Autism, a developmental disability, involves abnormal social relationships, communication skills, and unusual behaviors that occur by age three.

These characteristics can look very different in different individuals. Here are only a few examples of how autism may appear:

• Abnormal social relationships: Children with autism may favor objects or activities over social interactions. Others prefer interacting with adults over children. Or they may want to play with children but not understand how to interact with them.
• Abnormal communication: Children with autism may lack speech or have delayed speech. Others with mild forms of autism, such as Asperger syndrome, may develop speech at the typical age but have difficulty communicating what they want to say (abnormal "pragmatics"). Or they may have advanced vocabulary, sounding like "little professors", but not be able to describe how they feel.
• Unusual (often 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.). Others may fixate on specific topics, such as trains, or objects, such as traffic lights.

Autism exists as a spectrum from mild to very severe and is prevalent in about one in 88 children. People with autism often develop skills unevenly, showing delays in some areas and average or above average skills in other areas. 

The Duke Autism Clinic was established by G. Robert DeLong, MD, a distinguished pediatric neurologist, to diagnose and treat the symptoms of autism.

Treatments

Our multidisciplinary clinic offers the following services:

• Diagnosis
• Pharmacological treatment (medication management) of problem behaviors
• Genetic evaluation
• Communication evaluation and treatment
• Provision of advice about services for children with autism
• Referral for medical care and services
• Behavioral functional assessments
• Individual, family, and group behavioral therapy
• Applied behavioral analysis

What to Expect

You need a physician referral to schedule an initial evaluation in the Duke Autism Clinic. At your initial evaluation, a detailed history is taken and a physical examination is performed by an attending physician in the clinic.

A speech-language pathologist will assess the need for further communication evaluations, testing, or treatment to be conducted at a later date. Depending on need, the following services are then offered:

• Diagnostic testing for autism. Many new patients require further diagnostic evaluation and are seen by our educational specialist. The autism diagnostic observation schedule (ADOS) or other diagnostic tests are done at a subsequent clinic visit.
• Pharmacological management of problem behaviors. When appropriate, we offer medical management of problem behaviors for autistic patients. Problem behaviors might include sleep disturbances, social anxiety, aggressive behavior, self-injurious behavior, shorter attention span than expected for developmental level, and extreme stereotypies ("stimming"). Follow-up is arranged as necessary. For most problems requiring medication, behavior management is also recommended.
• Communication, feeding, and audiology evaluation and treatment. 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.
• Genetic evaluation. Basic genetic testing is offered in the clinic, with referral as necessary to pediatric geneticists who work in the clinic and are recognized experts in the genetics of autism. 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.
• Referral to a child psychologist. For problem behaviors, medical management works best in combination with behavior management. Referral to a child psychologist who is an expert in autism is offered to families.

Physicians and Staff

Physicians

Staff

Locations

Durham Child Development and Behavioral Clinic
402 Trent Drive
Durham, NC 27710
Tel: 919-668-5559
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.