Mele Kalikimaka!!

It’s the most wonderful time….of the year 🙂 I LOVE Christmas. I hope that you and your family enjoy this holiday season despite current circumstances. Your Keānuenue ‘Ohana wishes you all a Mele Kalikimaka and a Hau’oli Makahiki Hou!

Today’s topic doesn’t have anything to do with the holidays, BUT it’s still an important topic that I felt needed some discussion and one that we field lots of questions about.

Today I wanted to discuss AUTISM and touch base on what we do when there is any concern regarding your keiki’s development.

I feel like when people hear the word Autism, it has such a bad stigma. This is unfortunate because Autistic children are some of the most creative and intuitive ones out there. Because of this stigma, I wanted to shed some light on what Autism actually is and when and how we diagnose it.

So, if this is ever discussed with you during one of your visits with us, please know that it’s totally okay if your child ends up diagnosed with Autism. There are many resources out there which I will discuss soon. And most of our autistic kiddos end up doing really well.

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The definition can be complex but generally speaking, it’s a condition that includes difficulties with communication, social skills, and behaviors. Sounds too general, huh? That’s actually an important point to make. The reason why the overall definition is so general is because autism has a spectrum. This means that not every individual with autism will behave the same way. Some are higher functioning than others. Some have a difficult time with the social skills aspect while others may have a difficult time with the communication aspect of autism. Everyone is different.

Autism affects 1 in every 54 children and is usually diagnosed by the age of 3. The earlier the diagnosis, the earlier we can help children get access to necessary resources. Early diagnosis leads to improved outcomes, which is why we focus on developmental screening so much in Pediatrics!

Routinely, we screen for Autism during the 18-month and 24-month visits. We use a validated developmental tool called the M-CHAT. You may remember filling out that form for your keiki. While the validated screening tool helps us to see who MAY have Autism, we also use the history provided by each parent and our observations during your visit to help guide us on a possible diagnosis for Autism.


If we have a suspicion for autism, we usually refer to a Developmental Behavioral Pediatrician or clinical psychologist to help with the final diagnosis. Your general Pediatricians may also diagnose Autism. Here are some of the criteria used to diagnose someone with Autism:

  1. Persistent deficits in social communication and social interaction. Need 3 symptoms
    1. Difficulty with back-and-forth socialization
    2. Problems with nonverbal communication
    3. Difficulty maintaining relationships, making friends. No interest in others.
  2. Restricted, repetitive patterns. Need at least 2 of 4 symptoms
    1. Repetitive speech, motor movements or use of objects
    2. Resistance to change in routine, ritualized patterns
    3. Fixated interests in unusual objects
    4. Atypical sensory behaviors; i.e. looks at people from the corner of their eye, does not like certain textures or to be touched by certain objects
  3. Symptoms must by present in early childhood
  4. Symptoms impair their functioning

Do know that we do NOT wait until a diagnosis is made from a subspecialist or clinical psychologist before connecting the child with resources. It’s better to provide resources early whenever there is suspicion for delay rather than wait.

Remember that even with a diagnosis, Autism lies on a spectrum. There are different levels of severity with Autism depending on how much support the child will require.


  • Difficulty with transitioning from one activity to another.
    • Now, many toddlers do this. BUT it becomes more exaggerated. Even small changes in activities upset those with Autism.
  • Poor eye contact
  • Language delay
  • Little interest in other children or other adults
  • Upset with a change in routine


There are so many!!!!

  • Early Intervention –> offered to those less than 3 years old.
    • Helps with all aspects of developmental delay, not just with concerns for those with Autism.
  • Speech therapy –> helps with verbal and nonverbal communication
  • Occupational therapy –> helps with fine motor skills (writing, feeding, dressing)
  • ABA Therapy: Applied Behavioral Analysis therapy. Such a valuable resource! Helps those with autism develop the necessary skills needed to function optimally.
    • Helps with language, communication
    • Problem solving
    • Attention, focus
    • Other behaviors

No. That is not true. Why are people saying that? A study came out in 1998 by Andrew Wakefield that tried to link behavioral concerns like Autism to the MMR vaccine. It was a poor study that used an extremely small sample size of 12 children. There was a conflict of interest with his involvement in a lawsuit that targeted vaccine companies. He also tried to change the results of the study so that it showed what he wanted it to show.

There were many studies after this study came out that investigated whether MMR caused Autism. Over and over, these studies did not prove that MMR caused autism. It was retracted due to misinformation and it being a poor study. If you want a link or copy of that article at any time, I will be happy to send you the link. Know that Andrew Wakefield lost his license to practice medicine for disseminating this false information.

We still don’t know what exactly causes Autism, whether it’s genetic, environmental, or a complex combination of both, but there are many scientists and physicians that are working hard to answer this important question.

If you are concerned at any time that your child may have Autism, please give us a call. We will be more than happy to see your keiki in the clinic. Again, NEVER be ashamed of anything. As mentioned before, our goal is to get rid of the stigma and instead help your keiki be the best they can be. The earlier we give them resources, the better able they’ll be to reach their full potential. We will work together for the best possible outcome!

Please enjoy your holidays. Take care and stay safe.


Dr. Honda & Your Keānuenue ‘Ohana.