My husband (who is a physician) and I were not surprised when Lucas got the diagnosis of autism one day before his 3rd birthday in 1999 but what was shocking to both of us was that the doctor diagnosed him as having moderate to severe autism. We both thought that since Lucas had some language, didn’t exhibit any major problem behaviors, and was able to go to regular preschool by himself for a full year, he would have been diagnosed with mild autism.
At the meeting I asked the doctors how they could be so far apart with one diagnosing moderate to severe autism versus PDD-NOS. The doctor explained that some of this was subjective. It depended on the day. It depended on what testing was done and even how interactive Lucas was on the different testing days. He also said that the two diagnoses were actually not that far apart and explained it was like saying something is light red or dark pink. But what he said next really got my attention. He told me that what I really was asking him was what Lucas was going to be like at age 8 or 15. He said that neither of them had a crystal ball and no one knew.
Right before Lucas’ official diagnosis, I went to see a full day workshop done by an international autism expert, Dr. Glen Dunlap. At a break, I went to speak with Dr. Dunlap and told him that I believed Lucas had mild autism and I didn’t think he’d require much treatment. He looked at me and basically told me not to rest on my laurels, that in his 30-year career in the autism field, he saw lots of kids like Lucas who looked pretty good at the age of 2 or 3 and he thought they’d do well but by age 8, they were really impaired. He also saw kids who were severely impaired early on and he wouldn’t have thought they’d do well, but with very intensive ABA therapy, they surpassed the more mildly affected kids. Basically his advice was to treat Lucas’ autism like the most severe autism I had ever seen….that way, we would never regret not giving him the best chance.
So, can you predict how a 2-year-old diagnosed with autism will do at age 8 or 18, the answer is no. I have seen in my 2 decades in the field now that an early diagnosis and early behavioral intervention (20 or more hours per week of ABA therapy, not just 1 hour of speech and 1 hour of teacher time which is commonly offered in early intervention program) will give your child or client the best chances.
