One in 68 children in the U.S. has been identified as having autism, according to the Centers for Disease Control and Prevention.
Autism, a general term for autism spectrum disorder, is a developmental disorder which can affect social, emotional and communication skills. Autism affects more boys than girls, at a rate almost five times higher. Approximately one in 42 boys and one in 189 girls has been identified with autism.
The U.S. military has been at the forefront of working for special needs kids –first recognizing this need almost 40 years ago.
Lt. Col. (Dr.) Eric Flake is the program director of Developmental Behavioral Pediatrics at Joint Base Lewis-McChord, Wash. This Tri-service program is the only developmental pediatric training program within the military and one of the oldest developmental pediatric programs across the country.
The focus on caring for children with autism is another demonstration of how the Air Force is committed to families. In order for Airmen to be mission ready, the whole family must be ready. The health and wellbeing of Airmen’s families is critical to maintaining readiness of the total force.
Lt. Col. Flake advises that there are numerous available resources dedicated to the care of military children and it is important for health care providers to help families navigate these resources. “Most families come in wanting to know what they can do to help their children,” said Lt. Col. Flake. “As physicians, this is music to our ears. We are able to steer families to the best resources with the best possible outcomes.”
“The first step whenever there is a concern is to talk to your child’s pediatrician,” said Lt. Col. Flake. “During well-child visits there are tools available to screen whether a child is at risk or not at risk for autism. If there is a concern at any age, further medical evaluation is imperative. Another step would be to contact your local school, which can provide additional help and treatment.”
Critical to the care of children with autism is early detection and treatment, according to Lt. Col. Flake. This involves identifying whether a child is at risk for autism and then evaluating the child to determine whether the child has autism. The last component of detection and treatment is to get families and children with autism the therapies and resources needed to help with autistic symptoms.
“The goal is to identify autism between the ages of 2 and 3. Currently, the average is age 4,” said Lt. Col. Flake. “Within 90 days of identifying autism, children should be receiving a triad of support services which include support from a medical home, the community –both on and off the base—and the local educational system.”
“Autism is a disorder in social and language development,” explains Lt. Col. Flake. “The combination makes it difficult. If there is no drive to be social, you do not have as much need for language.”
“Social development is usually preprogrammed. However, for children with autism, it is not. Instead, this has to be taught or reprogrammed,” said Lt. Co. Flake. This reprograming often involves speech, occupational and intensive behavioral therapy.
The reason why the greatest emphasis is placed on identifying autism in children as early as possible is to begin teaching children the benefits of healthy social communication and to avoid the adverse consequences of social avoidant behaviors.
Just as we are all creatures of habit, Lt. Col. Flake explains that if symptoms are left undiagnosed or untreated, children with autism continue to develop habits which further pull them away from socially communicating.
Within the Air Force, children are screened for autism in their medical home during routine well-child visits. Well-child visits follow the American Academy of Pediatrics’ Bright Futures recommended schedule and should occur at the following milestones:
- 2 months
- 4 months
- 6 months
- 9 months
- 12 months
- 15 months
- 18 months
- 24 month
- 30 months
After this point, at 36 months and beyond, children should have an annual checkup. Lt. Col. Flake advises that vaccines do not cause autism. “The benefits of vaccinating children far outweigh concerns that vaccinations cause any hint of autism.”
“Autism is multifactorial,” explains Lt. Col. Flake. “We do not understand all components that lead to [autism]. Genetics and early atypical stressful events could make a child more likely to demonstrate symptoms of autism.”
This lack of knowing why a child has autism can sometimes lead to confusion for families after diagnosis. Unfortunately, there is no quick cure to turn symptoms around. Just as with other skills which require practice, for children with autism, learning how to be social takes constant, daily practice.
“Identifying a child with autism is not hopeless,” said Lt. Col. Flake. “Kids have the ability to learn skills and meet their optimal potential. Many individuals with autism are a great contribution to society and bring so much to improving our community.”
The Air Force Exceptional Family Member Program provides support for families with a member who has special needs. The EFMP helps the Air Force ensure that families with special needs children are assigned to locations which can support the medical and educational needs of those children. Families preparing for a permanent change of station should get in touch with the local EFMP office, preferably six months ahead of their move. Depending on the child’s age, the Airman and Family Readiness Center has a school liaison officer to connect children with the best educational options available. System navigators are also available through family services and can help families with the transition to their new home station.
Lt. Col. Flake advises that for families caring for a child with autism, it is important to connect with local families who also have a child with autism and seek a strong relationship with their child’s primary care doctor in the medical home. Primary care providers take care of all of the child’s medical needs and stand by ready to assist the family in connecting them with resources.
“My feelings are, as we reach out and bring our arms around the children and families of kids with autism, we all benefit and are elevated as a community and a military service,” Lt. Col. Flake said. “During this month of special recognition for children with autism, we have the opportunity to highlight and celebrate these amazing families and what amazing individuals these kids with autism spectrum disorders truly are.”