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Thanks to advances in science, a child born with autism today has greater opportunities than ever before to lead a happy, productive life. Research is also shifting our perspective on the condition. For instance, did you know that 46% of children diagnosed with autism actually have an average or above-average IQ? Still, as experts delve deeper into autism spectrum disorder (ASD)—defined by difficulties with social interaction, verbal and nonverbal communication, and repetitive behaviors—they find that we've just scratched the surface in terms of comprehending it. Consider these five game-changing facts about a condition that is all too often misunderstood.
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The Earlier It's Diagnosed, the Better the Prognosis
"An infant's or toddler's brain is quite plastic," explains Lisa Shulman, MD, director of Rehabilitation, Evaluation and Learning for Autistic Infants and Toddlers at the Kennedy Center at The Albert Einstein College of Medicine and Montefiore Health System in the Bronx. "The more you stimulate the brain, especially with language and social interaction, the more you can rewire it to minimize the effects of autism." Research has shown that babies with the condition begin demonstrating diminished eye contact as early as two months. While screening for this isn't currently available, parents should rely on their gut instinct, especially if they notice light or sound sensitivity or language delays. "Most autism specialists are hesitant to make a diagnosis earlier than 18 months, but if you do see warning signs—no big smiles by 6 months, no babbling or pointing by 12 months, no words by 16 months—call your state's Early Intervention program and have your child evaluated," advises Shulman.
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Autism's Causes Aren't What You Think
At least 50% of diagnosed autism cases can be traced back to gene-disabling mutations in one of about 500 genes found in the child—but not in his or her parent, according to a recent study. About 200 of these genes are known and appear to have a role in early brain development. While this study shows the surprising role genetics play in autism, some research also shows lifestyle factors may have an impact. Children born to women who were obese, had high blood pressure or had diabetes had a 60% higher risk of developing autism. Experts think the persistent inflammation and poorly controlled blood sugar levels that characterize these conditions may damage the fetus's developing brain. Connections are less clear for other lifestyle factors, such as mom's or dad's age or taking antidepressants during pregnancy. One thing experts know for sure: Vaccines play no role. A recent study of 95,000 kids found no increased risk of autism from immunizations at any age. "It needs to be blasted from the rooftops that over a dozen thorough studies have found no connection," says Leslie Speer, PhD, program director of the Autism Spectrum Evaluation Team at Cleveland Clinic Children's Center for Autism.
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Autism Can Be Linked to Other Health Problems
Managing one disorder is challenging enough, but many parents of children with autism have multiple issues to deal with in their kid. About 65% of children with ASD, for example, also have apraxia, an otherwise rare speech disorder. It's important to get screening for both conditions, since they respond well to early intervention but require different types of treatment, says Michael Rosanoff, MPH, director for Public Health Research for the nonprofit advocacy group Autism Speaks. Similarly, almost 30% of kids with autism also show signs of ADHD. "This is really important because children with both conditions tend to have a tougher time, especially with learning, and may require more support in school and other settings," explains Susan E. Levy, MD, MPH, director of the Regional Autism Center at the Children's Hospital of Philadelphia. Conversely, if your child has ADHD and significant social impairment, make sure he gets screened for autism as well. Kids with ASD are also more likely to have anxiety, depression, sleep disturbances and GI disorders such as constipation, diarrhea and irritable or inflammatory bowel disease. "We think there are physical differences in the guts of people with autism—they may have more 'bad' bacteria that trigger digestive symptoms," explains Rosanoff. Researchers are studying whether probiotics can help relieve symptoms.
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It May Be Both Over- and Under-Diagnosed
About 13% of kids initially told they have autism eventually lose the diagnosis, according to a CDC study. "Since the diagnosis is based on the skill and knowledge of the evaluator—both of which can vary—it's easy to see how some kids may be incorrectly labeled," explains Levy. "Others test differently after treatment." Both scenarios are more common in boys, as girls have an entirely different issue: under-diagnosis, perhaps because their symptoms may be more subtle. Girls with autism often display less repetitive and restricted behavior (like hand flapping or inflexibility with routine) than boys do. "Girls tend to not be as hyperactive and impulsive, and since their behavior is not as disruptive, it may not attract attention," says Levy. Some experts believe they are also more likely to observe other children and copy their social interactions, thus masking symptoms.
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Parents Can Be a Critical Part of Treatment
"It used to be believed that only highly trained therapists could work with children. As you can imagine, this was not always covered by insurance and became prohibitively expensive for many people," says Levy. "But now parents can take a more hands-on approach and actually do these therapies, which is more realistic, cost-effective and empowering for families." One of the key components of effective treatment is applied behavior analysis (ABA), which helps kids learn basic skills (such as listening and imitating) as well as more complex ones (like having a conversation and understanding someone else's point of view) primarily by rewarding "good" behavior. When begun early—at ages 18 to 30 months—these types of intensive therapies may significantly reduce autism symptoms years later. Other developments parents should be aware of: FDA-approved meds like risperidone and aripiprazole that alleviate irritability and reduce tantrums, aggression and self-injurious behaviors in children with autism. There's also very promising research on the horizon about pets (such as guinea pigs) that can help relieve social anxiety and a nasal spray containing the hormone oxytocin, which has been shown to improve social and emotional skills. "Still, it's important to remember that for most kids, autism will turn out to be a lifelong chronic condition," explains Speer. "Regardless, we can still give these children the tools they need to lead the best life possible and reach their full potential."
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There's much promising research taking place, but there are also enough sham therapies out there to make any mom's heart sink. "Parents become frightened and, as a result, can get taken in by false claims," warns Speer. Watch out for these three approaches that are truly too good to be true.
Gluten- or casein-free dietsThe claim: Allergies or sensitivities to these compounds cause autistic symptoms.The reality: Unfortunately, there's no solid research to support these diets' helping kids with autism, and without guidance from a dietitian, they can put kids at risk for nutritional deficiencies.
Chelation or hyperbaric oxygen therapyThe claim: The former removes toxic chemicals and heavy metals from the body, which some believe can cause or worsen autism. The latter involves breathing oxygen in a pressurized chamber.The reality: Two years ago the FDA issued an advisory warning that neither is effective at treating autism and both can be dangerous.
SupplementsThe claim: High doses of vitamin B6 and magnesium improve symptoms of autism.The reality: Several major reviews have found these treatments are ineffective.