Written By, Chris Bauer MD
April has been dedicated as World Autism Month and April 2 has been declared World Autism Awareness Day by the United Nations. According to The N.J. Department of Education, Autism Spectrum Disorder (ASD) affects 1 in 45 children in New Jersey. New Jersey has the highest rate of Autism spectrum disorder in the nation. In the last ten years, NJ has seen greater healthcare funding, more legislative measures, and more public advocacy for Autism research and awareness.
In discussing Autism spectrum disorder, correct terminology usage is very important. Autism spectrum disorder (ASD) is a neurological developmental disorder with deficits in social communication and interaction with restricted and repetitive patterns in activity and behaviors. Intellectual impairment and delayed or absence of language development are often observed as well. The repetitive movements often include hand flapping, rocking, toe walking or swaying. As the name implies Autism spectrum disorder is a diagnosis that encompasses a spectrum of criteria and no two people are affected in the same way. Boys are four times as likely to have Autism spectrum disorder as compared to girls. In addition, there is also an increased risk of ASD in siblings born after a child has been affected by Autism spectrum disorder. People with Autism spectrum disorder are also more likely to have seizure disorders and as many as 50 percent have attention deficit hyperactivity disorder.
To date, there has not been any agreed-on consensus on what the cause of Autism spectrum disorder is. A recent theory suggests that ASD is inherited genetically, and that brain development is affected in the process. The inherited altered genetic material will then alter the neural pathway of that individual. Exposure to environmental toxins, teratogenic material, and infections during pregnancy have been shown to increase ASD rates. Having a preterm delivery, low birth weight, being exposed to certain antidepressants, and medications used to treat seizures in utero or swallowing meconium at the time of birth will increase a persons’ risk of getting Autism spectrum disorder.
Diagnosing those with ASD early is an essential step in obtaining support services for children. The American Academy of Pediatrics recommends screening for Autism spectrum disorder at 18 and 24 months. Children’s parents who have concerns that their child has ASD can go to their primary care provider for an initial evaluation. Other healthcare providers who can assist with a diagnosis of Autism spectrum disorder include child psychiatrists, developmental-behavioral pediatrician, child neurologists and neuropsychologists. When a child is initially evaluated for ASD by a provider, a thorough history and physical is taken. Then a diagnosis of Autism spectrum disorder is made using observation of the child’s behavior and history and aligning that with the diagnostic criteria.
After the diagnosis is made, early intervention with programs tailored to assist a child’s language, social and behavioral skills have been shown to have a significant positive effect on a child’s future development. Examples of early intervention programs include, speech therapy, family therapy, physical therapy, hearing impairment therapy, and nutritional services. The goals of early intervention programs are tailored to each individual child and aim to assist with thinking, physical, social, emotional and communication skills. A complete listing of early intervention programs in New Jersey is available to families on the Department of Health in New Jersey website (www.njeis.org).