his or her main problem is with social communication and that’s the middle school or who just doesn’t get the social rules, does understand things and how they can be so easily marginalized and bullied.
Deborah: Yeah, it’s very-very sad. What are some of the basic risk factors of autism, if I may ask you?
Dr. Feldman: By that question I’m kind of assuming what is the cause. Well, it’s a great question because there is not one single answer, so to look at one can say if you look at the most of typical types of autism or more common types of autism in that situation, there is no single known cause. What is the thought is that there is a genetic predisposition to having autism and there are a number of what they called candida genes that may see more vulnerable to having this predisposition, so went into and gotta have this genetic predisposition, then on other hand you gotta have some kind of trigger that in instance unveils or unearth this predisposition, so that’s actually become condition and that is probably something in environment could be exposure to environmental toxin, this could something related to the immune system, we just don’t understand what it looks like it there or it is either one or series of triggers that trigger as a preset genetic mobility to manifest this condition.
Deborah: And the research continues to find those triggers.
Dr. Feldman: The research continues to find those triggers absolutely. The other subset is kind of is more of a single gene identifiable condition, so there are some genetic conditions like Fragile X syndrome, like tuberous sclerosis even the condition just located on the 15 chromosome which you know are more so identifiable, if you have problems in those areas, you have a great chance of actually developing autism.
Deborah: And then how was autism diagnosed?
Dr. Feldman: Right now, it’s basically diagnosed on observation and history. The best blood test presently to do you know like you could have blood test, if you had a heart attack or you could do blood in kind of measure enzymes and various factors, they will look like you probably had a heart attack. They’ve had no luck with that to the autism right now, so it essentially boils down to a parent giving a history and how well the history is obtained and that could be done by talking to the parent, talking to the teachers, talking to whoever knows the child and by giving parents or teachers questionnaire which have been designed to elicit information and the detailed history about autistic like behaviors and then observation. Observing the child and you can observe a child in every play, you want to observe them in many situations as you can and then they are now then developed if you like observational test which is an attempt to kind of standardized the observation of the child to see whether their behaviors when you pushed if you like or pressed in any given situation to see and assess their response and then quantify in an attempt to kind of give more qualification of the behaviors to see whether they are consistent with autism.
Deborah: We have so much more to cover, but we have less than 2 minutes. For soon-to-be moms listening or mothers who have a child with autism where can they go to learn more?
Dr. Feldman: You know with internet now I would suggest they go to website would ne autismspeaks.org
Deborah: Autismspeaks.org, okay.
Dr. Feldman: Yeah. It’s a great place. It’s a great resource. You know not everything on the internet is great and autismspeaks.org generally has a lot of good stuff and may be some information that may be questionable, but on the whole I think that is a really reputable place to go. They will give a lot of information on books that they can read.
Deborah: Thank you so much Dr. Feldman for being with us. Will you come back, so we can explore this topic more? There is so much we didn’t chance to cover today.
Dr. Feldman: I will be happy too. Thank you for giving me the opportunity.
Deborah: Thank you very much for the hard work you do and best of luck in finding those and isolating those triggers. To listen to the podcast or for more information please visit memorialcare.org. I am Deborah Howell. Join us again next time as we explore another weekly dose of wellness.
Autism Awareness – Knowing Can Make A Difference
Deborah Howell (Host): Hello and welcome to the show. You are listening to weekly dose of wellness. It’s brought to you by MemorialCare Health System and I am Deborah Howell with today’s guest. He is Dr. Gary Feldman medical director of the Stramski Children's Developmental Center, Miller Children’s Hospital Long Beach since 2004. Dr. Feldman received his bachelor of medicine and surgery degree from the University Of Cape Town School Of Medicine in South Africa. He completed his residency in pediatrics at Red Cross Children’s Hospital and university of Cape Town in South Africa and worked in primary care pediatrics for five years prior to moving to the United States in 1999. He is a member of the Academy of sleep medicine and society for developmental and behavioral pediatrics. Welcome to you Dr. Feldman.
Dr. Gary Feldman (Guest): Thank you. Thank you for having me.
Deborah: You know I could talk to you forever about Cape Town one of my very favorite places to visit, but today’s topic is autism, so let’s get ready and how common is autism.
Dr. Feldman: You know that’s a hotly debated topic and every year the number seems to indicate that it’s becoming more and more prevalent and it is increasing. Right now, you look at from a global perspective, approximately 1% of the world population has autism and if you break it down to what the figures are up in the United States presently about 1 in 88 children will be diagnosed with the condition and if you break it on further you can probably say about 1 in 50 of those will be male and 1 in 250 of those will be female.
Deborah: So, that’s fairly common for sure at least in our country.
Dr. Feldman: Well, that’s those of the figures that we have here. You know, as such it is difficult to ascertain you know around the world into kind of get reliable, but what seems to be happening you know if this is the case, all these numbers increasing because people are just getting better at diagnosing the condition.
Deborah: Right that was my question, yeah.
Dr. Feldman: Or is it because the incidence is actually increasing and the answer is probably a little bit of both.
Deborah: Okay because there was a very rare when I was coming out to you. You just didn’t hear about it and now it’s everywhere. I mean it’s all over the media, so what are some of the signs and symptoms of autism?
Dr. Feldman: You know, Deborah you can basically break it down into two broad categories. The first is a problem or difficulty with social communication. Social communication is weird, unspoken way of how we talk to each other you know the analogy is the young couple that are in love that are now in the restaurant to having the romantic dinner. They are sitting across the table and looking at each other and they are not saying a single word.
Deborah: Nothing.
Dr. Feldman: But, looking at each other and raising of the eyebrows and you know that of the corner of the one side of the mouth, they will mean things.
Deborah: Yes.
Dr. Feldman: And they interpreted and then the partner will respond with something else and that is all kind of nonverbal communication that takes place and we do it all the time, you know when we talk to each other, we are using our hands for gesture because we trying to convey some kind of meaning. We may be watching someone to see what their action is, when we are talking and thinking oh my gosh they interested, may be I should stop talking, looking are they really interested that means I need to talk some more or keep on the topic, so that’s just the tip of the iceberg to explain what social communication is and if we have time we can swing back on this, so that’s the one category, the problems with social communication. The other category is serve an intense interest or need for things that are all the same, so an intense need for rituals, living a great ritualistic life and doing repetitive behaviors and these can be the with people all mostly knows the pacing up and down, walked on the toes, their hand flapping, preoccupation with movement, spinning of wheels.
Deborah: I hadn’t heard that one. I was thinking of more was Rain Man based on an artistic person that movie when you pick up the Dustin Hoffman walking back and forth and needing to see the same show over and over and over and over.
Dr. Feldman: Exactly. So, you know for kids commonly what they all do for the repetitive behaviors, they might have a favorite DVD that they are watching and they will watch either the whole DVD over and over and again or they actually selected section within a DVD and loop that had been played over and over again and these kids will do a lot what we called scripting that they might not afraid. You know an autistic child who likes toy story might keep on saying repeatedly to infinity and beyond and will be talking about the context You know, hi Tony. How are you? And he will say to the infinity and beyond.
Deborah: Right.
Dr. Feldman: Repeatedly and may just repeat words like hi, how are you and child would say hi, how are you, so it’s really just a repetitive what we call echolalia and if that’s just one another example of somebody’s stereotyped patterns of behavior.
Deborah: Which sort of maximum targets at school I would imagine you know.
Dr. Feldman: I think if think about autistic behaviors makes kids targeted, targeted schools, I think you know you can have kids you don’t have these repetitive behaviors and these intense dependencies on routine. They can just have like you can have a child who has got high functioning autism, his or her main problem is with social communication and that’s the middle school or who just doesn’t get the social rules, does understand things and how they can be so easily marginalized and bullied.
Deborah: Yeah, it’s very-very sad. What are some of the basic risk factors of autism, if I may ask you?
Dr. Feldman: By that question I’m kind of assuming what is the cause. Well, it’s a great question because there is not one single answer, so to look at one can say if you look at the most of typical types of autism or more common types of autism in that situation, there is no single known cause. What is the thought is that there is a genetic predisposition to having autism and there are a number of what they called candida genes that may see more vulnerable to having this predisposition, so went into and gotta have this genetic predisposition, then on other hand you gotta have some kind of trigger that in instance unveils or unearth this predisposition, so that’s actually become condition and that is probably something in environment could be exposure to environmental toxin, this could something related to the immune system, we just don’t understand what it looks like it there or it is either one or series of triggers that trigger as a preset genetic mobility to manifest this condition.
Deborah: And the research continues to find those triggers.
Dr. Feldman: The research continues to find those triggers absolutely. The other subset is kind of is more of a single gene identifiable condition, so there are some genetic conditions like Fragile X syndrome, like tuberous sclerosis even the condition just located on the 15 chromosome which you know are more so identifiable, if you have problems in those areas, you have a great chance of actually developing autism.
Deborah: And then how was autism diagnosed?
Dr. Feldman: Right now, it’s basically diagnosed on observation and history. The best blood test presently to do you know like you could have blood test, if you had a heart attack or you could do blood in kind of measure enzymes and various factors, they will look like you probably had a heart attack. They’ve had no luck with that to the autism right now, so it essentially boils down to a parent giving a history and how well the history is obtained and that could be done by talking to the parent, talking to the teachers, talking to whoever knows the child and by giving parents or teachers questionnaire which have been designed to elicit information and the detailed history about autistic like behaviors and then observation. Observing the child and you can observe a child in every play, you want to observe them in many situations as you can and then they are now then developed if you like observational test which is an attempt to kind of standardized the observation of the child to see whether their behaviors when you pushed if you like or pressed in any given situation to see and assess their response and then quantify in an attempt to kind of give more qualification of the behaviors to see whether they are consistent with autism.
Deborah: We have so much more to cover, but we have less than 2 minutes. For soon-to-be moms listening or mothers who have a child with autism where can they go to learn more?
Dr. Feldman: You know with internet now I would suggest they go to website would ne autismspeaks.org
Deborah: Autismspeaks.org, okay.
Dr. Feldman: Yeah. It’s a great place. It’s a great resource. You know not everything on the internet is great and autismspeaks.org generally has a lot of good stuff and may be some information that may be questionable, but on the whole I think that is a really reputable place to go. They will give a lot of information on books that they can read.
Deborah: Thank you so much Dr. Feldman for being with us. Will you come back, so we can explore this topic more? There is so much we didn’t chance to cover today.
Dr. Feldman: I will be happy too. Thank you for giving me the opportunity.
Deborah: Thank you very much for the hard work you do and best of luck in finding those and isolating those triggers. To listen to the podcast or for more information please visit memorialcare.org. I am Deborah Howell. Join us again next time as we explore another weekly dose of wellness.