There is a growing number of vaccines recommended for babies, coupled with concern over potentially toxic ingredients has left many parent worried. Here’s some perspective….

Question:
What are the real concerns about vaccines?

Answer:
Overall, vaccines are safe and effective at preventing diseases. However, they do have some rare but serious side effects, such as seizures and brain inflammation. Parents should be informed of these slight risks and weigh them against the dangers posed bu the diseases themselves.

Question:
The American Academy of Pediatrics schedule recommends that infants receive a combination of as many as six immunizations during each of their 2, 4, and 6 month checkups. If a baby has a bad reaction, it’s difficult to identify which vaccine is the culprit. Also, many chemicals in vaccines, such as aluminum and formaldehyde are know carcinogens or are potentially toxic to young brains when given in too high doses. Giving fewer shots per visit, as well as spacing them out over several years instead of giving them within one year, allows the body to better process and eliminate these chemicals without compromising protection. (See Dr. Bob’s Alternative Vaccination Schedule below)

Question:
I’ve been hearing so much about mercury. Is it still a concern?

Answer:
Except for two brands of flu shots, mercury is no longer used to preserve vaccines. Still, I recommend mercury free flu shot or none at all.

Dr. Bob’s alternative Vaccination Schedule
To limit side effects and avoid chemical overload, pediatrician Robert W Sears, MD recommends the vaccination schedule shown below for babies and toddlers ages t months to 3.5 years. It starts with vaccines against diseases that are most dangerous to young children, then follows with shots for rare and /or usually mild diseases. (visit Cispimmunize.org for the AAP’s recommended schedule.)

2 Months:
DTaP, Rotavirus

3 Months:
Pc, Hib

4 Months:
DTaP, Rotavirus

5 Months:
Pc, Hib

6 Months:
DTaP, Rotavirus

7 Months:
Pc, Hib

9 Months:
Polio

12 Months:
Polio, Mumps

15 Months:
Pc, Hib

18 Months:
DTaP, Varicella

2 Years:
Polio, Rubella

2.5 Years:
HepA, HepB

3 Years:
Hep B, Measles

3.5 Years:
HepA, HepB

*A Key to the abbreviations: DTaP: diptheria, tetanus and pertussis; Pc: pneumococcal; Hib: Haemophilus influenza B; Varicella: Chickenpox; Hep A: Hepatitis A; Hep B: hepatitis B.
*Children between ages 6 months and 5 years should get a non mercury flu vaccine yearly at the start of lue season; the should should be given separately from any other vaccinations. (Children should be give two doses one month apart for the first year.)
*Start Hep B at birth if mom, dad or any close family members are carriers of the disease.

Some of the early signs and symptoms that parents and Pediatricians look for to alert them that a child needs further evaluation for autism include:

• not smiling by six months of age
• not babbling, pointing or using other gestures by 12 months
• not using single words by age 16 months
• not using two word phrases by 24 months
• having a regression in development, with any loss of language or social skills

Infants with autism might also avoid eye contact, and as they get older, act as if they are unaware of when people come and go around them, as you can see in this autism screening quiz.

Keep in mind that autism usually isn’t diagnosed until about age 3, although some experts believe that some children begin to show subtle signs as early as six months of age.

There is also an autism study that showed that some children with autism had abnormal brain growth. Specifically, they had a smaller than average head size at birth (at the 25th percentile), but then had a period of rapid head growth during which their head size moved up to the 84th percentile by age 6-14 months. But rapid head growth is not a sign in all kids with autism.

In general, if you are concerned about your child’s development, especially if you think that they might have autism, you should talk to your Pediatrician and consider a more formal developmental evaluation.

Getting An Evaluation

One of the frustrating things that occurs when parents think something is wrong with their child’s development is that they may be told ‘not to worry’ or that they ’should just wait.’ Experts think that it is better for parents to trust their instincts and get their child evaluated if they think that they aren’t developing normally. This guide from First Signs is a good resource for parents trying to share their concerns with their Pediatrician.

Your local early childhood development program may also be able to do an evaluation if you are concerned about your child’s development.

Sharing Concerns Parent to Physician                   

Parents often have a difficult time sharing concerns about their child. The following outlines four crucial steps to follow with your child’s physician, and highlights the importance of a patient but persistent approach.

Each well visit provides an opportunity for your child to receive a routine developmental screening; however, if you don’t ask, it may not be offered. Whether or not you have specific concerns about your child’s development, it is best to come to the doctor’s office prepared. Physicians rely on parents to provide information about their child. As a parent, you are your child’s best advocate and a “resident expert” about your child’s health and development. During a well visit, a physician usually sees a child for less than 15 minutes, even less if there has been an emergency that day. It is a challenge, for both the parent and the physician, to cover the wide range of issues related to a child’s health within a limited time.

If you have concerns about your child’s development, take the following four crucial steps: be prepared, express your concerns clearly, ask questions, and follow up.

1. Be prepared. Before you go to your next well visit, write out your list of questions or concerns, write down a few concrete examples that might assist your physician:

• “My child doesn’t respond to my voice.”
• “He spends so much time lining up his toys, he has no interest in other children.”
• “She hasn’t learned a new word in months.”
• “He doesn’t look at me—he never makes eye contact.”

Whether or not you have concerns, ask your doctor for a routine screening.

2. Express your concerns clearly. While this issue can be an emotional one, try to focus on your concrete concerns, such as developmental milestones. If your physician doesn’t want to perform a screening, or isn’t responsive to your concerns, be persistent. Ask why. And remember, “don’t worry” or “let’s wait and see” are not adequate responses. Schedule a follow up appointment, if necessary, or ask for a referral to a developmental pediatrician. Your child’s healthy development is your most important concern.

3. Ask questions. If there are terms you don’t understand, ask your physician to explain. After the screening, ask what the results show, and what they mean. Inquire about referrals to specialists. Ask what the next step will be.

4. Follow up. For most parents, routine screenings indicate that a child is following a typical development pattern. Screenings at well visits in the future will help to confirm that. For other parents, who learn from the screening that their child may be at risk of a developmental delay, follow up is crucial. Children at risk of atypical development are routinely referred to Early Intervention for a closer look by a developmental specialist. You also may want a referral to a developmental pediatrician, a psychologist, a neurologist, a psychiatrist, or a specialist for further evaluation.

Through all four steps, some parents may stumble or falter. Grief and disbelief can prove to be great hurdles. Parents may fear the worst and not move forward. Other parents may feel uncomfortable questioning their physicians. Proceed with confidence, as parents know their child best. Only by pursuing your questions and concerns, forming a sharing relationship with your child’s physician and then by following up with him/her, can you ensure the best possible outcome for your child. Be patient with yourself and persistent for your child. Get the help your child needs.

“Pediatricians are the only professionals with knowledge of development who are in routine contact with the families of young children. Parents turn to their pediatrician for information about development, for assessment of whether their children are doing all right or not. If pediatricians don’t know or aren’t sure or don’t have the appropriate tools, the children with delays or disorders are missed.” (Frances Page Glascoe, Ph.D., Professor of Pediatrics)

According to the National Institute of Child Health and Human Development, there are a number of things that parents, teachers, and others who care for children can look for to determine if a child needs to be evaluated for autism.  This autism quiz asks about ‘red flags’ that could be a sign that a Pediatrician or other health professional should evaluate a child for autism or a related communication disorder.

Keep in mind that other conditions can also cause these symptoms, that you have to consider what your child can do in an age appropriate manner (for example, a 6 month old likely won’t respond to his name), and that normal children can have some of these symptoms and behaviors (like being independent, walking on her toes, or preferring to play alone).

Having one or more of these signs, symptoms, and behaviors should prompt a discussion with your Pediatrician to see if further evaluation needs to be done.

Your child…

1. does not respond to his/her name.

2. cannot explain what he/she wants.

3. has language skills or speech that is delayed.

4. doesn’t follow directions.

5. at times, seems to be deaf.

6. seems to hear sometimes, but not others.

7. doesn’t point or wave goodbye.

8. used to say a few words or babble, but now he/she doesn’t.

9. throws intense or violent tantrums.

10. has odd movement patterns.

11. is hyperactive, uncooperative, or oppositional.

12. doesn’t know how to play with toys.

13. doesn’t smile when smiled at.

14. poor eye contact.

15. gets “stuck” on things over and over and can’t move on to other things.

16. seems to prefer playing alone.

17. gets things for him/herself only.

18. very independent for age.

19. does things “early” compared to other children.

20. seem to be in their own little world.

21. seems to tune people out.

22. is not interested in other children.

23. walks on his/her toes.

24. shows unusual attachments to toys, objects, or schedules (i.e., always holding a string or having to put socks on before pants).

25. spends a lot of time lining things up or putting things in a certain order.

Keep track of your yes answers, write it down so that you can talk to your pediatrician about it. The more yes answers you have the more likely you will need an evaluation for your child.

Autism is a disorder that can last throughout a person’s entire life. It’s part of a group of disorders called autism spectrum disorders (ASD). Today, 1 in 150 individuals is diagnosed with autism, making it more common than diabetes, AIDS and cancer combined. It affects all racial, ethnic, and social groups and is four times more likely to strike boys than girls. Autism affects a person’s ability to communicate and relate to others. It’s known for inflexible routines and repetitive behaviors, like obsessively arranging things or following specific routines. Symptoms can range from  mild to severe.

ASD can and is usually diagnosed by age 3, and new research is pushing back the that age to as 6 months. Parents are usually the first to notice unusual behaviors in their child or their child’s failure to reach appropriate developmental milestones. Some parents describe a child that seemed different from birth, while others describe a child who was developing normally and then lost skills. Pediatricians may initially dismiss signs of autism, thinking a child will “catch up,” and may advise parents to “wait and see.” New research shows that when parents suspect something is wrong with their child, they are usually correct. If you have concerns about your child’s development, don’t wait: speak to your pediatrician about getting your child screened for autism.

If your child’s diagnosed with autism, early intervention is very important to gain maximum benefit from therapy. Some parents have concerns about labeling a toddler as “autistic,” the earlier the diagnosis is made, the earlier interventions can begin. Currently, there are no effective means to prevent autism, no fully effective treatments, and no cure. Research indicates, however, that early intervention in an appropriate educational setting for at least two years during the preschool years can result in significant improvements for many young children with autism spectrum disorders. As soon as autism is diagnosed, early intervention instruction should begin. Effective programs focus on developing communication, social, and cognitive skills.