April is Autism Awareness Month. For years, the Autism Society has been setting aside this month to increase public education and awareness regarding issues surrounding autism, including the importance of early detection, diagnosis, treatment, and prevention, in order to better understand this puzzling, increasingly prevalent condition which presents as a spectrum of social, communication and behavioral differences.
The symbol for autism awareness is a puzzle piece. At my boys’ public elementary school, which operates a cutting-edge preschool program for children with autism and other developmental disabilities, and where kids with autism are generally well-integrated into the fabric of life, many parents and teachers proudly display this symbol on their cars, along with the usual baseball, soccer, and political bumper stickers.
The complexities of this puzzle are still being worked out. A recent study by the CDC (Centers for Disease Control) found that the prevalence of ASD (Autistic Spectrum Disorders) is now 1 in 88, or 1.13% of U.S. children, a bump in 23% from two years ago. As in previous studies, the diagnosis was more common in boys, but this new study also found a significant increase in black and Hispanic children. Undoubtedly, increased recognition of signs of autism by parents, educators and physicians has contributed to the rise in diagnosis. And as more sound epidemiologic research is done, the beginning of a few answers, and even more questions, emerge. More and more evidence points to a clear genetic component, and there may be a complex collection of variables which also contribute, including advanced maternal age (could it be that part of the rise is related to more women choosing to bear children later in life?). Other environmental factors may also play a role, perhaps depending on genetic vulnerability. Large epidemiologic studies such as the National Children’s Study, funded by the NIH, the CDC and other child and health care advocacy organizations, are currently attempting to track autism and possible associated environmental factors. Of note, the vaccine question is really the only environmental factor that has been carefully and exhaustively studied, and thus far, dozens of sound, credible scientific studies have shown no link between vaccines and autism.
As more research is done, some of the information that is beginning to emerge on treatment is promising. Early, intensive behavioral and developmental intervention may significantly improve long-term outcomes for certain children with autism. There is a real need for further research to qualify and quantify these possible benefits, especially in the current environment of increasingly limited resources in health care and education. More clear evidence translates into more funding in school systems, more coverage by health insurers for developmental support.
Most of us know a child with autism, through family, friends, our kids’ schoolmates or other routes. It is an issue which affects all of our villages, either directly or indirectly. While the answers are still not clear and a good chunk of the puzzle is still pretty messy, the mere act of being aware may help to sort a few things out, shed light, and provide hope.