What is Autism and Why Does it Matter to Me? Part 2: Characteristics and Prevalence of Autism

Welcome to the second post in my series on autism. This section is taken from a paper I wrote and is quite a bit more technical, so I have prefaced it with a summary. For the casual reader, the summary describes the contents fairly adequately. For the reader who wishes more details and citations, read the full content.

Summary: Autism Spectrum Disorder (ASD) is characterized by social and communication deficits, as well as repetitive behaviors and fixated interests (Parritz & Tory, 2014, p. 122). For a diagnosis of autism, we look for difficulties with social and emotional interactions, difficulty understanding and employing non-verbal communication, difficulty developing and maintaining relationships, repetitive behaviors, and fixated interests. Children with ASD also are more likely to have intellectual disability, ADHD, and anxiety disorders. Sometimes these co-existing disorders are more apparent to a parent than autism itself. 1 in 68 children are estimated to have autism. Boys are 4.5 times more likely to have autism than girls, but girls with autism are more likely to also have a diagnosis of intellectual disability. Autism is not something from which one can be “cured” because the neurological differences will be present throughout an individual’s lifetime. However, the behaviors and symptoms of autism may decrease in severity, especially with quality early intervention.

Characteristics

            Autism Spectrum Disorder (ASD) is characterized by social and communication deficits, as well as repetitive behaviors and fixated interests (Parritz & Tory, 2014, p. 122). The most recent Diagnostic and Statistics Manual (the standard for diagnosing childhood disabilities) outlines three social and communication deficits which must be present for the diagnosis of autism spectrum disorder in a child. These are deficits in “social– emotional reciprocity; deficits in nonverbal communication during social interactions; and deficits in developing and maintaining relationships” (Parritz & Troy, 2014, p. 123). In addition, children must display at least two types of repetitive behaviors and fixated interests (Parritz & Troy, 2014, p. 123). These can be movements, such as when Brett jumps up and down or claps his hands over his years. Brett’s obsession with trains is an example of a fixated interest. This category could also include repetitive speech (echolalia), inflexible routine, and atypical sensitivity to sensory input (Parritz & Troy, 2014, p. 123).

Previously, children were diagnosed with several different disorders under the category of autism. Children with more symptoms were diagnosed as autistic, while children who had more social and language skills were diagnosed as high-functioning autistic or Aspergers (Parritz & Troy, 2014, p. 120). Under the current DSM, all of these conditions are now considered autism spectrum disorder, with varying levels of support required (Parritz & Troy, 2014, p. 123).

Autism is frequently associated with comorbid disorders such as intellectual developmental disorder (IDD), attention-deficit hyperactivity disorder, and anxiety disorder (Parritz & Troy, 2014, p. 123). Although boys are more frequently diagnosed with autism than girls, girls with autism are more likely to have a comorbid diagnosis of IDD. The ADDM found that as many as 50% of children diagnosed with autism have an IDD (Christensen et al., 2016, p. 9). Half of children diagnosed with both ASD and IDD are nonverbal (Parritz & Troy, 2014, p. 129). A comorbid diagnosis of IDD can make interventions difficult even for children with speech and may impede their development (Matson & Horovitz, 2010, p. 1).

Prevalence

Current studies evaluated by the CDC estimate that 1 in 68 children have autism spectrum disorder (Data & Statistics, 2016). This is consistent with findings from international studies identifying children with autism at a rate between 1% and 2% (Data & Statistics, 2016). ASD is 4.5 times more likely to appear in boys than in girls (Data & Statistics, 2016). It is less likely to be diagnosed in black and Hispanic Americans, but it is unclear whether this is due to lower rate diagnosis of children with ASD or a lower level of susceptibility (New Data on Autism, 2016).

The estimated prevalence of children with autism has more than doubled since the Autism and Developmental Disabilities Monitoring Network(ADDM) began monitoring children in 2000 (Data and Statistics, 2016). Researchers are not convinced that the numbers show a true increase in autism but may be better explained as a reflection of diagnostic practices. According to Matson & Kozlowski (2011), “The relatively frequent change in diagnostic criteria appears to be at the core of the increasing prevalence of ASD” (p. 5). The public has also gained a greater awareness of autism since 2000 and may be more attentive to early warning signs. “More and more parents are having their children assessed who may not have previously done so” (Matson & Kozlowski, 2011, p. 6).

Prognosis

            Symptoms of autism persist throughout an individual’s lifetime. The severity of these symptoms depends on several factors. Comorbidity of autism with IDD is an indication of more severe symptoms throughout the life span (Matson & Horovitz, 2010, p. 8). Studies have shown that without quality intervention, symptoms of autism will remain stable and persistent over the course of an individual’s life (Matson & Horovitz, 2010, p. 7). Recent emphasis on early intervention hopes to change this, but at this time we do not have data which observes children over the course of their childhood and maturation into adults (Matson & Horovitz, 2010, p. 6). Time will tell how much interventions are able to improve adult symptoms of ASD. At this point, we know that early intervention can bring about great improvement in young children (Zachor et al., 2007, p. 12).

Individuals who have been diagnosed with autism rarely go into remission to the point of no longer receiving a diagnosis of ASD (Matson & Horovitz, 2010, p. 8). However, depending on the treatment they receive, they may receive a diagnosis of requiring less support than originally diagnosed (Zachor et al., 2007, p. 1). Those that do the best in response to interventions and adulthood are generally those that exhibited less severe symptoms initially and displayed a normal IQ (Matson & Horovitz, 2010, p. 8). Some adults with less severe symptoms of autism go on to have careers and even marriages, but many continue to struggle with relational challenges (Parritz & Troy, 2014, p. 132).

References

Christensen, D. L., Baio, J., Braun, K. V., Bilder, D., Charles, J., Constantino, J. N., . . . Yeargin-Allsopp, M. (2016). Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2012. MMWR. Surveillance Summaries, 65(3), 1-23. doi:10.15585/mmwr.ss6503a1

Data & Statistics. (2016). Center for Disease Control and Prevention. Retrieved from http://www.cdc.gov/ncbddd/autism/data.html

Matson, J. L., & Horovitz, M. (2010). Stability of Autism Spectrum Disorders Symptoms over Time. Journal of Developmental and Physical Disabilities, 22(4), 331-342. doi:10.1007/s10882-010-9188-y

Matson, J. L., & Kozlowski, A. M. (2011). The increasing prevalence of autism spectrum disorders. Research in Autism Spectrum Disorders, 5(1), 418-425. doi:10.1016/j.rasd.2010.06.004

New Data on Autism: Five Important Facts to Know. (2016). Center for Disease Control and Prevention. Retrieved from http://www.cdc.gov/features/new-autism-data/index.html

Parritz, R. H., & Troy, M. F. (2014). Disorders of childhood: Development and psychopathology. Belmont, CA: Wadsworth Cengage Learning.

Zachor, D. A., Ben-Itzchak, E., Rabinovich, A., & Lahat, E. (2007). Change in autism core symptoms with intervention. Research in Autism Spectrum Disorders, 1(4), 304-317. doi:10.1016/j.rasd.2006.12.001

 

 

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What is Autism? Part 1: Why Worry?

  • Intro to Series and Vocab
  • What is Autism and Why Does it Matter to Me? Part 1
  • What is Autism and Why Does it Matter to Me? Part 2
  • Tricks of the Trade – Tools for calming and teaching your autistic or special needs child
  • Choosing an Educational Option for Your Special Needs Child
  • Individualized Education Plans: A Step-by-Step Guide to Developing a Plan to Educate your Special Needs Child or Student

Welcome to my series on Autism! This post is the first of two designed to break down for you the common symptoms of autism, how often autism occurs, and why it is important to be aware of the possibility that your child has autism. Many parents shy away from “labeling” their child as autistic, so let’s begin with the reasons why you should honestly evaluate your child for autism.

Why Worry?                  

Why should you evaluate your child to determine if they have autism? Many parents, especially in the homeschool community, prefer a wait-and-see approach to possible disorders that their child might have. Parents don’t want their child to feel as if they are “labeled” or categorized and restricted based on a diagnosis. Some parents recognize that children develop at different rates and do not wish to push their child to conform to a timeline, developmentally or academically. These are valid ideas, especially as they acknowledge that children don’t all develop on a strict timeline. However, if they discourage a parent from honestly evaluating their child’s development, they may be harmful to the child in the long run. Diagnosis of autism has so many benefits, but two primary benefits stick out.

Early Intervention = Fewer Symptoms in the Long Run

            As we have improved in diagnosing children with autism at younger ages, it has come to be known that the earlier a child is diagnosed and interventions are begun, the better their long-term chance for operating as a neuro-typical child and adult. In other words, if your child has not begun to speak or has limited vocabulary at the age of 3, they are much more likely to develop fluent speech if you begin interventions then than if you wait until they are five. At the very least, they will develop it sooner! Children with social difficulties are much more likely to learn empathy and learn to interact normally in social situations if they begin interventions as a two or three year old than if they go on as usual until they are seven. I won’t go into all the technical jargon here, but you are welcome to contact me if you would like to see studies on the importance of early intervention. A search of google scholar should also yield many studies which show the same thing.

Understand your Child

            Possibly the greatest benefit to diagnosing a child with autism is that you can learn to understand your child. Although stereotypes are rarely effective, there are many elements common to individuals with autism in the way they think, relate to others, and react to their environment. When you understand these common elements and begin to understand what is behind some of your child’s behavior, a whole new world of relating and teaching can open to your family. You can learn to adapt your behavior, home, and parenting to your child’s disability, rather than forcing them to fit into a neuro-typical box. You may feel that your parenting is gracious and gentle enough that you are not forcing them into a box, but why limit yourself to only understanding your child through the lens of how you see the world? Recognizing that your child has autism is the first step to understanding how they see the world and learning to walk with them in it.

Think about it: If your child needed physical therapy to learn how to walk, would you ignore it and let them develop at their own pace?

We would never ignore physical disabilities in the same way that many have tried to ignore mental disabilities. Seeking a diagnosis for your child doesn’t mean you are trying to label or limit them, it means you are looking for the best way to help them reach their potential. Understanding them is the first step to unlocking that process.

            If you are a teacher, rather than a parent, the same principles apply. Your ability to teach a child is limited by how well you understand what that child needs in order to grow academically. If you want to be an effective teacher, recognize when your students may not be neuro-typical and seek to understand them to a greater degree.

Should you be concerned about your child?

So what about you and your child? Should you be looking for further evaluation? This is a list compiled by Autism Speaks which I feel does a great job of breaking down the symptoms of autism. My explanations are in italics. Please remember that ANY of these symptoms are cause for further evaluation; your child need not show all symptoms. It can’t hurt your child to evaluate them; it can be detrimental to delay evaluation until you’re sure they need it.

“Possible signs of autism in babies and toddlers:

  • By 6 months, no social smiles or other warm, joyful expressions directed at people
  • By 6 months, limited or no eye contact
  • By 9 months, no sharing of vocal sounds, smiles or other nonverbal communication
  • By 12 months, no babbling
  • By 12 months, no use of gestures to communicate (e.g. pointing, reaching, waving etc.)
  • By 12 months, no response to name when called
  • By 16 months, no words
  • By 24 months, no meaningful, two-word phrases
  • Any loss of any previously acquired speech, babbling or social skillsWe really aren’t able at this time to diagnose autism in children under the age of two because of the social and communicative nature of the disorder, but if you see signs of autism in babies and toddlers you can be prepared to have them evaluated formally soon after they turn two. You also will be able to implement some of the resources and tools I’ll discuss in a later post at home as soon as you notice a developmental delay, no diagnosis necessary!

Possible signs of autism at any age:

  • Avoids eye contact
  • Prefers to be alone
  • Struggles with understanding other people’s feelings May not recognize that others feel differently than they do about something or if they do that their feelings are valid.
  • Remains nonverbal or has delayed language development May not start conversations or may have difficulty maintaining a conversation and following the social norms of conversing with others.
  • Repeats words or phrases over and over (echolalia)
  • Gets upset by minor changes in routine or surroundings May react violently to doing new things.
  • Has highly restricted interests They like to talk, read, watch movies about a limited number of things or they have only certain toys or types of toys with which they like to play.
  • Performs repetitive behaviors such as flapping, rocking or spinning May be something as simple as tapping the floor or swaying back and forth.
  • Has unusual and often intense reactions to sounds, smells, tastes, textures, lights and/or colors May reject foods based on their texture and appearance, may complain of noises being too loud or lights too bright.”

(Autism Speaks, 2012).

I would add to this list that symptoms parents most often notice aside from these are:

  • Behavior problems
  • Tantrums
  • Difficulty in school
  • Lack of back-and-forth or imaginative play
  • Lack of inhibition – no sense of what is acceptable to say to someone (For instance, may remark to someone that they are fat).
  • Lack of inhibition – may be inappropriately friendly with strangers.

 

The next post will dig much deeper into the prevalence of autism and what autism really is. This list is just to get you thinking about common symptoms of autism so that you can more easily recognize them in your child or student. If you have questions about what you read today, please feel free to comment or contact me privately. My passion is coming alongside families and helping them understand their children and unlock their potential, so I am more than glad to answer your questions and share my opinions or ideas.

References

“Learn the signs of autism.” Autism Speaks, 24 July 2012, http://www.autismspeaks.org/what-autism/from-first-concern-to-action/learn-signs.

What is Autism? (And Why Does it Matter to Me?)

Did you know that 1 in 64 children have autism? That means if you go to a church the same size I do, at least one child is likely to have autism. As many as 1 in 6 children in the US may have a developmental disability, the broad category under which autism fits (CDC, 2015). Risk factors are as varied as the disability, but this essentially means that the likelihood of having a child or student with developmental disabilities or autism is not outlandish. Rather, if you are a parent it would not be uncommon, and if you are a teacher it is to be expected.

One of my passions as a student and now as support staff in the world of special education is to educate parents to the signs of autism and other disorders and give them tools to make decisions and manage their child’s behavior and symptoms. Many parents feel that something is “off” or different about their child but are not able to put their finger on it. Other parents would like to homeschool their special needs child but feel overwhelmed by the prospect. This series is designed to be a primer to autism and educating a child with autism or other special needs.

The first post asks, “Why Worry?” and discusses the reasons for being aware of the symptoms of autism and honestly evaluating your child if you feel something isn’t right. The next post will delve further into the technical aspects of what actually defines autism spectrum disorder, how many children have autism, and whether or not rates of autism are increasing. Following that in later posts, I’ll give insider resources and tools for working with your autistics/special needs child or student, pros and cons of different educational options for special needs children, and a guide to planning your child or student’s education. I’ll link to each post that is published here so that you can navigate between them more easily.

If you are a Christian School teacher rather than a parent, please stick around. It is so important for teachers to understand all of their students, not just the typical children. If you feel lost when trying to decide how to educate your students that just don’t learn like everybody else, pay attention. If your student has autism, you need to know about it. If you’re not sure how to modify or alter your special needs student’s curriculum, pay careful attention to the post on Individualized Education Plans. Tricks of the Trade will also have insights for you on tools that will help you motivate your special needs students.

A Short Vocabulary

There are a few terms which will be beneficial to both you as a reader and me as a writer if we both understand what they mean.

Special Needs Child: A child who has different or more needs than the average child.

Autism Spectrum Disorder: Commonly referred to as “autism” or “ASD,” this disorder is characterized by social and communication difficulties.

Neuro-typical: Children with autism and developmental delays have different neurological “wiring” than the typical or average child of their age. Rather than calling the average child “normal” and calling children with autism and other disorders “abnormal,” we call the average child “neuro-typical” in reference to the fact that their brains are as we typically expect to find them in a child with no disorders.

Intervention: Something done to alter the behavior or development trajectory of a child with autism, such as teaching them new social behaviors or therapy to assist with developmental delays.

 

I hope you’ll join me at taking a look at autism and why it matters to you!

  1. Intro to Series and Vocab
  2. What is Autism and Why Does it Matter to Me? Part 1
  3. What is Autism and Why Does it Matter to Me? Part 2
  4. Tricks of the Trade – Tools for calming and teaching your autistic or special needs child
  5. Choosing an Educational Option for Your Special Needs Child
  6. Individualized Education Plans: A Step-by-Step Guide to Developing a Plan to Educate your Special Needs Child or Student

 

 

References

Developmental Disabilities. (2015, July 09). Retrieved from https://www.cdc.gov/ncbddd/developmentaldisabilities/about.html

Vaccines and Autism: Autism Awareness Month

In honor of Autism Awareness Month, I’d like to share with you information that I have learned about autism in my study of special education. Today, I’m sharing a paper written for a class on the subject of “Vaccines and Autism.” This may seem like an odd place to start when discussing autism, but how we think about causation influences how we think about a disorder. Vaccines are one of the hottest and most controversial health topics when it comes to children. Much misinformation and pseudo-science have been employed in the discussion, as well as legitimate observations. This briefly addresses common misconceptions about vaccines and autism and highlights some of the research which shows without a doubt that autism is not caused by vaccines. See my end note for my thoughts on vaccines and other adverse outcomes, as well as links to studies you can read yourself.

This topic hits close to home for me. One of my younger sisters has Autism, and our journey with her has been highly influential in my decision to pursue special education. She was born in 1998, so she grew up during what I believe was the peak of the vaccination-autism discussion. I remember overhearing my mom tell a friend, with tears in her eyes, that she had watched my sister change before her eyes and was afraid that she had done that to her child. This morning, as I spoke to my mom about my sister, I was able to tell her, “Mom, the evidence shows that vaccines don’t cause autism. You did not do this to your child.”

So with autism, one thing to keep in mind is that it is 95% caused by genetics, just like Down Syndrome or other developmental disabilities. We don’t know what the other 5% is yet. Most people that say vaccines caused their child’s autism don’t know or don’t believe that it is 95% caused by genetics. But even if we assume that we’re all aware that 95% of the causation is genetics, if we didn’t know that vaccines don’t cause autism, it could make sense to theorize that it’s part of the 5% that we don’t know about. There are other things people have wondered about too, like induced labor with Pitocin, toxins in the environment, or ultrasounds. Vaccines and Pitocin both have very reliable studies behind them (several studies in the case of vaccines) that shows that the rate of autism among unvaccinated or un-induced children is the same as the vaccinated and induced population. The big study that most people point to as evidence of vaccines causing autism was very poorly done and later retracted and debunked.

I understand parents feeling like vaccines played a part in their child’s autism because it is during those key years (at the same time the child is being vaccinated) that we can see the greatest regression in autism. Sadly, it’s just the nature of the disorder. Some children exhibit symptoms of autism from infancy, but others do not begin to exhibit autistic symptoms until they are 2-3 years old. This is known as regressive autism, because it may appear that the child’s development regresses. Watching a child experience regressive autism is a bewildering and frightening experience for any parent. A child that seemed to develop normally suddenly struggles. Many parents, doctors, and advocates wonder why. Some advocacy groups point to the increase in vaccinations alongside the increase in autism prevalence and imply that there is a correlation. Others pointed to heavy metals in vaccinations from the preservative thimerosal as a likely cause. Yet others acknowledged the genetic makeup which makes children susceptible to autism, and believe that vaccines are the environmental factor that may push them over the edge so to speak. However, each of these beliefs has been debunked through scientific studies. No scientific study done under the proper conditions has ever shown a connection between vaccinations and occurrence of autism.

Parents are exposed to many of these beliefs, many of which are supported by outdated facts or misconceptions. For instance, it is true that children receive more vaccinations now than in the 90’s. Alongside the increase in autism prevalence, many may assume that there is a connection. However, the overall amount of antigens that a child is exposed to during the normal course of vaccinations has significantly decreased since the 90’s. A CDC study noted that “The maximum number of antigens to which a child could be exposed by age 2 years was 315 in 2012, compared with several thousand in the late 1990s” (as cited in Autism Speaks, 2013). Some raise concern about the presence of thimerosal in vaccines, although that has not been shown to correlate with autism either. Even so, thimerosal has not been used in routine childhood vaccines since 2001 (Brown, n.d., p. 6).

Media outlets and many books fail to do the research and see that there is no support for the claim that vaccines cause autism. Furthermore, it is often claimed that the people that overlook vaccine safety are in the pockets of the vaccine companies. Ironically, while this is not true, alternative medicine companies are often sponsors of advocacy groups which fight against vaccines (Brown, n.d., p. 6; See the list of sponsors at generationrescue.org). All of these reasons are why I would encourage parents to do the research for themselves, by examining unbiased peer reviewed studies and reassuring themselves with the data. Vaccines have helped us rid our society of many dangerous diseases. Families with histories of allergic reactions to vaccines or other medications or contraindicating conditions should decide with a doctor whether or not the risks outweigh the benefits in their case, just as they should with any other medical decision.

2 Timothy 1:7 says, “For God has not given us a spirit of fear, but of power and of love and of a sound mind” (New King James Version). Fear persuades us to listen to what sounds like a good solution, but a sound mind should lead us to examine the facts, make a decision based on evidence instead of fear, and trust God with our children’s lives.

End note: I don’t know a great deal about vaccines in relation to other problems, so I still think people should educate themselves about vaccines, as long as they make sure there is good hard science behind their choices. I used to be much warier of vaccines, mainly because I had heard of the autism-vaccine connection. Now that I know a lot of the pseudo-science behind that claim, it really makes me skeptical of a lot of other claims about the harmful nature of vaccines. It’s very important to make sure the information on which you base your beliefs and choices is from a reliable study, with a reliable control group, a large enough size, and not funded or done by people who already have a bias one way or the other. There are allergic reactions to vaccines, just like for other medications. But, I’m guessing the chance of an allergic reaction to a vaccine is much smaller than the chance of being seriously harmed by an illness such as the measles.

Studies concerning vaccines and autism:

This study examines vaccinated and unvaccinated children, including some at higher risk for autism (older sibling with autism), and found no increased risk due to the MMR.
This study surveyed multiple studies to combine their sample groups, and found no connection between vaccines and autism. I’m not sure you can read the entire paper online without a subscription to a database, but the abstract is available.
This page is a directory and summary of many studies concerning vaccines, including a number specifically concerning MMR and autism.

 

References

Brown, A., MD. (n.d.). Clear Answers and Smart Advice About Your Baby’s Shots. Retrieved November 22, 2016, from http://www.immunize.org/catg.d/p2068.pdf

Study Addresses ‘Too Many Too Soon?’ Vaccine Concerns. (2013, March 29). Retrieved November 22, 2016, from https://www.autismspeaks.org/science/science-news/study-addresses-‘too-many-too-soon’-vaccine-concerns

Worldview and Womanhood

This article was originally published in The Virtuous Daughter, a magazine for young women.

What is the core of a biblical woman? We throw around the term, “Biblical Womanhood,” but what does that really mean? I think usually when we say “Biblical” womanhood, we are making a distinction between a worldview that is centered on and shaped by God and a worldview shaped by the world. Continue reading →