Autism Spectrum Disorders
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.
Our multidisciplinary clinic offers the following services:
- 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
|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|
|Yong-hui Jiang, MD, PhD||Clinical and metabolic genetics, genetic syndromes, evaluation and treatment of metabolic disorders, genetic evaluation of neurodevelopmental and neurometabolic disorders, autism spectrum disorders, genomic-imprinting disorders including Angelman and Prader-Willi syndromes|
|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
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
- Yong-hui Jiang, MD, PhD at 919-684-2036
- 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).
Inaugural Triangle, NC
Saturday, April 13, 2013
Join Autism Speaks as we walk to change the future for all who struggle with autism!
Walk Now for Autism Speaks is a fun-filled, family friendly event and is our single most powerful force to fund vital research that will lead us to the answers we need. Experience the power of thousands united by a single cause by joining Walk Now for Autism Speaks. [Learn more]
- 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