Autism Spectrum Disorders: What Can Otolaryngologists Do?

Children with autism spectrum disorders also may engage in unusual stereotypic behavior patterns such as repetitive hand movements, rocking body movements, or walking on toes, and their play has predictable patterns, such as lining up toys or organizing them obsessively into categories or patterns.

More often than not, children on the autism spectrum have significant difficulty with change and transition. Often, minor changes can result in great distress, and children may exhibit this distress with acting out behaviors, or even tantrums. It is critically important to be aware of the factors that precipitate dramatic emotional reactions so that they can be anticipated, prevented, and mitigated.

Dr. Rubin commented that he prefers to use the term unusual when describing the behaviors and behavior patterns, because it is more positive and encouraging for the children and the family. It is important to establish and maintain a positive attitude among everyone involved, because with timely and appropriate intervention and management, the children have good potential for optimal development and, ultimately, fulfillment in life.

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Figure. Dr. Lindee Morgan, Director of FSU’s Center for Autism and Related Disabilities, notes that pediatric otolaryngologists are in a unique position to identify children with autism spectrum disorders. Play-based assessment works well with very young children.

Role of the Otolaryngologist

Dr. Rubin suggested that one thing an otolaryngologist can do to move the child who may have a speech delay or early signs of autism in the right direction is to refer the child to a speech pathologist. There is nothing better than to get off to a good and early start in life, he said.

He advocates a triad of therapeutic approaches: speech therapy to improve language and communication, occupational therapy to improve coordination and sensory integration, and some form of behavior-based therapy, such as Floortime for younger infants and applied behavior analysis for older children and those with more challenging behaviors. Obviously, also, education and socialization are part of the formula for success. He maintains, however, that the most important positive factors in the child’s life are his or her parents and siblings or other family members. Because of their unconditional love and commitment, the children are provided opportunities for progress in growth and development.

Although studies of diagnosis and treatment of autism are limited, Lindee Morgan, PhD, Director of the Center for Autism and Related Disabilities at Florida State University (FSU) in Tallahassee, said her work as research coordinator for the First Words Project at FSU, a program funded by the National Institutes of Health and the Centers for Disease Control and Prevention, appears to show that early intervention can be successful.