A child with autism is more likely to do well if his mother is white and educated.
This is the message of a study just released in the journal Pediatrics, and it's something we need to pay attention to -- now.
Researchers from Columbia University wanted to find out what happens to children with autism over time. So they looked at the records of more than 6000 children with autism who were enrolled in California's Department of Developmental Services (DDS). To get into DDS they had to be referred, and their diagnosis had to be confirmed by someone with expertise in autism.
What they found was that when it came to social and communication skills, for the most part the kids fell into groups ranging from low-functioning to high functioning. The kids did make progress; the most rapid gains were before age six, and the high-functioning kids tended to make more progress than the low-functioning ones. Even as they made progress they tended to stay in the group they started in -- with one notable exception. That exception was a group the researchers called the "Bloomers". These kids were low-functioning when they were diagnosed, but made rapid gains and ended up as high-functioning.
The researchers also looked at the birth records of the children, which gave them facts about the mother's age, race, place of birth, education level, and whether she was on Medi-Cal, the California version of Medicaid (the public insurance for low-income people). This is where it gets really interesting. They found that:
This is a real social justice problem.
The researchers didn't have information on what kinds of services or treatments the kids got, so they couldn't give an explanation for what they found. But they guessed, as all of us might, that children with more educated and affluent mothers not only had better home and neighborhood environments, but access to more and better services -- and parents who were more able to fight for those services.
That makes total sense to me as the pediatrician of many autistic children, and is a social justice problem in and of itself. But there is even more that worried me reading this article. Why, for example, were fewer poor and minority kids in the high-functioning group? Do they slip through the cracks entirely because they are muddling through, and never get diagnosed or get services? And why are there fewer white and affluent kids in the low-functioning group? Is there something about being poor or minority that makes autism worse from the beginning?
Just last week the Centers for Disease Control came out with the news that one in 88 children has autism, up 23 percent since 2009. It's five times more common in boys--the rate for them is one in 54. And here's what makes the Pediatrics article even more worrisome: the biggest increases were among Hispanic and black children -- their rates of autism went up 110 percent and 91 percent, respectively. Not only is this a social justice problem, it's a public health problem.
There is hope for many children with autism -- this study shows that clearly. But it is fundamentally unfair when hope -- or lack of it -- is an accident of birth.
We say that we are a country founded on the idea that all men are created equal. Autism just may test us on this. If all men are created equal, if all children are equally deserving of a good future, it's time to get to work. It's time to put real money and real energy into understanding autism's inequalities -- and ending them.
Follow Claire McCarthy, M.D. on Twitter: www.twitter.com/@drClaire
Jenee Woodard: On a Pilgrimage With My Autistic Son
Todd Drezner: The New Autism Numbers
Lisa M. Dietlin: Making a Difference: The World of Giving -- April Is Autism Awareness Month
However, speaking as an adult autistic activist -- what next? How do we start to rectify the problem???
And This:
"Rate of Peanut Allergies in Children More Than Tripled Between 1997 and 2008, Study Finds"
I'm no scientist, but if someone really rich doesn't hire someone really smart, really soon to figure out why stuff like this is happening...
I think we're in for a world of hurt.
Someone way smarter than me needs to start connecting more dots.
However, I know that if I didn't have the education and self-confidence to fight that doctor, then my son wouldn't have gotten diagnosed until much later, and even if he had been diagnosed, he wouldn't have gotten any help until the age of 3 because of the lack of local services.
One thing that would help all kids is if doctors are more informed of what early signs of autism are. Doctors are the professionals that see kids before the age of 3 but they often think mothers worry too much and they are focused on physical well being instead of developmental well being.
Those who are following the "every man for himself" approach to health care being heralded by the Republicans should understand that money spent on early intervention and on education for ALL produces a productive society.
We must reach out and help one another. We are all in this together.
Universal heath care should be a right, not a privilege.
http://www.reuters.com/article/2010/02/08/us-autism-age-idUSTRE6174UC20100208
How do we get from one in 200 to one in 88 in less than twenty five years? We can't rule out misdiagnoses and panic, but that can't account for all or even the majority of that growth. We are looking at an epidemic, and instead of trying to address the source, we're offered...awareness. Support. And, of course, requests for money, which will go not to research, but...more awareness and requests for money.
Please, look up NIDS (Neuro-Immune Dysfunction Syndrome), "Immune Autism", and the literature linking autism-spectrum disorders to immune responses (http://www.sciencedaily.com/releases/2004/11/041117004123.htm; http://www.sciencedaily.com/releases/1998/10/981031181106.htm).
Treating the symptoms without treating the cause does nothing! But there is an industry built around autism, one which refuses to acknowledge even the possibility that it's anything other than a life a sentence!
I bookmarked the articles. Thanks.
Either it's being over-diagnosed or we're facing a huge health crisis that could spell the end of humanity!
So far we're not doing so well on any of those. We can do better.
We dont even have money for the public school systems to give non-autistic children of low-socioeconomic status a chance at life most of the time. Why would you possibly expect money to go into this? It's the sad reality of this country right now.
HOWEVER, in order to get assessed and diagnosed, a parent has to realize that something is going on with a child and has to bring this up with the pediatrician or self-refer to a 0-3 program. I find that in my work, parents with less education don't recognize developmental/communication concerns. Even when we point them out, families with less education don't get what we're talking about in terms of things like using eye contact, using gestures, bringing things to show, etc. My families with less education will say at their child's initial evaluation that the child does not talk, but is otherwise totally fine. They usually don't know whether their child (who is 2 or 3) can sort objects, have an exchange with a peer, help with household tasks, and other things that would distinguish a typical child with delayed speech from a child with a serious developmental disorder, because they haven't tried these things.
There's also the issue that people in poverty and people of color have historically been labeled as slow, deficient, etc. when this is not actually true, so a lot of people are understandably resistant to having their child evaluated.
Also, even when a child has been diagnosed and is receiving services, parents with less education are less likely to understand and follow through with strategies in the home.