Cynthia Miller-Lautman

Welcome. My name is Cynthia Miller-Lautman and I’m an occupational therapist and intervention team leader at Disability Program Specialized Services.

Bethany Hartropp

Good morning. My name is Bethany Hartropp, and I’m an occupational therapist and a clinical advisor with the Disability Programs.

Cynthia Miller-Lautman

During our training week in March 2021, the Disability Programs Specialized Services team offered an online info session. Bethany and I spoke about autism spectrum disorder. But in the last 30 minutes of that afternoon, we received and answered several related questions about autism.

Bethany Hartropp

So this is a really big topic. And because there were so many of you participating in the chat, thank you so much. We were not able to get to every question, and some questions required some further explanation, we thought. So we’re recording this conversation today as the third part in our series, in the hope that by listening or watching this video, we can clarify and maybe give you some more information. So to really understand where these questions are coming from, please go back to our web page and take a look at our podcast Episodes one and two. And Cynthia, we ready to start?

Cynthia Miller-Lautman

We are. So we have narrowed down ten questions that we really wanted to get into today. So we will go through them. And I’m excited for this. So let’s start with the first one, Bethany. This came up a few times on the chat and a lot of people, after a diagnosis of autism, start asking these questions. So the question was, “Is autism linked to drug use? And what about if the father uses drugs?”

Bethany Hartropp

Right. So this is a really good question. And the reasons for autism right now are being researched. But at the moment, no specific reason has been linked to drug use at all. And while drug use is not great for the baby, so please talk to your doctor about any specifics for for the baby and drug use. There’s nothing for sure known about drugs and autism with either parent right now. Right.

Cynthia Miller-Lautman

So the next question was, “Can having an older parent say a parent in their forties or fifties be a potential cause of autism spectrum disorder?”

Bethany Hartropp

So, Cynthia, that’s also a good question. And again, this is being researched, but there are no clear results or conclusions about the age of parent and autism. So, yeah, no. Autism causes are being researched and and there’s no results right now.

Cynthia Miller-Lautman

Yeah. And I think I think this is something that parents do a lot. Sometimes when they’ll get a diagnosis, maybe not even just autism. They question, what did I do? What did I do wrong? And that’s very hard. And I encourage parents not to go down that route. We don’t have the answers yet, although there are lots of people looking into the research. And I really do hope in the next few years or decades we do have more answers. But don’t beat yourself up that there was anything you did during your pregnancy. So the next question was from the chat that was asking, “Is autism the same as Asperger’s?”

Bethany Hartropp

Right. So over the past few years, diagnosis names have changed a little bit. For various reasons, the term Asperger’s does not exist anymore as a diagnosis. And this can be a bit confusing because we’ve heard it for a lot of years. A lot of people have been diagnosed with Asperger’s, but people are not diagnosed with Asperger’s anymore. And now it’s called autism spectrum disorder.

Cynthia Miller-Lautman

Yes, I hear a lot of people still refer to using Asperger’s and what they were describing often was someone that had strong verbal skills, meaning they could talk very well, but we don’t use high and low functioning anymore. Actually, people with autism do not want that terminology and either do people with other disabilities. What we would still instead do is talk about more about where their strengths are and what their weaknesses are. So, for example, you would talk about an autistic person that has very strong communication skills exactly that way, but that same person might have very strong communication skills, but might have a lot of trouble with another area of their life and might, that might be a little bit invisible because you see how strong they’re able to talk. But they might be really struggling with their sensory processing. So that’s how their body feels, the senses from the world and then reacts.

Bethany Hartropp

So another question we’ve got, Cynthia, is “How early can autism be detected?”

Cynthia Miller-Lautman

Well, the first thing is that I should say, is that babies are born with autism. They have it when they’re born. When it gets detected, when parents or doctors or people around you start to notice is different. So that can be as often parents are noticing in around 18 months of age. So a year and a half when the baby is learning to talk. And maybe the parents might notice that they’re not playing or communicating the same way as their siblings, as the brother and sister that came before them, they might notice a lack of play skills at 18 months when play starts to increase where the 18 month olds and two year olds start feeding themselves and pretending they’re feeding their doll or their dog. So this is when parents often start to notice, the red flag goes up. But if you look back at a home video of a baby who was autistic, you would see on the video, you would probably notice little things like they had more trouble having back and forth laughing sessions with their parents when they’re giggling back and forth. Maybe they showed less interest in traditional objects that babies neurotypical, as we say, developing. Typically, babies would have for example, they may not be interested in looking at the doll and the stuffed animal dancing across their mom is using or their dad is using. They would instead would maybe be really interested in that stroller wheel and how it turns. And that’s just an example that is not all people with autism, but that would be an example. Okay, so how early let me just say that again. If people are born with autism, but it it’s often detected around 18 months, but many kids don’t get the diagnosis till later. So often it’s around three or four years of age.

Bethany Hartropp

Okay. So the next question that we received was how can we encourage parents that are hesitant to move forward with getting a diagnosis for their child? For example, if a parent is reluctant to sign a consent form or if they are in denial that their child may have autism.

Cynthia Miller-Lautman

Yeah, I too, I felt a bit uncomfortable with this question, but I think it’s really important that we address questions like this because there’s a danger when we pressure or move parents faster than they can on their journey. Each journey of a parent who has a child is different. Some had a vision of what their child would be strong and or good, and even though they before they were born. So for some, the journey is hard. For some it is easier. But all parents go on a journey when they’re going through a diagnosis for any disability. So what I really encourage is not to come on full force like you must sign this consent form, you must do this. This is the wrong approach. You must gently explain your concern and be willing and accepting that they might not be ready to hear you.

And that’s okay. But you might have been the first person to mention something. And then a few years later, or a few months later, there might be another person that mentions it and then the parents might start noticing things. And then a third person mentions that they’re concerned. And guess what? Maybe that’s when the parent is ready for the journey to go through a diagnosis.

So we cannot rush it. My third child. So I have a family who are not neurotypical neurodivergent family members. They have ADHD. But that journey was hard for my third person in my family to be diagnosed. So you would think that I should be okay. But I’ve already had two people that were diagnosed in my family. That journey as a parent was really tough.

I know there had been psychologists that were diagnosing my second child who mentioned I’m maybe your third child has it, too. And I just I couldn’t listen. I could not hear them. I was not able to I was going through the journey of my other child at that moment, and I needed to go one at a time, and that was me.

That’s not everyone, but that was my journey. So if someone had stood there with like a hammer over my head saying, You must get this consent signed and you must diagnose this child, I probably would have run away and not come back. So it was gentle reminders from professionals over time that made me slowly. It took about two more years to say, Oh, it’s time. So I just just be gentle and family and just know you are playing a piece and be gentle on yourself. You don’t have to solve it. You don’t have to get it done. You were doing your piece as a professional.

Bethany Hartropp

I think something too. I mean, you’ve referred to it the Cynthia too, that that whole journey can be such a big change for the family, too. And it, it can’t it can be really, really hard to go through that process. Q You’ve described your own like what it was like for you and you went through your own and it was different for each for each person with you as a as a parent.

Bethany Hartropp

And some families have no idea what they’re getting into when they go when they’re referred for a diagnosis, even when they consent, they don’t know what it’s like and what it what that process is going to be from the assessment and then potential treatments. And so if as a family, you’re going through this right now and you’re finding that it’s a lot.

So really we would recommend that you reach out for help, whether it’s a support group or a case manager or an elder. There’s the support line as well there. Really, it’s it is a lot to to go through.

Cynthia Miller-Lautman

Yeah. Diagnosis is a journey for parents and it’s an emotional one right.

Bethany Hartropp

And if you’re being diagnosed as an older person, as a teenager or an older adult, it’s also a journey for you as well. So recognize that whatever you’re going through as an emotion, it’s important that you get support for that emotional part as well. Not just the assessment piece, but getting the support for for what? For what that means as well for you.

Cynthia Miller-Lautman

Yeah. Bethany, that is a great point because there are many adults who go through the process of diagnosis with their child and then end up realizing, hey, maybe, maybe I have that too. Maybe this is explains my symptoms. So yes, I think that’s a great a great point. So I’m going to change gears a little bit and ask you a different question, Bethany.

And this came from the chat again. Were there are there any positive results with service animals and autism spectrum disorder?

Bethany Hartropp

Yes, there are. So service animals are sometimes known as therapy animals. And these can be really great for people with autism, Autistic people and a service animal is not a pet, a service. Annabelle is trained to be calm, friendly and sociable. So in Quebec it is MIRA that trains the animals.

Cynthia Miller-Lautman

So if I. Sorry, Can you say that again? It was MIRA.

Bethany Hartropp

MIRA. M I R A trains the animals and helps the person with their needs. So for example, a service animal with a person with anxiety, for example, could get a service animal to help them manage stress. So being with that service animal can be really relaxing. So if anyone has a pet at home, you know that just like it can be really relaxing to sit and pet your dog or like cuddle with a cat or even like and while any animal really, like often it’s just like really nice to like sit and be with your animal. Yeah. And, and just imagine if you’re stressed and could take your pet to work or to school. And that’s what a service animal is there for, is really to help manage whatever the the needs of the person is to really meet those needs of the person. I gave the example of anxiety. But for people with autism, the the best thing to do is to have a trial to see if they like animals.

Bethany Hartropp

Not all people like animals, and then observe and see if the animal helps the person and is a good fit. And Mira will help with that.

Cynthia Miller-Lautman

Great. So again, that’s the MIRA Foundation in Quebec. Yeah. That provides service.

Bethany Hartropp

Had I had some friends who had a MIRA animal for their, for their child and it was a beautiful fit and it was like this animal became. Became part of the family and was like a best friend, almost fur for that child. It was lovely.

And moving on, Cynthia, another question came up. How can I help parents to use visual schedules?

Cynthia Miller-Lautman

Right? So in in part one and two of our Autism series podcast, we talked about visual schedules sometimes being one of the best practice tricks that people use to help them communicate. So the best way, though, visual schedules are different than how a neurotypical people might communicate, although they benefit everyone often, but you need to get the parents on board.

And how do you do that? Don’t just tell them. Don’t talk to them about it. You can talk a little, show them, show them how it works. If you’re a teacher at school and you’ve been using a visual schedule, you’re a special needs educator and have been using a visual schedule with the child practice and then show this is the best way to encourage parents to buy in because parents have a lot on their plate when they have a child who is going through a diagnosis or is autistic. They have a lot of things going that they’re working on. So another thing on their plate can be overwhelming. So how do you encourage parents, show them, help them and do some, create a visual schedule for them, make it. And how do you do that? Well, if you didn’t see our we have episodes on our website about visual schedules and blog posts of how to create one where you can download a template of a visual schedule.

Cynthia Miller-Lautman

So I thought and again, so our website is disability programs, specialized services, dot org. But I thought I would show you a little story. So this was an older teenager who is autistic and he he was struggling to communicate. He had words, but he was struggling to communicate everything he wanted to say. And the parents were having the same difficulty back and including the grandmother.

So some great group of case manager and therapist got together and made him a binder of official schedules and pictures that he could add or the family could add to the visual schedule. So they made this, they practiced it with him, and then they showed the family the grandmother, who didn’t want anything to do with it, saw how incredible it was working with her grandson, and she asked for a whole nother binder to be created and left at her home.

So I thought that was a really nice show of like show and prove and show that it works for that client because not all clients succeed. Well, this technique then go ahead and use it and you’ll get buy in. And so show and help. Don’t expect them to do it all themselves.

Bethany Hartropp

I liked your point this, Cynthia, about how like, don’t start off by really giving the the schedules and giving the pictures and really providing all the all the supplies and the equipment. A lot of families have commented that, you know, you get like a five minute program from the O.T. and a five minute program from the physio and then a five minute program from the SNE. But like the set up takes 20 minutes to convince the person to participate in the program and then you and that’s just for the O.T. and then another 15 minutes to set up for physio and, and it actually ends up being a lot of time in the day. So the more that we can do to help families make things super easy and just become part of the day without any extra is really great.

Cynthia Miller-Lautman

So I’m going to move on to the next question. And the question was, do you have any suggestions on how we can educate students about autism spectrum disorder?

Bethany Hartropp

Right. It is really important to educate people about autism spectrum disorder and knowledge. The more there is, the more there is understanding and compassion. And so part one and two in this podcast series that are available on the website, those would be really good for like grades five up and they would be able to to watch them, listen to them and hear the information in there and then see, yeah, that would be one recommendation.

There are other websites available about autism as well, but that would be for specifically for Cree-based, for Eeyou Istchee, that would be a starting point.

Cynthia Miller-Lautman

You know, I thought of something else too. And the more and more I speak with parents who have children with autism or autistic people themselves, including them, if you want to teach students about autism, let them meet someone with autism and talk to someone with autism. If you can find someone in your community that is willing to share and there’s a lot of open people about that, parents that are willing to share their journey and what it was like for their child. Or if the child can talk now and is an older teenager or an adult in inviting them to talk to you about their autism and what their what their strengths are and what their weaknesses are and what’s easy and what’s hard for them, That’s about that’s teaching also about autism.

Bethany Hartropp

Cynthia, Another question that came in was why are some autistic clients picky eaters?

Cynthia Miller-Lautman

That’s a good one, and I think we’ll probably end it here today. So this is our last question, and this is a big one for parents. I’m so glad someone asked this. Well, if you remember in parts one and two about autism spectrum disorder, we talked about that many, many, many autistic people have trouble regulating their senses. They feel too much or too little all over their body and all the senses of the world.

They would describe the world sometimes and the regular things that you and I can maybe tune out as. They can’t do that easily. So they take all their energy to control. Oh, I hear that noise. I don’t look, I don’t listen to that. And I have to focus on you. Well, now I have to also tune out that noise that you and I would maybe do easily.

So when they feel too much, that also extends to their mouth. So, for example, foods that we may tolerate more easily are really hard for some people with autism to feel in their mouth. So, for example, they might not like chewing heavy meats because they have to really feel that meat around their mouth. So they’ll go for something like minced chicken instead because that just kind of melts in their mouth because it’s easier. They might not eat things with what’s called mixed texture. So that might be something with milk and cereal mixed in together. They might want to go for just plain old Cheerios that they can easily put in their mouth and it melts. So again, they feel a lot in their body. And this is a lot to tune out. So it just extends right to the mouth. And it’s hard sometimes for parents to find healthy food that the kids will eat and a variety of food because they don’t like this fruit or they don’t like that fruit. So if you are worried about this, it is serious. And the earlier we get help, the better it is. So talk to your doctor and get a referral to your local nutritionist or the occupational therapist. They may be able to help you. So another trick as an occupational therapist that I tell families is really the importance of toothbrushing early on, when your baby is young and this is this will help a lot of different picky eaters get that toothbrush into their mouth even before they have teeth. If you already have a child who is experiencing picky eating and they have teeth already, get an electric toothbrush and at first they will not like that in their mouth, but in keep trying it a little bit, brush the sides of their cheeks. Brush their tongue. The tongue. If you if you go really far back, it will make you gag. If you brush too far back in your mouth, it makes you gag. Well, some people who are picky eaters and feel too much in their mouth will gag when you just put the toothbrush on the tip of the mouth of the tongue. So you can imagine why foods make them feel sick. So within electric toothbrush, you can safely give your kid more experience in the mouth to decrease how much they’re feeling and hopefully increase some tolerance to food. So that’s just one trick that easily you can do. So you can buy an electric toothbrush if you don’t have an electric toothbrush, it would be the parent then would go in and and brush. But that’s a little bit more invasive for the child. So you’d like to have them have control of the toothbrush and so they can decide when it’s too much. So that’s just a little trick.

Bethany Hartropp

So just to go back to the toothbrush, those bristles in the mouth like the soft bristles in them on the toothbrush helps like desensitize the mouth. And then as the mouth becomes more desensitized, the person is more able to eat like regular food rather than being such a picky eater.

Cynthia Miller-Lautman

Yeah, you got it. It’s and not all kids are picky eaters because of the sensory feeling in the mouth, but a bunch are. So that would be a trick. Yeah.

Bethany Hartropp

So I have another question that didn’t come in, but this is from me. Is this one of the reasons like the sensory, like the difficulty dividing between like textures? Is that one of the reasons that a lot of kids like preferred junk food because it’s already like pre processed and like all mushed up already.

Cynthia Miller-Lautman

Absolutely. And it tastes the same. Junk food usually is in a box, right? Right. When food is in a box like Kraft dinner, it tastes the same no matter how you do it, because the ingredients are so predictable. But when you get an apple, for example, an apple could be hard one apple and the next apple you get is soft and mushy.

Cynthia Miller-Lautman

So it’s not predictable and it feels different in their mouth. And so they don’t go for that. They go for the things that they can guarantee won’t feel too much in their mouth. So, yes, and some people call those multiple foods. So there are things that easily kind of melt away in your mouth, like soft pasta, white bread, soft cereals.

That’s often what parents will describe when you look at a food history with the. Okay. So again, this is a little more complex and please reach out for help. You know, just because your kid is not losing weight doesn’t mean they’re not having some food issues. If they are really, really picky. So ask for a referral from your doctor for the nutritionist.

Bethany Hartropp

Right. And that toothbrush again really important because it helps with no cavities.

Cynthia Miller-Lautman

Yes, when kids are sensitive in their mouth, they don’t like things in their mouth, especially toothbrush. So, you know, it’s a fight every night for parents. So they tend not to brush their teeth and the kids can end up with a lot of cavities. And we see higher amounts of cavities in children with autism spectrum disorder and other disabilities.

So this is a great activity you could you could do at home. So, yeah, Bethany, I think we’ve come to the end of our questions we’re going to address today.

Bethany Hartropp

We have. Yeah, those were all the questions we got in plus a few extra from me.

Cynthia Miller-Lautman

But I really, really wanted to share a quote to end. And this is from the Autistic Self Advocacy Network called ASAN. It’s a network of people with autism or autistic people that are writing their own blogs and information. And I really wanted to share this quote from them. Autism is a developmental disability that affects how we experience the world around us.

Autistic people are an important part of the world. Autism is a normal part of life and makes us who we are. So again, that’s the Autistic Self Advocacy Network. ASAN So if you have any questions or questions about autism spectrum disorder, ASD and the diagnosis, speak to your child’s doctor. Bethany, thanks so much for being here today. It was a pleasure.

Bethany Hartropp

Thank you. Cynthia. Meegwetch, Chinskumitin. Thank you to the DPSS team. Thank you to everyone who submitted their questions for today’s podcast.