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7 things everyone should know about autism
Autism is a widely misunderstood condition surrounded by falsehoods, half-truths, and cultural assumptions.
- Autism-spectrum disorder covers a wide range of neurodevelopmental conditions that are highly individualized.
- The prevalence of autism continues to increase in the United States, not due to vaccines but increased awareness and improved diagnosis.
- Autism awareness is crucial as treatment strategies are more effective if accessed early.
Autism has captured headlines, and therefore an undue amount of cultural panic, for many years. Yet, many people remain befuddled regarding basic information of this developmental disorder.
They don't believe people with autism experience emotions. (They do.) They fear that their child may catch autism from a classmate. (No, it's not contagious.) They wonder if the parents are to blame. (They aren't.) And they always want to know what an autistic person's savant talent is. (Autistic people certainly have talents, but movies have left us with the false assumption that autism equals Rain Man.)
To help spread awareness — and cut through the falsehoods, half-truths, and misinformation — here are seven things everyone should know about autism.
1) What is autism?
Autism is a neurodevelopment disability. People with autism have difficulty communicating or interacting socially and may engage in repetitive behaviors. They interact, behave, and learn in unique ways. Their behaviors may include avoiding eye contact, having trouble processing everyday sensory intake, showing no interest in make-believe games, and not enjoying physical contact such as hugging.
It's considered a spectrum condition because it affects people differently (hence the phrase "on the spectrum"). No two people will display identical conditions nor require the same support. Some autistic people can live healthy, independent lives, while others require more extensive care and support.
Originally, the Diagnostic and Statistical Manual of Mental Disorders categorized autism under the umbrella term "pervasive developmental disorder." But when the manual was updated to its fifth edition in 2013, it revised its criteria for autism. The category is now "autism-spectrum disorder," and it combines conditions that used to be diagnosed separately. These include autistic disorder, Asperger syndrome, and pervasive development disorders not otherwise specified (or PDD-NOS).
There is no lab test, like a blood test or genetic screening, available to determine if someone has an autistic-spectrum disorder. Medical professionals must make the determination based on behavior and development observations.
2) What causes autism?
Scientists don't know what exactly causes autism. Current investigations suggest a genetic origin, though environmental factors have not been ruled out entirely.
While it's difficult to untangle the interplay between genes and the environment, a longitudinal cohort study published in JAMA Psychiatry has provided the largest attempt so far. Researchers examined health data of more than 22,000 children diagnosed with autism spectrum disorder (ASD) from five countries. They estimated the heritability of ASD to be approximately 80 percent. They also found maternal effects — that is, the idea that the condition of the mother's body makes a child more likely to develop autism — to be insignificant.
"Although families are often most concerned about environmental risk factors for autism, the reality is that genetic factors play a much larger role overall," Andrew Adesman, director of developmental and behavioral pediatrics at Cohen Children's Medical Center in New Hyde Park, told HealthDay News. (Dr. Adesman was not involved in the study.)
It remains unclear how genes linked to autism are being activated, and researchers are quick to note that we can't altogether ignore potential environmental factors. After all, they are the ones we can potentially adjust or learn to avoid, and even if genes play the dominant role, the environment could still activate them.
The National Institute of Environmental Health Sciences lists the following as associated with autism:
- advanced parental age at time of conception;
- prenatal exposure to air pollution or certain pesticides;
- maternal obesity, diabetes, or immune system disorders;
- extreme prematurity or very low birth weight; and
- any birth difficulty leading to periods of oxygen deprivation to the baby's brain.
Please note: No one claims these environmental factors cause autism, but they do appear to increase a child's risk of developing it when combined with unfavorable genetic factors.
3) Are rates of autism increasing?
A graph showing the number of people with autistic-spectrum disorder in the world. (Source: IHME/Our World in Data)
Yes, they are.
The CDC's Autism and Developmental Disabilities Monitoring Network estimates the prevalence of autism among 8-year-old children in the U.S. Its estimates are based on more than 300,000 children across the U.S., with updates released every two years.
In 2016, the CDC estimated the prevalence of autism to be 1 in 68 children. By 2018, about 1 in 59 children were identified as autistic. That's a rate twice as high as 2004 (1 in 125).
Worldwide, the trend is similar. According to the Institute for Health Metrics and Evaluation, in 2014 17.92 million people were estimated to have autism. By 2016, the number had grown to 18.30. As in the United States, boys are four times more likely than girls to be diagnosed as autistic.
4) What is causing this rising prevalence?
Scientists aren't sure why the numbers keep climbing, but they know it's not something we added to the water. The likely answer is increased awareness and improved diagnosis.
For example, white children are identified as autistic more often than black or Hispanic children, but the reason for this is not genetic. Rather, income, a lack of healthcare access, and non-English primary language are all cited reasons for the discrepancy. As these barriers are reduced, the gap has shrunk.
"Autism prevalence among black and Hispanic children is approaching that of white children," Stuart Shapira, associate director for science at CDC's National Center on Birth Defects and Development Disabilities, said in a release. "The higher number of black and Hispanic children now being identified with autism could be due to more effective outreach in minority communities and increased efforts to have all children screened for autism so they can get the services they need."
States with more extensive outreach services report higher a prevalence of autism among children, too. New Jersey has the highest reported prevalence, but it furnishes extensive resources for professionals and support services. Conversely, the rural state of Alabama reports the lowest prevalence in the nation.
And let's remember that Asperger's syndrome and other disorders on the spectrum have been folded into a single diagnosis. As such, the number of children being diagnosed under a more cohesive criteria may bolster numbers previously spread out over distinct conditions.
5) Do vaccines cause autism?
Healthy young child goes to doctor, gets pumped with massive shot of many vaccines, doesn't feel good and changes - AUTISM. Many such cases!— Donald J. Trump (@Donald J. Trump)1396010150.0
No, they do not.
This isn't news, but there remains a lot of doubt and confusion. To pick one notable anti-vaxxer, President Donald Trump recently walked back this 2014 tweet linking autism to vaccines but still claims that too many vaccines in too short a time frame could have caused the rise in autism rates. He has also considered establishing a special autism commission to investigate this thoroughly-vetted practice.
A 2019 Danish cohort study look at the medical histories of more than half a million children born between 1999 and 2010. The researchers found no link between autism and the MMR vaccine (a vaccine for measles, mumps, and rubella). They also found no increased risk of the vaccine triggering autism in susceptible subgroups.
This is just one of many such studies that have failed to link the two. So again: Vaccines do not cause autism.
6) Is there a cure for autism?
No, there is no cure for autism, but the question — often phrased in this manner — is misleading. Autism is a neurodevelopmental disorder, not a disease. People with autism won't be cured with a pill because they aren't sick. They think and see the world in unique ways. However, therapies and interventions have been designed to help individuals and families address the challenges of living with autism.
"Intervention can help to lessen disruptive behaviors, and education can teach self-help skills for greater independence," writes the Autism Society. "But just as there is no one symptom or behavior that identifies people with autism, there is no single treatment that will be effective for everyone on the spectrum." [Emphasis original.]
Strategies include social skills training, speech therapy, cognitive behavioral therapies, occupational therapy, family service plans, and individualized education plans. Which psychosocial interventions are selected will depend on the individual's strengths and weaknesses. Biomedical interventions have been proposed and used, but the National Institute for Health and Clinical Excellence has ruled out many of them. In children, for example, they recommend never using chelation, secretin, or hyperbaric-oxygen therapies.
While therapy strategies will vary based on the individual's needs, they are all most effective if they are accessed as soon as possible.
"The earlier a child with autism is diagnosed and connected to services, the better," Coleen Boyle, director of the CDC's National Center on Birth Defects and Developmental Disabilities, told Scientific American. "Our message to parents is, if you have a concern about how your child learns, plays, speaks, acts or moves, take action. Don't wait."
7) What does the future hold for autism?
The future looks bright. A drive toward autism awareness means more children are more likely to be diagnosed younger so they can begin therapies sooner. More communities are developing the resources necessary to support individuals and families living with autism. And a cultural shift toward neurodiversity has begun to lessen the stigma surrounding autism-spectrum disorders and other mental health conditions.
Even the increased prevalence of autism, which seems scary as a raw number, is ultimately a positive trend. The more young children diagnosed, the sooner their families can connect with the support and resources they need.
Researchers continue to look into the genetic causes of autism, too. They have begun to identify the genes linked to autism and to understand the relationship between autism, hereditable genes and de novo mutations. Revelations that may lead to new treatments and advancements in personalized medicine.
"In essence, that is personalized medicine, that is taking the genetic finding and determining what is the logical treatment and matching that patient up with an appropriate drug," said Jonathan Sebat, chief of the Beyster Center for Molecular Genomics of Neuropsychiatric Diseases. "If we can find a few compounds that modulate neurodevelopment in the way that we want it to, and we can understand real disease mutations and how they respond to these drugs, then that's the beginning of precision medicine."
With improved awareness, dispelled half-truths, and scientists working toward new treatment options, the future may be very bright indeed.
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The COVID-19 pandemic is making health disparities in the United States crystal clear. It is a clarion call for health care systems to double their efforts in vulnerable communities.
- The COVID-19 pandemic has exacerbated America's health disparities, widening the divide between the haves and have nots.
- Studies show disparities in wealth, race, and online access have disproportionately harmed underserved U.S. communities during the pandemic.
- To begin curing this social aliment, health systems like Northwell Health are establishing relationships of trust in these communities so that the post-COVID world looks different than the pre-COVID one.
COVID-19 deepens U.S. health disparities<p>Communities on the pernicious side of America's health disparities have their unique histories, environments, and social structures. They are spread across the United States, but they all have one thing in common.</p><p>"There is one common divide in American communities, and that is poverty," said <a href="https://www.northwell.edu/about/leadership/debbie-salas-lopez" target="_blank">Debbie Salas-Lopez, MD, MPH</a>, senior vice president of community and population health at Northwell Health. "That is the undercurrent that manifests poor health, poor health outcomes, or poor health prognoses for future wellbeing."</p><p>Social determinants have far-reaching effects on health, and poor communities have unfavorable social determinants. To pick one of many examples, <a href="https://www.npr.org/2020/09/27/913612554/a-crisis-within-a-crisis-food-insecurity-and-covid-19" target="_blank" rel="noopener noreferrer">food insecurity</a> reduces access to quality food, leading to poor health and communal endemics of chronic medical conditions. The U.S. Centers for Disease Control and Prevention has identified some of these conditions, such as obesity and Type 2 diabetes, as increasing the risk of developing a severe case of coronavirus.</p><p>The pandemic didn't create poverty or food insecurity, but it exacerbated both, and the results have been catastrophic. A study published this summer in the <em><a href="https://link.springer.com/article/10.1007/s11606-020-05971-3" target="_blank">Journal of General Internal Medicine</a></em> suggested that "social factors such as income inequality may explain why some parts of the USA are hit harder by the COVID-19 pandemic than others."</p><p>That's not to say better-off families in the U.S. weren't harmed. A <a href="https://voxeu.org/article/poverty-inequality-and-covid-19-us" target="_blank" rel="noopener noreferrer">paper from the Centre for Economic Policy Research</a> noted that families in counties with a higher median income experienced adjustment costs associated with the pandemic—for example, lowering income-earning interactions to align with social distancing policies. However, the paper found that the costs of social distancing were much greater for poorer families, who cannot easily alter their living circumstances, which often include more individuals living in one home and a reliance on mass transit to reach work and grocery stores. They are also disproportionately represented in essential jobs, such as retail, transportation, and health care, where maintaining physical distance can be all but impossible.</p><p>The paper also cited a positive correlation between higher income inequality and higher rates of coronavirus infection. "Our interpretation is that poorer people are less able to protect themselves, which leads them to different choices—they face a steeper trade-off between their health and their economic welfare in the context of the threats posed by COVID-19," the authors wrote.</p><p>"There are so many pandemics that this pandemic has exacerbated," Dr. Salas-Lopez noted.</p><p>One example is the health-wealth gap. The mental stressors of maintaining a low socioeconomic status, especially in the face of extreme affluence, can have a physically degrading impact on health. <a href="https://www.scientificamerican.com/index.cfm/_api/render/file/?method=inline&fileID=123ECD96-EF81-46F6-983D2AE9A45FA354" target="_blank" rel="noopener noreferrer">Writing on this gap</a>, Robert Sapolsky, professor of biology and neurology at Stanford University, notes that socioeconomic stressors can increase blood pressure, reduce insulin response, increase chronic inflammation, and impair the prefrontal cortex and other brain functions through anxiety, depression, and cognitive load. </p><p>"Thus, from the macro level of entire body systems to the micro level of individual chromosomes, poverty finds a way to produce wear and tear," Sapolsky writes. "It is outrageous that if children are born into the wrong family, they will be predisposed toward poor health by the time they start to learn the alphabet."</p>Research on the economic and mental health fallout of COVID-19 is showing two things: That unemployment is hitting <a href="https://www.pewsocialtrends.org/2020/09/24/economic-fallout-from-covid-19-continues-to-hit-lower-income-americans-the-hardest/" target="_blank" rel="noopener noreferrer">low-income and young Americans</a> most during the pandemic, potentially widening the health-wealth gap further; and that the pandemic not only exacerbates mental health stressors, but is doing so at clinically relevant levels. As <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7413844/" target="_blank" rel="noopener noreferrer">the authors of one review</a> wrote, the pandemic's effects on mental health is itself an international public health priority.
Working to close the health gap<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDc5MDk1MS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYxNTYyMzQzMn0.KSFpXH7yHYrfVPtfgcxZqAHHYzCnC2bFxwSrJqBbH4I/img.jpg?width=980" id="b40e2" class="rm-shortcode" data-rm-shortcode-id="1b9035370ab7b02a0dc00758e494412b" data-rm-shortcode-name="rebelmouse-image" />
Northwell Health coronavirus testing center at Greater Springfield Community Church.
Credit: Northwell Health<p>Novel coronavirus may spread and infect indiscriminately, but pre-existing conditions, environmental stressors, and a lack of access to care and resources increase the risk of infection. These social determinants make the pandemic more dangerous, and erode communities' and families' abilities to heal from health crises that pre-date the pandemic.</p><p>How do we eliminate these divides? Dr. Salas-Lopez says the first step is recognition. "We have to open our eyes to see the suffering around us," she said. "Northwell has not shied away from that."</p><p>"We are steadfast in improving health outcomes for our vulnerable and underrepresented communities that have suffered because of the prevalence of chronic disease, a problem that led to the disproportionately higher death rate among African-Americans and Latinos during the COVID-19 pandemic," said Michael Dowling, Northwell's president and CEO. "We are committed to using every tool at our disposal—as a provider of health care, employer, purchaser and investor—to combat disparities and ensure the <a href="https://www.northwell.edu/education-and-resources/community-engagement/center-for-equity-of-care" target="_blank" rel="noopener noreferrer">equity of care</a> that everyone deserves." </p><p>With the need recognized, Dr. Salas-Lopez calls for health care systems to travel upstream and be proactive in those hard-hit communities. This requires health care systems to play a strong role, but not a unilateral one. They must build <a href="https://www.northwell.edu/news/insights/faith-based-leaders-are-the-key-to-improving-community-health" target="_blank" rel="noopener noreferrer">partnerships with leaders in those communities</a> and utilize those to ensure relationships last beyond the current crisis. </p><p>"We must meet with community leaders and talk to them to get their perspective on what they believe the community needs are and should be for the future. Together, we can co-create a plan to measurably improve [community] health and also to be ready for whatever comes next," she said.</p><p>Northwell has built relationships with local faith-based and community organizations in underserved communities of color. Those partnerships enabled Northwell to test more than 65,000 people across the metro New York region. The health system also offered education on coronavirus and precautions to curb its spread.</p><p>These initiatives began the process of building trust—trust that Northwell has counted on to return to these communities to administer flu vaccines to prepare for what experts fear may be a difficult flu season.</p><p>While Northwell has begun building bridges across the divides of the New York area, much will still need to be done to cure U.S. health care overall. There is hope that the COVID pandemic will awaken us to the deep disparities in the US.</p><p>"COVID has changed our world. We have to seize this opportunity, this pandemic, this crisis to do better," Dr. Salas-Lopez said. "Provide better care. Provide better health. Be better partners. Be better community citizens. And treat each other with respect and dignity.</p><p>"We need to find ways to unify this country because we're all human beings. We're all created equal, and we believe that health is one of those important rights."</p>
Astronomers spot an object heading into Earth orbit.
Minimoons<p>Scientists have confirmed just two prior minimoons. One was <a href="https://en.wikipedia.org/wiki/2006_RH120" target="_blank">2006 RH120</a>, which orbited us from September 2006 to June 2007. The other was <a href="https://en.wikipedia.org/wiki/2020_CD3" target="_blank">2020 CD3</a>, which got stuck in the 2015–2016 timeframe, and is believed to gotten away in May 2020.</p><p>2020 SO, the new kid on the block, is expected to arrive in October 2020 and pop out of orbit in May 2021.</p><div id="37962" class="rm-shortcode" data-rm-shortcode-id="f4c0fc8a2cba6536ea4cd960ebed3e6e"><blockquote class="twitter-tweet twitter-custom-tweet" data-twitter-tweet-id="1307729521869611008" data-partner="rebelmouse"><div style="margin:1em 0">Asteroid 2020 SO may get captured by Earth from Oct 2020 - May 2021. Current nominal trajectory shows shows capture… https://t.co/F5utxRvN6Z</div> — Tony Dunn (@Tony Dunn)<a href="https://twitter.com/tony873004/statuses/1307729521869611008">1600621989.0</a></blockquote></div>
Identifying 2020 SO<p>The first clue 2020 SO isn't your ordinary asteroid is its exceptionally low velocity. It's traveling much more slowly that a typical asteroid — their <a href="https://www.lpi.usra.edu/exploration/training/illustrations/craterMechanics/" target="_blank">average rate of travel</a> <a href="https://www.lpi.usra.edu/exploration/training/illustrations/craterMechanics/" target="_blank" rel="noopener noreferrer"></a>is 18 kilometers (58,000 feet) per second. Even <a href="https://en.wikipedia.org/wiki/Moon_rock" target="_blank">moon rocks</a> sent careening into Earth orbit by impacts on the lunar surface outpace pokey 2020 SO.</p><p>For another thing, 2020 SO has an orbital path very similar to Earth's, lasting about one Earth year. It's also just slightly less circular than our own orbit, from which it's barely tilted off-axis.</p><p>So, what is it? <a href="https://cneos.jpl.nasa.gov/ca/" target="_blank">NASA estimates</a> that the object has dimensions very reminiscent of a discarded Centaur rocket stage from the <a href="https://en.wikipedia.org/wiki/Surveyor_2" target="_blank" rel="noopener noreferrer">Surveyor 2 mission</a> that landed an unmanned craft on the moon. Back in the day, rocket stages were jettisoned as craft were aimed toward their desired position. This stuff, if released high enough, remains in space. It appears that this Centaur rocket, launched in September 1966, is now making its way back homeward, at least for a little bit.</p><p>When 2020 SO arrives at its closest point in December, the rocket is expected to be about 50,000 kilometers from Earth. Its next closest approach is much further: 220,000 kilometers, in February 2021.</p><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDQzMDk3NC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYyODg1MTQ1MX0.HGknDwqp0GmeuczKY_AS7vrPG7KMFUc_XO95tNoI2xo/img.jpg?width=980" id="e5cda" class="rm-shortcode" data-rm-shortcode-id="85eb1f790d8c3ee5b261f7ba13eaa5e1" data-rm-shortcode-name="rebelmouse-image" alt="Centaur rocket stage" />
Centaur rocket stage
What we may be able to learn<p>Earthly space programs being as young as they are, scientists would love to know what's happened to our rocket during a half century in space.</p><p>While 2020 SO won't get close enough to drop into our atmosphere, its slow progress has scientists hopeful that they'll still get some kind of a decent look at it.</p><p>Spectroscopy may be able to reveal what the rocket's surface is like now — has any of its paint survived, for example? Of course, being out in space, it's likely to have been hit by lots of dust and micrometeorites, so the current state of its surfaces is also of interest. Experts are curious to know how reflective the rocket is at this point, valuable information that can help planners of future long-term missions anticipate how well a craft out in space for extended periods will remain able to reflect sunlight.</p>
Shannon Lee shares lessons from her father in her new book, "Be Water, My Friend: The Teachings of Bruce Lee."
- Bruce Lee would have turned 80 years old on November 27, 2020. The legendary actor and martial artist's daughter, Shannon Lee, shares some of his wisdom and his philosophy on self help in a new book titled "Be Water, My Friend: The Teachings of Bruce Lee."
- In this video, Shannon shares a story of the fight that led to her father beginning a deeper philosophical journey, and how that informed his unique expression of martial arts called Jeet Kune Do.
- One lesson passed down from Bruce Lee was his use and placement of physical symbols as a way to help "cement for yourself this new way of being, or this new lesson you've learned." By working on ourselves (with the right tools), we can develop the skills necessary to rise and conquer new challenges.
How to deal with "epistemic exhaustion."