Today's guest blogger is Laura Dewey, Ph.D., a pediatric psychologist at Nemours/A.I. duPont Hospital for Children, and an sssistant professor of pediatrics at Jefferson Medical College.
The word "autism" is scary to anyone, especially caregivers, and hearing that it is "on the rise" can be especially alarming. The most recent report from the U.S. Centers for Disease Control and Prevention estimates that one in 68 children meet criteria for Autism Spectrum Disorder (referred to as ASD, the most up-to-date name for the neurodevelopmental disorder characterized by deficits in social interaction and communication and repetitive, restricted patterns of behaviors, interests, or activities). This is about 30 percent higher than the previous 2012 report from the CDC.
There is ongoing debate as to why there has been an increase in ASD prevalence; some say that this is a result of better awareness and diagnosis, some say the diagnosis is given more freely in order to access services, and some say that these factors cannot fully account for the increase.
The CDC report does point out that, over the past decade, there have been a growing number of children diagnosed with ASD with average intellectual abilities. This might mean that kids who had been considered "quirky" or "socially awkward" several years ago are now found to meet criteria for ASD. Often, this conceptualization is helpful for families to address strengths and weaknesses, and it can allow schools and treatment teams to know how best to support a child in reaching their full potential.
Although "autism" is scary, there are a few things about ASD that caregivers should keep in mind that can help ease their fears. To begin, we don't know what causes ASD. It's likely a combination of factors, including genetic and environmental, that caregivers, for the most part, don't have control over. So worrying too much about ASD isn't needed – if it's there in your child, there's no way you could have prevented it.
Additionally, we know that early, behavior-based intervention as soon as possible (hopefully before age 5!) is the best thing we can do to help all children with ASD reach their full potential. When children are young, their brains are still developing, and behavior-based interventions that expand social flexibility and functional communication have been shown to improve social, functional, cognitive, and communication outcomes.
So what should caregivers do? First, caregivers should know the early signs of ASD so that they can monitor their child's development. It's just like making sure they are eating the right foods or getting enough sleep – we want to make sure they're also meeting their social and communication milestones, such as making eye contact, smiling at other people, and using babbling or words to communicate their needs and ideas. CDC's "Learn the Signs. Act Early." program is an excellent place to start, as it provides behaviors to watch for and resources to access if parents are concerned.
Second, if you are worried at all, talk to professionals you trust. Your pediatrician is a great place to start. The American Academy of Pediatrics recommends developmental screening at months 9, 18, and 30, and ASD-specific screening at months 18 and 24 or if concerns are noted by caregiver or pediatrician. So don't be afraid to speak up, and definitely do not take a "wait and see approach." Ask for referrals to professionals specializing in ASD to make sure your concerns are addressed thoroughly.
And last, remember that all children have strengths and weaknesses. Just because we have a "label" for ASD doesn't change a child – it just gives us more information to understand them and help them grow.