1) Understand the implications of eliminating Asperger’s Disorder. For most children, this change should not have much impact in the diagnostic process. It will impact some children who are higher functioning and who would have, in the past, been diagnosed with Asperger’s Disorder. The DSM-5 includes severity criteria which were designed in part to incorporate these types of kids into the new diagnostic framework. That said, many in the field think that some kids may no longer receive a diagnosis if their symptoms are less severe. Some of the initial studies demonstrate that some kids who would have been diagnosed in the prior DSM will not receive a diagnosis using DSM-5. As a parent, be ready to have this discussion with a clinical provider – and be ready to ask questions like “If the old system was in place, would my child have been diagnosed as Asperger’s?” You may need to advocate more strongly than before for your child. Focus on the need for services that could make a difference for your child’s development and collaborate with your practitioners to make sure your child has every opportunity to benefit from intervention.

2) Understand the implications of eliminating other alternate diagnoses. DSM-5 does away with other diagnostic options like Pervasive Developmental Disorder Not Otherwise Specified. The impact may be felt for kids who have many symptoms of ASD but not necessarily the exact profile. There may be no alternative diagnosis despite the fact that they have many developmental issues that need attention. Make sure your practitioners seem savvy about DSM-V and know how to make sure a kid with this kind of mixed presentation doesn’t get lost in the transition to the new diagnostic framework. Have that discussion with them and be satisfied – or seek out another opinion.

3) Beware of the severity criteria and insurance. Many clinicians have told me that they are concerned that insurers may balk at covering services for some children who are rated to show less severe symptoms. We don’t know this yet. Make sure your clinician is on top of these issues and that the team is ready to take on battles if necessary. You want to have confidence in your providers because this is all new and it is not clear how it will all unfold.

4) Remain vigilant about the early signs of autism. Just because the way ASD is diagnosed has changed in DSM-V, that doesn’t mean the warning signs have changed. They remain the same and you should be aware of red flags that deserve clinical consideration.

5) Remember that early intervention still matters. If you suspect that your child may have ASD, it is better to get started as early as possible with the evaluation process – and if necessary intervention. Intervention helps any child, no matter what the severity, and early intervention is, right now, the best we have to offer kids with ASD. The fact that we have switched to DSM-5 does not alter the importance of early intervention – though, again, you need to be aware that you might need to fight harder to get intervention. It’s a fight worth taking on.

Autism Awareness via Shutterstock.com

Many Kids Will Experience A Mental Disorder

The primary reason parents need to know about DSM-5 is that many psychiatric disorders that originate in childhood are not uncommon. Consider some rough numbers:

• Around 1 in 50 kids are being diagnosed with Autism Spectrum Disorder
• Around 1 in 10 kids are being diagnosed with Attention Deficit Hyperactivity Disorder
• Around 1 in 10 kids are being diagnosed with Conduct Disorder
• Around 1 in 10 kids are being diagnosed  with an Anxiety Disorder
• Around 1 in 10 kids are being diagnosed with a Mood Disorder
• Around 1 in 2 teens have reported meeting diagnostic criteria for at least 1 disorder in their lifetime

Having a good look at these numbers means that lots of parents will be faced at some point in time with the possibility of having their child evaluated for a disorder – and will need to consider treatment options. That’s where the DSM-5 comes in.

DSM-5 Is The Primary Guide For Clinical Diagnosis

The DSM-5 is the handbook used by a broad range of health care professionals who evaluate individuals (youth and adults) for potential psychiatric disorders. It’s an authoritative guide that reflects a consensus statement on the best way to categorize disorders along with the specific symptoms and rules to be used to make a diagnosis. The intention is to make it reflect current clinical thinking that is supported by research. It is not perfect, it reflects a particular point of view by those charged with generating the guidelines, and there is much debate (and criticism) of the diagnostic approach taken by the DSM-5.

All that said, the fact remains that the DSM-5 will be used if you bring your child to a health care professional for evaluation. The clinician will consider lots of information during this process – the DSM-5 does not dictate what information they use and how they get it. It’s intended to serve as a guide to the endpoint of making (or not making) a diagnosis. And it serves as the template for a health care provider to request reimbursement from insurance companies to support treatment.

Why All The Controversy Now?

The DSM-5 is a revision of the prior version which was released in 2000. As such, it includes a number of changes – some of which are minor, some of which are major. Beyond the more general discussions about what’s “normal” and what isn’t, the key things that parents need to know are the practical implications of the changes. As a parent, you should be aware of the changes to disorders that are especially relevant for youth. Here’s a brief overview:

Autism Spectrum Disorder: Major changes have occurred. In the prior version, a spectrum of disorders were available to clinicians, reflecting important variations in symptom profile. Four disorders were listed: Autistic Disorder, Asperger’s Disorder, Childhood Disintegration Disorder, and Pervasive Developmental Disorder Not Otherwise Specified. The key change is that there is now just one diagnosis made of Autism Spectrum Disorder (ASD) – and the other diagnostic categories will no longer be used. Proponents of this change suggest that it is more accurate by defining the core features of ASD that were common to all of the disorders in the spectrum and allowing for differences in severity level under one diagnostic umbrella. Critics suggest that a number of youth who require diagnosis and treatment will not be diagnosed – and that the reliance on severity levels may make it harder for kids with more mild symptoms to receive treatments they need. There’s no answer to these issues yet – they will unfold over time as data are collected. But if your child is evaluated for ASD, it’s in your best interests to be up on the debates and have informed discussions with your clinician in order to make sure you are advocating for the best care for your child.

Attention Deficit Hyperactivity Disorder (ADHD): Minor changes have occurred. In the past, there had to be evidence that a child showed symptoms of ADHD before age 7. That has been extended to age 12 in the DSM-5. There is also more attention to making diagnoses in adults more manageable. All of these changes mean that if you have an older child who has never been diagnosed with ADHD, they might now be evaluated differently. It’s also important to know what isn’t in the DSM-5 – a lower limit on age. That is, there are no guidelines in terms of how young a child may be when making a diagnosis. This is relevant as there have been (controversial) suggestions that kids as young as 4 years of age could be diagnosed (and many in fact have). Know that DSM-5 does not offer guidance here and you will need to make up your own mind if this makes sense for your child –  hopefully with the appropriate guidance of a well-trained clinician. Overall, the worry here is that kids of all ages may be overdiagnosed.

Conduct Disorder (CD): Minor changes have occurred. Conduct disorder represents a persistent pattern of rule breaking behavior and behavior that violates the rights of others. It can be diagnosed in young children as well as teens. The primary change has been to incorporate symptoms indicating a callous and unemotional interpersonal style. The thinking here is kids with this profile may be especially prone to experience problems in the future – and require more intensive management and treatment. Be aware that these symptoms will receive more attention now in the diagnostic process.

Disruptive Mood Dysregulation Disorder (DMDD): This diagnosis reflects a major change – it is a new diagnostic category. The idea was to provide a diagnostic option for kids who show persistent irritability and extreme emotional and behavioral outbursts. The rationale for developing the DMDD criteria was to make sure kids who show these symptoms do not get mislabeled as having pediatric bipolar disorder – but still may qualify for treatment. The controversy is that many feel that there is not sufficient evidence to support this new diagnosis – and in the worst case scenario kids who do not have psychiatric problems will be diagnosed with a disorder and get treatment that they don’t need.

Over the next few days, I will publish blog posts that consider each of these four disorders in greater detail, and provide some guidance for parents to help sort through these complex issues. There are no straightforward answers to be found – rather parents need to know about DSM-5 so they can be prepared to navigate the best decisions for their child.

Such is the advice given by Steve Gross, Executive Director – and Chief Playmaker – of The Life is good Playmakers, the action arm of The Life is good Kids Foundation, a nonprofit organization established by Life is good to raise money to help kids in need. Life is good is a company with a positive purpose and is committed to spreading the power of optimism and donating 10% of its net profits to helping kids in need through The Life is good Kids Foundation.

Steve Gross, Chief Playmaker, Life is good Playmakers

The Life is good Kids Foundation directly funds the Life is good Playmakers program. The Life is good Playmakers provide training and support to childcare professionals, who use these tools to ensure that children grow up feeling safe, loved and joyful.

Steve certainly champions the essential nature of play in a kid’s life  (“Children need food and water to survive, but to truly live, they’ve gotta play”). But he points out that we often get the message that play happens in a designated time and space and includes specific activities – which means much of the time we don’t harness the power of playfulness in the majority of moments in a kid’s everyday life. He suggests that we want kids to develop the trait of playfulness as a style they bring to everything they do. Steve defines playfulness as “the motivation to freely and joyfully engage with, connect with, and explore the surrounding world.” It’s an attitude, and a style, that provides a cognitive and emotional platform for kids to embrace themselves and fuel for them to bring themselves to the world in a positive way.

Four ingredients make up Steve’s recipe for playfulness:

AFFECT: Kids need to experience joyfulness in their everyday moments – not just the time that’s “reserved” for play. Most of the opportunities for “play” happen in real time. Steve gives a wonderful example of how getting a kid ready to go to play is an ideal time to promote joyfulness – and also a moment that often turns in the other direction for parents. Rather than getting stressed about making sure a toddler has their shoes on and their coat ready, how about treating THAT time as the time to get silly and experience joy and anticipation. It may be even more fun than when you actually get outside to “play.” It’s these little moments that define the affective climate for a child – and bringing anticipation, lightness, joy, and overt silliness to the everyday tasks infuses a kid with a playful spirit that makes most of the day feel like play rather than the other way around.

SOCIAL CONNECTION: Interacting with people is play. It’s as important – if not more important – that your kid is looking at you and seeing you laugh and smile and express joy when you are playing than being engaged in the play itself. Think about all the moments you have to simply talk to your kid – especially babies and toddlers. Don’t underestimate how fun and rewarding (at a very deep level) it is for your kid to explore your face and your emotions and your tone of voice. It’s a constant stream of engaging content for them that they could never find in a toy or a device. So Steve proposes that treating the everyday interaction moments as opportunities to cultivate joyfulness helps a kid discover the power of social connection.

INTERNAL CONTROL: Steve suggests that kids need to feel like they are in control of themselves, and that the world is a safe place for them. They need to feel like they can explore without fear of bad consequences. Sure, you need to keep your kid safe. But a constant stream of “No No No” communicates two things to a little one: the world isn’t safe to explore, and your little one is not competent enough to explore it. One of the tricks of the trade is to practice redirection: rather than saying “Don’t do that!” focus on saying, “Do this instead!” Cultivate the curiosity and direct it in a safe way. That way, you are following Steve’s advice by showing your kid how to explore the world in a safe manner and you are making them feel like they can – and should – follow their instincts to do that.

ACTIVE ENGAGEMENT: One of the wonderful deliverables of playfulness is the ability to be focused and get in the flow of an activity – whatever that activity happens to be. Steve’s conception of active engagement is a core part of what we think of as creativity. Kids need to get lost in the moment, block out everything else, and just follow where the experience takes them. As Steve points out, this doesn’t just happen during what we think of as “play” (although those are of course opportune times to witness this). For younger kids, it can be looking at rocks, following a bug, watching mom put on lipstick, or playing with a zipper on a pocketbook. For older kids, “play” can involve math, English, science, music – whatever turns them on. This all goes to Steve’s overriding message – it’s all about kids bringing a sense of playfulness to everything they do.

In the busy world we live in, we often think it is difficult to find time to play with our kids and give our kids opportunities to play. But if we embrace the philosophy of Steve Gross – Executive Director AND Chief Playmaker of the Life is good Playmakers– we see that we actually have more than enough time to infuse our kids with a sense of playfulness, and a trait that will serve them well for their entire lifetime.

Steve in Haiti

Images courtesy of Life is good

How can you encourage optimism in your kids? Well, the easy answer is to say being optimistic yourself. That said we all know that parenting is hard, and the realities of the daily grind can wear down even the most optimistic parent. To that end, I spoke with John Jacobs – co-founder with his brother Bert of the Life is good Company – to get his insights on the role optimism has played throughout his life. Why John Jacobs? He and Bert spent five years selling homemade tee shirts without much success. One of their ideas, though, caught fire – a drawing of a face with an infectious grin and the slogan “Life is good.” Turns out that deceptively simple expression of optimism resonated with lots of folks, and now “Life is good” is a hugely successful lifestyle brand, as well as an ambassador for the power of optimism in people’s lives. Today, Life is good’s mission is to spread the power of optimism and help kids in need, which they accomplish by donating 10% of their net profits to the Life is good Kids Foundation.

The Jacobs brothers selling tee shirts

John is well positioned to talk about optimism for many reasons. In addition to his successful career and the central role that optimism plays in the “Life is good” story, he credits many experiences he had growing up with optimistic parents. And, as John is a dad to a four-year-old, a two-year-old, and a baby not yet six months old, he lives the life of a parent who brings optimism into his kids’ lives on a daily basis. John articulated a number of  important take-home messages for parents drawn from his many experiences – which I share here as 4 things you can do right now, everyday, to cultivate optimism in your kids.

LAUGH MORE, COMPLAIN LESS

John did not grow up with many traditional advantages. He was one of six kids growing up in a small house. Yet the emotional climate of the house was very positive:

“There was plenty to complain about if you wanted to, yet it seemed like when we woke up in our bunk beds, we’d hear our mom singing or cracking up over something. She just decided to focus on things that made her laugh or things that would be exciting to her kids. There was no dwelling on the fact that the toast was burning again or one the kids was wearing cleats to school because they couldn’t find their shoes.”

The bunkbed from John’s childhood

John summed up his mom’s parenting strategy as “keep the circus moving forward.” Yes, life with kids can be chaotic, stressful, and a little crazy sometimes. It can wear you down. But, making the decision to laugh (at least some of the time) rather than complain or dwell leads to a positive emotional climate in the home – and the foundation for an optimistic attitude in kids which doesn’t deny reality, but makes the best of it.

FRAME THE DAY

John recalls that there was something especially powerful about waking up each day to the sound of his mother’s happy, joyous singing. He, too, suggests that parents “frame the day” by setting a positive tone:

“I love the word ‘excited.’ It can be used every day when you wake up! You can talk in an excited voice about the color of the trees today or what the sky looks like. You can generate enthusiasm about what you’re planning to do that day, or who you’re going to see. It’s not a trick. You can fuel a kid’s excitement so that they get pumped up about playing with an empty box and they end up turning it into a rocket ship or an airplane or a clubhouse. It’s a decision you make on how you are going to frame your day from morning to night.”

This advice resonates strongly with clinical experience. Many families who express lots of negativity and interpersonal stress start off their day this way. There are usually triggers that gets parents and kids started with a negative attitude first thing in the morning – whether it involves issues with eating breakfast, getting dressed. These little things might not sound like a big deal – but it drags the energy level down and can turn into a way of seeing the day’s tasks as a burden.

John’s idea is so powerful because it covers the entire day – he also suggests you try to “frame the day” at night as well. How? Simply put, instead of everyone talking about all the lousy things that happened during the day (and we know there are usually a few every day), you make a concentrated effort to also talk about the good things that happened. John’s family has a habit of everyone (even the toddler) taking a turn at the dinner table and talking about one good thing that happened that day:

“Before dinner every person at our table shares what they are grateful for. Our four-year-old has taken over the leadoff slot. He likes to start the conversation and usually he just keeps going – it’s good stuff! He’ll say things like, ‘I’m grateful for the floor, for the ceiling, for the lights, the ocean, and the color green.’ We love hearing that and seeing the smile on his face makes it hard to cut him off. The food might get cold but you’re thrilled to see a kid that young frame the world in that way.”

It’s a powerful way of making sure that the good doesn’t get lost in the bad – and that your kids develop the habit of framing their day with realistic positives, including both expectations of things to come and appreciation for things that came.

DISCOURAGE BOREDOM

We’ve all heard our young (and not-so-young) children complain about how bored they are. Such boredom often comes hand in hand with a dreary, enervated experience of the world. Don’t tolerate it! And certainly don’t mitigate it by allowing your children to watch television. John has a powerful recollection from his childhood days:

“I remember distinctly my mom saying to us ‘The only people who get bored are boring people.’ That was the last time I used the word ‘bored’ – when I was maybe six years old.”

Part of boredom is to shoot down ideas – to find the negative in anything. You know the drill – I don’t wanna do that ‘cause it’s boring. Blah blah blah. But this kind of pessimism doesn’t serve kids well. Check out John’s perception based on his career as an entrepreneur:

“Pessimism closes doors and squashes ideas before they have a chance to breathe, grow and develop. If you have a naysayer who’s squashing things, who focuses on why something won’t work, you’ll never have an innovative idea. Negativity sucks the energy out of a meeting; it sucks the life out of it. That’s why optimism is a trait we look for when hiring people.”

Give your kids the message that it’s up to them to make life interesting. It’s up to them to find ways to make themselves happy. It’s up to them to find ways to engage themselves. This is a fundamental aspect of optimism that you don’t necessarily hear that much about. Try it. You will be very surprised and pleased to see how creative your kids will be when left to their own devices.

ENCOURAGE MISTAKES

If you don’t try something new, you won’t succeed. It’s that simple. A primary reason kids become reluctant to try new things is that they are afraid of failure. John – like many entrepreneurs – has always embraced mistakes as a key way to learn:

“Even though you know you’re going to ‘fail,’ one of the biggest lessons we learned was that when you try, you either succeed, or you learn. These are both positive things. My business partner and I made so many – hundreds! – of mistakes, yet the power of the message and mission of our company, which is to spread optimism, just carried us through. We learned to try to keep trying, to stay nimble enough to try out new things, to make mistakes, to fall down, and to learn from all of that ‘failure.’ That’s how you get smarter. If you fold your arms and tuck away and get defensive, it’s not a good recipe to grow and develop.”

John strongly encourages his kids to try new things, even if they don’t know whether they will be good at it. As he tells them, they don’t have to do something perfect the first time:

“The most tangible example for me was teaching my oldest son to ride a bike. It was so exciting! We had the brief little protest of ‘I don’t have the training wheels’ and ‘I needthe training wheels’ – that kind of thing. But he got focused on what was in front of him and started to push down that front pedal. Twenty minutes later, he had a big smile on his face. It was a metaphor for so many stages in life. There are so many of those situations growing up when a kid is not sure and nervous about trying something. Then you go for it a little bit and maybe you stumble once or twice but eventually you have a positive experience.”

John Jacobs

If your kids don’t learn how to learn – that “mistakes” are a part of the learning curve – they will deprive themselves of the chance to get good at something. The optimist knows that they will get better if they really pay attention to all those mistakes and use them as a platform for improvement – one small step at a time. Those small steps add up when you take them.

PUTTING IT ALL TOGETHER

As John reflects:

“This idea of what you choose to focus on is one of the most basic foundations for a happy life for you and your kids. Do you want your child growing up thinking how lucky he or she is and how incredible this world is—and how many opportunities there are every day to do things that are new, and to grow as a person? This isn’t corny to me.  It’s what I truly believe.”

If you make these kinds of choices, your kids will also believe that “Life is good.” The will know how to ride out the bad times and learn from them. And they will have the skills to ensure that good things will come. 

Cold cognition can be thought of as processing information in a “factual” way without regard to emotional or social cues. We can try to teach kids “rules” about sharing – when you should share, when you don’t have to share, why sharing is a good thing. While this type of knowledge is important to acquire, bear in mind that it can be rather abstract.

Which brings us to hot cognition. Hot cognition is the type of processing that directly integrates social and emotional factors with that “knowledge” that comes about via cold cognition. So while you can tell a preschooler that it is important to share – or that they don’t have to share – it’s different when they are in the moment interacting with another child, and they have to deal with their own emotions, the other kid’s emotions, and the social situation.

Let’s take two concrete examples. First, you have two kids in a preschool in a morning meeting with a teacher. They are told about the “rules” of sharing. Second, they then  go off  and one kid starts playing with a toy. The other kid comes over and wants to play with it too. In that situation, it’s not just about the “rules” – and it’s hard to know what will happen next. Maybe the kid doesn’t want to share it. The other one gets frustrated. They have a little exchange about it. Or … maybe the kid with the toy wants to share it. Maybe the other kid asks if they can both play with it. Maybe they are friends and that happens. Maybe they don’t get along well and it doesn’t happen.

The thing is, the outcome isn’t the point. The process is the point. The process of processing all of this stuff – the rules, the emotions, the relationship – is the stuff of real social, emotional, and cognitive development. Kids need a chance to try out their social “rules” as they arise in real-time interaction and get integrated with emotion. Adults should be at the ready to help them sort through the issues and offer informed support. But without the chance to experience ‘hot’ cognition all that ‘cold’ cognitive processing becomes somewhat meaningless. That’s why it’s really important to let kids experience social interactions and help teach themselves the rules of play and sharing – because that’s how they learn how to interact with each other.

Kids Playing via Shutterstock.com

ASD is no longer a rare disorder. The estimated rate keeps rising. Parents need to be aware of the most telling signs in order to promote early recognition in their kids – and also provide a platform for understanding why a pediatrician may broach the subject.

Such early recognition is essential because early intervention can make a huge difference for a child with ASD. New interventions hold particular promise. While intervention at any time is beneficial, it’s clear that the earlier it starts, the more effective it may be.

Even if ASD hasn’t touched your life directly, it’s still important to know something about it. ASD has become, in a way, like cancer – it seems like we all know someone with cancer. You may have a friend who will have a child diagnosed with ASD in the next few years. Your kid may become friends with someone who has a sibling with ASD. Your kid may become friends with a child who has ASD.

Here are a few good links to follow to learn more about ASD:

Autism Speaks

National Institute of Mental Health

Child Mind Institute

Autism Awareness via Shutterstock.com

Megan Conner – a top singer/songwriter in Nashville who is also a fitness expert – crossed the finish line about 15 minutes before the explosions occurred. She was close enough to hear the explosions go off and see the clouds of smoke. The experience of being there that day not only gave her a sense of connection to all those involved, but also, as she described to me, an “overwhelming love and concern” and a need to do something for the families who are dealing with a very long healing process. So she wrote and recorded a song called “Dear Boston” as a way of capturing the emotions involved and serving as a platform for raising funds to help those who need help.

You can hear the song and watch her accompanying beautiful video on YouTube. Follow the link on the video to download the song for $1 (which will help support the victims and their families) or click here for a link to do so.

It’s a great song for a great cause.

The answer from decades of research on preschoolers is … they should get experience in trying to try to work things out themselves, with good guidance from adults.

To get an expert perspective on this, I contacted Dr. Melanie Killen, who is Professor of Human Development, Professor of Psychology (Affiliate), and the Associate Director for the Center for Children, Relationships, and Culture at the University of Maryland.  She is the author of Children and Social Exclusion: Morality, Prejudice and Group Identity (2011), co-editor of Social Development in Childhood and Adolescence: A Contemporary Reader (2011), and serves as the Editor of the Handbook on Moral Development (2006, 2013). Dr. Killen has a distinguished record of conducting seminal research on the social, moral, and cognitive development of preschoolers (as well as older children), and as such is well positioned to offer a perspective on sharing in the preschool years. Below is her take on a few key issues.

ARE EXPERIENCES THAT ARISE FROM CONFLICTS ABOUT SHARING IMPORTANT IN EARLY CHILDHOOD?

Yes. Sharing toys and resources is a fundamental aspect of early childhood social interactions that promotes the development of social competence. In fact, children who learn how to resolve conflicts about sharing in constructive ways (e.g., through negotiation and bargaining) are more liked by their peers and better adjusted in school contexts than are children who resort to aggressive strategies (such as insistence on one’s own way). What children learn from conflicts about sharing toys under optimal conditions is how to bargain, negotiate, and apply principles of fairness to their peers.

WHAT’S WRONG WITH TELLING KIDS THAT THEY HAVE TO – OR DON’T HAVE TO – SHARE?

A policy that mandates either sharing or “no sharing” is a problem from the start because it removes the opportunity for children to understand the principles that underlie sharing behavior.  These principles include the fair distribution of resources – how do we share resources (or toys) in such a way as to treat others with mutual respect?  This involves explaining to children the conditions in which not sharing toys is being unfair to another child (“If you play with all of the toys then he won’t have any to play with”). However, it’s also important to recognize that there are also conditions in which not sharing toys is viewed as legitimate, such as claims to ownership (“This is her special birthday present and she doesn’t want it to get broken”), or previously agreed upon rules about the use of resources (“She had the toy yesterday so today it’s your turn to use the toy”).

WHAT ROLE SHOULD ADULTS PLAY IN SHARING?

The bottom line is that a unilateral policy takes away from the learning opportunities for young children through which they teach each other what makes it wrong to refrain from sharing (“You had it all morning and I didn’t get to play with it so can I play with it now?”).  Adults need to facilitate the opportunities for children to discuss, negotiate, and interact about how to play with toys, especially in early childhood when the stakes are still low.  Learning how to share toys, which includes the recognition of ownership claims is a fundamental social skill that is related to constructing notions of equality, fair treatment, and mutual respect.

Children Playing via Shutterstock.com

It’s Not Just DNA: The landmark twin study published in 2011 suggests that while genes are important, environmental factors that increase likelihood of ASD are a key etiological influence as well. This finding is a critical one as it is the first twin study to show such a strong environmental effect after controlling for the role of genetics. It gives new impetus to examining a range of environmental influences in addition to searching for genes that increase risk for ASD.

Recovery From ASD Is Possible: While it’s been a controversial topic in the scientific literature, a recent study provides solid evidence that some kids can “outgrow” ASD. What we still don’t know is why that is the case. But this paper does stand out as important documentation that the phenomena of recovery is real.

Psychosocial Interventions Can Change Brain Functioning: While complete recovery from ASD is still rare, the positive effects of early intervention are not. New research published in 2012 provides dramatic evidence that some interventions – such as the Early Start Denver Model – may not just improve behavior, but also “normalize” brain functioning in response to social stimuli. This is a dramatic result because it demonstrates there is ‘plasticity’ in the brain that can be shaped by intensive intervention. It shows that we should give more weight to supporting psychosocial interventions, in part because they can effect biological development.

ASD Is More Common Than Ever: A recent paper reported that 1 in 50 kids have ASD. While it is difficult to generate a premise statistical estimate of the frequency of ASD,  it is clear that each new attempt reports that the frequency is higher than previously reported. This trend may, of course, reverse with the publication of the new DSM 5 criteria for ASD. That said, the newest estimates bring attention to how common ASD is in the population – and how many kids need appropriate diagnosis and intervention.

Human Brain Research via Shutterstock.com

To get to this answer, the study took on two core issues that need to be resolved:

• Did the youth really have ASD? (Or put another way –  were they misdiagnosed initially?)
• Did the youth fully recover? (Or put another way – did they lose all of their symptoms, or just enough to lose the diagnosis?)

This study was able to address these issues by combining the clinical resources of a number of institutions, and by using a longitudinal design that tracked kids over time. Via comparisons with two other groups of kids (one with current ASD, another without ASD) - along with rich clinical and developmental histories –  they were able to document complete recovery in 34 cases. By complete recovery, they answered the above questions as follows:

• The youth had documented ASD earlier in life using current diagnostic criteria.
• The youth lost all of their symptoms over time (not just some of them).

The question the study has not answered yet is what factors contributed to the complete recovery of these 34 cases. It is anticipated that a future publication will examine this.

While complete recovery is a goal for many parents, right now it is not the typical outcome for the majority of kids with ASD. That said, great strides are being made with intervention – especially early intervention. Getting kids diagnosed early and using that as a platform for early intervention will always lead to improvement in functioning over time, even if complete recovery is not achieved.

Autism Diagnosis via woaiss / Shutterstock.com