What more doctor bloggers are writing about COVID-19

Perhaps one of the greatest lessons we are learning from this pandemic is our need for social connection and community. Perhaps we can ask ourselves, what does it mean to build real community in care communities?

I’ve been reading what some other physician bloggers are writing about the COVID-19 pandemic. Here I share some of them with you. While I believe they are all reliable and honest sources of information, my sharing does not imply endorsement,complete agreement, or advice. This is a topic in which information changes daily if not more often, so all information is subject to change. Always consult the CDC and your state and local health departments for the most recent information that pertains to you.

What to do if you think you have COVID-19

Dr. Linda, a family doctor, explains what to do and what not to do if you think you have caught the coronavirus.

Don’t Panic. The majority of patients will get better without any treatment. I’ve seen many patients, even among those with no symptoms, with very high levels of anxiety. When we turn on the TV these days, it’s all about COVID-19. Remember that the news always shows the worst case scenarios. If watching it makes you more fearful, switch it off. You still need to get updates but limit your exposure to all the negativity aimed at you. Maybe, just check your state’s department of health sites to know what you need to be aware of.

Don’t Go to the ER Because You Think You Have COVID-19/

EMERGENCY-sign
Photo by Pixabay
A COVID-19 Overview

Dr. Andrew Weil, well known as an integrative medicine proponent, wrote this overview of what we know about the coronavirus. He also offers his recommendations for vitamins and supplements that might be safe to take during the pandemic (although not known to prevent or treat the infection) and what substances you should avoid. I reviewed one of Dr. Weil’s books at this link.

Dr. Weil considers the following natural immune stimulating and antiviral agents as likely safe to take before and during a COVID-19 virus infection. However, we don’t know for sure whether any of them will affect the symptoms or severity of the infection.

COVID-19: What You Should Know About Coronavirus

illustration showing the coronavirus which causes COVID-19
Photo by Pixabay on Pexels.com

Changing our view of nursing homes

Sonja Barsness is not a physician but she wrote a guest post for Dr. Bill Thomas’ blog, Changing Aging.

Perhaps one of the greatest lessons we are learning from this pandemic is our need for social connection and community. Perhaps we can ask ourselves, what does it mean to build real community in care communities?

Covid and Culture Change

If you are depressed and thinking about or planning suicide, please stop and call this number now-1-800-273-8255

cover photo

Centers for Disease Control and Prevention (CDC) activated its Emergency Operations Center (EOC) to coordinate with the World Health Organization (WHO), federal, state and local public health partners, and clinicians in response to the coronavirus disease 2019 (COVID-19) outbreak. CDC is closely monitoring the situation and working 24/7 to provide updates.

credit: CDC/James Gathany-public domain

exploring the HEART of health in a pandemic

I shared other COVID-19 blogs in another post . I hope you check out other posts from these physician bloggers.

I would love for you to start following Watercress Words : use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn. Thanks so much.

                              Dr. Aletha 

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Fighting disease at the CDC-from malaria to COVID-19

Our country and the world are confronting a new and serious health challenge which just a few weeks ago we knew little about but are learning more every day- the COVID-19 disease outbreak. This crisis presents a unique opportunity for us as citizens to watch the private and the public healthcare sectors work together to control and contain the spread of this disease.

Since the start of 2020, you’ve probably heard and learned more acronyms than ever before. Medicine, chemistry, computer science, the military, and government use acronyms- abbreviations formed from the initial letters of words to create new words. Acronyms make it easier to write and say complicated names. But in medicine, sometimes they represent serious and dangerous diseases-

  • MI-myocardial infarction, heart attack
  • CVA-cerebrovascular accident, stroke
  • DM-diabetes mellitus
  • HIV-AIDS-human immodeficiency virus-acquired immundeficiency syndrome
  • SARS-CoV-sudden accute respiratory syndrome (due to coronavirus )
  • SARS-CoV-2 sudden accute respiratory syndrome(due to coronavirus 2)
SARS-CoV-2

In an online article on March 3, 2020 , three physicians from Johns Hopkins School of Public Health reported a December 2019 outbreak of viral pneumonia in Wuhan China, a city of several million people, a place I had never heard of. Scientists determined they were infected with a novel (new) coronavirus which they called SARS-CoV-2, which was soon shortened to COVID-19-corona virus disease 2019. The World Health Organization, WHO, declared this a Public Health Emergency of International Concern. The authors concluded

it is clear now that COVID-19 will spread widely in the world, including in the U.S….health care and public health systems need to move quickly forward in their efforts to be ready to confront this disease around the country

Drs. Adalja, Toner, Inglesby,March 3, 2020, JAMA, The Journal of the American Medical Association
symptoms of COVID-19-fever, cough, shortness of breath

I don’t remember if I had seen that article, but I had been reading about COVID-19 on several medical websites. On March 5, 2020 I spoke at my local DARDaughters of the American Revolution-meeting as chair of the Women’s Issues Committee, which focuses on family, career, and health. By mid April when I looked back at my notes , I was stunned to realize how much had happened and how much our lives had changed in a mere 6 weeks. Here’s what I reported to the group that day.

What I told DAR about COVID-19

Our country and the world are confronting a new and serious health challenge which just a few weeks ago we knew little about but are learning more every day- the COVID-19 disease outbreak.  This crisis presents a unique opportunity for us as citizens to watch the private and the public healthcare sectors work together to control and contain the spread of this disease.

The public health response is coordinated by President Donald Trump –POTUS-and the U.S. Department of Health and Human Services (HHS). The Secretary of Health and Human Services, Alex Azar ,serves in the President’s cabinet.

avoid contact with sick people, do not touch your eyes, nose, mouth; wash hand often
“effective Health and Human Services”

The mission of the U.S. Department of Health and Human Services (HHS) is

“to enhance and protect the health and well-being of all Americans by providing for effective health and human services and by advances in the sciences underlying medicine, public health, and social services.”

The Constitution doesn’t mention health or medical care but maybe the department’s creation was inspired by the preamble to the Constitution which pledges to “promote the general welfare.”

In terms of spending, HHS is now the largest government agency, surpassing even the Department of Defense-DoD. The 2121 budget proposal includes $94.5 billion in discretionary funds and $1.3 trillion in mandatory funding for HHS. (This was prior to the 2020 COVID-19 response.)

This HHS budget funds multiple agencies including 

  • CMS- Centers for Medicare and Medicaid
  • ACA- the Health Insurance Marketplace for the Affordable Care Act 
  • FDA-the Food and Drug Administration 
  • IHS- the Indian Health Service 
  • NIH, the National Institutes of Health, which includes the National Institute of Allergy and Infectious Disease (NIAID) directed by Dr. Anthony Fauci
  • Head Start and other services to children
  • Services to disabled and elderly people
  • Mental health and substance abuse programs 
  • USPHS- the US Public Health Service including the Surgeon General (OSG)
  • CDC-the Centers for Disease Control and Prevention 
What is the CDC ?

The CDC’s mission is

“to work 24/7 to protect America from health, safety and security threats, both foreign and in the U.S.”

The Communicable Disease Center (CDC) opened on one floor of a small building in Atlanta Georgia in 1946, with a simple yet challenging mission: prevent malaria from spreading across the nation, from the southern states, the heart of the malaria zone.

With a budget of $10 million and 400 employees, the agency acquired trucks, sprayers, and shovels to wage war on mosquitoes, whose bite transmits malaria. 

CDC Founder Dr. Joseph Mountin advocated for public health issues and for CDC to extend its responsibilities to other communicable diseases. He was a visionary public health leader with high hopes for this small and insignificant branch of the Public Health Service. 

This image was created by Centers for Disease Control and Prevention (CDC) Public Health Advisor, Cleopatra Adedeji, RRT, BSRT, while the CDC’s 2014, Domestic Training Course for healthcare workers was underway. Outside the mock Ebola Treatment Unit (ETU), under the tutelage of CDC Medical Officer, Dr. Satish Pillai (center, behind gurney), and lead by Epidemic Intelligence Service (EIS) Officer, Dr. Mary Choi, this group of three students, was in the process of assembling, and properly disinfecting a transport gurney they had used in this simulated Ebola patient care scenario.
Additional Information:
The 3-day courses took place at the U.S. Federal Emergency Management Agency Center for Domestic Preparedness in Anniston, Alabama. Training participants included physicians, nurses and other providers who were to be deployed to countries affected by the Ebola epidemic, thereby, providing direct patient care. “The primary purpose of the course was to ensure that clinicians intending to provide medical care to patients with Ebola have sufficient knowledge of the disease, and its transmission routes in order to work safely and efficiently in a well-designed ETU.” CDC/ Cleopatra Adedeji, RRT, BSRT, public domain

In 1947, CDC paid Emory University $10 for 15 acres of land in Atlanta that now serves as CDC headquarters. Since then, its focus has expanded to include all communicable diseases, safety, traveler’s health, environmental health issues, prevention of chronic diseases, and to provide practical help to state health departments when requested.

The CDC and COVID-19

Since February 15, 2020, led by Director Dr. Robert Redfield, the CDC has been studying, monitoring, researching, and reporting the status of the SARS-CoV-2 virus and the disease that apparently first entered the U.S. in January 2020, COVID-19. Both the general public, health care professionals, and government officials depend on the agency for up-to-date and accurate information.

Knowledge about COVID-19 grows and changes daily, and what we thought was true yesterday may be far different tomorrow. I have never seen the medical community acquire and apply knowledge about a disease process so quickly in the 42 years I have been in healthcare.

Dr. Mountin and the other professionals who started out with the goal of eliminating the threat of malaria likely never imagined that their future colleagues would face such a formidable foe. The $10 spent on a plot of land in Atlanta is proving to be one of the best investments our country has made.

exploring the HEART of public health

I would love for you to start following Watercress Words : use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn. Thanks so much.

                              Dr. Aletha 

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Pets and their people-together safe at home with COVID-19

But for some people, especially those who live alone, pets may provide much needed companionship and relief of stress and anxiety during this unsettling time.

While sheltering at home during this COVID-19 outbreak, many people are spending more time than usual with their pets. If you spend much time on social media you’ve seen the memes of pets who miss the privacy they usually enjoy when people are away.

But for some people, especially those who live alone, pets may provide much needed companionship and relief of stress and anxiety during this unsettling time.

To date, there is no evidence that pets can spread the virus (coronavirus) to people.

CDC

When animals are more than pets

Dogs have been used to help visually impaired persons for hundreds of years, but now they and other animals assist people with other types of disabilities, as well as provide companionship and comfort.

Besides “guide dogs” who assist blind persons, other categories of animal helpers include

emotional support animals

An emotional support animal (ESA) is a companion animal which provides therapeutic benefit, such as alleviating or mitigating some symptoms of the disability, to an individual with a mental or psychiatric disability. Emotional support animals are typically dogs and cats, but may include other animals.

cat lying on the ground next to green shrubs

service animals

A service animal is any dog that is individually trained to do work or perform tasks for the benefit of an individual with a disability, including a physical, sensory, psychiatric, intellectual, or other mental disability.

Psychiatrist Dr. Vania Manipod, blogger at freud and fashion  explains how these terms apply to psychiatric illnesses in her blog post here-

Therapy Pet-Friendly Guide

In the United States, there is no evidence to suggest that any animals, including pets, livestock, or wildlife, might be a source of COVID-19 infection at this time. However, because all animals can carry germs that can make people sick, it’s always a good idea to practice healthy habits around pets and other animals.

CDC
woman on a horse
a rare experience for me-riding a horse

The Americans with Disabilities Act, ADA, “requires State and local government agencies, businesses, and non-profit organizations (covered entities) that provide goods or services to the public to make “reasonable modifications” in their policies, practices, or procedures when necessary to accommodate people with disabilities. The service animal rules fall under this general principle.”

Other countries may have different laws so if you plan to travel abroad with your animal assistant, you should check the laws for your destination prior to arrival to avoid any problems with your animal’s entry or departure.

Remember that animal assistants are not just pets, they are working; so we should not distract them or interfere with their duties when we encounter them, as this report warns.

Guide dog handlers are urging the public to resist the temptation to pat the working animals regardless of how cute they are.

The Veteran’s Health Administration uses horses to help veterans deal with PTSD.

I know from my own experience with rescued Arabians, who as a breed have a reputation of being easily excited, that they help me be calm and unhurried around them. It is almost as if they provide me with biofeedback and reflect back to me what my own degree of tension might be.

Dr. Hans Duvefelt

Read more at his blog “A Country Doctor Writes”

If Nothing Else Works, Try a Horse

And for some veterans, “living with wolves” saves their lives.

If you are sick with COVID-19 (either suspected or confirmed), you should restrict contact with pets and other animals, just like you would around other people. Although there have been no reports of pets becoming sick with COVID-19 in the United States, it is still recommended that people sick with COVID-19 limit contact with animals until more information is known about the virus. This can help ensure both you and your animals stay healthy.

CDC

For more information about pets and COVID-19, talk to your pet’s veterinarian and refer to the CDC website for recommendations.

If You Have Animals

These two stayed with us while their owner was on a trip. We thought we were taking care of them, but we received just as much as we gave.

And a resource from the American Medical Veterinary Association

SARS-CoV-2 in animals, including pets

exploring the HEART of health with pets

I would love for you to start following Watercress Words : use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn. Thanks so much.

                              Dr. Aletha 

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Answers to your questions about COVID-19

At times you may feel stressed, anxious, have trouble sleeping, or feel afraid. Seek the support of family, friends, clergy, and health professionals. And if you find your anxiety becoming overwhelming, don’t hesitate to contact someone you trust for help. No one of us has to go through alone.

I’ve been posting about COVID-19 regularly on Facebook and Instagram and I hope you’ve been following. If so, this post will be a re-cap; if not, I hope you learn something. Most of this information comes from the CDC, Centers for Control and Prevention, and some from state, local, and private health agencies.

what are the symptoms of covid-19?

symptoms of COVID-19-fever, cough, shortness of breath
COVID19_SYMPTOMS

how can i keep myself and my family from being infected with covid-19?

avoid contact with sick people, do not touch your eyes, nose, mouth; wash hand often
Until we have a vaccine, the single most important prevention is frequent hand washing.

how is covid-19 different from colds, flu, and allergies?

covid-19 vs other respiratory illnesses

What else can we do to stay safe from covid-19?

should we be afraid of covid-19?

MANAGE ANXIETY-DON'T BE AFRAID-BE SMART
managing covid-19 anxiety

exploring the HEART of health by understanding COVID-19

Thanks for reviewing this outline of this new disease that we are all learning about and that has changed our lives so drastically. I appreciate the CDC and other sources for making these easy to understand graphics available.

COVID-19 is a new, serious, contagious health risk that concerns the medical community as well as government, schools, business, religious groups, charities, and private citizens. These communities have banded together quickly to develop plans to manage this threat effectively.

Just like other challenges we face, it can be daunting and sometimes scary; but sometimes that’s when we accomplish the greatest good in the long run.

At times you may feel stressed, anxious, have trouble sleeping, or feel afraid. Seek the support of family, friends, clergy, and health professionals.

And if you find your anxiety becoming overwhelming, don’t hesitate to contact someone you trust for help. No one of us has to go through alone.

I would love for you to start following Watercress Words : use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn. Thanks so much.

                              Dr. Aletha 

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National Doctors’ Day 2020- battling the COVID-19 pandemic

Doctors’ Day 2020 will be somber for not only U.S. doctors, but for physicians all over the world. This year we are all working together against the biggest medical foe any of us have ever faced- the novel coronavirus pandemic

National Doctors’ Day

Did you know there is a national day to honor physicians? In 1990, the U.S. Congress established a National Doctors’ Day, first celebrated on March 30, 1991.

The first Doctors’ Day observance was March 30, 1933, in Winder, Georgia. The idea came from a doctor’s wife, Eudora Brown Almond,  and the date was the anniversary of the first use of general anesthetic in surgery.

an electron microscope image of the coronavirus
used with permission, CDC.GOV

Doctors’ Day 2020

But Doctors’ Day 2020 will be somber for not only U.S. doctors, but for physicians all over the world. This year we are all working together against the toughest medical foe any of us have ever faced- the novel coronavirus pandemic.

March 30 is Doctors' Day

You may not have a chance to honor your doctor in person, but you can commit to doing your part to establish a trusting, respectful relationship with your doctors. It will be good for both of you.

a medical person holding a stethoscope

how to improve communication with your doctors-

Be open and honest about your medical history,lifestyle, and concerns. 

Sometimes patients leave out important information due to forgetting, thinking it’s not important, embarrassment, or fear. But that may be the very piece of data I need to pinpoint what’s wrong.

So tell the doctor

  1. If you can’t do something you’re asked to do
  2. If you can’t afford medication, tests, or treatment
  3. If you are afraid of a test or treatment
  4. If other doctors are caring for you
  5. Your social habits-alcohol use, smoking, sexual behavior

Learn more tips on talking with your doctor here-

How to talk to your doctor to improve your medical care a male doctor holding a tablet

Give details about your problem, explain what you feel

I find that patients often have difficulty describing how they feel. They may say they hurt, cough, itch or get short of breath, but give few details. Maybe because we use  text messaging with its brevity, abbreviations and emoticons. We have forgotten how to use descriptive words.

I don’t think we doctors expect our patients to always recite a rehearsed narrative  about “why I came to the doctor today.” But it does help if you come prepared to answer questions as specifically as possible.

You might try thinking about your problem using the PQRST mnemonic. It will help your doctor identify possible causes for your symptoms, and may also help you understand your problem and even suggest ways you can help yourself.

Find out what PQRST means at this post-

How to tell your doctor what’s wrong with you.

Female doctor looking at an xray
Recognize your doctors are people first

As physicians, our patients’ “social histories” help us understand factors in your life that impact your health -where you live, your job, your family, your hobbies . Besides that, we enjoy getting to know you, especially the things that make you and your life unique and interesting. That feeling can go both ways.

a woman in white coat with mask over mouth

Exchanging a few social words can make the encounter more satisfying for you and your doctor. Some of us will be more open about sharing our personal lives, and some subjects may be off limits. But I don’t think any of us will object to polite,  caring interest in our lives outside of medicine.  

You may cry when you read about a unique doctor-patient relationship in this post-

A simple way to help your doctor beat burnout

Finally, in honor of Doctors’ Day, meet some physicians with unique experiences to share, just a few of the many doctors who work tirelessly to share the HEART of health.

INTERNATIONAL HEALTHCARE

Dr. Kent Brantly awoke feeling ill- muscle aches, fever, sore throat, headache and nausea. As his condition progressively worsened to include difficulty breathing, he learned the cause of his illness- the Ebola virus. Having spent the past few weeks caring for patients caught up in the Ebola epidemic that swept Liberia in the spring of 2014, Dr. Brantly had contracted the disease himself, and would likely die, as almost all victims do.

Continue this story at-

Surviving Ebola, “Called for Life”- Dr. Kent Brantly

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 DISASTER HEALTHCARE

When she applied for a position in New York City at the NYC Office of the Chief Medical Examiner (OCME), Dr. Judy Melinek never imagined that decision would plunge her into the nightmare of September 11, 2001. She was at the ME office that day when the Twin Towers were attacked and fell, killing thousands of people.

She and the other staff collaborated with the team of investigators who worked night and day identifying remains of the victims, a task she vividly describes in the book. This was basically their only job, since the cause of death was for the most part irrelevant, and impossible to determine. Sometimes they had only a small body part, as little as a finger, to extract DNA to identity a victim. Such identification was critical to bring closure to the families who lost loved ones, people who left for work that day, and never came home.

Read more about Dr. Melinek at this review of her book-

Working Stiff: Two Years, 262 Bodies, and The Making of a Medical Examiner- a review of words worth sharing

Meet the 91 year old still practicing physician, whose grandfather was a slave- Melissa Freeman, M.D.

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exploring the HEART of dedicated physicians

Join me on Facebook March 30 through April 3 where I share stories about physicians past and present who share the HEART of health every day.

I would love for you to start following Watercress Words : use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn. Thanks so much.

                              Dr. Aletha 

Top post of 2017- why the increase in autism?

My most viewed post of 2017 was about autism-why the increase?

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.

UNIQUELY HUMAN- A DIFFERENT WAY OF SEEING AUTISM, a book by Barry Prizant, Ph.D.
UNIQUELY HUMAN- A DIFFERENT WAY OF SEEING AUTISM

 

 

 

 

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.

THE SPARK, a book cover; a mother's story of nurturing, genius, and autism
THE SPARK

 

THINKING IN PICTURES MY LIFE WITH AUTISM book by Temple Grandin
THINKING IN PICTURES MY LIFE WITH AUTISM

 

 

 

 

 

 

 

 

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.”

 

 

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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 

 

 

 

 

 

 

 

 

 

 

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