What Is The Outlook For People With Autism Spectrum Disorder
In many cases, the symptoms of ASD become less pronounced as a child gets older. Parents of children with ASD may need to be flexible and ready to adjust treatment as needed for their child.
People with ASD may go on to live typical lives, but there is often need for continued services and support as they age. The needs depend on the severity of the symptoms. For most, it’s a lifelong condition that may require ongoing supports.
A note from Cleveland Clinic
Through research, there has been much that has been learned about autism spectrum disorder over the past 20 years. There is ongoing active research on the causes of ASD, early detection and diagnosis, prevention and treatments.
Last reviewed by a Cleveland Clinic medical professional on 12/29/2020.
References
The Truth Behind The Myth
A study by Andrew Wakefield, which has been retracted, started the debate about a link between vaccines and autism. Mr. Wakefield’s medical license has since been revoked due to conduct considered dishonest and irresponsible.
The fact is, vaccines do not cause autism. This statement is supported by vast research and evidence.
A scientific review by the Institute of Medicine concluded, “the body of epidemiological evidence favors rejection of a causal relationship between the measles-mumps-rubella vaccine and autism.
The committee also concludes that the body of epidemiological evidence favors rejection of a causal relationship between thimerosal-containing vaccines and autism.”
A 2012 report, also by the IOM notes, “few health problems are caused by or clearly associated with vaccines” and “the evidence shows there are no links between immunization and some serious conditions that have raised concerns, including type 1 diabetes and autism.”
In one of the largest studies ever, researchers analyzed medical records of over 95,000 children, more than 15,000 who were unvaccinated at two years of age and more than 8,000 who were age five and unvaccinated.
About 2,000 of the children were considered high risk for autism because they had an older sibling with a diagnosis.
The researchers found no evidence linking the MMR vaccine to autism even in the children who had an increased risk for the disorder.
What This Means For Arizona
In Arizona, key findings indicate that 1 in 71 8-year-old children were identified with ASD, whereas the previous Arizona prevalence was reported at 1 in 64 children this estimate was slightly higher than the average number of children identified with ASD in all areas of the U.S. where CDC tracks ASD.
Even though the rates of autism in Arizona seem to have gotten better from the last report, it is important to realize these numbers are only estimates, says SARRC Vice President & Research Director Christopher Smith, PhD. Given these rates are only based on 8-year-old children and people continue to get diagnosed with ASD after age 8, it is probably most accurate to consider the rates to be between 1.5 and 2 percent of the population.
It is important that SARRC remain vigilant on improving early detection and diagnosis. We need to continue our work to move that needle and get children identified earlier so they have the best opportunity to reach optimal outcomes.
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Getting To The Causes Of Autism
Getting to the cause — or, more accurately, causes — of autism will be more difficult than unraveling the causes of cancer, says Gary Goldstein, MD, president and CEO of Kennedy Krieger Institute in Baltimore, a facility that helps children with autism and other developmental disorders.
“This is harder than cancer because in cancer you can biopsy it you can see it on an X-ray,” Goldstein says. “We don’t have a blood test . There is no biomarker, no image, no pathology.”
“There won’t be one single explanation,” says Marvin Natowicz, MD, PhD, a medical geneticist and vice chairman of the Genomic Medicine Institute at the Cleveland Clinic.
“There’s been a lot of progress in the last few years in terms of understanding the causes of autism,” Natowicz says. “We know a lot more than we did.” Still, he says, research has a long way to go. “One number you see often is that about 10% of those with autism have a definitive diagnosis, a causative condition.” The other 90% of cases are still a puzzle to the experts.
Often, a child with autism will have a co-existing problem, such as a seizure disorder, depression, anxiety, or gastrointestinal or other health problems. At least 60 different disorders — genetic, metabolic, and neurologic — have been associated with autism, according to a report published in The New EnglandJournal of Medicine.
On one point most agree: A combination of genetics and environmental factors may play a role. Scientists are looking at both areas.
Autism Among Children In The United States
In an effort to track the number and characteristics of children in the U.S. with autism, the CDC established the Autism and Developmental Disabilities Monitoring Network in 2000. The network collects data from 11 sites throughout the country in order to better understand the impact of ASD in different communities.
The 11 surveillance areas vary in their data set. For example, Arkansass site consists of all 75 counties in the state, whereas Marylands site is just one county in the Baltimore metro area.
Data published in the most recent ADDM Network report, which was released in March 2020, revealed significant shifts and differences in ASD diagnoses and prevalence around the country. Overall, ASD estimates increased significantly across the country, with some sites exhibiting much higher rates of autism than others.
In 2016, the prevalence of ASD among 8-year-old children living across the 11 sites was as follows:
- Arizona: 1.6%
- Tennessee: 1.6%
- Wisconsin: 1.7%
Researchers from the ADDM Network are still gathering information to better understand why prevalence rates vary so much between sites.
While there was no overall difference in autism prevalence among black and white children, there were disparities in early diagnoses and interventions for black children. On average, black and Hispanic children received initial evaluations and diagnoses later than white children, as well as more delayed opportunities for early intervention services.
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Older Parents Are More Likely To Have Autistic Children Autism Statistics Remark
Namely, parents in their mid-40s have a 5%10% higher chance of having an autistic kid compared with those aged 20. A study has remarked that the older the man, the higher the chance of having an autistic child. For instance, a father aged 45 and over has a 75% higher chance of having an autistic kid.
Healthgoogle Glass Offers Hope To Kids With Autism
Experts say affected kids fare best with early diagnosis and treatment, but some doctors may dismiss early signs and some parents may be unaware of autism symptoms, the CDCs Dr. Stuart Shapira said.
The Pediatrics survey found that about one-third of kids with parent-reported autism received no behavior treatment and showed that many parents had trouble getting services for their children, echoing earlier studies.
Shapira noted the agency has a free Milestone Tracker phone app to help parents recognize developmental delays.
The Associated Press Health & Science Department receives support from the Howard Hughes Medical Institutes Department of Science Education. The AP is solely responsible for all content.
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New Analyses Also Find That A Third Of Children With Autism May Lack Treatment
The prevalence of autism has risen over the past few decades, a finding established by multiple methods of assessing prevalence. New analyses of a national survey emphasize this trendestimating a rate of 2.5 percent. They also call attention to the barriers that families face in trying to access services and treatment for children with the condition.
Nearly a third of children with autism arent receiving treatment, says Wei Bao, the lead author of one analysis and an epidemiologist at the University of Iowa. Autism is a condition with a lifetime impact, so we want to see children receive appropriate treatment, because it will benefit their lifetime health.
Two research teams recently mined the 2016 National Survey of Childrens Health for insights on autism prevalence and treatment. The survey encompassed 43,000 children across the United States parents of those children reported whether a mental health professional had ever told them their child had autism. Both papersone published in Pediatrics and one published in JAMA Pediatricsreported that based on parents responses, 2.5 percent of U.S. children age 3 to 17 have an autism diagnosis.
Unvaccinated Children With Autism
Numerous studies have been done comparing autism rates between vaccinated and unvaccinated children. No difference has been found.
One study from Japan looked at the MMR vaccine, which was withdrawn from the country due to concerns about aseptic meningitis. In that study, a statistically significant number of children were found to have developed autism even though they had not received the MMR vaccine.
Another study published in the February 2014 issue of the journal Autism found, “the rates of autism spectrum disorder diagnosis did not differ between immunized and non-immunized younger sib groups.”
One 2018 study reported in JAMA Pediatrics aimed to determine vaccination patterns of children with and without autism, as well as those of their younger siblings.
The researchers determined that the children who had autism and their younger siblings had higher rates of being un- or under-vaccinated.
This, the study authors note, suggests that these children are at higher risk for vaccine-preventable diseases. So, while there is no proven benefit of avoiding vaccines in terms of autism prevention, this research highlights a proven danger of doing so.
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Are Siblings At Greater Risk For Autism Spectrum Disorder
The truth is that genetics do play a role in autism. When one child is diagnosed with ASD, the next child to come along has about a 20% greater risk of developing autism than normal. When the first two children in a family have both been diagnosed with ASD, the third child has about a 32% greater risk of developing ASD.
Kids Are Getting Diagnosed Sooner
There’s no laboratory or medical test for detecting autism, so doctors must rely on behavioral signs. In the past, many were reluctant to label a child as autistic until symptoms became obvious. “The average age for diagnosis had been about 3.5, with many children diagnosed much later,” says Amy Wetherby, Ph.D., director of the Center for Autism and Related Disabilities at Florida State University, in Tallahassee. But that’s changing.
One reason is that pediatricians are becoming more aware of autism. At the same time, autism specialists are better at identifying early telltale signs such as a lack of babbling or pointing. “Most children with autism will show some signs of developmental disruption by their first birthday,” says Rebecca Landa, Ph.D., an autism researcher at Baltimore’s Kennedy Krieger Institute.
And while no one is yet diagnosing autism in children that young, doctors can now make a reliable assessment by 24 months when a child’s brain is still rapidly developing. “If we can intervene while a child’s brain is very immature, it will be much easier to help change her behavior,” Dr. Wetherby says.
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More Us Kids Being Diagnosed With Autism
HealthDay Reporter
THURSDAY, April 26, 2018 — Autism rates continue to climb in the United States.
About 1.7 percent of children — one in 59 — are now believed to have autism spectrum disorder, up from an estimated rate of 1.5 percent in 2016, according to data from the U.S. Centers for Disease Control and Prevention.
The CDC said Thursday that some of the increase comes from better identification of autism cases in minority populations.
“Autism prevalence among black and Hispanic children is approaching that of white children,” said Dr. Stuart Shapira, associate director for science at the CDC’s National Center on Birth Defects and Developmental Disabilities.
“The higher number of black and Hispanic children now being identified with autism could be due to more effective outreach in minority communities, and increased efforts to have all children screened for autism so they can get the services they need,” he added in an agency news release.
Autism is a developmental disorder characterized by repetitive behaviors, and challenges with social skills and communication.
But autism experts said better detection is not solely responsible for the continued increase in autism rates.
“We are seeing an increase, and I think it’s a meaningful increase,” said Thomas Frazier, chief science officer for Autism Speaks, an autism advocacy organization. “I don’t think this increase can be completely accounted for” by the closing of disparity gaps.
Morbidity and Mortality Weekly Report
How Is Autism Spectrum Disorder Diagnosed
There are no laboratory tests to determine ASD. However, certain healthcare providers receive specific training and can do screenings and evaluations if needed and who might ask parents or teachers to record observations. These providers might include specialized physicians, psychologists and speech-language pathologists.
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Heres A Rundown On The Three Surveys:
The latest estimate is based on responses from about 43,000 parents of kids aged 3 to 17. They were asked if their child had ever been diagnosed with autism spectrum disorder, the formal name that encompasses mild to severe cases. The 2016 survey was internet-based earlier ones were telephone surveys showing slightly higher rates but the researchers say the results arent comparable,
The nationally representative survey suggests that about 1.5 million U.S. kids have autism 2.5 percent or 1 in 40.
The Centers for Disease Control and Prevention collects nationally representative information from in-person interviews. In 2016, it also asked parents of kids aged 3 to 17 about ever being diagnosed with autism and came up with a slightly higher rate than in previous years but similar to the 1 in 40 estimate.
The CDC also uses an 11-state tracking system. Its based on health and school records showing which kids meet criteria for autism, focusing on 8-year-olds because most cases are diagnosed by that age. A report from this network released in April, showed that 1 in 59 kids have autism although much higher rates were found in some places. This estimate is considered the most rigorous, but its not nationally representative.
Autism Speaks, an advocacy group, is among organizations that use the CDCs network estimate. It tends be more conservative and potentially more accurate than parents reports, said neuroscientist Dean Hartley, a senior director for the group,
How Common Is Autism
In 2018, the Centers for Disease Controls Autism and Developmental Disabilities Monitoring reported that approximately 1 in 59 children in the United States has been identified with an Autism Spectrum Disorder . This estimate is a 14% increase from the 1 in 68 rate in 2016 and a 47% increase from the 1 in 88 rate in 2012. In the 1980s autism prevalence was reported as 4 in 10,000. In the nineties, prevalence was 1 in 2500 and later 1 in 1000.
It is problematic to compare autism rates over the last three decades, as the diagnostic criteria for autism have changed with each revision of the Diagnostic and Statistical Manual , which outlines which symptoms meet the criteria for an ASD diagnosis. In 1983 the DSM did not recognize PDD-NOS or Aspergers syndrome, and the criteria for autistic disorder were more restrictive. The previous edition of the DSM, DSM-IV, included autistic disorder, childhood disintegrative disorder, PDD-NOS, and Aspergers Syndrome. Due to inconsistencies in diagnosis and how much we are still learning about autism, the most recent DSM only has one diagnosis, autism spectrum disorder , which encompasses each of the previous four disorders. According to the new diagnostic criteria for ASD, one must have both deficits in social communication and interaction, and restricted repetitive behaviors, interests, and activities .
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What Are The Signs Of Autism Spectrum Disorder
Signs of ASD range from mild to severely disabling, and every person is different. The following signs are considered to be red flags that indicate your young child may be at risk for autism. If your child shows any of the following signs, please get in touch with your childs healthcare provider to discuss a referral for an autism evaluation.
The signs include the following:
- Your child doesnt respond to their name being called at all or responds inconsistently.
- Your child doesnt smile widely or make warm, joyful expressions by the age of 6 months.
- Your child doesnt engage in smiling, making sounds and making faces with you or other people by the age of 9 months.
- Your child doesnt babble by 12 months.
- No back-and-forth gestures such as showing, pointing, reaching or waving by 12 months.
- No words by 16 months.
- No meaningful, two-word phrases by 24 months.
- Any loss of speech, babbling or social skills at any age.
What Is Autism Spectrum Disorder
ASD is a neurodevelopmental disorder that includes impairments in language, communication skills, and social interactions combined with restricted and repetitive behaviours, interests or activities.Footnote 1 Signs of ASD are typically detected in early childhood, with boys four to five times more frequently diagnosed with ASD than girls.Footnote 2
Each person with ASD is unique and will have different symptoms, deficits and abilities. Because of the range of characteristics, this condition is named a “spectrum” disorder, where ones’ abilities and deficits can fall anywhere along a spectrum, and thereby, support needs may range from none to very substantial. It is a complex life-long condition that impacts not only the person with ASD, but their families, caregivers and communities.
In Canada, the diagnosis of ASD is usually provided by medical doctors or psychologists. ASD diagnostic assessments typically use both direct observation and developmental interviews to inform the diagnosing clinician’s clinical judgement based on ASD criteria from the Diagnostic and Statistical Manual of Mental Disorders .Footnote 3
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