Dr. Mitch can only provide general medical insights. He cannot counsel you on your own particular case. Information about a specific individual's medical condition can only properly be managed by a health care professional who has examined that person and done a proper evaluation. Furthermore, Dr. Mitch will not be able to respond to individual requests for referral or diagnosis or management or to provide a second opinion. His intent is to help people know more about medicine and science so that they can ask their health care professional the right questions and make more informed decisions with respect to their health. You should consult with your health care professional before following any of Dr. Mitch's advice to confirm that it is appropriate for you.


Is Autism On The Rise?

There's no doubt that more children are being diagnosed with Autism or as it is now designated, Autism Spectrum Disorder (ASD). Why? Part of the reason is statistical. For example: we are diagnosing children at an earlier age. Although the average age at diagnosis is 4 - 4 1/2 years old, we can diagnose some children as early as 2 and that's happening more often. The earlier the diagnosis is made, the more effective therapy can be but that also means that it will initially seem as if there is an increase in the number of children with the disorder. We are also replacing other diagnoses such as mental retardation, learning disabilities and language difficulties with ASD and so that is shifting the numbers. Other forces are at work. Diagnosing a child as having ASD opens the door to resources that might not otherwise be available and so there is a subtle pressure to make that diagnosis to enable children to get the help they need. There is also better case finding. We are more alert to the signs of the disorder both as parents, teachers, day-care professionals and health care providers so whereas in the past as many as 40% of the children with this diagnosis may have been missed, hopefully we are missing less now. Case finding is also accelerated if there is pending legal proceedings so in situations where class action suits are being prepared, more cases are likely to be found because of increased scrutiny. However there is also a valid medical side to this increase. It's not all statistics. Older parental age (both Mom and Dad) is associated with an increased risk as are Moms who develop diabetes or have bleeding during their pregnancy. Smaller babies (less than 2000 grams at birth) also have an increased risk and more of these babies are happily surviving the sometimes rocky period after birth. The last area of concern is environmental triggers. In spite of what Playboy bunnies and other such "scientific experts" might claim, there is absolutely no evidence whatsoever that vaccination or the use of certain preservatives in vaccines causes ASD. That has been conclusively disproved and the researcher who's work (published in 1998) started this falsehood has been disbarred from medicine and his paper retracted.
At the end of the day it's true that there is a real increase in the number of children with ASD but the numbers are probably not as alarming as they might seem at first glance. Having admitted that, it still means that we have to be able to diagnose these children as early as possible. We also need to have the resources available when the children can gain the most from our intervention which means eliminating long delays. And we need to understand what the various causes are so that we can put into place preventative measures to reduce the incidence of this disorder which can have a devastating effect on the child and their entire family. Let's take advantage of this month to make these things happen.

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