a risk factor too. Not to be alarmist –
certainly most women who experience
depression in pregnancy won’t have
a child with autism – but it is a little
piece to the puzzle. We can see there
are some environmental factors that
could be affecting a mother that,
through no fault of the mother, get
passed down to the child.”
Autism can be ‘cured’
“You hear that word sometimes, even
from reputable service providers.
Something that I mention to parents
when they’re looking at the endless
barrage of treatments they hear
about, a red flag for them should be
if a provider is claiming they’ll be
able to cure their son or daughter.
That’s a sign you should think twice
about proceeding. They’re claiming
something they can’t possibly deliver,”
warns Dr Fischer. He shares that
even though, with intensive therapy,
a child with autism may become
indistinguishable from a typical child,
they still have autism. “The reality is
they’re not cured. They have to try
harder than a typical person would to
appear typical.”
The path to diagnosis
Parents with concerns about their
child have a few options when
seeking help. The first step is usually
to discuss your worries with your
doctor or paediatrician, who will be
able to give advice and, if necessary,
recommendations for a psychologist
who is experienced in assessing
children. Hong Kong’s government-
run child assessment clinics (CACs)
can provide assessments, but the
waiting lists may be long. Assessments
include measuring the child’s
language, motor skills, play skills,
social skills and general development,
and a specialised autism diagnostic
observation schedule (ADOS) test will
also be undertaken. Parents will also
be interviewed to give as full a picture
of the child’s development as possible.
After the assessment, parents will meet
with the psychologist to discuss the
results and recommendations.
If you first notice that your child
may be exhibiting some signs of
autism after they have started school
or pre-school, you can discuss your
worries with teaching staff. Michele
Fernandes, Principal at Discovery
Mind International Play Centre,
says, “Parents and guardians are
always encouraged to talk to us
about any concerns they have. Most
often, parents will ask to talk to a
class teacher or myself if they notice
anything that concerns them.”
Alternatively, a school may contact
parents if they have concerns after
observing a child. Michele Fernandes
says, “When we notice anything
that might give us cause for concern,
before talking with parents we observe
for repeated patterns of behaviour
or other areas of concern. Then,
we discuss observations at a weekly
teacher meeting and ask parents to
come in for a talk at their convenience;
we appreciate both parents coming
in for these meetings so that we are
all on the same page. We ask parents
for their observations, if they have
sought any help and what they feel is
the right approach if they have sought
help and have knowledge of what we
have brought up. If not, we will offer
suggestions, expert referrals and ask
them to keep us informed.”
Michele Fernandes explains
the school’s involvement in the
assessment and therapy processs.
“Class teachers do not diagnose as
we are not professionally recognised
experts, however we are involved in
working together with any therapists
once a child has had an assessment.
Assessment centres or child
psychologists will usually ask for our
written observations about a child who
has been referred to them. In some
cases, a child may continue to receive
therapy while continuing in playgroup
with us. The written assessment report
and regular updates from parents are
helpful to teachers – schools require
these for admission/ placement – so
that they may continue to help and
reinforce the child’s development and
progress.”
If parents do notice anything that
gives them cause for concern, Dr
Fischer strongly advises taking prompt
action. He says, “The risk of not doing
anything is extremely high. The best
time to get services is when the child is
young. If you wait, the door can close
on some early intervention results.”
While a ‘wait and see’ approach might
feel best for those who are uncertain,
experts warn the impact of being
passive can be serious.
First steps to treatment
Facing the unknown is difficult. Once
a diagnosis is made, a personalised
journey should be created for your
child. Each child is unique and parents
need to create a plan that will best
serve their child.
Dr Minna Chau, a child
psychologist and centre director at
Sprout in Motion, shares her advice
for parents facing a fresh diagnosis.
“Sit with it. Don’t jump into the first
treatment programme you come
across immediately following news of
the diagnosis.” Allowing that small
but significant space to make such an
important, but timely, decision is of
great importance. It is advisable to
take time to learn about the options
and think through the best course of
action for your child. As one mum
kindly shared with us, “It takes
a village, and each child needs a
different village. It will be different for
each kid, be ready to try and keep an
open mind.”
May 2016
47
