Early Diagnosis and Autism’s Unpredictable Trajectory

Reading any book—especially a parent narrative that goes through the stages of birth, toddlerhood, detecting and knowing that “something is wrong,” diagnosis, the struggle to educate one’s child—my thoughts stray to my son Charlie’s own development. In particular, I have always been curious about whether or not a child who is later diagnosed with autism is able to talk prior to diagnosis and therapy. Because Charlie did not talk and it has more and more seemed to me that, had he not been diagnosed at a quite young age (2 years old) and started various therapies, some intensively, he would not have talked.

George, Charlotte Moore’s older autistic son, had lots of words prior to his being diagnosed; Sam, while having more challenges in a number of areas of his learning, is a boy of fewer words. So far, neither boy seems to have the articulation issues that have long made Charlie’s speech indecipherable to all but a few people (me, often). And yet, as Moore makes clear, lots of language or not, both boys have more than a few challenges:

I can’t imagine an independent existence for George and Sam. This doesn’t mean it won’t happen; it means exactly what it says—-that I am not able to imagine it. I also feel that there’s little point in trying to imagine it. Autism follows an unpredictable trajectory. (p. 284)

I think back to when Charlie was 2 1/2 and I wondered every night: “What if Charlie never talks?” And now he can talk. He has not been a child who suddenly started producing paragraphs; every word, every syllable, has been the work of much effort.

On the other hand, Charlie’s not having any speech when he was young was one reason he was diagnosed very early and we started him on many therapies (ABA and the gluten-free casein-free diet) when he was very young. Moore indeed notes that, had she to do it all again, she would have started them on the gfcf diet and ABA or Verbal Behavior “as early as possible” (p. 127); George was nine and Sam was seven when they began ABA (p. 111). Like Moore, I too cannot imagine an “indepedent existence” for Charlie as he is now (and despite, indeed, seven and a half years of various therapies), but then, I once could not imagine Charlie being able to talk……..you never know.