Media Contact: Keith.O’Connor@baystatehealth.org, 413-794-7656
SPRINGFIELD – The Centers for Disease Control and Prevention released its latest report on autism on the eve of National Autism Awareness Month (April). And, the news wasn’t good.
According to the latest report, conducted by the CDC’s Autism and Developmental Disabilities Monitoring Network, 1 in every 88 U.S. children has autism. The new figures affirm what many have long thought – the population of individuals with autism is continuing to rise.
“We are seeing more people than ever before being diagnosed with autism, and some are calling it an epidemic. When I was training in child psychiatry, we considered autism to be relatively rare, about 4 to 5 cases per 10,000 children,” said Dr. Bruce Waslick of Baystate Child Behavioral Health at Baystate Medical Center.
Autism, for which there is no cure, is a complex developmental disorder that typically appears in the first three years of life. It is characterized by atypical development in socialization, communication, and behavior. Symptoms can manifest in a variety of ways including delayed speech or language development, cognitive problems, social interaction problems, stereotypical behaviors such as hand flapping, lack of interest in one’s environment, and profound sensory issues such as sensitivity to sound or touch.
Today there are an estimated 1.5 million Americans living with autism. Autism occurs all racial, ethnic, and socioeconomic groups, but are four to five times more likely to occur in boys than in girls. What is still uncertain, however, is whether autism is truly occurring more frequently in the population or whether, for a variety of reasons, diagnostic practices have changed over time leading to more frequent utilization of the diagnosis in individuals who previously would have been considered outside of the autistic spectrum.
With so much talk in the media today about autism, it is common for parents to worry about any unusual behavioral or developmental signs their child might be exhibiting, noted Dr. Waslick.
“Parents are usually the first to notice any of these unusual signs such as not making eye contact, verbal difficulty, not answering when their name is called, lack of social interaction, and odd physical behaviors such as rocking or walking on their toes,” said Dr. Waslick.
There is currently no definitive medical test for use in the diagnosis of autism. Instead, clinicians diagnose the disorder by taking a thorough developmental history along with a behavioral evaluation of the child’s actions at home, school, and in other locations. Direct observation of the child by an experienced and trained clinician is essential. Other types of diagnostic instruments, such as standardized observation interviews, diagnostic criteria interviews and symptom rating scales are often used. Also, doctors will want to make sure that any symptoms are not a direct result of an underlying medical disorder, so some degree of medical and neurological evaluation may occur, along with at times specialized genetic testing.
“Early recognition of autism is key so that children can benefit by interventional services as soon as possible to help with language development, sensory problems, social interaction, and to assist parents in providing a suitable and appropriate environment where the child can thrive to the best of his or her ability,” said Dr. Waslick.
While there is presently no cure for autism or medical interventions which treat the disorder’s core symptoms of social impairment, communication deficits or developmental delays, some medications can help with associated symptoms such as sleep disturbance, anxiety, hyperactivity, inattention, mood swings, aggression, and agitation. These medications should be prescribed only by individuals qualified in the assessment and treatment of autism spectrum disorders (ASD).
Dr. Lawrence Kaplan, director, Division of Developmental and Behavioral Pediatrics at Baystate Children’s Hospital, noted that positive strides have been made
recently in early intervention and education for children with autism spectrum disorder.
“The focus of many of these interventions is to help children to develop joint attention skills, or the ability to recognize the perspective of others and, in turn, project their own perspective on them,” said Dr. Kaplan.
“Beginning these interventions early, even before starting school, correlates with improved social skills. The important message is that while there remain many unknowns about autism spectrum disorder, we do know that developmental and educational interventions can be effective. This is not a static condition and children with ASD can follow their own unique developmental trajectories despite having this diagnosis,” he added.”
On the positive side for area families, Dr. Waslick said Massachusetts has undertaken an initiative to train primary care physicians and pediatricians to increase their vigilance during well-child visits, so as to identify children at an earlier age who are showing signs of atypical development. The end result would be to have these children referred for evaluation and hopefully receive the services they need as early as possible to maximize their developmental gains and potential. It is important for parents to feel free to bring up any kind of developmental concerns they might have about their child
with his or her primary care doctor, who at that point often becomes the first and key
person in terms of recognizing and intervening with children who may be showing signs of an autism spectrum disorder.
Additionally, there is a controversy brewing in the psychiatric profession centering around the latest update of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM), to be published next year – which clinicians refer to in their diagnosis of mental health disorders – that proposes the redefinition of autism.
The proposal by the DSM-5 Neurodevelopmental Work Group recommends a new category called autism spectrum disorder (ASD), which would subsume several diagnoses which are now listed separately in DSM-IV including Autistic Disorder, Asperger’s Disorder, Childhood Disintegrative Disorder and Pervasive Developmental Disorder Not Otherwise Specified (PDD NOS).
Baystate Medical Center, along with Stanford University in California, recently served as DSM-5 Field Trial sites for autism spectrum disorder aimed at identifying
diagnostic reliability in the implementation of the new criteria to determine whether or not to move forward with the new definition. The results are not known yet, and data is still being analyzed by a research group at the American Psychiatric Association.
For more information on Child Behavioral Health at Baystate Medical Center, visit
www.baystatehealth.org and click on the Behavioral Health tab under Services.