About That White Paper in the Doctor’s Office
February 26, 2007 by Kristina Chew, PhD
Filed under Health
When a parent notes that a toddler (even an infant) does not seem to be meeting developmental milestones, some kind of delays—developmental, gross motor, speech—may be suspected and the child brought to a doctor for an evaluation. Dr. Eileen Costello, a children’s physician at the Boston University School of Medicine, co-author of Quirky Kids (2003), and mother of a son with Asperger’s Syndrome, notes this interesting “tool” for diagnosing autism:
Instead of checking for rashes and stiff necks, she now finds herself looking out for entirely different symptoms, including an infant’s ultra-sensitivity to his surroundings, she said.
“I watch the babies when I put them on the exam table with that crinkly white paper that we pull out for each new patient,” Costello related. “And some babies love the feeling of the paper. They can’t wait to squeeze it, put it in their mouth.”
“And then, every now and then, I see a baby who, the minute they hit the paper, they can’t stand the feeling of it, they can’t stand the sound of it, they have to be picked up immediately,” she continued.
“And that may be a subtle signal that we can see very early, this is a child who’s going to have some sensory issues. They’re going to be sensitive to sound, to touch, to texture, to lights.”
Dr. Costello is quoted in an article about new techniques for diagnosing autism in very young children, Ped Med: The autism diagnosis challenge(February 26). While Dr. Costello’s observations about how a child responds to the crinkly white paper on the exam table is of course not any kind of formal test, I think her noting this detail concerning a child’s sensory needs is intriguing. First, it is interesting that she specifically notes a child’s sensory interactions with the environment, rather than other factors such as a child’s communication, social, and play skills.
Second, there has always been something about that white paper on the exam table of a doctor—something attracting not only my son Charlie’s eyes but also his other senses. In our past visits to the pediatrician—which seem to be lessening, after numerous visits when Charlie was younger for viruses, various tests, the removal of a splinter—the paper has always been a thing of interest, perhaps for its crinkly, shiney, rather slick and smooth (and readily rippable) surface.
Perhaps diagnosing autism, while a “challenge” as proclaimed in the title of the Ped Med: The autism diagnosis challenge article, is not so mysterious when one knows what to look for.
He he he, if my son had been her patient, she’d have spotted his autism at about 18 months… He can’t stand that white paper on the exam table!!!
oooh yes, those dreadful ‘well baby’ checks with all of them in tow in a room the size of a cupboard – one shredding the paper the other trying to be fifty miles from the paper. Sounds like I could have done with the ‘paper’ test myself.
Cheers, very interesting.
Once when we lived in St. Louis a doctor pulled out a huge roll for Charlie to play with since he was looking at it….quite a sight!
They would have probably spotted me right away too. I apparently ran to the other side of the room every time the doctor opened his mouth.
I would have been caught right away, too, I think. I couldn’t stand the paper or the touch of my mother’s hands on bare skin when I was little. (I also hated blood tests and the ear thing, but loved tongue depressors. I was not a fun kid to take into the doctor’s.)
I always asked for a shot. Every time.
>They would have probably spotted me right away >too. I apparently ran to the other side of the >room every time the doctor opened his mouth.
I don’t know what my reaction to the paper was, but I definitely had fear of doctors, which was significant as I had to have regular checkups and eventually heart surgery.
They would have had me even earlier than they did…I hated how the paper felt and looked. So I turned off the lights as soon as I could reach and sat under the desk thing.
I still hate that paper…
Ugh, I always found that paper to be too loud — when they were pulling it out, it made thundery sounds. I also didn’t like it moving under me when I sat down.
I hate that paper too… I don’t know how I reacted to it as a baby but as long as I can remember I have tried to sit on the very edge of it and then not move. At all. And definitely not touch it. You’d think they could do something about that… with modern technology and all.
I liked the smell of the paper and the tongue depressors.
I don’t remember how I felt about the feel of the paper when I was little. I don’t care for it all that much now, but I understand its function and necessity. I also don’t care much for the paper gowns — they don’t keep me as warm as cloth ones would, they make noise when I move (I hate wearing anything that makes noise, I have some very nice-looking rubber-soled shoes for dressing up!), and they don’t feel very nice. Ickiness all around.
All my kids react badly to being put on the table, but I think that’s more of a “oh, no, I might get a shot!” thing than anything else at this point.
I think the real craziness is that the DSM and ICD definitions of autism say nothing about sensory atypicalities.
As I wrote in my contribution to the 2005 conference at Case Western Reserve on Autism and Representation:
“[N]early all people on the autism spectrum capable of doing so will acknowledge sensory issues to be a major factor in their lives, an integral part of their being autistic, and a dimension in which they diverge from the mainstream; yet sensory issues are nowhere present in the DSM-IV or ICD-10 clinical definitions of autism. They are the elephant in the middle of the cocktail party that none of the guests seem to be willing to talk about – at least the figurative cocktail party at which the diagnostic manuals were written.”