ASQ and MCHAT Developmental Screening

A few weeks before your appointment for ages 4 mo, 9 mo, 12 mo, 24 and 36 mo checkups, you should receive an email or phone call regarding the ASQ screening. At the 18 month well visit, a similar form, the MCHAT—a specific screener for Autism—will be given to you at your appointment. Both of the screening tools are designed to be completed prior to your appointment.

Why are the ASQ and MCHAT important?

In addition to asking questions of parents about the general development of their child at the well child check, the AAP recommends pediatricians perform screening with standardized tests which have been vigorously validated as good tools to differentiate a developmental delay, or, specifically, Autism, at 18 months. Great things about the ASQ and MCHAT questionnaires are that they're available in multiple languages, are easily scored, have good psychometric qualities and are very commonly used.

We want the screening tools to be available to all parents at any time, as questions arise frequently in-between doctor visits and parents are often the best judges of their child's development while observing their child in their home environment. Thus, parents can check this site for the ASQ questionnaires. https://asqonline.com/family/bac32c

From Dr. Chafen Hart’s blog:
An overview for the parent: Autism and screening for developmental delay

There are many signs of Autism and an experienced clinician who has seen many cases will recognize subtle clues in the behavior of an infant; however, most of the time the child presents to the pediatrician after the parents have noticed deficits related to communication. Infants with autism may not hold their arms up to be lifted or held, may not learn to jabber in a conversational way with their parent, often do not point to indicate wants or needs and avoid eye contact. Many will not be interested in or play with regular toys in a normal way and may be very visually oriented—responding to visual stimuli like light coming through a window with fascination which can last hours. Some can be very difficult colicky babies and others very easy-going.

After the age of one, the child with Autism typically has trouble developing language. They may not respond to their name or any verbal cues from a parent, they often cannot follow commands like "bring me your shoes," and they may have trouble communicating wants and needs. For example, some will lead their parent by the hand to the refrigerator for milk instead of verbalizing or gesturing. They may enjoy books because it combines communication with visual interest and may be completely engrossed by T.V. Motor skills are often impaired as autistic children may not be able to operate a tricycle or be able to jump or skip. They often have great difficulty with simple imitation and retreat to repetitive play routines when challenged. Some line up colors or trains, form patterns with sticks or crayons and can play by themselves happily rearranging over and over again objects which are visually interesting or feel good to touch. Occasionally autistic children have repetitive self-soothing activities like running a car over their arms over and over, or rubbing their face with a blanket in a certain pattern. They require more physical reassurance from parents and may be very threatened by new places, smells or sounds.

To read more of her blog, click here.

It's extremely important to identify these children early. The ASQ and M-CHAT help us do this. Most insurance companies are reimbursing for providing or discussing these screening tools. However, regardless of insurance companies' reimbursement policies, we feel using formal screens as part of the well child check visit is an important AAP guideline, and a much more effective and objective measure of your child's development in which the parent plays a critical part.

Some Thanksgiving “Food for Thought” by Hillary Lewis, M.D.

During the Thanksgiving holiday, millions of people will be traveling. There are a few things we want you to be aware of, in order to keep your child safe this holiday season!

If you're flying, you are likely to encounter unforeseen problems, flight delays, irritable passengers, and bad weather. Try and plan ahead. Pack healthy snacks, toys, favorite pillow and blanket. All carry-on baggage will be screened. Talk to your child about the process. Let them know someone will look in their bags or they may have to go through the x-ray machine. Many kids don't like anyone, especially strangers, touching their belongings.

Once you arrive at your destination, most places will not be childproof. Keep an out for these danger spots:

• Window blind cords
• Electrical outlets
• Pets and pet food
• Fireplace
• Sharp edges on furniture
• Cleaning supplies
• Pool
• Firearms
• Paper shredder
• Treadmill
• Flat screen TVs that are not mounted to the wall
• Shelving units that could be pulled on top of your child

Let’s Talk Turkey

When thawing your turkey, do not leave it out on the counter. While the inside may still be cool and safe, the outer portion could be in the danger zone. Thaw in the refrigerator, cold water, or microwave. For more info, visit http://www.foodsafety.gov/keep/types/turkey/index.html

After your Thanksgiving feast, food should not be left out longer than 2 hours. Leftovers should be eaten within 3-4 days.

Holiday Decorations:

When decorating for the holiday, be sure to keep these things in mind:

• Choose a fire resistant Christmas tree, if selecting an artificial tree.
• When setting up a tree at home, place it away from fireplaces, radiators or portable heaters.
• Cut a few inches off the trunk of your tree to expose the fresh wood. This allows for better water absorption and will help keep your tree from drying out and becoming a fire hazard.
• Check all tree lights. Make sure that there are no frayed wires, broken sockets or loose connections.
• Some light strands may contain lead in the bulb sockets and wire coating, sometimes in high amounts. Make sure your lights are out of reach of young children who might try to mouth them, and wash your hands after handling them.

Happy holiday season from your POD family!

References

AAP 2014 Holiday Safety Tips and Mental Health Tips

HealthyChildren.org

Foodsafety.gov

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Carseats and Coats
by Hillary Lewis, M.D.

It's a natural parental instinct to want to keep your child warm and bundled while traveling. However, it is important NOT to put your child's coat on before buckling them in the carseat. The bulky padding in your child's coat can compress with the force of a crash, which would allow your child to move within the carseat harness, thus increasing risk for severe injury.

Before, strapping him in with his coat on, try the "coat test," which can help determine whether your child's outer layer is safe to wear in the carseat. Put your child in the carseat with his/her coat on and pull the straps snug. Then unbuckle and take his/her coat off. Place your child back in the carseat and check the straps. If the straps are too loose, then your child's jacket is not safe to wear in the carseat.

So, how do you keep your child warm during the winter season? Here are a few ideas:

• Cover your child up with a blanket after securing him/her in the carseat
• Place your child's coat on backwards after securing him/her in the carseat
• Use the carseat covers for infant carseats

The cold weather has certainly ushered in the wintertime germs; however, in addition to keeping him healthy, we want to keep him safe!

References

HealthyChildren.org