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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.

Image source: Wikimedia Commons
  • 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.

Other studies have found connections between autism and high levels of processed foods in maternal diets, as well as an absence of certain gut bacteria.

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?

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 against 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. It seems unlikely that we'll ever cure it with a pill; however, therapies and interventions have been developed to assist individuals and families addressing 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.]

Treatment strategies can 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 utilized, 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 treatment 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.

Neom, Saudi Arabia's $500 billion megacity, reaches its next phase

Construction of the $500 billion dollar tech city-state of the future is moving ahead.

Credit: Neom
Technology & Innovation
  • The futuristic megacity Neom is being built in Saudi Arabia.
  • The city will be fully automated, leading in health, education and quality of life.
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A new study suggests that a century-old vaccine may reduce the severity of coronavirus cases.

Closeup of a BCG vaccination.

Credit: Kekyalyaynen.
Surprising Science
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Human brains remember certain words more easily than others

A study of the manner in which memory works turns up a surprising thing.

Image Point Fr / Shutterstock
Mind & Brain
  • Researchers have found that some basic words appear to be more memorable than others.
  • Some faces are also easier to commit to memory.
  • Scientists suggest that these words serve as semantic bridges when the brain is searching for a memory.

Cognitive psychologist Weizhen Xie (Zane) of the NIH's National Institute of Neurological Disorders and Stroke (NINDS) works with people who have intractable epilepsy, a form of the disorder that can't be controlled with medications. During research into the brain activity of patients, he and his colleagues discovered something odd about human memory: It appears that certain basic words are consistently more memorable than other basic words.

The research is published in Nature Human Behaviour.

An odd find

Image source: Tsekhmister/Shutterstock

Xie's team was re-analyzing memory tests of 30 epilepsy patients undertaken by Kareem Zaghloul of NINDS.

"Our goal is to find and eliminate the source of these harmful and debilitating seizures," Zaghloul said. "The monitoring period also provides a rare opportunity to record the neural activity that controls other parts of our lives. With the help of these patient volunteers we have been able to uncover some of the blueprints behind our memories."

Specifically, the participants were shown word pairs, such as "hand" and "apple." To better understand how the brain might remember such pairings, after a brief interval, participants were supplied one of the two words and asked to recall the other. Of the 300 words used in the tests, five of them proved to be five times more likely to be recalled: pig, tank, doll, pond, and door.

The scientists were perplexed that these words were so much more memorable than words like "cat," "street," "stair," "couch," and "cloud."

Intrigued, the researchers looked at a second data source from a word test taken by 2,623 healthy individuals via Amazon's Mechanical Turk and found essentially the same thing.

"We saw that some things — in this case, words — may be inherently easier for our brains to recall than others," Zaghloul said. That the Mechanical Turk results were so similar may "provide the strongest evidence to date that what we discovered about how the brain controls memory in this set of patients may also be true for people outside of the study."

Why understanding memory matters

person holding missing piece from human head puzzle

Image source: Orawan Pattarawimonchai/Shutterstock

"Our memories play a fundamental role in who we are and how our brains work," Xie said. "However, one of the biggest challenges of studying memory is that people often remember the same things in different ways, making it difficult for researchers to compare people's performances on memory tests." He added that the search for some kind of unified theory of memory has been going on for over a century.

If a comprehensive understanding of the way memory works can be developed, the researchers say that "we can predict what people should remember in advance and understand how our brains do this, then we might be able to develop better ways to evaluate someone's overall brain health."

Party chat

Image source: joob_in/Shutterstock

Xie's interest in this was piqued during a conversation with Wilma Bainbridge of University of Chicago at a Christmas party a couple of years ago. Bainbridge was, at the time, wrapping up a study of 1,000 volunteers that suggested certain faces are universally more memorable than others.

Bainbridge recalls, "Our exciting finding is that there are some images of people or places that are inherently memorable for all people, even though we have each seen different things in our lives. And if image memorability is so powerful, this means we can know in advance what people are likely to remember or forget."

spinning 3D model of a brain

Temporal lobes

Image source: Anatomography/Wikimedia

At first, the scientists suspected that the memorable words and faces were simply recalled more frequently and were thus easier to recall. They envisioned them as being akin to "highly trafficked spots connected to smaller spots representing the less memorable words." They developed a modeling program based on word frequencies found in books, new articles, and Wikipedia pages. Unfortunately, the model was unable to predict or duplicate the results they saw in their clinical experiments.

Eventually, the researchers came to suspect that the memorability of certain words was linked to the frequency with which the brain used them as semantic links between other memories, making them often-visited hubs in individuals's memory networks, and therefore places the brain jumped to early and often when retrieving memories. This idea was supported by observed activity in participants' anterior temporal lobe, a language center.

In epilepsy patients, these words were so frequently recalled that subjects often shouted them out even when they were incorrect responses to word-pair inquiries.

Seek, find

Modern search engines no longer simply look for raw words when resolving an inquiry: They also look for semantic — contextual and meaning — connections so that the results they present may better anticipate what it is you're looking for. Xie suggests something similar may be happening in the brain: "You know when you type words into a search engine, and it shows you a list of highly relevant guesses? It feels like the search engine is reading your mind. Well, our results suggest that the brains of the subjects in this study did something similar when they tried to recall a paired word, and we think that this may happen when we remember many of our past experiences."

He also notes that it may one day be possible to leverage individuals' apparently wired-in knowledge of their language as a fixed point against which to assess the health of their memory and brain.


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