Diagnosing

Cooper, laughing:
Oh. Ohhh.

COOPER
Autism Diagnostic Screening

Chelsea Papp
Cooper’s Mother:
Cooper at fourteen months old was a very happy, to me typical little boy. I didn’t see much wrong or different about him at all. He seemed to really love his toys, made very little fuss, didn’t cry. Cooper, however, at his fourteen-month-old’s well-check had raised concerns to his doctor, and his doctor had noticed in a series of yes-or-no questions that a lot of my answers were “no.” And that was pertaining to communication, social and emotional growth and eye contact.

Cooper:
Yeah.

Therapist:
Yeah, I know it’s an exciting book! I know, I know it’s so exciting!

Chelsea Papp:
Many people did not see what the doctors had told me initially. My family and my friends said, “Most likely Cooper will be just fine. You don’t need to do anything.” Inside I felt like, “Cooper is just a baby boy. He’s fourteen months. He, he’ll grow out of this.” And I had that doubt in my head, “What if? What if he doesn’t grow out of this? What if I don’t do anything?”

Cooper:
Uhhh.

Therapist:
Rubber ducky.

Amanda C. Gulsrud, Ph.D.
Clinical Psychologist, UCLA Semel Institute:
Cooper is a little boy who, when I first saw him, was displaying very marked impairments in social communication. He had a few vocalizations, early babble, but those weren’t really directed to people in his world.

Cooper:
Eh, eh, eh, eh.

Amanda C. Gulsrud, Ph.D.:
He also didn’t respond to his name when we, when repeatedly called, um, nor did he want to kind of share the world with others. He wasn’t using eye contact to initiate or start a social interaction with anyone, nor was he looking at another person when we tried to get his attention. Eye contact is really critical, and what we look for is whether a child is using eye contact socially and pairing it with other ways to communicate. A child who is typically developing who sees something of interest in their world may point to it and then may look back and forth between the object and the parent as if to say, “Do you see what I see?” even before language develops, and that was not something Cooper was doing. So he showed many of the classic signs of autism.

Therapist:
What about this one? Zoom, zoom, zoom!

Chelsea Papp:
When I first heard the word “autism” I started crying. I had no idea what it really meant, but I knew that it meant Cooper was different. I knew that, that it meant Cooper was going to be facing challenges. I needed to learn a lot more.

Therapist:
Whoa! Whoa! Very good. Ooh. 

Amanda C. Gulsrud, Ph.D.:
Many, many parents I talk to say they knew something was wrong with their child from a very early age, um, and they were frustrated because others, you know, weren’t seeing what they felt and what they knew was going on with their child. So there’s relief, um, there’s also a grieving process, um, sadness, uh, trying to come to terms with the fact that their child who they love and will continue to love has a developmental disability.

Therapist:
One, two, three! Come on, look at your mom. Four, five, six, seven, eight, nine, ten!

Amanda C. Gulsrud, Ph.D.:
You know, the biggest thing is how scary this process can be for families and oftentimes, um, you know, there’s a real resistance to kind of coming and asking for help, um, even though families are feeling like there’s something going on and they’re feeling nervous about what’s going on with their child. And even though we can’t predict the course of development for any child, we do know that the single best indicator of how they’re going to do is their age of diagnosis and age of accessing early intervention services.

Amanda C. Gulsrud, Ph.D.:
We know that early intervention works, and we know that the earlier we can get children into early intervention, the better their long-term prognosis. 

Chelsea Papp:
I have seen a great amount of progress since the diagnosis. The diagnosis itself was a gateway for us to be able to obtain more services, to bring in additional support.

Chelsea Papp:
Say, my turn.

Cooper, age 3:
My turn.

Chelsea Papp:
Good job, asking. Good job. You get the car now!

Chelsea Papp:
Good boy! Come here.

Chelsea Papp:
The value of knowing is what helped us treat him for what he needed. He was delayed in verbal communication and language, but to know that that’s not the only delay and to know that it’s under the spectrum of autism gives us a different approach to be able to help him.

Chelsea Papp, reading:
O.K. “I head towards the moon, past the stars twinkling. I love being an astronaut. It’s so much . . .”

Cooper, reading:
“fun.”

Chelsea Papp, reading:
“Fun.”  Good job, Cooper. What do we say to the book? Are we all done, book?

Cooper:
“We’re all done, book.”

Chelsea Papp:
I used to be the one who was on the floor begging him to play with me, and now Cooper will come and grab my hand when he wants to play with a car and ask me to help him. That’s extraordinary progress from where we were at a year and a half ago.

Amanda C. Gulsrud, Ph.D.:
Parent involvement is critical in early intervention. Um, Cooper’s parents were a perfect example. They dove in to this enthusiastically, optimistically, and they wanted learn how to interact with Cooper better, to promote his, you know, his growth. 

Chelsea Papp:
Cooper and I and my husband work as a family together, and I’m very pleased with all of the, all of the help that we’ve been able to get because of having an autism diagnosis. 

Chelsea Papp, laughing with Cooper:
Splat!

Chelsea Papp:
Good job!

Chelsea Papp:
I can only say that from this point forward I see a light at the end of the darkness, um, the darkness meaning that it felt very doom-and-gloom initially not knowing what this was, and now I see that what we’re doing is working. I see that Cooper’s smiling and laughing and interacting more regularly, and we still have a lot of progress that we need to make. But with starting so early and not ignoring those signs, I feel that we will only continue to make progress. And what else could I ask for, to have my child look in my eyes and to tell me that he knows that we’re there together by that verbal, without that verbal communication, with that eye contact? That is amazing.