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more articles by Duplan, Auguste L. , MD  |  author's bio

Autism Spectrum Disorders Becoming More Prevalent

Autism Spectrum Disorders Becoming More Prevalent

By Auguste Duplan, MD


According to the Centers for Disease Control, one child in 166 in the United States has some form of autism. Ten years ago, that figure was estimated to be one in 2,500. While it is difficult to know for certain whether the incidence of autism is increasing as dramatically as it appears to be, or whether we are simply better trained to recognize it, most experts agree that the rising figures can be attributed to a combination of both factors.


Defining Autism Spectrum Disorders (ASD)


The notion of a spectrum of autism disorders is a fairly recent development even though we have known for some time that people who share the diagnosis of autism can vary significantly in their abilities to function. Individuals who are severely autistic have little or no ability to communicate. If they are able to speak, they typically talk about themselves in the third person. Many are developmentally disabled and some suffer seizures. At the other end of the spectrum are highly functioning individuals, who have normal to above average IQs. They often go on to achieve well in professions that require only limited personal interaction; some are quite gifted in their chosen fields.


Under the umbrella of Autism Spectrum Disorders (ASD), in addition to Autistic Disorder, are associated disorders characterized by some but not all of the symptoms of autism, including Asperger’s Disorder, Rett’s Syndrome, Childhood Disintegrative Disorder, and Pervasive Developmental Disorder Not Otherwise Specified (PDD NOS).


Common Symptoms of Autism


There are a number of common features of autism that appear to greater or lesser degrees in most people with ASD.  One aspect may be more pronounced than others, depending on the individual.


1)    Impaired ability to communicate, including verbal communication and the ability to take visual cues from another person.

2)    Inability to engage in social interaction; not relating well to others. Preferring not to be touched.

3)    Repetitive behavior, either through gestures or obsession with objects.

4)    Restricted areas of interest, usually in solitary activities, such as coin collecting or tending plants.


Why autism occurs


There are no known causes of autism. There are, however, several hypotheses related to diet (gluten, casein), the environment (pollution), and childhood vaccinations. At this point in time these are purely speculations, as we do not have sufficient data indicating any one cause. We do know that autism tends to run in families and that if you have one child with autism, your odds of having a second child with autism are significantly higher than the general population.


Early diagnosis is critical


Most parents of children with autism grow suspicious that something is wrong early in their child’s development. Parents picking up on differences in their child can help facilitate a diagnosis as early as 18 months of age. Early evaluation and treatment are crucial to a child with autism; if a child reaches age five or six before deficits are diagnosed and addressed, the chances for a good outcome are diminished dramatically.


The signs to look for include: lack of verbal and non-verbal communication, an aversion to being touched, repetitive behavior, and an inability to filter stimuli. Babies with autism may not smile, or cry, or point at things. As they grow up and begin to attend school, children with autism sometimes can become aggressive toward other kids out of frustration and in response to being ostracized.


Autism is also highly correlated with other disorders, such as attention deficit/hyperactivity disorder (AD/HD), obsessive-compulsive disorder (OCD), and Tourette’s Disorder. It’s not at all uncommon in treating a patient with AD/HD or anxiety or depression to discover that the child also has an autism spectrum disorder.


Treatment for autism


There is no cure for autism but there are a number of approaches to treatment. It is important to place a child with autism in a special and supportive environment as quickly as possible. Applied Behavior Analysis (ABA) is one of the effective approaches to help a child with autism learn in small increments. It involves intensive one-to-one teaching, and breaking down learning into manageable steps.  Children with autism are easily over-stimulated. They cannot filter out the sounds and visual distraction of the ordinary classroom and in such a setting they are overwhelmed. However, individual teaching time in a small setting, where the child is not the target of bullying, can have a significant impact on early development.


Teenagers with autism have self-esteem problems and often struggle with depression and anxiety. Autism is a disorder that isolates children and they may act out aggressively. Parents need to ensure that these children are in environments that nurture them and help them develop social skills, even if the child is resistant and does not want increased social contact.  Over time, this kind of interaction can help these kids feel less anxious.


Autism is a life-long problem. People do struggle with it, and right now we have no cure. But the earlier autism is diagnosed and addressed, the better a child’s chances are for living a more normal life.


Dr. Duplan is a board-certified psychiatrist on staff in the Adolescent Behavioral Services Unit at Cayuga Medical Center. He did his fellowship training in child and adolescent psychiatry at New York Presbyterian Hospital—Weill Medical College of Cornell University.





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