What You Need To Know About Autism Spectrum Disorders
Today is World Autism Awareness Day. This topic is one of great interest to me as a pediatrician. Everyday in my office, as I observe a child, I am subconsciously on the look out for signs of this dreadful, perplexing condition. For those of you who don’t already know, Autism Spectrum Disorders are a group of disorders involving an impaired ability to communicate and socialize. They’re also defined by repetitive, restrictive behaviors, interests and activities. Some children with autism can be severely affected while others very mildly, which is why spectrum is included in the name.
Autism, shockingly, has increased in incidence exponentially in the last 20 years with 1 in 68 children now being diagnosed with Autism Spectrum Disorder (ASD). In the year 2000, 1 in 150 children received the diagnosis. The risk increases for those living in a developed country vs. a developing country. The cause of this discrepancy is not known, but has been explained by identifying differences in reporting rates as well as cultural factors. However, many scientists also feel that factors such as the increase in autoimmune disorders may be responsible. For example, women with a diagnosis of Celiac Disease are 350% more likely to have a child with Autism (Harvard).
Doctors don’t know exactly why ASD is being diagnosed in so many children, but we do know that there is a genetic component to ASD. In parents who have identical twins, if one child has ASD, then the other will be affected about 36-95% of the time compared to non-identical twins where there is a 0-31% chance that the second twin will be affected. But evolution doesn’t work that fast so genetics doesn’t fully explain the rapid increase.
Environmental and social changes are most likely at play. The most common associations cited in the medical literature include environmental toxins, infections, advanced paternal age, closely spaced children, excessive maternal stress during pregnancy or maternal depression, and prematurity greater than 9 weeks (NY Times). We also know that many autistic children have changes in their brain’s structure that can be seen before birth. Therefore, it’s likely that the factors causing an increased risk in autism are happening early in development and are related to what a woman has been exposed to during her pregnancy.
Autism Spectrum Disorders often are also associated with other disorders or comorbidities such as ADHD, anxiety and depression. Interestingly, children with ASD also have a much higher risk for gastrointestinal disorders such as severe diarrhea and constipation. They’re also often extremely picky eaters with highly restricted diets sometimes including only 4 or 5 foods. This is thought to be due to problems with sensory integration. Even normal sounds, smells, and textures can be overwhelming to an autistic child. Their food restriction is so severe that some children will only eat foods that are a precise temperature or texture such as very crunchy or a particular color (Pediatrics).
While we’re closer to finding out the answers to the many questions surrounding autism, there are many questions left unanswered. The one thing that’s certain about ASD is that we owe it to ourselves and our children to be more cognizant of what exposures we have and how we choose to live as individuals and as a society. On behalf of all of us here at PlushCare, our hope is that one day soon we’ll be closer to understanding this complex disease. We send a heartfelt shout out to all the parents who work tirelessly to help their children overcome some of the challenges that come with the diagnosis. Happy Autism Awareness Day.