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Today's Family Magazine

Autism: a Q&A with The Cleveland Clinic

Aug 05, 2016 11:54AM ● By Today's Family
By Jamie Lober

A new government survey shows that more than 1 in 45 U.S. children aged 3 and over have autism. Previously, experts estimated that 1 in 68 U.S. children had autism. This has raised some concern in the community and people’s interest in learning about the behavioral health issue has surged. We were also able to sit down with a great autism expert, Dr. Leslie Markowitz, pediatric psychologist at the Cleveland Clinic Children’s Center for Autism, who commented on what has contributed to the rise in diagnoses.

Q. Why has the rate of autism gone up?
It is believed that the rise in autism is due to an actual increase but also better classification. For instance, children or individuals who previously may have been labeled as having intellectual disability or what we call mental retardation may have had autism. We are getting better as professionals and parents are also getting better at being more aware of some of the symptoms, concerns and talking to providers earlier on to help identify kids with autism as early as possible.

Q. Do we know what causes autism?
We know there is a strong genetic link and there are a lot of genes and specific parts of genes that have been identified that likely play a role. We know that a lot of kids who have Fragile X [the most common known cause of inherited intellectual disability] are likely to have a diagnosis of autism for instance. There is also an environmental piece which is more heavily debated among individuals.

Q. Are some people at higher risk?
There is a large amount of research that supports early identification being the key so we want to identify kids who are at risk, meaning those who are born prematurely and kids who have older siblings who have been diagnoses with autism. We want to be more proactive as a medical team in monitoring these kids at 18-months or younger and getting them into services so there are better outcomes.

Q. Are there signs of autism?
It is a spectrum disorder so we look for difficulties with social engagement, social interaction with others, looking at caregivers, interacting, responding to back and forth games, restricted or repetitive behaviors, kids who do odd finger movements over and over or flap their arms. We also look at kids who are rigid or have a hard time with change, or children who have really intense interests. For example, a child who is just fascinated by windmills and will stare at them and as they get older want to read books on them. We also look at the behavioral aspect and the social aspect.

Q. Can kids with autism be successful?
There is a wide range of outcomes depending on not only early intervention, but type of services that are received, quality of services and other factors.

Q. Are there conditions similar to autism that we should look out for?
There are some conditions or diagnoses with similar symptomology like ADHD in really young kids or language delays. There may be a global developmental delay which means that a child is delayed in multiple areas and can be hard to pick apart whether there is a general delay or one that is specific to autism.

Q. Does autism coincide with other conditions and can they be managed?
There are a lot of common comorbidities [presence of one or more additional disorders] with autism, so kids with autism can also be anxious, have difficulties with depression or have language or speech delays. Treatment will depend largely on the child’s age and level of functioning. There is good support that speech therapy can help. There are other specific targeted treatments and interventions that can play a big role in helping these kids.

Q. What do you do if you suspect your child has autism?
If you have concerns, absolutely bring them up to your pediatrician, nurse practitioner or whoever you see on a regular basis for well-child checks. By vocalizing your concerns to those professionals you will be provided with referrals to get your child started in speech services, physical therapy or other things he may need.

Q. What does the future hold for kids with autism?
There is a lot of research going on nationally and internationally to not only figure out what causes it and to look at genetic research, but also look more in depth at interventions that can be done to help these kids and really capitalize on some of their strengths. We want to put them on a path to be the most successful people they can be. I want to emphasize that getting them identified early and started in services is what we know is the most beneficial as far as long-term outcomes.

For questions or to make an appointment, call the Cleveland Clinic Children’s Center for Autism at 216-444-5437.