Welcome to the January edition of Ask Dr. Emily! We often receive questions that we want to share with all our readers. To help with this, Dr. Emily Rastall, a clinical psychologist at Seattle Children’s Autism Center, will share insights here, on the last Friday of each month, in a question and answer format. We welcome you to send us your questions and Dr. Rastall will do her best to answer them each month. Send your questions to theautismblog@seattlechildrens.org.

Q: Is it possible for an 18 month old boy to sometimes act having all the signs described about autism then some other times he acts completely normal? I can not express how irregular his behavior is. Does that mean he has a variation of autism or some other disorder or is it just his personality at this age?

A: Many of the symptoms on the autism spectrum disorder symptoms checklist are behaviors that a number of typically-developing children “try out” and experiment with while they are developing. For example, repetitive movements; you might notice your 18-month old rocking themselves to sleep or walking on their toes. You might even notice echoed or repetitive speech patterns occurring while toddlers are learning to speak.

We do expect these behaviors to taper off over the course of development. The persistence of these behaviors past the time when we would expect them to cease can be (but are not always) a sign of challenges in that area. If you have concerns about your child’s development and/or behaviors, consult with your primary care provider and make a plan with them.

Q: I have a 3-year-old son with autism. I cannot decide where would be better for him to live? Should we move to the Netherlands, Germany, the United States? Is it true that kids with autism in the Netherlands have to go to special schools? That’s not the case in Germany or the U.S. Please help!

A: I wish I had more specific answers for you, but I do not know what school and/or treatment programs look like outside of the U.S. What I can tell you is that no matter where you are planning to live (within the U.S. or not), you will want to conduct detailed research regarding the school options; you will want to inquire about support available, approaches to handling behavior, experience and resources for educating children with autism spectrum, and classroom structures. In addition, you will want to look into the community resources available (e.g., private autism services, clinics, social and cultural acceptance of and acknowledgment of ASD), insurance options and coverage, and potential government resources (e.g., funding for respite, behavioral support, etc.). Best of luck in your search!

Dr. Emily Rastall is a clinical psychologist at Seattle Children’s Autism Center, where she works to evaluate and treat children and families affected by autism spectrum disorder and related or co-morbid disorders. The information contained in this blog should not be used to replace the relationship that exists between you and your healthcare provider. Please contact your healthcare provider for specific medical advice and/or treatment recommendations.