Why Is Autism So Common Now?

Monday, April 1st, 2013

In 1980, the rate of autism was typically quoted as 4 in 10,000. The most recent rate reported is 1 in 50. While it is difficult to get a precise estimate, it’s abundantly clear that rates of autism have increased dramatically since 1980 – and in fact over the last decade. So what has changed?

There are a number of factors that have brought the startling levels of autism to our attention. These include:

Better Awareness: In 1980, autism was first introduced as a separate diagnostic category in the third addition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). Prior to that time, clinicians using the DSM applied other categories such as childhood schizophrenia. Since 1980, there has been extraordinary growth in awareness – both for professionals and parents alike. This is particularly so over the past decade. Advocacy groups have done an admirable job of helping us understand what autism is (and isn’t). Pediatricians now screen for early warning signs – as do parents. These actions have all led to a much greater awareness of the symptoms of autism which undoubtedly translates in more proper diagnoses being made. In addition, the increased awareness has permitted older kids to be diagnosed more properly when the signs earlier in life were not recognized as autism.

Expansion Of The Symptoms: In parallel with efforts to increase awareness, diagnostic changes that recognized autism as a spectrum – now referred to as Autism Spectrum Disorder (ASD) – helped capture the wide range of symptoms that go beyond “classic” autism. Including a much broader representation of social, communicative, and repetitive/stereotyped behaviors certainly helped recognize the disorder in many youth who would not have been diagnosed in past years. Of course, there is debate about how the changes in the upcoming DSM-5 may result in a reduction in the rate of diagnosed ASD in the future. But up until now, recognizing the variation in symptoms that can characterize ASD has certainly been a factor in understanding how common autism really is.

Changes In Etiological Factors: Less understood is the role of new causative factors that increase risk for ASD. Much attention is being given to a large number of potential environmental contributors. There is the suggestion that specific genetic mutations that may be linked to autism – and associated with paternal age – are more common in the population because of average increases in paternal age over the last few decades. Much of this work, though, is work in progress, as it is believed that ASD typically results from the combination of a number of environmental and genetic risk factors. But many researchers operate under the assumption that there are both environmental and genetic risk factors that may be increasing in the population, though they remain elusive.

So, since 1980, what we have learned? We know now that autism is very common, is best thought of as a spectrum that includes substantial variation in how symptoms are expressed, and may be influenced by increasing levels of risk factors that are not well understood at this time. For all these reasons, it is critical that we keep researching the causes of autism, and continue to promote awareness of the early signs and symptoms in order to support early diagnosis and intervention.

Image: Autism Awareness Ribbon via Shutterstock

Summer Camp: “The New Harvard” ?!

Saturday, March 30th, 2013

Such was the suggestion in a fascinating article in the New York Post. 

Some reasons?

• Increased pressure to secure a slot early – before they are all gobbled up
• The idea that specific theme camps will give kids “an edge” in terms of skill development
• The perception that some camps are especially prestigious and may build up a kid’s “resume”

I have seen how camps – day camps in particular – fill up earlier and earlier each year.

So… the question for all you parents is … How do you deal with this? Do you get on it early and try to get summer camp booked in winter? Do you just roll with it and figure that you’ll figure out something? Or do you not even look into summer camp?

Leave a comment below!

Kids playing via Shutterstock.com

Red-Hot Parenting Recap February 2013: Child-Haters, Genes, Parenting, and Barriers To Services

Thursday, February 28th, 2013

February 2013 was a busy month in the world of parenting – lots of things going on. Here’s a snapshot: 

CHILD-HATERS

The news that an adult male slapped a stranger’s toddler on a plane led to a conversation about how our culture may be breeding, at a minimum, a lack of respect for our youngsters – and at worst, provide a context in which child-hating is tolerated.

GENES

Speaking of conversations, we had many about if we should use what we are learning about genetics to support genetic engineering, including targeting childhood psychiatric disorders. Then came news that new research suggests some genes might predispose to a number of forms of mental illness – but it’s not at all clear that this will move us closer to genetic solutions.

PARENTING

We always include applications of current research to help guide us decide on good parenting strategies. One study suggest how important it is to let your toddler – and not you – be the “boss” when you are playing. And compelling research showed how the simple act of turning off violent shows and replacing them with educational content – without limiting the amount of TV watched – is beneficial for kids.

BARRIERS TO SERVICES

We took on some key barriers to getting kids mental health services and broke them down in understandable turns. Now we all wait to see if sequestration is going to provide the biggest barrier of all.

Time For Review via Shutterstock.com

Sequestration: Why It Will Impact Kids

Thursday, February 28th, 2013

As the clock ticks and the likelihood of sequestration increases, you may have heard lots of opinions expressed. One reality is that it will – directly and indirectly – impact kids. Here’s why.

RESEARCH WILL BE CUT

Immediate cuts will be made to research budgets. I’ve seen funding already be pulled or killed for projects in anticipation of sequestration. When research funds are taken away, the knowledge base is reduced – which derails our efforts to use research to help kids. Keep in mind that there is typically no source to replace these funds – when they go away, research is compromised or ended.

EDUCATION WILL BE CUT

There are a range of educational services that will take a hit. Cutting our support of education is not a good thing.

PARENTS WILL LOSE JOBS

People will lose jobs – which means that some parents will lose jobs. This will directly impact their kids’ lives.

THE BOTTOM LINE

Keep a few things in mind. Sequestration was set up to force politicians to come to a compromise about budget issues. The idea is that they would never let a policy put in place that arbitrarily takes a hatchet to many fundamental services. Yes, we have a budget crisis. Yes, it needs to be solved. But in a thoughtful, bipartisan way. Not in a cavalier, non-conceptual manner that has no rhyme or reason. You can look at sequestration through a variety of lenses – but one bottom line is that it will affect kids. The clock is ticking, and something needs to be done.

Sticky Notes on Office Clock via Shutterstock

Gun Violence And Gun Safety: Parents Magazine’s Facebook Town Hall With Vice President Biden

Monday, February 18th, 2013

Parents Magazine is hosting a Facebook Town Hall with Vice President Biden on Tuesday, February 19, at 3:30 PM (eastern time). You have an opportunity to post questions that may be asked of the Vice President on Parents’ Facebook page. 

Gun violence and safety is a complex topic – certainly one of four public health issues raised by the Sandy Hook Elementary tragedy – and this is a unique opportunity to get the Vice President’s thoughts on the matter.

I encourage you to be a part of this.

Town Hall via Shutterstock.com