Autism is a neuro-developmental disease which causes a spectrum of behaviors; restricted or pattern behavior, and social miscommunication are the common characteristics. Spectrum here stands for a wide form of manifestations of the same condition. In 2013, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) reclassified the autism spectrum.
No scientific cause of the disease has been conclusively identified as of yet. Scientists have theorized that the causes can be genetic, environmental or social, which can affect brain chemistry and structure of autism diagnosed patients. Autism has a higher incidence rate with some genetic anomalies such as fragile X syndrome, tuberous sclerosis, congenital rubella syndrome and untreated phenylketonuria (PKU). Harmful substances ingested by pregnant women have also shown an increase in autism diagnosis in their children.
Autism is the fastest growing neuro-developmental disorder in America. According to Centers for Disease Control and Prevention (CDC), data suggests that every one in 68 child has some form of autistic disorder. The data was collected according to the prevalence and incidence of autism among eight-year-old children in 11 communities within Arizona, Arkansas, Colorado, Georgia, Maryland, Missouri, New Jersey, North Carolina, South Carolina, Utah, and Wisconsin, in year 2012.
Also Read “Autism: The Child And The Parents“
The sudden rise observed in the autism rates before this, from one in 500, to one in 68, can be attributed to better diagnostic criterion guidelines available for the doctors right now than before. As the learning curve of the doctor improved, more cases of autism were reported. The cases have shown a gender bias where every four boys get diagnosed for one girl. The autism disorder is more prevalent in whites (15.5 per 1,000) than Hispanic (10.1 per 1,000) and American African (13.2 per 1,000) children. Scientists also attribute these results usually to the diagnosis rate rather than incidence rates though further investigations are needed to prove this hypothesis.
Around 3.5 million people in United States live with the autism spectrum disorder currently, whereas 1 percent of the current United Kingdom population has the same disorder. Economists form UC Davis estimate that in 2015 autism in America will cost $268 billion dollars and nearly $461 billion in 2025.
The coverage rates for MMR vaccine in comparison to 1998 (86 percent; lowest rate from 1994 to 2014) is now at 91.5 percent in 2014.
The 2nd April, 2016, has been declared as the World Autism Awareness Day by the United Nations after being proposed by Qatar in December 18, 2007. Autism has not only been given a day to highlight its importance but also to pay attention and improve the life of people living with such disabilities, in an effort to make them productive citizens of the world.
“On this World Autism Awareness Day, I call for advancing the rights of individuals with autism and ensuring their full participation and inclusion as valued members of our diverse human family who can contribute to a future of dignity and opportunity for all “, said the current UN General Sectary Ban Ki-moon.
The United Nations General Assembly adopted the Sustainable Developmental Goals (SDGs) last year for the next 15 years. Five out of 17 goals indicate disability and people living with disability. This roadmap pays special attention to the people with disabilities and reaffirms global commitment to mainstream disability, raise awareness, design, implement and monitor policies at political, social and economic level.
There is no test that 100 percent concludes the existence of an autism spectrum disorder. It’s the doctor’s analysis based on guidelines developed to observe the behavior of the patient, which helps diagnose the condition. Generally, the cases are diagnosed before the child reaches the third year of his or her life. Diagnosis can be sometimes made at 18 months or younger. By the age of two years, a medical professional can very reliably diagnose the condition. The sooner the condition can be diagnosed, the earlier the interventions can be made which, as has been proven, can improve the life of the child exponentially.
The United States Preventive Services Taskforce, in February 2016, concluded that not enough evidence was available to conclude that autism should be universally tested or not. It was not a recommendation for or against Universal Testing, rather a call for more research in the area.
A recent study from Sweden has found that people with autism have lower life expectancy than neurotypical people. Epilepsy, depression, ADHD, OCD, and Parkinson’s disease is way common in people with this disorder. Suicide rate is also way higher in people with ASD than normal rate.
Autism And Vaccines — A Misunderstood Relation
Autism is almost always associated with vaccines in one way or another. It is a raging debate whether there is a link between the two or not. From political frontrunners such as Donald Trump to your next door neighbor, everyone has an opinion. Recently in a GOP debate Donald trump answered on whether the vaccines cause autism, “Just the other day, two years old, two and half years old, a child, a beautiful child went to have the vaccine, and came back, and a week later got a tremendous fever, got very, very sick, now is autistic.”
The most popular belief is that either the vaccine itself can cause autism or its ingredients like thimerosal can, but there is no scientific basis or proof for either.
Autism Vaccines Controversy
When such claims, as that of Donald Trump’s, are made in public, fear increases, leading to false controversy. When an outlandish claim becomes such a widespread phenomenon, the question that should be asked is: how did it start?
The answer can be found in a Lancet research paper, published in 1998, titled “Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children”, by Wakefield, A J and co-authors. In this paper 12 children with developmental regression were studied. Nine had autism and eight of the children’s parents thought they got autism from vaccination. There was no scientific proof of any kind of association between the two: vaccines and autism.
In 2004, 10 of the 12 co-authors retracted their theory, the 11th could not be contacted before the retraction, and the lead scientist Wakefield, A J maintained his stance. He is no longer licensed to practice medicine in the United Kingdom.
Several studies, particularly for MMR vaccines, were conducted to study this theory but not one could find the same results. In 2005, a systematic review (scientific study of the studies) was conducted that studied 31 different studies but could not find an association between the two conditions of getting vaccinated and getting an autistic diagnosis. The study was updated in 2012, and analyzed five randomized control trials (RCTs), one controlled trial, 27 cohort studies, 17 case control studies, five time-series trials, one case cross-over trial, two ecological studies, and six self-controlled case series studies. Still it concluded the same thing.
Tripedia was primarily used as a vaccine against whopping cough, diphtheria, and tetanus. The vaccine was manufactured by Sanofi Pasteur, Inc, but was discontinued by the company on their own accord in 2011.
Recently, a piece of news has been making the rounds that the FDA has admitted that vaccines can cause autism due to FDA mentioning autism as an adverse effect in the vaccine insert available on their website.
To understand this, one should know several key facts. Firstly, adverse effects mentioned in the insert do not prove that any link exits between the given effects and the drug. FDA has an adverse event reporting system, or FAERS, set up to collect data and help monitor the drugs which have already been approved. According to the site, “There is no certainty that the reported event (adverse event or medication error) was actually due to the product. FDA does not require that a causal relationship between a product and event be proven, and reports do not always contain enough detail to properly evaluate an event.” Anyone can report an event here. It can be voluntary or mandatory. Mandatory reporting is where this particular insert mentioned autism as an adverse effect. When a manufacturer conducts a study, they are legally required to mention any medical adverse event that happened to the recipient of their drug or vaccine, down the line. It does not matter whether the event was caused by the medication or not. For example, if everyone has pizza in school lunch, you would be obligated to report that certain amount of people who had pizza developed an ear infection, or an eye infection, or a leg injury. No matter the reason, you would be legally obligated to disclose complete information.
Secondly, even if autism is an adverse event, it does not mean that a vaccine is the cause because in scientific terms two events occurring together does not mean that there is a cause and effect. Association is not causation. If everyone having pizza got an early off that day, it does not necessarily mean that they got out a little early because they had pizza. It could mean that probably their teacher was out sick or the school had a power shortage and had to cancel classes. Understanding the difference between the two is very important, along with what reliable and unreliable scientific studies are.
When people are vaccinated at a large scale, it helps prevent outbreaks of infection in the community even if one person gets an illness which is communicable. This phenomenon is known as “herd immunity”. When people perceive vaccines as dangerous, they can, according to the US law, deny vaccines for themselves and their children. This causes the vaccinated population number to go down, thus decreasing herd immunity. This is why understanding this conspiracy theory is very important. The more aware an individual person, the healthier is the general public. Raising awareness is critical to prevent outbreaks and epidemics (sudden outbreak affecting large portion of the population).
Efforts To Understand Autism
Considering the difficulties — such as depression, economic burden and general decreased productivity — of living with an autistic disorder, it is critical for the state and global health organizations to come together and formulate plans for adults to be more constructive in the society. Currently, all the efforts are being aimed at new diagnosed cases and their guardians. The plan should be more wholesome and comprehensive, which can be applied to any age group.
More streamlined efforts for timely and effective diagnosis, proper guidelines for treatment management services and research in preventive and treatment areas is what is needed.