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Ricki G. Robinson, M.D., M.P.H Headshot

World Autism Awareness Day: A Call to Action

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WORLD AUTISM DAY

Today is World Autism Awareness Day. The United Nations established this day in 2007 (Resolution 62/139) to annually raise awareness of autism as a global health crisis with particular emphasis on early diagnosis and early intervention. This is also a day to celebrate the unique talents and accomplishments of individuals living with autism in each of our communities worldwide. To commemorate the event, prominent buildings and icons in the United States and around the world -- including the Empire State Building in New York City --will turn their outer lights blue on April 1 and 2.

With 1 out of 110 children diagnosed with an Autism Spectrum Disorder (ASD) in the United States today (a new case is diagnosed almost every 15 minutes) parents and professionals must strive to identify those children at risk as soon as possible. New research following newborns who have a sibling with ASD suggests that an infant who is later diagnosed with ASD shows evidence of developmental delays in social interaction and communication by 6-12 months of age. Early identification allows treatment to begin immediately for these children, offering the greatest potential for them to live a full and meaningful life.

In the U.S. today also begins Autism Awareness Month -- a time to recognize all of the needs of those living with ASD. Beyond early diagnosis and treatment these children encounter numerous obstacles throughout their lifetimes. One of the many challenges families encounter is obtaining appropriate medical care for their child with ASD. Individuals living with autism experience a myriad of medical issues many of which go undetected and untreated.

Since autism affects a child's ability to relate and communicate, a child may be aware of pain but may be unable to express it, resulting in no or inappropriate treatment. On the other hand a child with ASD who has difficulty with sensory processing may not even be aware that he is sick or in pain. Consequently, he may not respond in a way we might expect a child with a sore throat or an earache to respond. Instead he could become more irritable, have increased repetitive routines, inattention, self absorption, even aggression or self injurious behavior.

Medical professionals often attribute this change in the child's behavior to the "autism." While that could be the case, when the child is unaware or unable to express his pain with words, his behavior is often a means of communicating that message. When a child with ASD shows increased "autistic" behaviors, we must consider the possibility for a medical issue underlying the behavioral change.

As a pediatrician caring for children with ASD over the past 20 years I have learned to be ever vigilant when trying to detect underlying medical issues. Research shows that children with ASD have, in addition to the expected childhood illnesses, even greater rates of gastrointestinal, sleep, immunologic and seizure disorders than their typical peers. Increased anxiety from living under such stress and most recently depression has been found to occur much more frequently in this group than previously recognized.

Left untreated it's no wonder that children with ASD can have uncontrolled behavioral symptoms. As the current generation of children with ASD ages, we do not yet know what other health problems may arise but we do know the medical field is underprepared to meet the needs of the growing population of individuals living with ASD.

The bottom line is that a healthy child with ASD is better equipped to concentrate, relate, communicate, think and learn than one who has unmet medical needs. Given the amount of time a child can spend in a therapeutic program and the costs associated, it is imperative that he or she be fully present in the treatment. Therefore on this World Autism Awareness Day, physicians and medical personnel must commit to early detection and intervention of infants at risk and also recognize and treat their medical issues.

It is fitting that Autism Speaks, one of the sponsors of World Autism Awareness Day, has recently announced an expansion of the Autism Treatment Network (ATN) to 17 cities across the U.S. and Canada. ATN medical treatment centers are multidisciplinary in that they bring together the expertise of physicians, nurses, specialized therapists, and clinical researchers to address the medical challenges of children with ASD. The goal of these centers is to develop and disseminate novel treatments, practice guidelines and clinical tools for all professionals. Medical professionals from communities are invited to use the ATN center resources for referral and consultation.

Children and families living with autism have suffered with untreated medical conditions far too long. Parents know when something is not right with their child. It is time for the medical community to listen and do what we do best -- provide help and hope to those in need.

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