Autism Omaha NE
Omaha NE Autism Physician Specialties
Omaha NE Autism Doctors and medical specialists that may be involved in the diagnosis, treatment or ongoing care of Autism in Omaha.
Featured Omaha NE Autism Article
By Ronald King
Autistic Spectrum Disorders, sometimes also known as Pervasive Developmental Disorders, are a group of neurodevelopmental disorders that affect both verbal and non verbal communications. These are typically characterized by social impairments including communication difficulties and stereotyped or repetitive behaviors. Disorders under the umbrella of Pervasive Development Disorders include Autism, Asperger's Syndrome (sometimes referred to as "high functioning autism"), Pervasive Development Disorder-Not Otherwise Specified (PDD-NOS) and RETT Syndrome. Today, it is estimated that one in every 110 children is diagnosed with an Autism Spectrum Disorder. In this article we will focus on autism.
Autism was first described in 1943 by Leo Kanner, a psychiatrist at Johns Hopkins University, but the term "Infantile Autism" did not occur until 1980 when the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) was published.
Most of the time, frustratingly, no one knows exactly why autism occurs. There are some cases where a medical cause may be found, such as Fragile X Syndrome, a hearing impairment or congenital rubella, but most of cases of autism elude a specific reason for why these changes have occurred. There are, however, some general relationships and characteristics that have been identified.
Gender carries a risk. Simply being male puts a child at higher risk for a diagnosis of autism. In fact, autism is 2-4 times more likely to be found in boys than girls. Genetic causes have been implicated as well. Parents with a child who has a PDD have a much higher chance of having another child with a PDD. If an identical twin is diagnosed with autism, there is an 80% chance the other twin will also be diagnosed. Language and cognitive abnormalities are more common in relatives of those diagnosed with autism. However, no one knows exactly what gene or genes may be involved. Lastly, being an older mom or dad brings with it a higher risk of having a child with an ASD.
The statistical evidence tells us the incidence of autism is on the rise in the United States. There is no real concrete reason for why at this point. Increased awareness of autism and a changes in the diagnostic standards in 1987 (with DSM-III Revised) and 1994 (with DSM-IV) seem to have some role with the increase, but while some experts feel it is due to better detection and screening methods others feel it may be an environmental factor that is contributing to this increase. Concern about vaccines causing autism, specifically the measles-mumps-rubella (MMR) vaccine given at 12 – 15 months of age, has been examined in large studies and in many countries and no connection between MMR vaccination and autism was found. At this point, there needs to be further research to isolate the reason(s) more autism is being diagnosed.
Children who have autism typically show symptoms before their first birthday, and always by the time they turn three years old. No two children with autism may behave exactly the same. Despite the differences in manifestations of autism these children typically have problems in the same areas of development: social interaction, language and behavior.
Problems in the area of social interaction may include a child not pointing to an object s/he wants by twelve months old, not giving hugs, kisses or cuddling, and eye contact is poor or non-existent. Having trouble forming friendships is another concerning sign, and an autistic child often withdraws to play in his or her "own world" for hours.
Verbal skills suffer, with many autistic children suffering from speech delay. If speech is present, it may be repetitive or rhyming without intending to convey any specific meaning to the listener.
In their daily routine, children with autism rigidly demand an identical daily routine. Deviation from the normal routine can trigger explosive tantrums. Repetitive behaviors are common, and some children may injure themselves through such behaviors. Autistic children may be exquisitely sensitive to some stimuli such as touch, but unfazed by things that cause pain or startle other children.
Many children with autism have mental retardation, and development of a seizure disorder is not uncommon.
There is no lab test available to diagnose autism. It is, rather, diagnosed based on the behavior of the child. A single encounter doesn't qualify, either – the behaviors of an autistic child would be expected to occur all the time and in every setting: with mom alone, dad alone, in school or daycare, with a babysitter or other family member. For this reason, parents need to be pro-active in sharing developmental information and concerns with the pediatrician. Part of the reason young children have "well check-ups" so often is to provide ample opportunity to discuss with the pediatrician what the child is doing and what s/he is expected to be doing in the coming months. Any deviations from these expected milestones can be discussed, and if necessary, a follow up appointment can be made to discuss these issues exclusively.
While there are no blood or urine tests available to diagnose autism, there are some screening exams that can be done if concern exists. Some of these tests include Ages and Stages Questionnaire (ASQ), Parents Evaluation of Developmental Status (PEDS) and Modified Checklist for Autism in Toddlers (M-CHAT), but many more exist. If screening tests suggest autism or another ASD then referral to a team of specialists for a complete diagnosis is in order. Such a team may consist of a pediatrician, a pediatric neurologist, a developmental specialist, a child psychiatrist, a psychologist, a geneticist, an occupational therapist, physical therapist and/or speech therapist.
These specialists may be available through an Early Intervention Program (a public program supported by the government) for children up to three years old, and through the public school's Special Education Department if the child has already turned three years old.
Treatment is customized for each patient, but the following rules of thumb apply. Early treatment is best. Intensive behavioral and communication therapies are important for improving social skills. Physical and/or Occupational therapies may be needed. Medications may be useful to help curb some symptoms of autism, but side effects may outweigh the benefit and a full discussion with the prescribing doctor should occur beforehand.
Raising a child with autism can be physically exhausting and emotionally draining for the parents or caregivers. There is isolation for the parents as there is for the child. Finding a team of trusted professionals to help you understand the diagnosis and make decisions on your child's treatment is important. Decisions made in the early years will impact a child's development in later years.
When caring for a child with autism, be sure to take respite time for yourselves. Without this, you will face emotional burnout in short order. Though you may feel alone, it's important to know that you're not. Connection with professional societies and support groups is essential to providing some of that support and keep you abreast of the latest research and treatment in the field. Your pediatrician or specialist can recommend websites germane to your child's diagnosis.
- Clinical Neurophysiology
- A neurologist who specializes in the diagnosis and management of central, peripheral, and autonomic nervous system disorders using a combination of clinical evaluation and electrophysiologic testing such as electroencephalography (EEG), electromyography (EMG), and nerve conduction studies (NCS), among others.
- Neurodevelopmental Disabilities
- A pediatrician or neurologist who specializes in the diagnosis and management of chronic conditions that affect the developing and mature nervous system such as cerebral palsy, mental retardation, and chronic behavioral syndromes, or neurologic conditions.
- Pain Medicine
- A neurologist or child neurologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists.
- A psychiatrist specializes in the prevention, diagnosis, and treatment of mental, addictive, and emotional disorders such as schizophrenia and other psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders, and adjustment disorders. The psychiatrist is able to understand the biologic, psychologic, and social components of illness, and therefore is uniquely prepared to treat the whole person. A psychiatrist is qualified to order diagnostic laboratory tests and to prescribe medications, evaluate and treat psychologic and interpersonal problems, and to intervene with families who are coping with stress, crises, and other problems in living.
- Addiction Psychiatry
- A psychiatrist who focuses on the evaluation and treatment of individuals with alcohol, drug, or other substance-related disorders and of individuals with the dual diagnosis of substance-related and other psychiatric disorders.
- Child and Adolescent Psychiatry
- A psychiatrist with additional training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
- Clinical Neurophysiology
- A psychiatrist with expertise in the diagnosis and management of central, peripheral, and autonomic nervous system disorders using a combination of clinical evaluation and elctrophysiologic testing such as electroencephalography (EEG), electromyography (EMG), and nerve conduction studies (NCS).
- Forensic Psychiatry
- A psychiatrist who focuses on the interrelationships between psychiatry and civil, criminal, and administrative law. This specialist evaluates individuals involved with the legal system and provides specialized treatment to those incarcerated in jails, prisons, and forensic psychiatry hospitals.
- Geriatric Psychiatry
- A psychiatrist with expertise in the prevention, evaluation, diagnosis, and treatment of mental and emotional disorders in the elderly. The geriatric psychiatrist seeks to improve the psychiatric care of the elderly both in health and in disease.
- Pain Medicine
- A psychiatrist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists.
- A pediatrician is concerned with the physical, emotional, and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive health care to the diagnosis and treatment of acute and chronic diseases.
- A pediatrician deals with biological, social, and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
- Adolescent Medicine
- A pediatrician who specializes in adolescent medicine is a multi-disciplinary health care specialist trained in the unique physical, psychological, and social characteristics of adolescents, their health care problems and needs.
- Clinical & Laboratory Immunology
- A pediatrician who utilizes laboratory tests and complex procedures to diagnose and treat disorders characterized by defective responses of the body's immune system.
- Developmental-Behavioral Pediatrics
- A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care, and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children, and in the family dysfunctions that compromise children's development.
- Medical Toxicology
- A pediatrician who focuses on the evaluation and management of patients with accidental or intentional poisoning through exposure to prescription or non-prescription medications, drugs of abuse, household or industrial toxins, and environmental toxins. Important areas of medical toxicology include acute pediatric and adult drug ingestion; drug abuse, addiction and withdrawal; chemical poisoning exposure and toxicity; hazardous materials exposure and toxicity; and occupational toxicology.
- Neonatal-Perinatal Medicine
- A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies.
- Neurodevelopmental Disabilities
- A pediatrician who treats children having developmental delays, or learning disorders, including those associated with visual and hearing impairment, mental retardation, cerebral palsy, spina bifida, autism, and other chronic neurologic conditions. This specialist provides medical consultation and education and assumes leadership in the interdisciplinary management of children with neurodevelopmental disorders. They may also focus on the early identification and diagnosis of neurodevelopmental disabilities in infants and young children as well as on changes that occur as the child with developmental disabilities grows.
- Pediatric Cardiology
- A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing, and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.
- Pediatric Critical Care Medicine
- A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients, and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitate patient care among other specialists.
- Pediatric Emergency Medicine
- A pediatrician who has special qualifications to manage emergencies in infants and children.
- Pediatric Endocrinology
- A pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands. These diseases include diabetes, mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region, and disorders of the thyroid, the adrenal and pituitary glands.
- Pediatric Gastroenterology
- A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children, and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer, and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs.
- Pediatric Hematology-Oncology
- A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases.
- Pediatric Infectious Diseases
- A pediatrician trained to care for children in the diagnosis, treatment and prevention of infectious diseases. This specialist can apply specific knowledge to affect a better outcome for pediatric infections with complicated courses, underlying diseases that predispose to unusual or severe infection, unclear diagnoses, uncommon diseases, and complex or investigational treatments.
- Pediatric Nephrology
- A pediatrician who deals with the normal and abnormal development and maturation of the kidney and urinary tract, the mechanisms by which the kidney can be damaged, the evaluation and treatment of renal diseases, fluid and electrolyte abnormalities, hypertension, and renal replacement therapy.
- Pediatric Pulmonology
- A pediatrician dedicated to the prevention and treatment of all respiratory diseases affecting infants, children, and young adults. This specialist is knowledgeable about the growth and development of the lung, assessment of respiratory function in infants and children, and experienced in a variety of invasive and noninvasive diagnostic techniques.
- Pediatric Rheumatology
- A pediatrician who treats diseases of joints, muscle, bones, and tendons. A pediatric rheumatologist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries, and "collagen" diseases.
- Sports Medicine
- A pediatrician who is responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice), and the role of exercise in promoting a healthy life style are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.