Category Archives: Children and adolescent development and health

a graphic about teeth and dental care

Surprising myths and truths about dental care

I seem to notice many more  television commercials for dental care products and services, and most of them follow a theme. In the past most advertisements were for toothpaste aimed at  preventing cavities. Now they seem to focus on whitening, stain removal, and straightening, and promotions for dentures and dental implants. There is a series of ads for dental clinics that promise “not to rob you” featuring skits portraying people afraid that dentists will demand huge amounts of money for dental care.

woman dentist with a patient

 

 

 

The myths 

I think these ads reflect  myths about dental care that many of us believe and unfortunately base our dental care behavior  on. We need to dispel these myths with some truths about oral health, which includes our teeth and mouth.

These myths include

  • Care of our teeth is mainly a cosmetic concern, affecting our appearance only.
  • Dental care is a luxury, nice but optional, not a necessity, it can be ignored.
  • Dental care is expensive and out of reach without insurance or a high income.
  • Tooth disease and loss is inevitable, so we might as well just accept it.
  • Dental care is low priority, behind food, housing, and medical care in importance.

 

Surprising myths and truths abut

The truths 

But the truth, based on recommendations from experts in oral and dental care, tells us differently.

  • Care of our teeth is functional- we need a healthy mouth for eating, drinking, breathing, and talking. Our mouths also help us interact with other people emotionally- frowning, smiling, kissing, singing.
  • Oral care is a basic component of health care, vitally important to overall health. I’ll say more about this later.
  • Dental care can be affordable; it’s probably more costly if neglected.
  • Loss or disease of teeth and other mouth disorders are preventable and treatable.
  • Dental and oral care is vital to overall good health, and ultimately can be cost effective.
Family of 4 sitting at a dining table.

Our mouth- eating, talking, smiling-connects us with our family and friends.

The teeth and oral cavity, the “window to general health”

The oral cavity, or simply called the mouth ,includes the teeth and gums, as well as the lips, the tongue, the palate (roof of the mouth), and the mucosa (sides of the mouth).

diagram of the mouth from the National Cancer Institute

The underside of the tongue and nearby structures (lip, tongue, salivary glands, and floor of the mouth) are identified. Alan Hoofring (Illustrator) public domain

Why  dental care improves our overall health.

Over 100 diseases and at least 500 medications can affect our teeth and mouths. Regular dental care can monitor for these effects and prevent them from progressing into tooth disease.

Our mouths contain over 500 species of bacteria and other organisms, some of which are protective and some destructive to our teeth. Good oral care can keep these in proper balance to prevent tooth and gum disease.

People with poor dental health have a higher incidence of heart attacks and stroke. Experts have not determined if this is direct cause and effect or coincidence, but believe it may be due to increased atherosclerosis (hardened arteries from cholesterol) due to the chronic inflammation of gingivitis.

Bacteria from the mouth can lead to  pneumonia in susceptible persons, like those with emphysema or those hospitalized with critical illnesses or injuries.

Diabetes, when the blood sugar is not controlled, negatively impacts periodontal health, and periodontitis makes glucose control more difficult. Periodontitis is inflammation and infection of the ligaments and bones that support the teeth.

Poor oral health during pregnancy increases the risk for miscarriage, low birth weight, preeclampsia, and stillbirth.

 Resources for understanding different types of dental and oral disease.

Gum Disease-Also called: Periodontal disease

Tooth disorders

Paying for dental care

Dental care should not be a luxury, and can be within financial reach with some research into available options. These sites can help you discover what you may quality for.

When You Don’t Have Dental Insurance

Free/Low-Cost/Sliding Scale Dental Clinics

The importance of dental care for children

Health teeth in adults ideally starts with dental care in childhood. Jenny Silverstone, blogger at Mom Loves Best, has created this  infographic about caring for children’s teeth. I suggest you also read her in depth article about helping children have healthy teeth. 

How to care for your child's teeth

Don’t neglect adult dental care

Continuing good mouth and tooth care as an adult can help you avoid tooth loss, painful gums, or other problems. If you have any problems with your teeth or concerns about your mouth, see your doctor or dentist right away.

a doctor looking into a patient's mouth

Michael Munger, M.D., examines a patient at his medical office in Overland Park, Kan. courtesy American Academy of Family Physicians

 

 

 

 

 

 

 

Here are some helpful things you can do:

  • Brush your teeth at least twice a day with a fluoride toothpaste.
  • Floss your teeth at least once a day.
  • Don’t smoke or chew tobacco.
  • Ask your doctor if your medicines have side effects that might damage your teeth.
  • Look inside your mouth regularly for sores that don’t heal, irritated gums, or other changes.
  • See your dentist every 6 months for regular check-ups and cleanings. 

(source: familydoctor.org)

Using a power toothbrush may keep your teeth healthier, especially if you have any difficulty using a manual brush.I use an Oral-B Rechargeable Toothbrush by Braun.

(This is an affiliate link. )

 

 

I appreciate your reading and sharing  this post on your social media pages.

And please follow Watercress Words for more information and inspiration to help you explore the HEART of HEALTH.

Thank you for  viewing  the advertisements and using the affiliate links  that fund this blog; with your  help, we can grow, reach more people, and support worthy causes that bring health and wholeness to people around the world.

Dr. Aletha  , sharing the HEART of health 

stethoscope with a heart

 

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The word AUTISM written in vintage letterpress type

Top post of 2017- why the increase in autism?

You’ve heard and read much about autism recently. The top new TV drama this season , The Good Doctor, has a major character with autism (although the actor himself is not).

This illustrates the interest in autism spectrum disorders, and the controversy. We are not certain of the cause, and wonder why the condition is diagnosed more frequently.

Perhaps that explains why this was the most viewed post on this blog in 2017.

Light it up blue-autism speaks

 

 

 

Like other physicians and families of people with autism, I puzzle over the increased number of children and adults diagnosed with autism. Most of us have theories about why we now believe 1 in 68 children have autism spectrum disorders.

People point out that “when they were children” they never knew of anyone with autism. There are those who are absolutely convinced that the increased numbers of autism followed the introduction of the measles-mumps-rubella vaccine, MMR. Others implicate genetics, environmental toxins, diet, and intrauterine brain trauma.

I found an article that offers a sound, well thought out and expressed explanation. It contains several points that I have identified and some I had not.

The article was published in Spectrum whose commitment is “to provide accurate and objective coverage of autism research.” Spectrum is funded by the Simons Foundation Autism Research Initiative. Senior News Writer Jessica Wright, Ph.D. in biological sciences from Stanford University, wrote the report. (Scientific American also published the article by permission.)

In the article, Dr.Wright concludes,

“The bulk of the increase (in autism rates) stems from a growing awareness of autism and changes to the condition’s diagnostic criteria.”

First , let’s consider some terminology. Prevalence is an estimate of how common a disease or condition is in a particular population of people at any given time.

So the prevalence of autism in children would be

the number of children identified as autistic at any given time

divided by  the total number of children alive at that time .

The currently accepted rate of autism is 1 in 68 children, or 1.4 %.

So  autism prevalence depends on children being correctly identified as autistic. At any given time, some autistic children may not be identified, and some may be  incorrectly identified.

We do not have any totally objective tests available for autism yet. There is no blood test, scan, culture, imaging study, DNA test, or  monitor to definitely conclude that autism is or is not present.

 

 

 

 

The definition of and criteria for autism have changed substantially since “infantile autism” was first identified by Leo Kanner over 70 years ago. Since 1980, the diagnosis is based on applying the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). In the most recent version, DSM-5, released in 2013, autism, Asperger syndrome, and pervasive developmental disorder, formerly separate, are now a single diagnosis.

Autism Spectrum Disorder is characterized by

  • Persistent deficits in social communication and social interaction across multiple contexts
  • Restricted, repetitive patterns of behavior, interests, or activities
  • Symptoms must be present in the early developmental period (But may not yet be fully expressed or may be modified by learned behavior in later life)
  • Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.
  • These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay.

At this link you may read the full detailed criteria from DSM-5

Diagnostic Criteria for 299.00 Autism Spectrum Disorder

 

When the diagnostic criteria for other diseases change, the prevalence also changes. Examples include diabetes, high cholesterol, high blood pressure, migraine, obesity, depression , even some cancers. So autism is not unique in this regard.

The currently accepted rate of autism, 1 in 68, comes from the Autism and Developmental Disabilities Monitoring Network, established by the CDC in 2000. Children are identified by reviewing health and school records of 8 year olds in selected counties. So possibly some children get missed, and some assigned incorrectly.

 

 

 

 

 

 

 

 

 

Another major milestone in autism awareness occurred in 1991 when the U.S. Department of Education ruled that autistic children qualify for special education services.

 

Parents of children with developmental and intellectual disabilities  have an incentive to secure accurate diagnosis, to qualify their child for services they otherwise might not  have access to.

 

 

Since 2006, the American Academy of Pediatrics recommends routine screening of all children for autism at 18 and 24 months old. Many physicians, psychologists, and therapists believe early intervention improves these children’s chances to do well intellectually and socially.

If we could go back and review records of children 10, 20, or 30 years ago, and apply current diagnostic criteria, would we find less autism than we do today? Perhaps. But such records would likely reflect the understanding of autism at the time, so might still fail to recognize autism, even when present by today’s standards.

The apparent increased number of children with autism seems alarming-some call it an epidemic. It may represent our increased awareness, recognition, and knowledge about this disorder. And while this increase should raise concern, it can lead to increased research, treatment options, and more effective care for autistic persons.

Here is a link to the original article

Autism Rates in the United States Explained

 

 

 

How The Good Doctor became such a hit

“Highmore’s ( actor who plays an autistic surgical resident ) restrained yet not emotionless portrayal has also resonated within the autism community. Shore (the producer) has heard from multiple people who have found the series inspiring, including one mother who told him that her son, who is on the spectrum and has struggled with depression, agreed to resume therapy after watching the first episode.”

 

 

Will you share this post on your social media pages?

And please follow Watercress Words for more information and inspiration to help you explore the HEART of HEALTH.

Thank you for  viewing  the advertisements and using the affiliate links  that fund this blog; with your continued help, we can grow, reach more people, and support worthy causes that bring health and wholeness to people around the world.

Sincerely, Dr. Aletha 

 

 

 

 

 

 

 

 

 

 

Light it up blue-autism speaks

Most viewed post #2- Why I have “A Different Way of Seeing Autism”- a book review

I write little about my personal life on this blog, but this post is an exception. I  write book reviews frequently, and this post is one of those.

The book is important to me for both personal and professional reasons, so it seemed a good choice to write about.  I am pleased that it made the top 5 this year.

Autism spectrum disorder (ASD) is a neurological and developmental disorder that begins early in childhood and lasts throughout a person’s life. It affects how a person acts and interacts with others, communicates, and learns. It includes what used to be known as Asperger syndrome and pervasive developmental disorders.  Due to changes in diagnostic criteria, lack of definitive tests, overlapping symptoms, and missed diagnoses it’s hard to say what the most common developmental disorder is, but autism likely falls within the top 5.

In this post I explained why I have “a different way of seeing autism.”

 

As soon as I started reading Uniquely Human: A Different Way of Seeing Autism, I knew I had found answers to many of my questions and ,more importantly ,fears about autism. The structure of the book parallels my journey with autism.

 

Part 1- understanding autism:

For the majority of my adult life I have understood autism as a physician, which means I understood little. My training and experience as a family physician taught me  the basics of autism, but  little of the treatment and of the condition. My few autistic patients went to    developmental pediatricians , neurologists, psychiatrists,or psychologists so my involvement was  limited to their physical needs.

From my limited exposure to autistic persons, I saw autism as a life altering, disabling , untreatable  condition that disrupted families as they struggled to cope and manage.

a banner reading "aok Walk for Autism

Part 2- living with autism:

My autism understanding and experience changed when I began living with autism- that is, when my 3-year-old grandson was diagnosed as autistic. At 2 years old he was not using words, even though he had been just a few months before. Other changes in his behavior concerned and alarmed me- lack of eye contact, withdrawing from me and his grandfather, ignoring what was happening around him.

Our once happy, friendly baby grandson seemed to disappear.

a cute baby boy

A happy, smiling, social baby boy, before things changed

 

 

I remember the day I sat at my computer searching the internet for “speech delay in toddlers”. The first, as well as the next several references, all returned the same words – “autism spectrum disorders.”

I cried the first of many tears imagining what the future held for our little family.

 

 

toddler

At age 2 years, we all sensed something had changed. Evaluations and therapy soon followed.

 

 

 

 

I started reading books, medical journal articles and autism focus web sites, trying to find something hopeful and helpful to bring to my family’s autism journey. In Uniquely Human I found that help and hope.

 

UNIQUELY HUMAN- A DIFFERENT WAY OF SEEING AUTISM

UNIQUELY HUMAN- A DIFFERENT WAY OF SEEING AUTISM

 

 

 

 

 

Uniquely Human was written by Barry Prizant, Ph.D.

Uniquely Human was published by Simon and Schuster.

According to his official Facebook page, Dr. Prizant is recognized internationally as a scholar in autism spectrum disorders and childhood disabilities.

He is an Adjunct Professor, Brown University, & Director, Childhood Communication Services.

His many honors include

2014 Honors of the American Speech-Language-Hearing Association,

2005 Princeton University-Eden Career Award in autism

2013 Divine Neurotypical Award of GRASP.

 

He is married to Dr. Elaine Meyer, an Associate Professor and Director, Center for Professionalism and Ethical Practice in the Harvard Medical School and father of teenage son Noah, a student at Washington University in St. Louis.

In his spare time, Barry plays drums in a rock/blues band, enjoys hiking, fishing and outdoor activities, and is an avid collector of Inuit, Native American and other indigenous art, and antiques.

In his book, Uniquely Human, Dr. Prizant approaches autism from a perspective gained from studying about and treating children with autism for 40 years.

He approaches autism more “how to” rather than “what or why”. He recommends working with the child’s strengths rather than trying to change or cure their weakness.

Much of the “treatment” of autism centers on controlling so-called autistic behaviors. He believes that these behaviors are the way autistic children cope with the challenges of “sensory dysregulation.” We should address the triggers of this dysregulation rather than trying to manipulate the behavior, he says.

 

 

“The central challenge of autism is a disability of trust

Trusting their body

Trusting the world

Trusting other people.”

 

 “The best way to help them (autistic children) progress toward fulfilling meaningful lives is

Find ways to engage them

Build a sense of self

Foster joyful experiences”

 

In his book, Dr. Prizant outlines  ways to help autistic people . From my family’s experience, we have learned the importance of almost all of them.  I list them here, along with some of my personal observations.

little boy walking with mother, holding hands

participating in our community Walk for Autism event

 

 

 

“Welcome them  into your world”

Include them in family and social activities to whatever extent they can and will participate.

 

little boy with Easter basket full of eggs

Success at an Easter egg hunt.

 

 

 

 

 

“Don’t label them – high-functioning  vs low -functioning”

I was pleased to read that Dr. Prizant’s does not use those terms. As he says,

“People are infinitely complex and development is multidimensional and cannot be reduced to such a simple dichotomy. “

He goes on to call these labels “terribly inaccurate and misleading ” and that using them is “disrespectful.” The label low-functioning can become a self-fulfilling prophesy.

He concludes,

“Instead of focusing on vague and imprecise labels, it’s better to focus on the child’s relative strengths and challenges, and to identify the most beneficial supports. “

 

He discusses this in more detail in this article from 2012.

A False (Harmful?) Dichotomy 

 

“Engage them; try to communicate”

Not all autistic people are verbal; but they all communicate in some way. We just need to understand how and work with that

2016-09-28-18-50-18

exercising with the video game

 

 

 

“Give choices”

“Treat respectfully, with empathy and  sensitivity”

“Meltdowns are a common occurrence with autism but are not “temper tantrums”. They usually reflect a need or want that isn’t being met, or a situation that is overwhelming or too stimulating.  We try to adjust the circumstances to his feelings, not force him into something that is uncomfortable for him.

 

little boy wearing sunglasses

Check out those shades; being silly helps sometimes.

 

 

 

 

“Humor”

Sometimes you just need to laugh.

 

children in Halloween masks

searching for the perfect Halloween mask with his older sister

 

 

 

“Offer to help but no unsolicited advice or criticism”

I ask a lot of  questions. Whenever I meet someone who has an autistic child or relative, a  special education teacher  or therapist of  developmentally challenged persons , I try to learn something from them. Friends occasionally offer  advice about a therapy or some facility that I often already know about. As long as it is offered non-judgmentally I appreciate their interest. So far I’ve never had anyone overtly criticise.

“Be positive; use tenderness with your honesty.”

 

little boy with a big camera

eager to try new things

 

 

 

 

 

“Celebrate with us”

Don’t be afraid to ask how things are going, as long as you don’t mind sometimes hearing the bad as well as the good.

 

girl and boy in a corn field

exploring the corn maze with sister

 

 

 

 

“Trust- be dependable, clear and concrete”

man and boy on the floor

Rough-housing with grandpa

 

 

 

 

 

 

I am happy to say my grandson is doing well. He benefits from speech and occupational therapy, special education in the public school, and the prayers and support from our friends and family, especially his parents and sister.

I  see him and every other person with autism as “Uniquely Human” ; knowing and loving him has changed my life in  ways I could not have imagined and would not want to miss.

Learn What motivated Dr. Prizant to write Uniquely Human

in this interview by autism specialist Becca Lory

THE SPARK- A Mother’s Story of Nurturing, Genius, and Autism

Another book that encouraged me is THE SPARK  by Kristine Barnett. When her son Jake was diagnosed with autism at 2 years old, doctors told her he would never attend school for “normal’ children. Undeterred, she taught him herself, building on his strengths. By 16, he was attending college- and helping to teach classes in quantum physics.

I don’t know if Mrs. Barnett knew of Dr. Prizant’s methods, but it certainly sounds as if she used them. Or maybe she just followed her motherly instincts. Here’s how she says it in the introduction.

“This book is the story of how we got from there to here, the story of a mother’s journey with her remarkable son…it is about the power of hope and the dazzling possibilities that can occur when we keep our minds open and learn how to tap the true potential that lies within every child. “

I highly recommend this book to anyone who needs or wants to know more about autism.

 

 

 

Please share with your friends and join me  for the year’s  most viewed post. 

Follow Watercress Words as we explore the HEART of HEALTH. 

Thanks for being here with me. I appreciate your interest. 

Dr.Aletha 

 

 

the word BLOG

Doctor bloggers you need to know

This post has several affiliate links, for your convenience and to support this blog. thank you!

In a previous series I recommended several physician written health blogs. In this post, I revisit some of those sites, and introduce you to a few more I have discovered.

These blogs are all written exclusively or mostly by physicians, or other healthcare professionals. While personal health blogs can be interesting and helpful, blogs that offer information from people who study and practice health and health care professionally offer extra benefits.

White Coat Pink Apron– good food for busy people

White Coat, Pink Apron web site

Dr. Diana, a Boston allergy specialist, blogs about food and shares recipes that are

“quick, easy, generally toddler-friendly, and sometimes Armenian, that anyone can make.”

In this post she shares two recipes for fish, salmon and cod, that adhere to the Paleo concept- no grains ,no beans, no dairy, and no sugar.

LEMON ROASTED SALMON AND KALE

dinner plate with fish, green beans and rice

illustration only, not actual recipe

Alert and Oriented.com

Dr. Michel Accad continues to blog about health care policies and economics, the doctor-patient relationship, and medical history, philosophy, and ethics.

 

According to Dr. Accad, human health is uninsurable; our bodies are not machines so cannot be evaluated objectively. He argues that health insurance is an income subsidy that helps sick people pay for medical care. In this thought provoking post, he explains why

Health insurance is not insurance

He has also published a book,

Moving Mountains: A Socratic Challenge to the Theory and Practice of Population Medicine

“This book will be of great interest to any reader concerned about healthcare. It will be of particular appeal to medical and public health students, as well as to healthcare professionals, including academics open to a challenging perspective.” Amazon

 

 

2 peds in a pod– (peds meaning pediatricians)

Practical pediatrics for parents on the go

Dr. Julie Kardos and Dr. Naline Lai practice pediatrics together and co-author this blog about infant, child, and adolescent  health issues. Including  “Essentials of Life- eat, sleep, drink, pee, poop, love”

Here they explain how to read food packaging labels accurately.

Deception in Packaging: Navigating the Nutrition Information Highway

Family of 4 sitting at a dining table.

Read food packing labels carefully to create nutritious meals.

Freud and Fashion

by psychiatrist Vania Manipod, DO

…BECAUSE IT’S STYLISH TO TALK ABOUT MENTAL HEALTH, ESPECIALLY HOW WE MAINTAIN OUR OWN.

sketch of clothes, shoes, pants

because it’s fashionable to talk about mental health

Dr. Manipod is active on several social media sites as well as her blog. As a psychiatrist, she focuses on mental health, for both patients and other physicians.

She offers Advice on How To Cope With Burnout,  advice she tries to take herself.

And in an interview post she discusses

how a New York woman fights the stigma of mental illness

Dr.Linda-

Just a family doctor speaking up from the frontlines of medicine

Dr. Linda Girgis, M.D. has published a  fiction book, Pandemic Rising

Pandemic RISING- a book

“The year is 2025 and there is a war of worlds in full swing: pathogens versus humanity. In the antibiotic-resistance era, people are living in a petri dish of toxic microbes. Unfortunately, humanity lost its most powerful weapons, antibiotics, when previous generations of doctors prescribed them indiscriminately. Additionally, the efficacy of vaccines waned when people refused these fortresses based on mythological beliefs. Across the globe, tens of thousands are dying while scientists and doctors race to find a cure and vaccine for these super-bugs. Will the medical community of scientists and doctors succeed in developing new ammunition? Or will humanity die off in the battle against the new world order of infectious diseases and pandemics?” Amazon

 

 

On her blog, she shares a poignant story about a terminally ill patient with an unshakable will to live in this post-

A Lesson a Patient Taught Me about Defying Death 

Please visit at least one of these doctor bloggers, and leave them a comment. They will appreciate  the support and you may learn something new.

Previous posts about  doctor bloggers

10 health blogs you should read- a pair of docs and more

10 health blogs you should read- a family (doc) reunion

10 health blogs you should read- blogs by docs

10 health blogs you should read- 3 blogs by 3 docs

 

Books also available at Barnes and Noble/Nook

$5 Off Your Order of $40+ and $10 Off Your Order of $75+

The word AUTISM written in vintage letterpress type

Are too many children autistic?

Like other physicians and families of people with autism, I puzzle over the increased number of children and adults diagnosed with autism. And most all of us have theories about why we now believe 1 in 68 children have autism spectrum disorders.

People point out that “when they were children” they never knew of anyone with autism.There are those who are absolutely convinced that the increased numbers of autism followed the introduction of the measles-mumps-rubella vaccine, MMR. Others implicate genetics, environmental toxins, diet, and intrauterine brain trauma.

I found an article that  offers a sound, well thought out and expressed explanation. It contains several points that I have identified and some I had not.

The article was published in Spectrum whose commitment is “to provide accurate and objective coverage of autism research.” Spectrum is funded by the Simons Foundation Autism Research Initiative. Senior News Writer Jessica Wright, Ph.D. in biological sciences from Stanford University, wrote the report. (Scientific American also published the article by permission.)

In the article, Dr.Wright concludes,

“The bulk of the increase (in autism rates) stems from a growing awareness of autism and changes to the condition’s diagnostic criteria.”

First , let’s consider some terminology. Prevalence is an estimate of how common a disease or condition is in a particular population of people at any given time.

So the prevalence of autism in children would be

the number of children identified as autistic at any given time

divided by  the total number of children alive at that time .

The currently accepted rate of autism is 1 in 68 children, or 1.4 %.

So  autism prevalence depends on children being correctly identified as autistic. At any given time, some autistic children may not be identified, and some may be  incorrectly identified.

We do not have any totally objective tests available for autism yet. There is no blood test, scan, culture, imaging study, DNA test, or  monitor to definitely conclude that autism is or is not present.

The definition of and criteria for autism have changed substantially since “infantile autism” was first identified by Leo Kanner over 70 years ago. Since 1980, the diagnosis is based on applying the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). In the most recent version, DSM-5, released in 2013, autism, Asperger syndrome, and pervasive developmental disorder, formerly separate, are now a single diagnosis.

Simply explained, Autism Spectrum Disorder is characterized by

  • Persistent deficits in social communication and social interaction across multiple contexts
  • Restricted, repetitive patterns of behavior, interests, or activities
  • Symptoms must be present in the early developmental period (But may not yet be fully expressed or may be modified by learned behavior in later life)
  • Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.
  • These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay.

Here is the full detailed criteria from DSM-5

Diagnostic Criteria for 299.00 Autism Spectrum Disorder

 

When the diagnostic criteria for other diseases we diagnose and manage changed, the prevalence also changed. Examples include diabetes, high cholesterol, high blood pressure, migraine, obesity, depression , even some cancers. So autism is not unique in this regard.

The currently accepted rate of autism, 1 in 68, comes from the Autism and Developmental Disabilities Monitoring Network, established by the CDC in 2000. Children are identified through reviewing health and school records of 8 year olds in selected counties. So possibly some children get missed, and some assigned incorrectly.

Another major milestone in autism awareness occurred in 1991 when the U.S. Department of Education ruled that autistic children qualify for special education services. This ruling encouraged parents of children with developmental and intellectual disabilities to secure accurate diagnosis, to qualify for services they otherwise might not  have access to.

Since 2006, the American Academy of Pediatrics recommends routine screening of all children for autism at 18 and 24 months old. Many physicians, psychologists, and therapists believe early intervention improves these children’s chances to do well intellectually and socially.

If we could go back and review records of children 10, 20, or 30 years ago, and apply current diagnostic criteria, would we find less autism than we do today? Perhaps. But such records would likely reflect the understanding of autism at the time, so might still fail to recognize autism, even when present by today’s standards.

The apparent increased number of children with autism seems alarming-some call it an epidemic. It may represent our increased awareness, recognition, and knowledge about this disorder. And while this increase should raise concern, it can lead to increased research, treatment options, and more effective care for autistic persons.

Here is a link to the original article

Autism Rates in the United States Explained

 

The story of autism isn’t just about statistics, theories, and criteria; it is about the  children and adults with autism, and their families. Here are just two of many stories of how autism plays out in real life.

We Are Autism, Too. Don’t Forget About Us.

“My boy, with his classic autism, the kind that used to be the only face of autism half a century ago, is the one who does not belong now.”

Looking Into the Future for a Child With Autism

“As my son’s limitations became clearer, I found it harder every year to write a vision statement for his I.E.P. Then he showed us how.”

 

And in this  previous post  I share my personal experience with autism.

Why I have a different way of seeing autism

Light it up blue-autism speaks

Why I observe Autism Awareness Day

Every year  people around the world observe April 2 as World Autism Awareness Day (WAAD) and April as World Autism Awareness Month. What’s it all about? Why observe such a day?

World Autism Awareness Day, established in 2007,  is one of only three official health related United Nations Days.

The purpose of Autism Awareness is

  • to  bring the world’s attention to autism, a pervasive disorder that affects tens of millions.
  • to raise awareness about autism throughout society and
  • to encourage early diagnosis and early intervention. 
     

Autism is a brain disorder that often makes it hard to communicate with and relate to others. With autism, the different areas of the brain fail to work together.”

 

As a physician, I am  professionally aware of  the symptoms of  autism. As the grandmother of a child with autism, I have become intimately and personally aware of what it means to experience life with autism.  A few months ago I reviewed two books  that gave me much needed information  and hope about autism. I believe they will help other autism families and anyone who wants to know more about this condition.

So in observance of World Autism Day I am repeating that post for you now.

 

Uniquely Human: A Different Way of Seeing Autism 

As soon as I started reading Uniquely Human: A Different Way of Seeing Autism, I knew I had found answers to many of my questions and ,more importantly ,fears about autism. The structure of the book parallels my journey with autism.

 

Part 1- understanding autism:

For the majority of my adult life I have understood autism as a physician, which means I understood little. My training and experience as a family physician taught me  the basics of autism, but  little of the treatment and of the condition. My few autistic patients went to    developmental pediatricians , neurologists, psychiatrists,or psychologists so my involvement was  limited to their physical needs.

From my limited exposure to autistic persons, I saw autism as a life altering, disabling , untreatable  condition that disrupted families as they struggled to cope and manage.

Part 2- living with autism:

My autism understanding and experience changed when I began living with autism- that is, when my 3-year-old grandson was diagnosed as autistic. At 2 years old he was not using words, even though he had been just a few months before. Other changes in his behavior concerned and alarmed me- lack of eye contact, withdrawing from me and his grandfather, ignoring what was happening around him.

Our once happy, friendly baby grandson seemed to disappear.

a cute baby boy

A happy, smiling, social baby boy, before things changed

 

 

I remember the day I sat at my computer searching the internet for “speech delay in toddlers”. The first, as well as the next several references, all returned the same words – “autism spectrum disorders.”

I cried the first of many tears imagining what the future held for our little family.

 

 

toddler

At age 2 years, we all sensed something had changed. Evaluations and therapy soon followed.

 

 

 

 

I started reading books, medical journal articles and autism focus web sites, trying to find something hopeful and helpful to bring to my family’s autism journey. In Uniquely Human I found that help and hope.

 

UNIQUELY HUMAN- A DIFFERENT WAY OF SEEING AUTISM

UNIQUELY HUMAN- A DIFFERENT WAY OF SEEING AUTISM

 

 

 

 

 

Uniquely Human was written by Barry Prizant, Ph.D.

Uniquely Human was published by Simon and Schuster.

According to his official Facebook page, Dr. Prizant is recognized internationally as a scholar in autism spectrum disorders and childhood disabilities.

He is an Adjunct Professor, Brown University, & Director, Childhood Communication Services.

His many honors include

2014 Honors of the American Speech-Language-Hearing Association,

2005 Princeton University-Eden Career Award in autism

2013 Divine Neurotypical Award of GRASP.

 

He is married to Dr. Elaine Meyer, an Associate Professor and Director, Center for Professionalism and Ethical Practice in the Harvard Medical School and father of teenage son Noah, a student at Washington University in St. Louis.

In his spare time, Barry plays drums in a rock/blues band, enjoys hiking, fishing and outdoor activities, and is an avid collector of Inuit, Native American and other indigenous art, and antiques.

In his book, Uniquely Human, Dr. Prizant approaches autism from a perspective gained from studying about and treating children with autism for 40 years.

He approaches autism more “how to” rather than “what or why”. He recommends working with the child’s strengths rather than trying to change or cure their weakness.

Much of the “treatment” of autism centers on controlling so-called autistic behaviors. He believes that these behaviors are the way autistic children cope with the challenges of “sensory dysregulation.” We should address the triggers of this dysregulation rather than trying to manipulate the behavior, he says.

 

 

“The central challenge of autism is a disability of trust

Trusting their body

Trusting the world

Trusting other people.”

 

 “The best way to help them (autistic children) progress toward fulfilling meaningful lives is

Find ways to engage them

Build a sense of self

Foster joyful experiences”

 

In his book, Dr. Prizant outlines  ways to help autistic people . From my family’s experience, we have learned the importance of almost all of them.  I list them here, along with some of my personal observations.

little boy walking with mother, holding hands

participating in our community Walk for Autism event

 

 

 

“Welcome them  into your world”

Include them in family and social activities to whatever extent they can and will participate.

 

little boy with Easter basket full of eggs

Success at an Easter egg hunt.

 

 

 

 

 

“Don’t label them – high-functioning  vs low -functioning”

I was pleased to read that Dr. Prizant’s does not use those terms. As he says,

“People are infinitely complex and development is multidimensional and cannot be reduced to such a simple dichotomy. “

He goes on to call these labels “terribly inaccurate and misleading ” and that using them is “disrespectful.” The label low-functioning can become a self-fulfilling prophesy.

He concludes,

“Instead of focusing on vague and imprecise labels, it’s better to focus on the child’s relative strengths and challenges, and to identify the most beneficial supports. “

 

He discusses this in more detail in this article from 2012.

A False (Harmful?) Dichotomy 

 

“Engage them; try to communicate”

Not all autistic people are verbal; but they all communicate in some way. We just need to understand how and work with that

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exercising with the video game

 

 

 

“Give choices”

“Treat respectfully, with empathy and  sensitivity”

“Meltdowns are a common occurrence with autism but are not “temper tantrums”. They usually reflect a need or want that isn’t being met, or a situation that is overwhelming or too stimulating.  We try to adjust the circumstances to his feelings, not force him into something that is uncomfortable for him.

 

little boy wearing sunglasses

Check out those shades; being silly helps sometimes.

 

 

 

 

“Humor”

Sometimes you just need to laugh.

 

children in Halloween masks

searching for the perfect Halloween mask with his older sister

 

 

 

“Offer to help but no unsolicited advice or criticism”

I ask a lot of  questions. Whenever I meet someone who has an autistic child or relative, a  special education teacher  or therapist of  developmentally challenged persons , I try to learn something from them. Friends occasionally offer  advice about a therapy or some facility that I often already know about. As long as it is offered non-judgmentally I appreciate their interest. So far I’ve never had anyone overtly criticise.

“Be positive; use tenderness with your honesty.”

 

little boy with a big camera

eager to try new things

 

 

 

 

 

“Celebrate with us”

Don’t be afraid to ask how things are going, as long as you don’t mind sometimes hearing the bad as well as the good.

 

girl and boy in a corn field

exploring the corn maze with sister

 

 

 

 

“Trust- be dependable, clear and concrete”

man and boy on the floor

Rough-housing with grandpa

 

 

I am happy to say my grandson is doing well. He benefits from speech and occupational therapy, special education in the public school, and the prayers and  support from our friends and family, especially his parents and sister. I  see him and every other person with autism as “Uniquely Human” ; knowing and loving him has changed my life in  ways I could not have imagined and would not want to miss.

 

THE SPARK- A Mother’s Story of Nurturing, Genius, and Autism

Another book that encouraged me is THE SPARK  by Kristine Barnett. When her son Jake was diagnosed with autism at 2 years old, doctors told her he would never attend school for “normal’ children. Undeterred, she taught him herself, building on his strengths. By 16, he was attending college- and helping to teach classes in quantum physics.

I don’t know if Mrs. Barnett knew of Dr. Prizant’s methods, but it certainly sounds as if she used them. Or maybe she just followed her motherly instincts. Here’s how she says it in the introduction.

“This book is the story of how we got from there to here, the story of a mother’s journey with her remarkable son…it is about the power of hope and the dazzling possibilities that can occur when we keep our minds open and learn how to tap the true potential that lies within every child. “

I highly recommend this book to anyone who needs or wants to know more about autism.