Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

After an autism diagnosis: A new parental role

Lisa Shulman, MD
Conditions
May 1, 2015
202 Shares
Share
Tweet
Share

A variety of factors contributes to the challenge. First, even in this era, in which autism is a household word, it is not unusual for me to give the diagnosis to parents who have not considered the possibility that their child has autism. Statistically speaking, the children we see at Albert Einstein College of Medicine’s Children’s Evaluation and Rehabilitation Center for these initial evaluations are very young — on average, 24 months of age­­ — and the most common scenario is that the toddler is not yet speaking. The child may have been referred by the pediatrician or another medical specialist, or possibly a diagnostic evaluation was recommended by an early intervention therapist or a daycare provider. 

A difference of parental opinion

The parents may or may not share that concern. Maybe one parent is concerned, but the other is not, noting that he, too, spoke late. While the parents may agree that the child should be talking more, the possibility that the child has autism, a lifelong condition, may never even have been considered. That difference of opinion means that at a parent conference, I can find myself sharing a diagnosis that comes as a complete shock to one or both parents.

Even when the parents are prepared for the possibility of autism, the session may involve extreme displays of emotion. Tissues are handy and generally needed. (I go through a box a week.) I’ve watched couples hold hands and draw close, seeking mutual support. Some parents have lashed out, screaming at me, at one another, at vaccinations and other things or events they believe may have contributed to the diagnosis.

A lifetime of change

At the session’s end, heartfelt concerns often surface, many relating to the child’s future: Do you think she’ll be able to go to regular kindergarten? To college? Will he get married? Unexpected queries regarding typical two year olds, but valid ones for these parents who are in new territory.

And then the questions often veer to the potential stigma of the diagnosis on the parents or family: What should we tell our relatives? Our friends? Our older children? Do we need to tell the daycare provider?

I often feel as though I see parents visibly and viscerally struggling with a change in identity before my very eyes. They arrived at the office the parents of a toddler who possibly had language delay (delay being a term that implies the child will eventually catch up) and are leaving the parents of a child with a lifelong developmental disability. It is a new parental role — one they would never have chosen but have now been thrust into. They are crying and shouting due to their concerns about not only their child’s future, but their own as well.

Lisa Shulman is a neurodevelopmental pediatrician and director, infant and toddler services, Children’s Evaluation and Rehabilitation Center (CERC), Albert Einstein College of Medicine, Bronx, NY. She blogs at the Doctor’s Tablet.

Prev

What to tell your kids about the Baltimore riots

May 1, 2015 Kevin 42
…
Next

The downsides of automating health care

May 2, 2015 Kevin 7
…

Tagged as: Neurology

Post navigation

< Previous Post
What to tell your kids about the Baltimore riots
Next Post >
The downsides of automating health care

More by Lisa Shulman, MD

  • Pediatricians should listen to parents. Here’s why.

    Lisa Shulman, MD
  • a desk with keyboard and ipad with the kevinmd logo

    New hope for those diagnosed with autism

    Lisa Shulman, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Children with developmental disabilities and the guilt parents feel

    Lisa Shulman, MD

Related Posts

  • Paid parental leave is long overdue

    Catherine Spaulding, MD
  • Why positive role models are essential in medical education

    Robert Centor, MD
  • Crippling drug costs: the role of insurers

    Janice Boughton, MD
  • 5 urban legends about risk-adjusted diagnosis coding

    Betsy Nicoletti, MS
  • The expanding role of specialists in value-based care

    Martin Lustick, MD
  • Finding a mentor to replace a medical student’s parental support

    Tasnim Ahmed

More in Conditions

  • From clocking in to clocking out: the transition to retirement

    Debbie Moore-Black, RN
  • Overcoming Parkinson’s: a journey of laughter and resilience

    Cynthia Poire Mathews, FNP
  • The untold struggles patients face with resident doctors

    Denise Reich
  • Maximize sleep efficiency with stimulus control

    Pedram Navab, DO
  • The endless waves of chronic illness

    Michele Luckenbaugh
  • Surviving and thriving after life’s most difficult moments

    Rebecca Fogg, MBA
  • Most Popular

  • Past Week

    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • The untold struggles patients face with resident doctors

      Denise Reich | Conditions
    • The psychoanalytic hammer: lessons in listening and patient-centered care

      Greg Smith, MD | Conditions
    • Physicians are a finite resource we need to protect

      Jack Resneck, Jr., MD | Physician
    • Revolutionizing COPD management with virtual care solutions [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
  • Recent Posts

    • Physicians are a finite resource we need to protect

      Jack Resneck, Jr., MD | Physician
    • From clocking in to clocking out: the transition to retirement

      Debbie Moore-Black, RN | Conditions
    • Breaking free from a toxic relationship with medicine [PODCAST]

      The Podcast by KevinMD | Podcast
    • Tom Brady’s legacy and the importance of personal integrity in end-of-life choices

      Kevin Haselhorst, MD | Physician
    • The hidden truths of hospital life: What doctors wish you knew

      Emily Stanford, DO | Physician
    • 10 commandments of ethical affiliate marketing for physicians

      Aaron Morgenstein, MD & Amy Bissada, DO | Finance

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 1 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Journal Shows Its Commitment to Exploring AI in Medicine
  • Do Away With 'Lockout' Period in iPLEDGE, FDA Advisors Urge
  • Cluster Headache, Migraine Linked to Circadian System
  • Smaller Liver Transplant Candidates Wait Longer, Less Likely to Receive Organ
  • A 'Double Whammy' for Gastric Cancer Risk

Meeting Coverage

  • Oral Roflumilast Effective in the Treatment of Plaque Psoriasis
  • Phase III Trials 'Hit a Home Run' in Advanced Endometrial Cancer
  • Cannabis Use Common in Post-Surgery Patients on Opioid Tapering
  • Less Abuse With Extended-Release Oxycodone, Poison Center Data Suggest
  • Novel Strategies Show Winning Potential in Ovarian Cancer
  • Most Popular

  • Past Week

    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • The untold struggles patients face with resident doctors

      Denise Reich | Conditions
    • The psychoanalytic hammer: lessons in listening and patient-centered care

      Greg Smith, MD | Conditions
    • Physicians are a finite resource we need to protect

      Jack Resneck, Jr., MD | Physician
    • Revolutionizing COPD management with virtual care solutions [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
  • Recent Posts

    • Physicians are a finite resource we need to protect

      Jack Resneck, Jr., MD | Physician
    • From clocking in to clocking out: the transition to retirement

      Debbie Moore-Black, RN | Conditions
    • Breaking free from a toxic relationship with medicine [PODCAST]

      The Podcast by KevinMD | Podcast
    • Tom Brady’s legacy and the importance of personal integrity in end-of-life choices

      Kevin Haselhorst, MD | Physician
    • The hidden truths of hospital life: What doctors wish you knew

      Emily Stanford, DO | Physician
    • 10 commandments of ethical affiliate marketing for physicians

      Aaron Morgenstein, MD & Amy Bissada, DO | Finance

MedPage Today Professional

An Everyday Health Property Medpage Today iMedicalApps
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

After an autism diagnosis: A new parental role
1 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...