Ethan screamed every time he went into a Giant supermarket, making trips to the local grocery store no easy task for his mother, Karen Johnson. However, the single mother of two often had no choice but to bring her children along.
Met with sharp stares and even direct comments about disciplining Ethan, Johnson did not know the shopping trips were just as stressful to her son as they were to her. Unknown to her at the time, Ethan’s outbursts were being triggered by environmental factors in the grocery store.
“It would be frustrating,” Johnson said. “I just knew a spanking was not the answer there, period, because if you hit a child that’s already hitting, he’ll continue to hit and you’re just reinforcing the behavior.”
At the age of 4, Ethan, now 7, was diagnosed with autism.
“Before his diagnosis, we didn’t know why he would fall out or he didn’t want to do things without crying and screaming,” Johnson said. “Once he got diagnosed, the ball really got rolling. It got a little bit easier and then we could understand why certain tantrums were happening.”
According to the Center for Disease Control and Prevention (CDC), many children are diagnosed with autism at about 4 years old. Many others have noted the standard age of diagnosis to be 2, but researchers have determined that African-American children may be diagnosed as much as 18 to 24 months later.
Johnson said doctors had a hard time diagnosing Ethan because of his evolving symptoms, but once he was placed in school, it became clear that he struggled with communication. His diagnosis came soon after.
In a nationwide study published in the journal Nature last month, doctors predicted with 80 percent accuracy which high-risk children would develop autism by age 2, based on MRI brain scans at ages 6 months and 1 year.
Though additional tests will need to be developed to validate and refine the finding of the study, the research paves the way for predicting which children develop autism before behavioral symptoms emerge.
But despite advancements in diagnostic tools and increased recommendation for screening, disparity still exists in autism diagnosis for minority and low-income children.
A study presented at the 2016 International Meeting on Autism Research showed black and Hispanic children were less likely to get a diagnosis of autism than white children and that children from high-income families are roughly 81 percent more likely to receive an autism diagnosis than those from low-income families.
A 2008 CDC study notes the diagnosis gap may be indicative of differences in screening and services than the actual prevalence.
Johnson said diagnosis was key to getting her son the services he needed. Since his diagnosis, Ethan participated in various forms of therapy including behavioral, speech, physical, occupational and, most recently, food.
“His language is still developing, but is pretty good,” Johnson said. “Now we’re doing food therapy, trying to get him to try new foods.”
Early intervention is often linked to better outcomes.
“There is no debate or doubt: early intervention is your child’s best hope for the future,” said a statement on the website for Autism Speaks, an autism advocacy group that sponsors and conducts autism research and outreach activities. “Early attention to improving the core behavioral symptoms of autism will give your child — and the rest of the family — several important benefits that you will not gain if you take a wait-and-see approach until your child enters school at age four or five.
“A good early intervention program has at least four benefits: It will provide your child with instruction that will build on his or her strengths to teach new skills, improve behaviors, and remediate areas of weakness,” the statement said.