Welcome to the Knights of Columbus Developmental Center at SSM Cardinal Glennon Children's Medical Center.

Children should be observed for developmental delays during primary care physician office visits.  As communication develops, primarily in the first two years of your child’s life, it is important to recognize early red flags for autism.

Red Flags for Autism:

      No smiling back at someone by 7 months

      No response to name by 7 months

      No ability to follow a point (gaze monitoring) by 8 months

      No following someone’s pointing/saying “look” to something by 10 months

      No pointing to ask for something by 12 months

      No showing of objects by 14 months

      No pointing out an object of interest to someone else by 14 
months

Absolute Indication for Autism Evaluation:

      No babbling or gestures by 12 months

      No spontaneous meaningful words by 16 months

      No 2-word spontaneous phrases by 2 years

      Loss of language or social skills at any age

Developmental screening with tools such as Ages and Stages Questionnaire (ASQ) and the Child Development Inventory (Ireton) is encouraged at each primary care visit at 9, 18, 24 and 30 months. In addition, at 18 and 24 months, your child should be screened for autism using the Modified Checklist for Autism in Toddlers (M-CHAT). If your child does not pass the M-CHAT, he or she should be referred for a comprehensive ASD evaluation.

Without having to wait for the evaluation, your child should be referred for therapy to Early Intervention (age 0-3) or Early Childhood Education Services (older than age 3).  Read the Guidelines from the American Academy of Pediatrics.

After completing a physical, neurological exam and screening for abnormal features, a primary care provider should refer your child for a formal hearing test and evaluation with an autism specialist as well as necessary therapies.

Autism Diagnostic Evaluation

Children should have testing for speech and language, fine motor and visual-motor skills, adaptive functioning, as well as verbal and non-verbal cognition. A review of developmental and family history, a structured interview with the child’s parents using the Childhood Autism Rating scale (CARS) or the Autism Diagnosis Interview-Revised (ADI-R), as well as use of an observation scale like ADOS, are highly recommended.

Genetic testing is recommended for most children with autism. Brain wave studies (called EEGs) during sleep and wake time are recommended for any child with language and / or social regression. Children with developmental delays, seizures, a small head circumference and abnormal neurological exams should have a brain MRI. Additional lab testing is based on specific clinical findings and medical history.

Autism Treatment

Treatment for autism addresses the specific needs of your child and includes:

      Applied behavior analysis (ABA): behavior management

           Speech and language therapy

           Occupational therapy for fine/visual motor skills, sensory integration therapy

      Play skills training, independence skills therapy, music and art therapy

       SCERTS: behavior intervention combined with sensory diet

          TEACCH: structured educational programs with visual schedules

     Relation development intervention (RDI): social awareness

     “Floor-play” therapy, social skills

     Swimming, therapeutic horsemanship, respite care, mentoring from a parent support group

Autism Prognosis

Children with autism that have spoken five or less meaningful words by age 5 and have an intelligence quotient (IQ) lower than 70 are considered to have low functioning autism. Children that develop meaningful spoken language by age 5 and have normal intelligence are considered to have high functioning autism and have a better prognosis. Early intervention has been shown to improve the prognosis of children with ASD.