When autism makes the news, as it continues to do, the result seems to be less rather than more public understanding of this complex developmental disability.
The continuing news is that the prevalence of autism is increasing. One of 88 American children now has autism — an increase of 78 percent since 2002. The alarming increase, along with results of a now rejected study, led many parents to suspect a link between autism and vaccines given to children. Multiple studies since have demonstrated the safety of vaccines and of thimerosal, a mercury-containing preservative that once was used to prevent contamination of vaccines. What is definitely unsafe is to have children unvaccinated.
What is responsible for the increased prevalence is unknown, but at least some of it is due to increased public awareness and changing standards of diagnosis. In some cases, the label is desired by parents and doctors in order to become eligible for more services.
Children affected show great variation in the severity of symptoms, and this has led to the diagnostic term “autism spectrum disorder.” About 70 percent of autistic children have mental retardation, but others are of normal intelligence or have what is known as Asperger’s syndrome, with high IQs and high functioning but social problems.
The most recent news, of course, involves a highly intelligent young man, presumably with Asperger’s syndrome, who shot and killed 28 children and adults in a Newtown, Conn., elementary school.
Doctors and parents have said that any efforts to link these mass murders — or any violence — to autism does an “enormous disservice” to persons with autism, who, they say, are more likely to be victims of violence than perpetrators. Contrary to the implications of reports, persons with autistic spectrum disorder often have a great deal of empathy, but may have trouble expressing their emotions. No link between autism and violence has ever been reported.
Basically, autistic spectrum disorder involves problems in three important areas of development.
Language: Autism is often first detected when a child learns to talk late or shows difficulty picking up language. In some cases, the child acquires an ability to use words or sentences, but then loses that ability. Later in life, the autistic person may avoid eye contact when asking for something and may have trouble starting a conversation or keeping one going.
Social interaction: The autistic child has problems understanding and using appropriate social gestures and facial expressions. As a child, he may tend to play alone and frequently retreat into his own world. Although he may desire to have friends, he lacks knowledge of how to initiate and maintain friendships.
Behavior: The behavior of an autistic person is often seen by others as odd or unusual. This may include repetitive movements such as rocking, spinning or hand flapping or elaborate routines and rituals. He may become fascinated by small details of a toy, such as the spinning of wheels, rather than the toy itself.
In some cases, the symptoms are extreme; in others, the person may simply seem socially awkward. These symptoms usually start appearing in the first year or two of life, and the causes are still a puzzle. Twin studies have demonstrated that autism is highly genetic.
One study reported in Cell (November 2012) found that a gene mutation can disrupt how a child’s brain circuits organize themselves. A study of Danish children published in Pediatrics (Nov. 12, 2012) found that offspring of women who suffered the flu or a fever lasting more than a week had a greater chance of developing autism by the age of 3. A mother’s antibiotic use during pregnancy increased the risk slightly.
Older fathers have been linked to a higher risk of autism; and mothers exposed to traffic pollution were more likely than others to have an autistic child.
There is no known cure for autism, and medications are used mainly to help control bothersome symptoms. Autistic children can be helped considerably, however, with highly structured education programs and therapies that focus on developing better skills of communication and social interaction. One study found that intense, early treatment during the pre-school period helped autistic children make significant improvements in their language and social skills.
Rupp is a certified information and referral specialist on aging for NODA Area Agency on Aging. Contact her at 237-2236.