You may be wondering why we need an Autism Awareness month. Well, there are different perspectives on what this month entails, ranging from an opportunity to inform the general public and the media about the numerous challenges faced by people on the Autism Spectrum and their family members, to motivating scientists to focus their efforts on promising areas of research. It should also serve as a red flag for health-related government and insurance companies to recognize the high prevalence rate of autism, and set aside the necessary funds to face this increasing reality affecting those on the spectrum and their families. It is estimated to cost at least $17,000 more per year to care for a child with Autism Spectrum Disorder (ASD) compared to a child without ASD. At this time, the financial burden is assumed mostly by families.
And the situation is getting worse as the prevalence of autism is on the rise. According to estimates from CDC's Autism and Developmental Disabilities Monitoring (ADDM) Network, 1 in 68 children has been identified with ASD in 2010, a steep dégringolade from the estimated 1 in 150 children in 2000! At this time, Canadian statistics are not available since the Public Health Agency of Canada is still working with stakeholders and key experts to develop and implement a national surveillance system for autism.
It is often suggested that autism’s rising numbers may be explained by expanded diagnostic criteria and reporting practices. This assumption is largely based on a Danish study which found a 60 percent rise in autism prevalence following the 1994 broadening of Denmark’s diagnostic criteria for the disorder. But half of the increase is still unexplained and researchers do not discount other factors that may be contributing to the dramatic rise in autism prevalence over recent decades.
ASD diagnoses are based on a combination of factors. In Canada and the U.S., the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) is used as the standard screening tool for ASD. According to Michael Rosanoff, Autism Speaks’ director of public health research, last year’s constricting of DSM-5’s criteria could in fact artificially reduce the prevalence of autism.
So what accounts for the remaining 40% increase in autism rates? While the causes of autism are unknown environmental factors and their interactions with genetic susceptibilities are likely contributors to the increase in prevalence. For example, a new American study published in Environmental Health Perspective found a doubled autism risk among children of women exposed to high levels of particulate air pollution during pregnancy.
To this day, autism is often characterized as a puzzle and few breakthroughs in the autism field have occurred since Dr. Leo Kanner first wrote about autism in 1943. What makes ASD more difficult to understand and to treat is that it develops differently in every individual; there is no such thing as a "typical" person with ASD. Symptoms can occur in combinations and in degrees of intensity - ranging from relatively mild to debilitating - in each individual affected.
However, the microbiome – the 100 trillion microorganisms residing in our gut, mouth, skin and elsewhere in our bodies – constitutes a promising area of investigation. A special issue on the role that gut bacteria may play in autism has just been published this month by the on-line journal Microbial Ecology in Health and Disease. In my clinical practice, I have consistently observed the positive impact of restoring gut ecology on the expression of autism symptoms. I have also often found that these children are affected by single nucleotide polymorphisms (SNPs), small genetic variations affecting, for example, our susceptibility to environmental factors such as toxins. In my opinion, this is one of the most important factors that explain their vulnerability to common ingredients found in vaccines, for example.
Clinicians well-versed in functional medicine and other evidence-based approaches such as the one promoted by the Autism Research Institute (ARI) can help restore gut integrity through elimination diets and certain supplements such as probiotics, L-glutamine, maximizing nutrient absorption, optimizing detoxification pathways through the use of highly bioavailable vitamins such as a good B-complex and glutathione precursors found in quality whey proteins, and balance neurotransmitters with supplements like L-theanine, 5-HTP and GABA.
The message that I would like to leave you with during this year’s Autism Awareness month is one of hope. Many children do recover from autism. As clinicians, we have to remember that each child is unique in terms of its biochemical individuality, and as parents, that they possess their own sets of gifts and talents. Armed with patience, love and more understanding of the causes behind this epidemic, we are making progress.
To learn more and how you can help make a difference please visit: www.autismspeaks.ca
Lavelle TA1, Weinstein MC, Newhouse JP, Munir K, Kuhlthau KA, Prosser LA. Economic burden of childhood autism spectrum disorders. http://www.ncbi.nlm.nih.gov/pubmed/24515505
Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2010
Surveillance Summaries March 28, 2014 / 63(SS02);1-21 http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6302a1.htm?s_cid=ss6302a1_w
Building an Autism Spectrum Disorders Surveillance System for Canada http://www.hc-sc.gc.ca/hc-ps/dc-ma/autismsurv-eng.php
Stefan Hansen, M.Sc., section for biostatistics, department of public health, Aarhus University, Denmark; Amy Daniels, assistant director, public health research, Autism Speaks, New York City; Nov. 3, 2014, JAMA Pediatrics, online
Government of Canada, Autism spectrum disorder (ASD) http://healthycanadians.gc.ca/diseases-conditions-maladies-affections/disease-maladie/autism-eng.php
Environ Health Perspect; DOI:10.1289/ehp.1408133 Autism Spectrum Disorder and Particulate Matter Air Pollution before, during, and after Pregnancy: A Nested Case–Control Analysis within the Nurses’ Health Study II Cohort http://ehp.niehs.nih.gov/1408133/