Autism Spectrum Disorders
Autism, a developmental disability, involves impaired social interactions, impaired communication skills, and restricted, repetitive and stereotyped patterns of behavior evident by age three.
These characteristics can look very different in different individuals. Here are only a few examples of how autism may appear:
- Impaired social interactions: Children with autism may have difficulty using non-verbal behavior such as eye contact and gestures to regulate social interaction. Forming developmentally appropriate peer relationships may be difficult for children with autism.
- Impaired communication: Children with autism may have a delay in or total lack of speech. Initiating or sustaining a conversation with others may be difficult. Children diagnosed with autism may engage in repetitive and stereotyped language such as repeating television shows or commercials.
- Restricted, repetitive behaviors: Children with autism may have repetitive body movements (e.g. hand flapping, body rocking, etc.) or activities (e.g. spinning the wheels of a car, etc.). Restricted range of interests and distress over minor changes in the environment or schedule are also common.
Autism exists as a spectrum from mild to very severe and is found in about one in 88 children. People with autism often develop skills unevenly, showing delays in some areas and average to above average skills in other areas.
Duke Autism Services were originally established by G. Robert DeLong, MD and Gordon Worley, MD, to diagnose and treat children with autism spectrum disorders.
Our multidisciplinary clinic offers the following services:
- Diagnostic Assessment for Autism
- Academic Achievement Testing
- Intelligence Testing
- Adaptive Behavior Assessment
- Pharmacological Treatment (medication management) of problem behaviors
- Behavioral functional assessments
- Individual and family behavioral therapy
- Applied behavioral analysis
- Referral for a genetic evaluation
- Referral for a communication evaluation and treatment
- Referral for medical care and services
What to Expect
A referral from a physician is required. It is also necessary for the child’s parents or primary care providers to return a completed information sheet before the first appointment is scheduled.
During your child’s first appointment, a detailed history is taken by one of the psychologists. Depending on the needs of the child and family, the following services may be offered.
- Diagnostic testing for autism. Many new patients require further diagnostic evaluation and are seen by one of our psychologists. The psychologists may use the Autism Diagnostic Interview (ADI-R) during the initial parent consultation and later evaluate the child using the Autism Diagnostic Observation Scale (ADOS). Intellectual, academic and adaptive functioning may also be assessed. During the follow-up meeting, the test results, treatment options and/or referrals will be discussed.
- Pharmacological management of problem behaviors. When appropriate, we offer medical management of problem behaviors for children and adolescents with autism. Problem behaviors might include sleep disturbances, social anxiety, aggressive behavior, self-injurious behavior, shorter attention span than expected for developmental level, and extreme stereotypes ("stimming"). Follow-up is arranged as necessary. For most problems requiring medication, behavior management is also recommended.
- Communication, hearing and feeding evaluations and treatment. When appropriate, your child may be referred for a communication evaluation. Duke Children's Speech Pathology and Audiology provides in-depth communication assessments. The use of visual language techniques and augmentative communication strategies for children with autism is an area of special expertise.
- Genetics evaluation. Your child may also be referred to pediatric geneticists who are recognized experts in the genetics of autism. A genetics referral is particularly helpful to parents contemplating having other children, for children with unusual facial or other features, and for children with a history of developmental regression.
- Behavior therapy. When appropriate, we offer behavior management services for physical aggression, self-injurious behavior, anxiety, depression, toileting challenges, property destruction, sleep disturbance, repetitive behavior and social impairment.
Physicians and Staff
|Name||Areas of Special Interest|
|Jeffrey P. Baker, MD, PhD||General pediatrics|
|Rachel A. Bowman, PhD||Diagnostic evaluations and psychological testing for children ages toddler through 18 years with autism spectrum disorder and other developmental disabilities, positive behavior support and applied behavior analysis; behavioral assessments and interventions for families with children with autism spectrum disorders, other developmental disabilities|
|Richard E. D'Alli, MD, MEd, ScM||Pediatric psychiatry evaluations, medication management of child and adolescent psychiatric disorders including autism, telemedicine, production of continuing medical education media and webinars, teaching|
|Ave M. Lachiewicz, MD||Assessment and management of children with attention deficit hyperactivity disorder, learning disabilities, developmental delays, intellectual disabilities, autism spectrum disorders, and fragile X syndrome; assessment of families with fragile X syndrome and other forms of hereditary mental retardation|
|Gail A. Spiridigliozzi, PhD||School-aged children with developmental and learning issues, including learning disabilities, mental retardation, fragile X syndrome, attention deficit/hyperactivity disorder, and autism; academically gifted children|
|Purnima Valdez, MD||Assessment and management of toddlers, children, and adolescents with developmental and behavioral disorders, including speech and language delay, learning disabilities, general developmental delay, autism spectrum disorders, Asperger's syndrome, disruptive behavior disorders, and ADHD|
Genetic Counselor/Associate Professor
Lauren Braswell, MS, CCC-SLP
Holly Moses, MS, BCBA, LPA, LPC
Psychologist and Behavior Analyst
Durham Child Development and Behavioral Clinic
402 Trent Drive
Durham, NC 27710
Hours: Monday to Friday 8:00 am to 5:00 pm
Appointments and Contact Information
To serve our patients and referring physicians, faculty physicians covering pediatric pulmonary are always on call to answer questions and provide consultation.
- For new and return appointments with a doctor in the Duke Autism Clinic, please call:
- Jeffrey Baker, MD, at 919-572-6098
- Richard D'Alli, MD, at 919-668-5559
- Purnima Valdez, MD at 919-668-5559
- Rachel Bowman, PhD at 919-668-5559
- Ave Lachiewicz, MD at 919-668-5559
- Gail Spiridigliozzi, PhD at 919-668-5559
- Holly Moses, MS, BCBA, LPA, LPC at 919-668-5559
- For urgent calls after business hours, on weekends, or on holidays, please call 919-684-8111 and ask the operator to page the child psychiatrist on call.
- For physicians requesting consultations or making referrals, please call the Duke Consultation and Referral Center at 800-MED-DUKE (800-633-3853).
- Autism: What It Is, What Can Be Done
- The Genetics of Autism: What We Know That You Should Know
- Do Vaccines Explain the Surge in Autism?
- Does the MMR Vaccine Cause Autism?
- Study Surprise Yields New Target for Assessing Genes Linked to Autism
- Understanding Language in a Social Setting
- Using Visual Cues to Improve Communication
- Duke Children's Child Development and Behavioral Health
- Duke Children's Medical Genetics
- Duke Children's Neurodevelopment
- Duke Children's Neurology
- Pediatric Division of Child Development and Behavioral Health
(Duke School of Medicine)
- Pediatric Division of Medical Genetics
(Duke School of Medicine)
- Pediatric Division of Neurodevelopment
(Duke School of Medicine)
- Pediatric Division of Neurology
(Duke School of Medicine)
- Duke Center for Human Genetics
- Duke Children's Speech Pathology and Audiology
- Autism Society of North Carolina
- Autism Speaks
- Exceptional Children's Assistance Center (ECAC)
- Mariposa School for Children with Autism
- Meredith College Autism Program
- The Arc of North Carolina
- Children's Education Law Clinic
- ABC of NC Child Development Center
- First Signs
- Floortime Foundation
- The Gray Center
- Alliance of Disability Advocates
- Family Support Network
- Parent Center Network
- The Hanen Center
- American Speech-Language-Hearing Association