Until recently, most scientists believed that autism is caused mostly by genetic factors. But groundbreaking new research indicates that environmental factors may be just as important in the development of autism—if not more so—than genes.
It appears that certain babies are born with a genetic vulnerability to autism that is then triggered by something in the external environment, either while he or she is still in the womb or sometime after birth.It’s important to note that the environment, in this context, means anything outside the body. It’s not limited to things like pollution or toxins in the atmosphere. In fact, one of the most important environments appears to be the prenatal environment.
PRENATAL FACTORS THAT MAY CONTRIBUTE TO AUTISM
- Taking antidepressants during pregnancy, especially in the first 3 months
- Nutritional deficiencies early in pregnancy, particularly not getting enough folic acid
- The age of the mother (children born to older fathers also have a higher risk of autism)
- Complications at or shortly after birth, including very low birth weight and neonatal anemia
- Maternal infections during pregnancy
- Exposure to chemical pollutants, such as metals and pesticides, while pregnant
While more research on these prenatal risk factors is needed, if you’re pregnant or trying to conceive, it can’t hurt to take steps now to reduce your baby’s risk of autism.
- Take a multivitamin. Taking 400 micrograms of folic acid daily helps prevent birth defects such as spina bifida. It’s not clear whether this will also help reduce risk of autism, but taking the vitamins can’t hurt.
- Ask about SSRIs. Women who are taking an SSRI (or who develop depression during pregnancy) should talk with a clinician about all the risks and benefits of these drugs. Untreated depression in a mother can also affect her child’s well-being later on, so this is not a simple decision to make.
- Practice prenatal care. Eating nutritious food, trying to avoid infections, and seeing a clinician for regular check-ups can increase the chances of giving birth to a healthy child.
AUTISM AND VACCINES
While you can’t control the genes your child inherits or shield him or her from every environmental danger, there is one very important thing you can do to protect the health of your child: make sure he or she is vaccinated on schedule.
Despite a lot of controversy on the topic, scientific research does not support the theory that vaccines or their ingredients cause autism. Five major epidemiological studies conducted in the U.S., the UK, Sweden, and Denmark found that children who received vaccines did not have higher rates of autism. Additionally, a major safety review by the Institute of Medicine failed to find any evidence supporting the connection. Other organizations that have concluded that vaccines are not associated with autism include the Centers for Disease Control and Prevention (CDC), the U.S. Food and Drug Administration (FDA), the American Academy of Pediatrics, and the World Health Organization.
WHAT TO DO IF YOU ARE WORRIED
If your child is developmentally delayed, or if you’ve observed other red flags for autism, schedule an appointment with your pediatrician right away. In fact, it’s a good idea to have your child screened by a doctor even if he or she is hitting the developmental milestones on schedule. The American Academy of Pediatrics recommends that all children receive routine developmental screenings, as well as specific screenings for autism at 9, 18, and 30 months of age.
- Schedule an autism screening. A number of specialized screening tools have been developed to identify children at risk for autism. Most of these screening tools are quick and straightforward, consisting of yes-or-no questions or a checklist of symptoms. Your pediatrician should also get your feedback regarding your child’s behavior.
- See a developmental specialist. If your pediatrician detects possible signs of autism during the screening, your child should be referred to a specialist for a comprehensive diagnostic evaluation. Screening tools can’t be used to make a diagnosis, which is why further assessment is needed. A specialist can conduct a number of tests to determine whether or not your child has autism. Although many clinicians will not diagnose a child with autism before 30 months of age, they will be able to use screening techniques to determine when a cluster of symptoms associated with autism is present.
- Seek early intervention services. The diagnostic process for autism is tricky, and can sometimes take awhile. But you can take advantage of treatment as soon as you suspect your child has developmental delays. Ask your doctor to refer you to early intervention services. Early intervention is a federally funded program for infants and toddlers with disabilities. Children who demonstrate several early warning signs may have developmental delays. They will benefit from early intervention whether or not they meet the full criteria for an autism spectrum disorder.