The rate of Autism Spectrum Disorders diagnoses climbed by more than 12% in two years according to the latest CDC report released last month, and Loudoun families are navigating therapies and interventions at a time when child development already is stunted by pandemic-related isolation.
Families are already battling the impacts of the pandemic on young children, which the CDC says includes children’s social, emotional, and mental well-being.
The condition manifests a range of traits, from strengths to deficits, to various degrees. Some autistic people are able to live typical lives needing minimal support, while others are completely non-verbal and need high levels of support to meet basic needs.
In December, the CDC announced that data collected from 2018 found that one in 44 8-year-old children in the U.S. has an ASD diagnosis, up from one in 54 in 2016.
The demand for therapies and services, like many early-childhood fields, is high. According to Johanna Van Doren-Jackson, senior manager for Loudoun County’s early intervention program, Infant and Toddler Connection, referral rates from pediatricians are through the roof. Pandemic-related staffing shortages and limited funds strain the resources available to the community’s youngest, most at-risk population.
“We have had an increase in referrals for children since probably March of 2021. Our numbers dropped in the beginning of the pandemic,” Van Doren-Jackson said. “I think a lot of children were missing those well-child checks. It seems like around the one-year mark of the pandemic there was a deep breath of ‘OK, I need to call about this.’”
While many parents speculate that their children are socially stunted because of pandemic-era isolation, there is no consensus among experts as to why ASD rates are burgeoning among youth.
“It’s fascinating,” Van Doren-Jackson said. “The field has changed. It was about parenting. Now it’s seen as possibly genetic.”
Van Doren-Jackson said that getting treatment for children as early as possible, while their brains’ neuroplasticity is high, is crucial. Services include speech therapy, occupational therapy, physical therapy, and feeding therapy.
“If we can get children talking meaningfully—I don’t mean just naming things or numbers, but really communicating with someone—if we can get that going before two, the prognosis for that person is so much better than if it happened later.” Van Doren-Jackson said. “That means we need the child by 18 months. Then we have time to get it going to support the child.”
The first five years of a child’s life are when their brains are most pliable and able to change.
But for older children, Van Doren-Jackson said, it’s not too late for intervention.
Children ages 2 and up can be referred to Child Find, the federally mandated program operated by the school division to provide special education. Children not yet school-aged are entitled to free developmental screenings to determine eligibility for special education preschool.
In Virginia, all families can refer their children to be evaluated for early intervention services provided by their county. In Loudoun, the Infant and Toddler Connection program serves children from birth to 36 months old. Van Doren-Jackson said that any family with concerns about their child’s development should call the program.
“We are happy to be wrong. We don’t have any problem screening or accessing a child to only determine that they’re perfectly typical,” Van Doren-Jackson said. “We’re not here to set up barriers or access to treatment.”
The CDC advises that parents look out for a wide range of particular traits or missed milestones. Traits include a child not making eye contact, not responding to their name, not pointing or making communicative gestures, and hand flapping are common traits of ASD in toddlers, though there are many others.
For new parents the signs can be easy to miss, said one mother of three in Ashburn who asked to not be identified. She said that when her second son turned a year old, she noticed he hadn’t been communicating in the same way that his older brother had at the same age. She looked back in her older child’s memory book and brought her concerns to her pediatrician.
“I went to the pediatrician and he said it is worrisome, but they said let’s wait until his 15 month checkup, and then his 18 month checkup,” she said.
She said she followed her gut instinct and pursued testing for her son. She got slightly discouraged not receiving a call back from two large institutions because of high volume, but a private practice in Tyson’s Corner got her son in quickly. Within a few weeks, her younger son received a diagnosis of ASD, which opened several doors to various therapies for the family.
“The diagnosis is important for a couple of reasons. In Virginia, it can give parents access to some types of services that they wouldn’t otherwise have. It is also helpful for parents to know the name of their child’s condition,” Van Doren-Jackson said.
Still, the diagnosis isn’t required to begin early intervention services with the county.
If an evaluation finds that a toddler is a certain number of months delayed in meeting milestones across multiple categories, they qualify for services.
Time is of the essence for getting children services, but there are things parents can do at home to improve communication. KayLynn Newton, clinic director at New Directions ABA in Herndon, said parents should mimic their children during play to encourage them to connect and communicate.
“Pay attention to what types of activitiesand toys your child is drawn to. Once you have a good idea of what they like, you can start to engage in the activity by following your child’s lead. When the child becomes accepting of you as a play partner, it is your opportunity to teach new things,” Newton said.
Van Doren-Jackson said for babies, it’s key to ensure they’re comfortable, or regulated.
“Children learn when they’re connected and happy. What can you do as a parent to extend those times when the child is connected and happy,” she said.
Newton also said that when it comes to therapies, balance is key.
“Parents and children can’t be expected to do it all. Seek balance and don’t expect your toddler to have a 40 hour-per-week ‘job,’” she said.
As with many early childhood education fields, early intervention is wildly underfunded, and there is a shortage of professionals, Van Doren-Jackson said. Early intervention is an unfunded mandate under the Individuals with Disabilities Education Act. She said Loudoun, as a locality, is generous toward early intervention. The department falls under the county’s Mental Health, Substance Abuse, and Developmental Services.
“It always leaves us wondering in that struggle of ‘will we have enough money to serve all the children, when the funds coming from the state and federal government are not sufficient?’” she said.