The Rise in Autism's Prevalence

All over the news today is the CDC's reported findings of a significant rise in the numbers of children being diagnosed with autism - 23% in cases from 2006 to 2008 and 78% since 2002. The incidence is now 1 in 88 children, and with boys, who have five times the rate as girls, the incidence is a shocking 1 in 54. Some of this is due to better diagnosis and increased overall awareness, so parents are more likely to request an assessment regarding concerns of their child. Hopefully, this new research will lead to some kind of standardization of diagnosis, so there will be fewer children being denied the important services they need and deserve. There is no question that this is an epidemic, yet there still is no real understanding of the causes. It is very frightening and certainly would give young people pause in their family planning.

It is good that research is finally focusing more on the relationship between genes and the environment rather than just genetics. Unfortunately, there are no medical interventions to date; the only intervention is educational. And the reality is that services are lagging sorely behind. There is so much to be done. The world is not at all equipped for this phenomenal number of children coming along. http://yourlife.usatoday.com/health/story/2012-03-29/CDC-Autism-is-more-common-than-previously-thought/53856542/1

The Toll of Caretaking

Two weeks ago, our small community experienced a horrific tragedy with the murder-suicide of a mother and her autistic adult son. Although we can never speculate as to the mindset of any another person, I believe we can likely assume that the stress of caregiving may have played a part in this very sad event. At a grief counseling session with the parents shortly after this tragedy, many there spoke of their own excessive anxiety and stress levels. They expressed understanding of how it was possible that a parent could be driven to do something so drastic. 

There are so many stresses in caring for a child with autism. Mixed in with a parent's constant sleep deprivation, frustration, loneliness, and frequent isolation is the worry of who will take care of their child when they die. These parents know that their kids are not easy to live with. Who besides a parent can love a child unconditionally and tolerate all their behaviors and quirkiness?  Parents also recognize with brutal clarity how vulnerable their child is to exploitation and even abuse, especially those who are on the more involved end of the autism spectrum. 

In most situations, it is the mother who is the primary caregiver and often must forego the opportunity to work outside the home or maybe only allow for part-time employment. Women typically have a difficult time admitting or even recognizing that they may be under insurmountable stress in the best of circumstances. Compound that with the additional problems of caregiving and we may have an insight into the kind of 24 hour on-call life these parents experience. But women are not the only ones stressed. A child who requires constant supervision for safety, hygiene and overall health will tax the emotional resources of an entire family.

As the caretaker, the parent does not have much time to reflect on what the future holds. They tend to take on each day one at a time. But certain milestones will force awareness of the passage of time – as children of family friends get their driver’s licenses, go away to college, marry. All are reminders that these are not the cards the family of the person with autism has been dealt. When a parent actually takes a moment to process this information, it can be overwhelming. When will it ever end? Will it ever end?

Some possible lessons learned from this tragedy are that we have all have to help one another, especially keeping in touch with other parents who really know the day to day struggle. Also, as those of us who work with these students, we would want the parents to know how very much we care for all of them – students and their families. Our staff was so significantly devastated by this sad and shocking event, it surprised the family completely.  Would that we had known! It is in our nature to want to help, so take advantage. And should a child be placed in a group home, we would watch very carefully to look for changes in behavior, food, dress, anything that might alert us or the parents that something may be amiss. Yes, it would be different, and it would never be the same or replace home, but that doesn’t mean it is not a reasonable option to allow parents to experience their child in a different way.

We miss the two who died tremendously and think of them with very heavy hearts. My only hope is that others will pay more attention to families who are struggling and even check in on those who seem to be doing fine. Because we all know caretaking for a person with significant disabilities is not at all easy.

A Convergence of Autism and Alzheimer's

Those of us immersed in the world of autism know that the numbers of children receiving that diagnosis are truly increasing, and likely will continue even with the upcoming changes of the DSM-V. Providing the education, housing and overall assistance that the families and these children require will cost everyone - and lots! There simply is no inexpensive way to educate these kids short of denying them services. And that may be a by-product of the new DSM-V; eliminating some of the previous categories of people who fall under the 'spectrum' label and thereby not providing them the services they need. Nonetheless, the lifetime expense of a person with autism are significant, with education and housing particularly driving the costs.

However, at the same time we are seeing the incidence of autism rising, we are also hearing much about the impending tsunami of baby boomers approaching old age. As older people are much more likely to suffer strokes, heart disease, Alzheimer's, etc., their disabilities will also demand increased funding to pay for services. And we are living longer. This convergence of two very costly groups should be at the forefront of policy makers' agendas. But I certainly don't hear much about it other than notice that both populations are increasing in size. No mention of how we will be able to pay for all this.

How will we be able to care for all these people and make the services more cost effective? Certainly the focus on healthy life styles is important as it may keep older people healthier longer and out of the system. For people with autism, I think it is critical to not view them as 'consumers' but as people who can participate and contribute in their local communities. The more opportunities they have to both volunteer and even work, the better. As the rest of the community becomes more familiar with people with disabilities, they are more likely to tolerate the differences people with disabilities display. Everyone will benefit, including older people. Yes, it is a Pollyanna way of looking at things, but I'm not sure what else can be done until there is a true understanding of what the issues are that we all are facing.