(3) Lancet retracts Wakefield’s MMR paper. Dyer C. BMJ 2010;340:c696. 2 February 2010 (https://pubmed.ncbi.nlm.nih.gov/20124366/)\r\n

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Autism Statistics and Facts | Autism Speaks

Autism Prevalence

• In 2021, the CDC reported that approximately 1 in 44 children in the U.S. is diagnosed with an autism spectrum disorder (ASD), according to 2018 data.
  • 1 in 27 boys identified with autism
  • 1 in 116 girls identified with autism
• Boys are four times more likely to be diagnosed with autism than girls.
• Most children were still being diagnosed after age 4, though autism can be reliably diagnosed as early as age 2.
• 31% of children with ASD have an intellectual disability (intelligence quotient [IQ] <70), 25% are in the borderline range (IQ 71–85), and 44% have IQ scores in the average to above average range (i. e., IQ >85).
• Autism affects all ethnic and socioeconomic groups.
• Minority groups tend to be diagnosed later and less often.
• Early intervention affords the best opportunity to support healthy development and deliver benefits across the lifespan.
• There is no medical detection for autism.

What causes autism?

• Research indicates that genetics are involved in the vast majority of cases. 
• Children born to older parents are at a higher risk for having autism. 
• Parents who have a child with ASD have a 2 to 18 percent chance of having a second child who is also affected. 
• Studies have shown that among identical twins, if one child has autism, the other will be affected about 36 to 95 percent of the time. In non-identical twins, if one child has autism, then the other is affected about 31 percent of the time.  
• Over the last two decades, extensive research has asked whether there is any link between childhood vaccinations and autism. The results of this research are clear: Vaccines do not cause autism. 

Intervention and Supports 

• Early intervention can improve learning, communication and social skills, as well as underlying brain development.  
• Applied behavior analysis (ABA) and therapies based on its principles are the most researched and commonly used behavioral interventions for autism. 
• Many children affected by autism also benefit from other interventions such as speech and occupational therapy. 
• Developmental regression, or loss of skills, such as language and social interests, affects around 1 in 5 children who will go on to be diagnosed with autism and typically occurs between ages 1 and 3. 

Associated Challenges 

• An estimated 40 percent of people with autism are nonverbal.  
• 31% of children with ASD have an intellectual disability (intelligence quotient [IQ] <70) with significant challenges in daily function, 25% are in the borderline range (IQ 71–85).  
• Nearly half of those with autism wander or bolt from safety.  
• Nearly two-thirds of children with autism between the ages of 6 and 15 have been bullied. 
• Nearly 28 percent of 8-year-olds with ASD have self-injurious behaviors. Head banging, arm biting and skin scratching are among the most common. 
• Drowning remains a leading cause of death for children with autism and accounts for approximately 90 percent of deaths associated with wandering or bolting by those age 14 and younger. 

Associated Medical & Mental Health Conditions 

• Autism can affect the whole body. 
• Attention Deficient Hyperactivity Disorder (ADHD) affects an estimated 30 to 61 percent of children with autism. 
• More than half of children with autism have one or more chronic sleep problems. 
• Anxiety disorders affect an estimated 11 to 40 percent of children and teens on the autism spectrum. 
• Depression affects an estimated 7% of children and 26% of adults with autism.  
• Children with autism are nearly eight times more likely to suffer from one or more chronic gastrointestinal disorders than are other children. 
• As many as one-third of people with autism have epilepsy (seizure disorder). 
• Studies suggest that schizophrenia affects between 4 and 35 percent of adults with autism. By contrast, schizophrenia affects an estimated 1.1 percent of the general population. 
• Autism-associated health problems extend across the life span – from young children to senior citizens. Nearly a third (32 percent) of 2 to 5 year olds with autism are overweight and 16 percent are obese. By contrast, less than a quarter (23 percent) of 2 to 5 year olds in the general population are overweight and only 10 percent are medically obese. 
• Risperidone and aripiprazole, the only FDA-approved medications for autism-associated agitation and irritability. 

Caregivers & Families  

• On average, autism costs an estimated $60,000 a year through childhood, with the bulk of the costs in special services and lost wages related to increased demands on one or both parents. Costs increase with the occurrence of intellectual disability. 
• Mothers of children with ASD, who tend to serve as the child’s case manager and advocate, are less likely to work outside the home. On average, they work fewer hours per week and earn 56 percent less than mothers of children with no health limitations and 35 percent less than mothers of children with other disabilities or disorders. 

Autism In Adulthood  

• Over the next decade, an estimated 707,000 to 1,116,000 teens (70,700 to 111,600 each year) will enter adulthood and age out of school based autism services. 
• Teens with autism receive healthcare transition services half as often as those with other special healthcare needs. Young people whose autism is coupled with associated medical problems are even less likely to receive transition support. 
• Many young adults with autism do not receive any healthcare for years after they stop seeing a pediatrician. 
• More than half of young adults with autism remain unemployed and unenrolled in higher education in the two years after high school. This is a lower rate than that of young adults in other disability categories, including learning disabilities, intellectual disability or speech-language impairment. 
• Of the nearly 18,000 people with autism who used state-funded vocational rehabilitation programs in 2014, only 60 percent left the program with a job. Of these, 80 percent worked part-time at a median weekly rate of $160, putting them well below the poverty level. 
• Nearly half of 25-year-olds with autism have never held a paying job. 
• Research demonstrates that job activities that encourage independence reduce autism symptoms and increase daily living skills. 

Economic Costs 

• The cost of caring for Americans with autism had reached $268 billion in 2015 and would rise to $461 billion by 2025 in the absence of more-effective interventions and support across the life span. 
• The majority of autism’s costs in the U.S. are for adult services – an estimated $175 to $196 billion a year, compared to $61 to $66 billion a year for children.  
• On average, medical expenditures for children and adolescents with ASD were 4.1 to 6.2 times greater than for those without autism.   
• Passage of the 2014 Achieving a Better Life Experience (ABLE) Act allows tax-preferred savings accounts for people with disabilities, including autism, to be established by states.  
• Passage of autism insurance legislation in all 50 states is providing access to medical treatment and therapies. 

For more information, download Autism and Health: A Special Report by Autism Speaks. 

Autism: what can parents do to help their child?

The first 2-3 years are especially difficult for a couple who have had their first child. Young mothers and fathers are still learning to be parents, and it is quite difficult to understand that the development of their child is different from others. It's even harder to accept that your baby may have a mental disorder. Childhood autism, or as it is now also called, autism spectrum disorders (ASD), today occurs in every 88th child. How to recognize the disease and what should parents pay attention to? These and other questions related to autism were answered by the Head of the Department of Psychiatry and Narcology, Doctor of Medical Sciences, Associate Professor Grechany Severin Vyacheslavovich.

What is autism? Is this disease born or is it an acquired condition in the environment in which the child grows up?

Childhood autism is a congenital disease. The fact of its occurrence cannot be the result of such external causes as, for example, the social or cultural level of the family. The decisive role is played by the biological factor that determines the birth of such a child. Of course, there are external circumstances that, ceteris paribus, provoke the appearance of symptoms of this disorder - a severe viral infection, in some cases even a sharp change in the family situation, for example, a sudden separation from the mother, hospitalization of the child in the hospital and more. Often an autistic child is the firstborn in the family, and parents do not yet know how the child should develop. Subsequently, they recall that they often thought about why their child did not develop like other children, but still they did not suspect serious deviations. Therefore, this day - April 2 - just calls for adults to take a closer look at the child in general and notice any anomalies in his development as early as possible. And whether this is autism or some other disease - this should be decided by the doctor.

How can parents tell if their child has the condition?

Unfortunately, often parents do not immediately pay attention to the atypical, age-specific behavior of their child. This circumstance gave rise to some myths that autism can occur with the wrong parenting approach or after some medical interventions, including preventive vaccinations. This cannot be believed, since childhood autism also goes through a latent phase in its development, when its symptoms are almost imperceptible, but this does not mean that it was not there from birth. However, you need to know the so-called "red flags of autism", with the manifestation of which it is worth contacting a specialist. These include:

• child does not use pointing gesture,
• does not make eye contact, does not smile in response to a smile,
• does not respond to his name or to requests addressed to him,
• does not hear speech, does not understand why adults turn to him,
• does not say a 2-word phrase by age 2,
• does not use toys for its intended purpose.

Often the child does not develop a plot game. For example, a car for a boy is not an image of a car that he saw on the street, but only wheels that can be turned. With the help of a toy, a child cannot reproduce the plot seen in life. In the same way, for a girl, a doll is not an image of a little man whom she can put to sleep or feed, but an indifferent object with moving parts. It is also worth paying attention to how the child communicates, whether he can follow the simple instructions of an adult, and concentrate his attention. If parents notice these features, then you need to see a doctor.

Is it possible to cure autism or only bring adaptation to life to a certain level? Which doctor to contact in this case?

Any specialist can suspect autism. Suppose the district pediatrician assumes that the child has autism and advises parents to contact a psychiatrist. However, it is important to understand that the final diagnosis may differ from the initial one, and there are other mental disorders besides childhood autism at an early age.

Is child autism treated at the Pediatric University Clinic?

We don’t have a separate department yet, besides, working with an autistic child is a long-term, often many-year work of a large team of different specialists, including not only doctors, but also correctional teachers, clinical psychologists and their varieties, rehabilitation specialists etc. However, we consult such children and their mothers at the stage of early diagnosis, when parents, for various reasons, are not yet ready to go to official psychiatric institutions. Thus, difficult and doubtful diagnostic cases are solved, the very first recommendations are given. For example, I receive at the Multidisciplinary Center, Vera Vladimirovna Pozdnyak takes at the Consultative and Diagnostic Center. We provide primary care to these children. We give advice on how to treat a possible disease in a child, how to behave with such children and what options for drug therapy exist. Most moms walk away grateful as they get answers to questions that have haunted them for a long time.

As far as treatment is concerned, we do not provide it. In addition, parents, faced with the problem of autism, must understand that it is impossible to completely cure it, and they will have to accept that throughout their life the child will be special, unlike all others. There has never been such a case that the same classic autism ended in complete adaptation in society, even if the child at some stage was able to master the profession. Although it is believed that with age the diagnosis of "autism" cannot be reconsidered for a child, but most of the actual "autistic" traits disappear on their own over time. And already at the age of 6-7, other problems related to behavior, underdevelopment of abstract concepts, misunderstanding of the context of communication, i.e. purely intellectual difficulties, come to the fore. In the future, parents will need to adapt the child to life with what is, including special requirements for the learning process. At home, you should also follow a special system of rules developed individually for a particular child.

How can parents help their child cope with autism? Can you give any recommendations for them?

The most important recommendation, from our point of view, is to initially understand the child's capabilities, not to do too much and not to set too high goals. The biggest conflict arises precisely when parents are faced with a contradiction between the real abilities of the child and their own ambitions for him. And everything negative that can happen later - protests, disobedience, experiencing disappointment and despair - all this comes precisely from this conflict.

The main principle for parents is to gain a sense of confidence as a caregiver and get rid of excessive feelings of guilt. You need to know that an autistic child is very sensitive to the internal state of his parents, easily reacts to their anxiety, confusion. With regard to mental development, one should be prepared for the fact that it will take a long time to achieve success, even small ones. It does not happen that a child falls asleep with one person and wakes up with another person.

Another common mistake is the opinion that the most important thing for a child is to learn to talk. This is not true. If speech does not appear on its own, then there are objective reasons for this. As soon as the prerequisites for pronouncing words are formed, the child will begin to speak independently without our help. Therefore, you should not artificially try to accelerate the development of such a child.

Is it possible to say that modern communication devices, computers, gadgets, mobile phones can develop autism in a child? And do they somehow affect children who have already been diagnosed with this disease? (Can modern technology help to socialize or, on the contrary, contribute to the fact that the child withdraws more and more into himself?)

In autism, this is neither good nor bad. There can be no universal recommendation here, everything is individual. It is important for a mother to understand whether her child is now ready to master society or whether she still needs to wait, subsequently carefully “grafting” him to life. Here the advice of a defectologist, a psychiatrist will help. True, very often the mothers of such children are guided only by their own opinion, without accepting someone else's help. This happens if their relatives betrayed them, the father left, the grandparents did not accept the child, and the mother is left alone with the problem.

Why is autism thought to be more common in boys? And why is it more characteristic of them?

Indeed, this is a fundamental fact. And childhood autism is not the only example. A lot of mental disorders occur more often in boys. Why this is so is hard to say. There are many hypotheses for this, but an exhaustive explanation has not yet been received.

Maybe there is some relationship between the mother's condition during pregnancy and the child's subsequently diagnosed autistic disorder? Is it possible to somehow predict the birth of a child with autism? What are the medical reasons?

Mothers often ask me: “Tell me, please, where, at what stage did I make a mistake? What did I do wrong? Unfortunately, despite the fact that we live in the 21st century, there are no prerequisites to predict the birth of such a child. With the exception of the examination of the amniotic fluid for gross genetic anomalies. If this is observed, then we can say with a high degree of probability that a clinical picture of autism should be expected here. In all other cases, it is difficult to predict anything. There is no data for this.

Is it true that autism is more common in children today than it was 10, 20, 30 years ago?

It is believed that the number of children with autism has not increased, diagnosis has improved. This happened due to the spread of information about autism and its manifestations. As a result, parents began to pay more attention to what they had not noticed before. And, as a result, the number of visits to doctors for the purpose of making a diagnosis has increased. What used to cause confusion and misunderstanding in parents, now prompts a search for answers in specialized literature, the Internet. As a result, the symptoms of autism began to be detected more often and at an earlier age. And here there is another extreme - the emerging trend towards overdiagnosis of this disorder. A special term has even appeared - autism spectrum disorders, the role of which is seen in drawing more attention of parents to any symptoms of deviant development, closely or remotely resembling childhood autism, in order to promptly apply for practical assistance.

Can an autistic child go to a regular school, or is it better to send him to a special school?

There are inclusive types of education that allow such children to study in a regular school. A group of 3-4 such children is recruited, and most of the time they study with a separate teacher. Periodically, the teacher selectively leads, as far as possible, such children to classes with healthy children. But the need for such classes must be considered individually. All possible consequences should be taken into account. For example, in practice, children with autism are not very physically healthy, they are characterized by weak immunity - this increases their risk of getting respiratory and other infectious diseases, which usually occur in a more severe form in children with autism. After all, even under normal conditions, autistic children get sick more often than other children. In addition, education in a mass school is possible if there is a special assistant or tutor nearby, a person who guides the child in each specific case and tells him what to do. Often such children, being in mass education, do not follow the school curriculum, but only formally attend the lessons. But what he will learn as a result is a separate question. More often it is a kind of “familiarization” with educational material. And in this situation, we have no right to demand that the child master the entire program. However, one should not forget that traditional defectological assistance in the conditions of ordinary correctional kindergartens and schools has great potential in terms of filling cognitive deficits, and the passage of inclusive education still does not eliminate the need to acquire specialized skills using routine correction methods.

Whatever problems parents face on the difficult path of upbringing, it is important to remember that parental love is important at any stage of growing up.

Publication date: 2.04.2020

"Children of the rain". What you need to know about autism

11 April 2019 12:01

Behind the poetic expression "children of the rain" lies the daily feat of people who are faced with a diagnosis of autism. Children who will never be able to perceive themselves as part of the world around them, and parents for whom every day is a series of battles and victories. First, fighting with yourself, accepting and realizing that their child will never be cured, and then fighting the disease for every gesture, every smile, every look and word of the child - small, but such important victories.

Scientists have not been able to reliably establish the causes of the disease. It is known about the genetic predisposition: signs of autism are more often manifested in people whose family already has an autistic person. Pregnancy in mothers of such children proceeds normally, and the children themselves are often very attractive in appearance - autism, as a rule, does not affect the physical development of the child. However, the development of autism is still in some cases associated with the manifestation of other diseases:

• cerebral palsy;
• maternal rubella infection during pregnancy;
• tuberous sclerosis;
• impaired fat metabolism (the risk of having a baby with autism is greater in obese women).

All of these conditions can have a bad effect on the brain and, as a result, provoke symptoms of autism. However, what autism is, and what are the causes of its manifestation, is still not completely clear.

Early diagnosis plays an important role in the further development of an autistic child. Autism in children is manifested by certain signs. Early childhood autism is a condition that can manifest itself in children at a very early age - both at 1 year old and at 2 years old. What is autism in a child, and whether this disease occurs, is determined by a specialist. But you can independently figure out what kind of illness a child has and suspect him, based on information about the signs of such a condition.

Early signs of autism in a child

This syndrome is characterized by 4 main signs. In children with this disease, they can be determined to varying degrees.

Signs of autism in children are:

• impaired social interaction;
• broken communication;
• stereotyped behaviour;
• early symptoms of childhood autism in children under 3 years of age.

The first signs of autistic children can be expressed as early as the age of 2 years. Symptoms may be mild when eye-to-eye contact is impaired, or more severe when it is completely absent. As a rule, autism manifests itself very early - even before the age of 1, parents can recognize it. In the first months, such children are less mobile, react inadequately to stimuli from the outside, they have poor facial expressions.

The child cannot perceive a holistic image of a person who is trying to communicate with him. Even in the photo and video, you can recognize that such a baby's facial expressions do not correspond to the current situation. He does not smile when someone tries to amuse him, but he can laugh when the reason for this is not clear to anyone close to him. The face of such a baby is mask-like, grimaces periodically appear on it.

Baby uses gestures only to indicate needs. As a rule, even in children under one year old, interest is sharply shown if they see an interesting object - the baby laughs, points with a finger, and demonstrates joyful behavior. The first signs in children under 1 year old can be suspected if the child does not behave like this. Symptoms of autism in children under one year old are manifested by the fact that they use a certain gesture, wanting to get something, but do not seek to capture the attention of their parents by including them in their game.

An autistic person cannot understand other people's emotions. How this symptom manifests itself in a child can be traced already at an early age. If ordinary children have a brain designed in such a way that they can easily determine when they look at other people, they are upset, cheerful or scared, then an autistic person is not capable of this.

The child is not interested in peers. Already at the age of 2, ordinary children strive for company - to play, to get acquainted with their peers. Signs of autism in children of 2 years old are expressed by the fact that such a baby does not participate in games, but plunges into his own world. Those who want to know how to recognize a child 2 years old and older should simply look at the company of children: an autist is always alone and does not pay attention to others or perceives them as inanimate objects.

It is difficult for a child to play using imagination and social roles. Children 3 years old and even younger play, fantasizing and inventing role-playing games. In autistics, symptoms at 3 years old may be expressed by the fact that they do not understand what a social role in the game is, and do not perceive toys as integral objects. For example, signs of autism in a child of 3 years old can be expressed by the fact that the baby spins the wheel of a car for hours or repeats other actions.

Child does not respond to emotions and communication from parents. Previously, it was believed that such children are not emotionally attached to their parents at all. But now scientists have proven that when a mother leaves, such a child at 4 years old and even earlier shows anxiety. If family members are around, he looks less obsessed. However, in autism, signs in children of 4 years old are expressed by a lack of reaction to the fact that parents are absent. The autist shows anxiety, but he does not try to return his parents.

In children under 5 years of age and later, there is a delay in speech or its complete absence (mutism). The speech is incoherent, the child repeats the same phrases, devoid of meaning, speaks of himself in the third person. He does not respond to other people's speech either. When the “age of questions” comes, parents will not hear them from the baby, and if they do, then these questions will be monotonous and without practical significance.

Stereotypic behavior includes obsession with one activity, repetition of daily rituals, development of fears and obsessions. At the same time, if the sequence of the ritual is violated, the child becomes hysterical or may show aggression or self-aggression.

Can autism be cured and is it curable at all? Unfortunately, there is no cure. How you can help your child depends on each individual case. Drug treatment is prescribed only in case of destructive behavior of a small patient. But, despite the fact that the disease is not curable, it is possible to correct the situation. The best "treatment" in this case is regular practice every day and the creation of the most favorable environment for the autistic. Classes are held in stages:

• To form the skills that are needed for training. If the child does not make contact, gradually establish it, not forgetting who it is - autistics. Gradually it is necessary to develop at least the rudiments of speech.
• Eliminate forms of behavior that are non-constructive: aggression, self-aggression, fears, withdrawing into oneself, etc.
• Learn to observe, imitate.
• Teaching social games and roles.
• Learn to make emotional contact.

The most common treatment for autism is practiced according to the principles of behaviorism (behavioral psychology). One of the subtypes of such therapy is ABA therapy. The basis of this treatment is to observe what the reactions and behavior of the baby look like. After all the features are studied, incentives are selected for a particular autist. Speech therapy practice is obligatory: if the kid regularly works with a speech therapist, his intonation and pronunciation are getting better. At home, parents help the child develop self-service and socialization skills. Since autists have no motivation to play, they get used to the daily routine, everyday affairs, cards are created where the order of performing this or that action is written or drawn.

Why is early diagnosis important? There are conditions that mimic autism that can be confused with its symptoms. But other methods are used to correct them.

ZPRR with autistic features

The symptoms of this disease are associated with a delay in psychoverbal development. They are in many ways similar to the signs of autism. Starting from a very early age, the baby does not develop in terms of speech in the way that existing norms suggest. In the first months of life, he does not babble, then he does not learn to speak simple words. At 2-3 years old, his vocabulary is very poor. Such children are often poorly developed physically, sometimes hyperactive. The final diagnosis is made by the doctor. It is important to visit a psychiatrist, speech therapist with the child.

Attention deficit hyperactivity disorder

This condition is also often mistaken for autism. With a lack of attention, children are restless, it is difficult for them to study at school. There are problems with concentration, such children are very mobile. Even in adulthood, echoes of this state remain, because it is difficult for such people to remember information and make decisions. You should try to diagnose this condition as early as possible, practice treatment with psychostimulants and sedative drugs, and visit a psychologist.

Hearing loss

These are various hearing impairments, both congenital and acquired. Hearing-impaired children also have speech delays. Therefore, such children do not respond well to the name, fulfill requests and may seem naughty. At the same time, parents may suspect autism in children. But a professional psychiatrist will definitely send the baby for an examination of auditory function.

Hearing aid helps solve problems.

Schizophrenia

Autism was previously considered one of the manifestations of schizophrenia in children. However, it is now clear that these are two completely different diseases. Schizophrenia in children begins later - at 5-7 years. The symptoms of this disease appear gradually. Such children have obsessive fears, talk to themselves, later delusions and hallucinations appear.

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