April is here, once again marking the return of Autism Awareness Month. This month will be filled with numerous events reminding us that the autism is still more prevalent than ever, and that more families are still struggling with what’s frustratingly termed “the mystery of autism.” To these families, autism is something they live with every day, not just one month a year, of course—but the increased focus is important.
Unfortunately, over the years I’ve been taking care of families with autistic children, several trends have gone in the wrong direction. First and foremost, more and more children are diagnosed every year. It’s now estimated that, in my home state of New Jersey, one in sixty boys is diagnosed with an autism spectrum disorder. And we still have no conclusive idea why. Yes, we have a growing amount of research elucidating the various environmental triggers that, under the wrong genomic influence and predisposition, lead to a biological unraveling presenting as a complex neurodevelopmental, gastrointestinal, and immunological disorder. That’s a mouthful, but at least we are starting to accept that autism is not simply a brain disorder. As neurologist Dr. Martha Herbert has noted, “The brain is downstream,” meaning that what we see—the impairment of communication, behavior, and social skills—is the result of many of other physiological processes going awry. This view of autism is encouraging in that it provides new avenues for evaluation, treatment, and—the holy grail—prevention. Yet, I must say, the pace of treatment developments has been excruciatingly slow. Parents often turn to alternative therapies (over 90% in one study I co-authored) because they are so frustrated by the lack of progress they perceive while devoting hours and hours to conventional therapies. Don’t misunderstand me—I definitely believe in mainstream therapies (speech, occupational, and physical therapies; behavioral therapies including but not limited to applied behavioral analysis or ABA). But these therapies do not always adequately address many of the important functional impairments, like sleep and gastrointestinal problems, common in autistic children. I have found that an evidence-based integrative approach is most effective in helping these families and children evaluate root causes and coordinate the comprehensive multi-system care needed.
More and more children will soon be teenagers and then adults with autism. Our society has never witnessed anything like this, and the emotional and economic impact due to educational and medical needs will soon force us to develop a more effective plan to hopefully stem the tide of new diagnoses. I urge you to take some time, especially this month, to think about how we can work together to make this a reality.