Google “causes of autism,” and you get millions of hits — and a multitude of conjecture. Is a genetic predisposition to blame? Are environmental factors at play? Maternal or paternal age, perhaps? Some sort of pregnancy complication? A virus, or pollutant in the air?
We do not know for sure, but genetics and the environment likely play a combined role, says Henry Roane, PhD, an associate professor of pediatrics and the division chief of the Center for Behavior, Development and Genetics at Upstate. Regardless of the cause of autism or the reason for its recent growth, he says treatment is most effective when begun early.
One in 68 children have autism spectrum disorder. The term “spectrum” is used now in reference to the range of impairment children can have, from mild to severe disability.
That represents a 30 percent increase in diagnoses from a couple years ago, partly because several individual disorders are now considered part of the spectrum. Awareness is also behind the increase, with more parents, teachers and primary care doctors on the lookout for early signs.
“It’s not like having a medical disorder where you can do a blood test and test for certain pathogens in your bloodstream and say ‘well, you have that disease.’ Autism is not like that,” Roane says “It is, to some extent, a subjective diagnosis in many cases. What one provider sees as autism, another provider might not see.”
Treatment is intensive behavioral therapy of 25 to 40 hours per week, to help improve cognitive and language skills. Roane says proper medical care plus early intervention can help change the trajectory of autism, especially in children who begin treatment before age 6. That means caregivers have to know what to look for, and what to ask the pediatrician.
Some signs of autism may be visible when a baby is just a few months old, although experts caution that the signs and symptoms of autism are highly variable among those affected. These 15 behaviors are possible signs:
* lack of sustained eye contact, especially to people or visually-interesting objects
* slow progression of language or delayed speech formation (not babbling, or making a single repetitive sound)
* not responding to their name by 12 months of age
* preference for playing alone
* flat or inappropriate facial expressions
* not pointing at objects by 14 months of age
* flapping hands, rocking body or spinning in circles
* avoiding or resisting physical contact
* unusual reactions to the way things sound, smell, taste, look or feel
* not playing pretend games (such as “feeding” a doll) by 18 months
* reversing pronouns (“you” instead of “I”)
* talking in flat, robot-like or sing-song voice
* lining up toys or other objects, or playing with them the same way every time
* repetitive movements, in older children
* getting upset by minor changes
Sources: Centers for Disease Control and Prevention and the National Institute of Mental Health.