Could use a little more cowbell (thewhiteowl) wrote in little_details,
Could use a little more cowbell

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Autism diagnosis and treatment in the 1970s

Setting: 1977, California.

My pov character is taking her two-year-old son for a doctor's check-up. I assume that a 24-month or thereabouts check-up is standard in America too?

Firstly, I understand that in the USA, children's primary care is carried out by a paediatrician rather than a family doctor (not sure where the 'family' comes in in that case, but hey). Would this be in a practice/clinic in the local area, or does she have to go to a hospital? The setting is somewhere in Greater Los Angeles.

More importantly, the child is displaying the following behaviour:
-Doesn't talk much, although he understands a fair bit of vocabulary
-'Off in his own world'; he won't interact with the doctor at all, and isn't too co-operative with Mommy in the consulting room either
-Motor development lag
-Fascinated with patterns, shapes etc
-Lines things up in order of size, lays blocks in a line instead of stacking them, and so on.
-Is of above average intelligence, so far as can be determined

Is the doctor at this date likely to 1) make a provisional diagnosis of what would nowadays be called an autistic spectrum disorder and 2) tell the mother this if she presses for information? (She's a lawyer and a reasonable forceful personality).

In the late 1970s, what treatment would there be available for a child like this? I imagine intervention wouldn't be as early as it is nowadays. Would the doctor tell the mother to work with the kid and try to get him to talk?

I googled combinations of 'autism' 'treatment' 'history' and '1970s', and at this date I gather that the blame-the-mother attitude was just on its way out, so is this likely to affect the doctor's attitude? (There is an older child who is clearly neurotypical, bright and well-balanced, currently kicking his heels/doing maths homework in the waiting room, if that would make a difference.) Either way, there is a good set-up for my poor mom to feel guilty.

EAT: The consensus seems to be that he wouldn't get a diagnosis of autism that young in the 1970s. Given the motor delay and the language delay (oh, and he's on the small end of normal for size, but that's genetic, tall dad, petite mother), would the doctor suspect whatever they were calling global development delay back then? What advice would he be likely to give my character about the language delay in that case? (And what's normal vocabulary size for a 24-month old male second child, anyway?)
Tags: usa: california, ~childrearing, ~medicine: historical, ~psychology & psychiatry: autism

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