9 Things You Should Know About Autism

April is National Autism Awareness Month, a time dedicated to understanding autism spectrum disorder, a condition that affects 1 in 68 children in America. Here are nine things you should know to help raise awareness and prepare you to minister to those with ASD.

9 Things You Should Know About Autism

1. Autism is the common term used to refer to Autism spectrum disorder (ASD), adevelopmental disorder that involves abnormal development and function of the brain. People with autism show decreased social communication skills and restricted or repetitive patterns of behaviors or interests. (Throughout the rest of this article autism will be referred to as ASD.)

2. The term autism (from Greek autos ‘self’ + -ism, a form of “morbid self-absorption”) wascoined by Swiss psychiatrist Eugen Bleuler in 1910 to refer to a subset of childhood schizophrenia. However, the first-ever clinical account of the disorder didn’t appear until 1943 when Leo Kanner, a pioneer in child psychiatry, published “Autistic Disturbances of Affective Disorder.” Around that same time Austrian pediatrician Hans Asperger wrote about the condition and noticed that many of the children he identified as being autistic were able touse their behaviors to their vocational advantage in adulthood. Asperger’s work was relatively unknown until 1981 when Lorna Wing coined the term “Asperger syndrome” in her paper on the condition.

3. Prior to 2013, autism was considered one of five different pervasive developmental disorders that included Asperger’s Disorder, Pervasive Developmental Disorder Not-Otherwise Specified (PDD-NOS), Childhood Disintegrative Disorder, and Rett’s Syndrome. In 2013 the American Psychiatric Association published the Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V), and the five disorders were subsumed under the diagnosis of ASD. (You can read the diagnostic criteria for the disorder here.)

4. Estimates are that 14.6 per 1,000 (one in 68) children aged 8 years are affected by the condition. ASD is estimated to be about four times higher among boys (23.6 per 1,000 or 1 in 42) than among girls (5.3 per 1,000 or 1 in 189), and significantly higher among non-Hispanic white children (15.5 per 1,000) compared with non-Hispanic black children (13.2 per 1,000), and Hispanic children (10.1 per 1,000).

5. The causes of ASD remain unknown, though it appears to have a strong genetic component. According to the Centers for Disease Control (CDC), studies have shown that among identical twins, if one child has ASD, then the other will be affected between 36 percent and 95 percent of the time. In non-identical twins, if one child has ASD, then the other is affected about 0 percent to 31 percent of the time. Parents who have a child with ASD have a 2 percent to 18 percent chance of having a second child who is also affected. ASD tends to occur more often in people who have certain genetic or chromosomal conditions. About 10 percent of children with autism are also identified as having Down syndrome, fragile X syndrome, tuberous sclerosis, or other genetic and chromosomal disorders. ASD commonly co-occurs with other developmental, psychiatric, neurologic, chromosomal, and genetic diagnoses. The co-occurrence of one or more non-ASD developmental diagnoses is 83 percent, and the co-occurrence of one or more psychiatric diagnoses is 10 percent.

6. Despite nearly 30 years of research, there has been no causal connection established between vaccinations and ASD. The claim that vaccines caused ASD was given credence in 1998, though, by the publication of a fraudulent research paper in the British medical journal The Lancet. That paper was later retracted when it was discovered that the chief researcher, a British surgeon named Andrew Wakefield, had manipulated the data and failed to disclose that he had been paid more than $600,000 by lawyers looking to win a lawsuit against vaccine manufacturers. Wakefield also was found to have committed numerous breaches in medical ethics, and in May 2010 British regulators revoked Wakefield’s license, finding him guilty of “serious professional misconduct.” They concluded that his work was “irresponsible and dishonest” and that he had shown a “callous disregard” for the children in his study. Despite being discredited for fraud and unethical conduct, Wakefield is still considered the primary source and champion for those who believe there is a connection between vaccines and ASD.

7. ASD imposes a significant economic burden on families. Children and adolescents with ASD had average medical expenditures that exceeded those without ASD by $4,110 to $6,200 per year, the CDC notes. On average, medical expenditures for children and adolescents with ASD were 4.1 to 6.2 times greater than for those without ASD.  In addition to medical costs, intensive behavioral interventions for children with ASD cost $40,000 to $60,000 per child per year.

8. ASD can also impose a significant disadvantage later in life. A study found that for youth with a ASD, only 34.7 percent had attended college (in comparison, about 68 percent of all U.S. students enroll in college after high school graduation, and about half will graduate). Additionally, only 55.1 percent had held paid employment during the first six years after high school. More than 50 percent of youth with ASD who had left high school in the past two years had no participation in employment or education. Youth with ASD had the lowest rates of participation in employment, and the highest rates of no participation compared with youth in other disability categories.

9. While there is no cure for ASD, children who receive therapies and behavioral interventions—especially when begun early in life—can have improved symptoms as they reach adolescence and adulthood. TheNational Institute of Neurological Disorders and Strokes also notes that families and siblings of children often need help with coping with the special challenges that come with having a family member with ASD. (Christina Fox offers four ways to serve families affected by autism.)