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We're autism aware. Now let's talk prevention.

Kristin Schafer's picture
Kristin Schafer
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AutismEach year we mark national Autism Awareness Month with an update on how many children officials say are now on the autism spectrum. We highlight the latest science linking prenatal pesticide exposure to increased risk. And we make an urgent pitch to shift from awareness to prevention.

Well, once again the numbers are up. CDC reports that 1 in 68 children are now on the autism spectrum, up from 1 in 88 in 2008 and 1 in 150 "way back" in 2002. And once again, new science links certain chemical exposures to derailed fetal brain development — with an ever clearer understanding of how the damage is done. The good news? When it comes to talking prevention, there's been real progress.

The conversation is shifting — if slowly — toward the question of what can be done to bring rates of autism back down. It's a daunting task, given the dramatic nature of the upward trend. Thirty years ago, 1 in 2,500 children were affected.

30 years ago, 1 in 2,500 children were affected by autism. Today, it's 1 in 68.

To be clear: when we talk about focusing on prevention, we're not talking about what a pregnant woman can do to reduce the risk of autism for her child. This puts a heavy and unreasonable burden on expectant mothers, who are already overwhelmed with a boatload of anxiety-causing "shoulds," "dos" and "don'ts."

No, we're talking about making changes that reduce the risk of autism for all children, across the board. And while there's still plenty of research to be done on the complex causation of the neurological disorder, there's widespread agreement that some combination of genetics and environmental factors is at play.

Brain-safe environments

We can't do much to change genetics, but when it comes to chemicals we have choices.

So while researchers are figuring out the details, an important first step toward autism prevention would be getting those pesticides and other chemicals that scientists tell us can derail brain development off the shelf and out of the mix. 

A pair of public health scientists recently made a strong case that our children's brains are under threat from chemical exposures — and that by failing to act, we're putting an entire generation at risk.

In their review of the latest studies on neurodevelopmental harms, Dr. Philippe Grandjean and Dr. Philip Landrigan identify a list of chemicals that have been found to interfere with brain development, and that are likely contributing to today's "silent pandemic" of learning disabilities and disorders.

These scientists are proposing a global prevention strategy that includes testing chemicals for their neurotoxic effects — and taking action to prevent exposure.

Grandjean is chair of environmental medicine at the University of Southern Denmark and an adjunct professor at the Harvard School of Public Health, and Landrigan chairs the department of preventative medicine at the Mount Sinai School of Medicine in New York City.

The urgent call for preventative action from these health professionals is powerful — and refreshing.

The fetal brain, unveiled

Meanwhile, the BRAIN Initiative launched by President Obama on last year's Autism Awareness day is gaining steam. To mark the one-year anniversary of this ambitious project, researchers released the online "BrainSpan Atlas," a tool mapping the stages of fetal brain development.

Through the brain mapping project, scientists are learning what part of the brain is linked to autism, what genes are controlling brain development during pregnancy, and how expression of these genes can be disrupted in ways that lead to neurological harm.

A recent study in the New England Journal of Medicine found that in the brains of children with autism, genetic markers were missing in brain cells. Researchers say this shows that the prenatal "crucial early developmental step" of creating layers of the brain with genetically specific types of brain cells had been "disrupted."

The study doesn't say what may have caused such disruption, but it does seem scientists are honing in on the right questions.

Turning the tide

Later this month, the National Institutes of Environmental Health will host a "virtual forum" on autism and the environment, a public conversation with researchers exploring the links between chemicals and neurodevelopmental harms.

The event is Tuesday, April 22nd, at 11am pacific. I'm planning to tune in, and invite you to join me — you can register here, and submit questions before and during the webcast online or via twitter (@NIEHS, #autismforum2014).

Yes, I've been accused of being relentlessly optimistic. But I truly do believe the conversation about autism is shifting. While there's still a clear need to raise awareness and invest in helping children on the autism spectrum reach their fullest potential, there are hopeful signs that we're also ready to invest in turning the autism tide.

Take Action »Want to add your voice? Take PAN's Healthy Kids! pledge, and get the tools to start a conversation about pesticides and children's health in your community.

Photo credit: CTRPhotos/iStock

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jimdiamond wrote:

Thanks for this timely and important article.  I applaud the emphasis on prevention but I’d like to point out that often, things that cause a problem in the first place may also exacerbate an existing problem.  For example, heavy metal poisoning (lead, mercury, etc.) can cause neurodevelopmental problems but can also affect adults.  It follows that when we learn how to prevent a problem – in this case, autism – we may also gain an insight in how to treat it.  I hope parents of autistic children, stressed as they are, don’t tune out of this conversation about prevention, because the science of prevention may also open windows for improvement of those already affected. 

Pesticides, because of the thousands of tons applied, are among the most important toxins in our environment and a good place to look for causes of the increase in autism.  (We’re making an effort in that direction at www.mappingautism.com .)  We hope that parents won’t sit on the sidelines as if diagnosis is destiny.  Involved parents are a mighty force which has had major impact on children’s health in combatting other medical conditions such as childhood leukemia, cystic fibrosis and epilepsy.  They’re stressed, but their involvement will help us move toward our goals of a healthier people on a healthier planet. 

Thanks again,

Jim Diamond, M.D.