Family Almanac

Family Almanac by Marguerite Kelly: Friday, Aug. 21, 2009

By Marguerite Kelly
Special to The Washington Post
Friday, August 21, 2009

Q.My sister's 2-year-old son often acts like he's autistic, which worries me terribly.

Every day is a struggle. He can't communicate well, either verbally or physically; his tantrums can last for hours and play groups are nonexistent. You can't even run errands when he's along.

I know my sister and her husband are frustrated, but they are trying to believe that this is just a phase. If it is autism, however, I want her to do something about it NOW, because I've read that early detection, diagnosis and therapy can make a real difference.

I'm not quite sure how to discuss this with her. She is obviously stressed and blames herself for her son's behavior, but she often gets defensive if I talk about it and its possible causes.

I'm not even sure if she and her husband think autism is a possibility, so how can I bring up the subject? What advice can I give? What steps should she take?

A.If there were such a thing as a Good Sister Award, you would win it. So many people avoid any family that has a difficult child, as if his problems would disappear as soon as they did. But they don't.

It would be both foolish and unkind to tell your sister that her son might be autistic, however, because the possibility is frightening and because you might well be wrong. Instead, tell your sister that you think her son has a physical problem; that it's not her fault; and that the sooner it is diagnosed, the more successful the treatment will be.

It will take a doctor, not an auntie, to figure out why your nephew speaks poorly and has tantrums every day. He could be autistic but he could also be -- like many little boys -- a slow talker, and his tantrums may last a long time simply because he has allergies or a sensory processing disorder. Autistic children usually have these problems, but so do many children who aren't autistic.

You'll help best if you gather the names of a half-dozen developmental pediatricians, because they usually diagnose autism best, and then call their offices to find out how long your sister would have to wait for an appointment and whether her son would have to meet any special requirements. Many developmental pediatricians will see only patients who are younger than 4, so their treatment will be more effective, and some of them insist that their patients be on the gluten-free, casein-free diet because many children -- autistic or not -- behave much better when they give up dairy, wheat, rye and barley. Once you have this information, you can give it to your sister, in person or in writing.

If the doctor says your nephew does have autism, your sister will need you to tell her, again and again, that this medical disorder is treatable, and that you will keep her up-to-date with the latest research.

No one knows why one child in 150 is autistic today when only one out of 2,500 was autistic 50 years ago, but there are a lot of theories. Some cutting-edge doctors think the disorder is caused by oxidative stress or by certain proteins in the body. Others blame autism on mercury, the preservative that was used in vaccines -- and in some cases, still is -- or they think autism occurs if a child gets too much aluminum in his body or not enough vitamin D. And those are just some of the theories.

Your sister can probably learn about most of them if she goes to the Autism Research Institute's next semiannual DAN (Defeat Autism Now) conference in Dallas from Oct. 8 to 12 and if you give her some books on autism, such as "Healing and Preventing Autism" by Jenny McCarthy and Jerry Kartzinel (Dutton, $27) or "Overcoming Autism" by Lynn Kern Koegel and Claire LaZebnik (Penguin, $15). "Could It Be Autism?" by Nancy D. Wiseman (Broadway, $13) is another good book, and so is "Eating for Autism" by Elizabeth Strickland, written with Suzanne McCloskey (DaCapo, $18). Strickland, a registered dietitian, gives some excellent recipes for the GF/CF diet and a lot of good advice.

The best gift of all, however, will be yourself. Try to babysit your nephew frequently, so your sister and her husband can get the breaks they need to keep their marriage strong. This is extremely important, because the parents of autistic children are at great risk for divorce.

Most of all, your sister will need you to listen to her dreams, to encourage her efforts and to comfort her. Always.

Questions? Send them to advice@margueritekelly.comor to Box 15310, Washington, D.C. 20003.

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