Autism: Reason for Concern, Reason for Hope

Autism: Reason for Concern, Reason for Hope

Just in time for World Autism Awareness Day comes a shocking new report from the CDC: Autism spectrum disorders (ASD) affect one in 88 children, not one in 110 as previously thought. That means the condition is being diagnosed about a thousand times more often today than it was 40 years ago.

What’s going on? Is autism really increasing -- exploding might be a better word -- or are doctors just more sensitive to signs of the problem than they used to be? If autism is on the rise, what’s fueling that rise? And what can we -- parents, friends, professionals -- do to help a child with autism or a related disorder? We asked Geri Dawson, PhD, chief science officer of Autism Speaks, the nation's largest autism science and advocacy organization, what the recent research tells us.
 
Even the new numbers may be an underestimate
Dawson has said that the new numbers make it clear that autism is a public health emergency. But, she told us, the problem may be even more prevalent than the new report suggests. An Autism Speaks-funded study, which made its estimate in a different way, found that one in 38 children have an autism spectrum disorder. “I know -- it’s shocking,” Dawson says.
 
It’s not clear which estimate gets closer to the truth. The CDC findings come from looking at children who have been diagnosed with ASD in 14 states, while the other researchers screened schoolchildren in South Korea to try to include kids with the disorder who had never been diagnosed. Autism Speaks is now funding a similar “wide net” study in the United States in collaboration with the CDC. Stay tuned for those results.
 
We’ll never find the cause of autism
That’s because there isn’t a single cause. “Autism is not one condition but many different conditions with many different causes,” Dawson says. The good news: We’re getting clearer on what some of those causes are.
 
Scientists have identified hundreds of genes that can raise risk, including some that can cause the disorder on their own, such as in Fragile X syndrome. We’re also getting a better picture of other factors that may raise risk, for instance, the age of either parent when the child is conceived. If a woman gets enough folic acid during pregnancy, that may help protect her child -- another reason to take those prenatal vitamins. And some studies suggest that exposure to air pollution or pesticides may add risk for vulnerable children.
 
Researchers are now following high-risk infants (ones who have a sibling with an autism disorder) from conception in order to get a better handle on possible autism triggers. “Those studies are going to be really informative about what factors play a more significant role,” Dawson says. The first results should come in the next year or so.
 
Treatment is getting better
It’s clear that early, intense behavioral intervention can have dramatic benefits for kids with ASD, Dawson says, increasing a child’s IQ and language ability and reducing some of the difficult behaviors that are a hallmark of the disorder. Now a number of groups are trying to identify autism earlier so the treatments could start earlier, too. “That’s the focus of a lot of work right now,” Dawson says.
 
How much earlier? Instead of preschool age -- which is when "early" treatment now generally starts -- researchers are working on ways to detect autism in infants, and on interventions that could be used for infants and toddlers. In a number of studies, parents are being taught everyday strategies to help engage their baby socially and stimulate early language development. Results of that research will start coming out soon, too.
 
“We’re very excited about this area of research,” Dawson says. “Not only do we hope children will have a more positive outcome, but this approach also empowers parents.”