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Ask Dr. Mike: Expecting and Anxious About Autism

The CDC recently indicated that 1 in 50 children have Autism, causing a stir among parents and those considering children.

With last month’s Centers for Disease Control and Prevention’s (CDC) reporting that as many as 1 in 50 children in U.S. schools have Autism, the topic of Autism has created an increase in parental anxiety in my practice as a psychologist. Parents want to know what the CDC’s study and those numbers could mean for them and their own potential for having an Autistic child.   

The parents who are most concerned are those who are either planning for pregnancy or who are pregnant and expecting. One parent I met with recently expressed a profound sense of relief after learning that the sex of their fetus is female, reminding me that boys are four times more likely to be diagnosed with Autism than girls. And, another parent indicated that, while they would love a fourth child, they do not want to “take any chances with autism being so rampant.”

We have all watched the rates grow year after year, so I’m not surprised that parents are becoming more anxious about Autism. In 2000, the Autism prevalence rate in the United States was 1 in 500 and during the past 13 years those numbers have climbed to today’s CDC’s finding that 1 in 50 U.S. children having Autism. One explanation for the startling increase is that diagnosis is improving and older children are now being diagnosed at higher rates.

And the CDC’s research findings have mirrored what I have been seeing in my practice for several years now, where I am diagnosing older children – usually male – who are generally high functioning. I have spoken to my colleagues whose experiences are similar, and I imagine that child psychologists all over the country are having the same sort of experience in their practices – that there is subset of children with High Functioning Autism, Asperger’s Disorder or Pervasive Developmental Disorder (PDD), that aren’t being identified or diagnosed until later in childhood. 

Presently, there is no medical test or genetic test that can identify Autism during pregnancy. However, several factors are associated with higher rates of Autism, including: premature births, babies low in weight at birth, low Apgar scores, parental age (for both fathers and mothers), high maternal stress, maternal use of certain medications, maternal hormonal and genetic status and fetal hypoxia. Some research has even shown a correlation with Autism and cesarean section delivery and having a baby in less developed countries than the United States or Europe.

Unfortunately, most of the above-mentioned factors for autism are not in one’s control, and the rise in Autism rates is raising parental anxiety. Pediatricians, child psychiatrists, child psychologists, and other professionals who work with parents who are planning for pregnancy or expecting or parents of young children need to be prepared to discuss Autism. 

My advice to my clients at this point is for them to focus on what is in their control: good maternal health at birth and good prenatal care. I also discuss the importance of early intervention and its proven positive impact for children on the Autistic Spectrum. I also support and work with parents whose children are being diagnosed later inasmuch as older children and adolescents on the Spectrum can benefit from behavioral therapy and social skills interventions. 

I also tell parents that Autism is an epidemic on a global level, but it is not a curse on an individual one. Some of the happiest parents I know (both personally and professionally) have children on the Autistic Spectrum. And it has been my honor and pleasure to work with many children, adolescents and adults with Autism over the years.

Michael Crosby May 06, 2013 at 06:36 AM
so i`ve never had that kind of experience. what do you think the best course of action is when dealing with her ? my concern is that she will just keep doing it and accidentally abusing people who aren`t really able to defend themselves as well as you or i can.
Nora May 06, 2013 at 06:41 AM
I'm afraid nothing we say will stop her from doing that. Obviously she hasn't even asked to know what offended you. Privilege is a dangerous thing.
Nora May 06, 2013 at 06:54 AM
In addition, you have to look at the basic belief system here. Autism is seen as evil and is associated (wrongly) with a lack of empathy. It is seen as a disease. If someone truly cannot see how autism would affect you positively, they can't be expected to respect your views.
Lizzy Soraya May 06, 2013 at 07:27 AM
Cynthia, I'm not autistic actually, but thanks for the compliment. You did mean it as a compliment didn't you? I am sure you would not use "autistic" as an insult ...
Michael Crosby May 06, 2013 at 02:21 PM
nora, i think you`re right. but maybe i`m being blinded by my own emotional baggage. i can`t stop thinking about the kids who are affected by this. not just the kids of the parents here, but the kids of parents who listen to them. and the kids and adults who are affected by the refusal to use vaccines. people are now dying from diseases that were all but eradicated by these "evil" vaccines, only because parents have refuse to vaccinate their children. one of the main things that motivates me to work so hard at bridging the gap between "us" and "them," maybe even the main thing, is that i don`t want anyone to go through what i did. and especially my own children. i know these parents` opinions won`t change until they`re ready to change. but i think they need to be help responsible for their choices, if only to protect people from the effects of their choices. i think it`s a difficult problem, and i don`t know what the answer is, but personally, if i have a choice between saving a child or saving an adult, i always choose the child. it`s gotten me in trouble before. part of the reason i didn`t survive working in special ed was because i prioritised the child.
Nora May 06, 2013 at 06:46 PM
I hear you. I think the reason I've prolonged this is also thinking about those poor kids. But the majority of people are not as extreme as the people commenting here. It took someone pointing out my ignorance on the Internet to make me even realize that what I'd heard about autism was so wrong, and why that mattered. I was just a well-meaning person who had been told the wrong thing, and had no idea that some of my beliefs were hurtful to autistics. And most of the NT people in your life are probably the same; not bad people, but just misinformed. It is communicating with those people who are able to listen and comprehend that will make a difference.
Michael Crosby May 06, 2013 at 06:55 PM
thanks. you`re right. it`s just very frustrating... we can only help the people we can help.
Michael Crosby May 06, 2013 at 06:57 PM
lol, i was ignoring stuff like that. it seemed like baiting. thanks for pointing it out.
Liz May 09, 2013 at 04:04 AM
To the pathetic tag team of trolls posing here as autistics and/or parents of autistic children: Can't you people get work where you don't have to hurt others? Seriously. This propaganda thread must have cost Pharma a pretty penny. And to the psychologist who authored this terrible article, I don't know what your problem is, but you shouldn't be diagnosing or giving psychotherapy to anyone.
Lizzy Soraya May 09, 2013 at 07:36 AM
That's right, anyone who doesn't belittle, berate and bully autistic people must be a troll paid for by the mythical "big pharma." The troll here is the person who came along 5 days after the conversation ended solely to post personal abuse - yes, YOU!
Liz May 09, 2013 at 01:26 PM
You can't count either. May 6th to May 9th would be 3 days. Get a real job.
Liz May 09, 2013 at 02:11 PM
"Belittle, berate and bully" describes what you do "Lizzy Soraya" and the other phony plants here. Parents are trying to tell of their painful experiences with very sick children, some of whom can't talk, require constant close supervision and wear diapers into adulthood, and you have the nerve to tell them that if you had the choice that you would choose to have autistic children, that these parents ought to suck it up and stop whining, that their attitudes and lack of love are causing their childrens' health problems. SHAME ON ALL OF YOU. And this psychological abuse is allowed as comments on a psychologist's article about how wonderful it is to have autism. SHAME.
Lizzy Soraya May 09, 2013 at 02:26 PM
Liz, my son is autistic, severe enough to attend a specialist school, are you happy now? If you want to keep up the autism hating you go for it. I choose not to and I certainly have better things to do than keep talking to someone like you. Good day!
Lizzy Soraya May 09, 2013 at 02:27 PM
Sunday-Monday-Tuesday-Wednesday-Thursday. Today is the 5th day although perhaps it was yesterday in whatever backward timezone you live in.
Liz May 09, 2013 at 02:58 PM
There needs to be a law passed to protect free speech on the internet. Agents paid by commercial interests, in this case no doubt Pharma, to disrupt conversations and to spread propaganda, must be made to reveal that they are compensated and by whom. This has got to stop.
Liz May 09, 2013 at 03:15 PM
"my son is autistic, severe enough to attend a specialist school" Right. And I'm Princess Diana. Now that you've been called out, you're all of a sudden too busy to talk. Moving on to your next assignment?
Nora May 09, 2013 at 04:22 PM
Goodness. Pharma has its flaws; they've been caught marketing drugs with questionable data and risk profiles behind them. Of course you should be informed about your and your family's health and willing to question marketers. Being informed is different from buying into any theory that paints pharma as a complicit enemy to our health and believing anything bad that is said about it. Why on earth would a pharmaceutical company hire people to tell people autism is not as awful as the media suggests? If anything they would want people to go on believing autism is a curse so they can market drugs and cures for autism in the future. Isn't it more likely that a lot of people do not believe vaccines cause autism, and any comment to the contrary is going to elicit responses from those people?
Lara Lohne May 09, 2013 at 04:31 PM
@Liz, do you even realize how paranoid and irrational your comments will appear to the average reader? If you are attempting to instill doubt about what parents of autistic children and autistics themselves have written here, you're doing a very poor job of it. And to advise you, most of the time, when someone is obviously trolling, it really isn't in anyone's best interest to respond so when you make comments like the ones you have made, don't be too surprised if nobody does respond and certainly don't take it as anything other then you being ignored because you aren't worth the trouble. This particular conversation ended last weekend. That being the case, you coming here and berating those who 'have the nerve' to stand up and say they are happy autistics or autism parents is a little petty to be honest. If you don't have autism, or a child or other family member with autism, then you really don't have anything to add that is related to the conversation or the topic of this article.
Liz May 09, 2013 at 05:19 PM
The public is well aware that there are paid trolls. True, many don't call them out as I have here. You're both phonies, obviously reading from a script. Authentic people don't express themselves the way you have. Your responses don't fit the characters you're playing. As I said, go find real jobs doing something worthwhile in society.
Cynthia Parker May 09, 2013 at 05:48 PM
Liz is right about the paid trolls. Google Lara Lohne as an illustration. Big Pharma wants unwary parents to first get all their vaccines, both for pregnant women and children, and then pay for their autism treatments, billions both ways.
Cynthia Parker May 09, 2013 at 06:29 PM
Tina, Judge Mitting last year restored the licenses of Dr. W's colleagues on the Lancet study, Drs. Walker-Smith and Murch, finding for the plaintiffs, that there had been NO FRAUD, the children's symptoms of autism or bowel disease starting within days or weeks of the MMR had been accurately reported, the sick chidren appropriately treated, and he reprimanded the GMC for its shallow reasoning and false conclusions. He mandated that the GMC include a legal board in future actions to prevent the abuses apparent in its taking the licenses from these doctors. Dr. W's insurance would not pay for him to be part of the lawsuit. Tina, it is you who are spouting dangerous propaganda. I urge all who are not trolls reading this to google HIgh Court Judge Sir John Mitting's exoneration of Lancet doctors, from March 2012, and you'll see who's spouting dangerous propaganda. Hundreds of thousands of children have regressed into autism shortly after getting the MMR, and, trust me, you do not want your child to be one of them.
Nora May 09, 2013 at 06:35 PM
You guys are losing what little credibility you might have had.
Liz May 09, 2013 at 06:44 PM
The other reason why you are surely a plant is because once your authenticity is questioned, you insist that the conversation is over. Who are you to decide that? The conversation is over when comments are closed, not when your employer stops paying you or it becomes difficult to continue your charade. Then there's the fact that you tried to shut me up by telling me to go away because you decided I am not autistic or don't have an autistic child, so I have no right to comment. You called me paranoid, wrote that other people won't believe me. All these tactics are those of a bully and a liar, not those of a parent of an autistic child. You twisted and deflected everything that the sincere posters expressed - a sorry version of "I know you are but what am I". You are all completely full of it.
Nora May 09, 2013 at 06:56 PM
But calling a random person a plant when they are not a plant is surely neither "bullying" nor "lying." We left the thread because IT WAS FRUSTRATING AND WE HAD BETTER THINGS TO DO. Especially when people were accusing us of being amused by this train wreck of a discussion. I am sorely disappointed that it is being revived in this way. Please have the maturity that Jackie and Cynthia had to realize that we were not going to agree and that there is no point in prolonging this. Good day.
Liz May 09, 2013 at 07:11 PM
Well, that's good. Why don't you leave then and let the people who want to express themselves honestly stay and have their say. Will your boss let you do that?
Michael Crosby May 09, 2013 at 09:12 PM
at this point, they don`t have any credibility. i think feeding them doesn`t help your credibility either. this is obviously trolling on their part because it has no content except personal attacks. let them say what they want. they can only make themselves look worse. ignoring them can only make you and me and the others look better. i think every valid point that possibly could be made has already been made.
Michael Crosby May 09, 2013 at 09:19 PM
if someone actually does google lara lohne, it doesn`t lead to anything useful to this conversation except this conversation and proof that you are saying what you believe. the idea that telling someone to google someone is somehow proof of anything is trollish behaviour at best. it`s a way of saying i have no proof, so i hope you don`t find any on google and you probably won`t fact check anyway. someone with valid proof will offer it directly. so... just let it go. they`re just getting stupider and stupider in their arguments. that means reality is winning, even in their own heads. and responding just makes it look like you or i or the rest have something to hide. it`s the same idea as saying the public knows there are paid trolls. it`s not even relevant. it`s a bid to the people who already agree with her. anyone else would discard it and put a mark against her. i call using extremely general and vague declarations as that "praising me with faint damns."
Michael Crosby May 09, 2013 at 09:35 PM
i can`t help but laugh at how cartoon-ish they`re getting... i`d apologise for getting mad and saying some derogatory things, but only a saint could ignore all the ways they`ve ignored me and insulted me. i`m sure i look like a fool to some people for trying to argue with them at all. it`s clear they`re not going to be more open minded until some random thing triggers a revelation.
Lizzy Soraya May 09, 2013 at 10:21 PM
I'm too busy spending my Big Pharma payola to comment any further!
Cynthia Parker May 10, 2013 at 01:52 AM
I'm glad you're here, Liz. Thank you.

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