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April is Autism Awareness Month

Dr. Christine Weyman

Medical Director for Lake Cumberland District Health Department

What do we know about autism in 2015? Over the last 20 years studies have grown exponentially and we have learned that it is a multi factorial condition, not caused by vaccines. The latter has been refuted time and time again by study after study. It is true that the incidence has increased, it is now 1 in 68 children with boys outnumbering girls by 5:1; most have average or about average intelligence.  A change in diagnostic classification may be partly responsible for the higher incidence-for example many individuals once diagnosed with profound intellectual disability, Asperger’s syndrome and Fragile X syndrome now fall under the autism umbrella.  Also we are much better at identifying children with this condition. What we are still not very good at is diagnosing it early.  Most children identified with autism get this diagnosis around age four but it would be much better if it was by 2 years of age, as intervention really makes a difference to long term outcomes. Developmental screening tools are now used by pediatricians so this should improve in the future.

It is now known that autism is associated with genetic and environmental factors.  Many correlation studies have shown an association with older maternal and paternal age, maternal obesity and pollution as well as a family history of autism. Although correlation does not mean causation it prompts more studies. A recent study found abnormalities of brain development in youngsters with autism and points to early gestational differences in how the brain is being formed. Thus the current understanding is that prenatal influences, whether they be genetic or environmental are responsible for brain development abnormalities found in autism.

Parents are usually the first to pick up signs that all is not well.  Almost everyone now has access to typical infant development  on websites, through health departments and their pediatricians. Babies should be interacting socially with their parents at an early age- 4 months.  By age 18 months they should be using at least 6 words and communicate by pointing.  Interaction and stimulation is necessary for both normally and slowly developing children.  TV is not a substitute and should be avoided altogether in the young and limited to no more than 2 hours a day in older children.  Human interaction has been shown to be better than “ Baby Einstein” like videos.

Agencies which can provide appropriate intervention and help for parents are desperately needed in rural areas. Some resources include;

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