During the next several days, the popular slogan: “April showers bring May flowers” will probably cross the minds of each of us as we begin to pull out our rain boots, umbrellas, and trench coats. April is such a hopeful month because we realize that summer is just around the corner and winter has finally exited the scene for good. We began to anticipate vacations, much needed relaxation, and endless days around the pool and grill. But in addition to all of the fun activities of which April reminds us, it also should prompt us to think about maintaining optimal health for not only ourselves but our families and the community at large.
With that in mind, April is National Minority Health Month. This is the time that we address specific issues plaguing communities of color around the nation. What I would like to do this month is not only discuss health issues for which we are most familiar but to also include conditions where we lack full understanding or those issues for which we have never been exposed.
For example, I was recently speaking with a very well educated African American mother who shared with me how uninformed she felt when her son was diagnosed with autism. She needed to know what it was, how did her son get it, and was it curable or treatable? And keep in mind that for this particular mom this was several years ago when there was probably minimal familial support.
Autism, contrary to the popular internet legends, is not caused by immunizations. The 1998 article in Lancet that reported an association between MMR, (measles, mumps, and rubella vaccine given between 12-15 months of life) and autism was later retracted due to numerous incorrect elements of the study. As a result of that erroneous information, the country saw a sudden dramatic rise in measles cases and more families, unfortunately, were choosing not to immunize their children.
The exact cause of autism is unknown. The cause may be a genetic disorder involving multiple genes. Conditions such as Fragile X Syndrome, Phenylketonuria (PKU) or a mother acquiring rubella during pregnancy are some possible risk factors. Factors associated with an increased risk of autism spectrum disorder (ASD) include male gender and having one older sibling with ASD.
Asperger’s syndrome falls under the category autism spectrum disorder but these children usually have higher cognitive and language skills and they lack a significant delay in self-help skills. They do however have the characteristic impairment in social functioning. For example, a child with Asperger’s may have difficulty differentiating between polite and inappropriate dinner conversation.
Autism is usually diagnosed in childhood after parents have noticed some peculiar behavior in the child, often describing the child as “different”. Common characteristics include:
- Delayed speech development during the first year of life
- Normal development and then regression and loss of skills after the first year of life
- Difficulty with peer relationships once child is school age
- Pattern of behavior or interests is usually repetitive or stereotyped
Some parents begin to notice some signs in infancy such as delayed onset of babbling, lack of eye contact, or lack of recognition of primary care giver’s voice. Autistic infants also may lack certain gestures of communication. In addition, these infants may also lack the ability to utter such sounds as “huh” or “uh oh.”
The treatment of Autism consists of three main categories: non-pharmacologic, pharmacologic, and diet. There has been some evidence to show that music therapy may improve the language skills of children with autism. Anti-psychotics are sometimes used on a short term basis to treat tantrums and aggression. A few small trials did show some limited evidence in the improvement of autistic symptoms with a gluten and casein free diet. However, vitamin B6 plus magnesium, dimethylglycine, and chelation therapy showed no significant evidence in the treatment of ASD.
The CDC estimates that one in 88 children have been identified with an autism spectrum disorder. Boys are more affected than girls by at least five times. In addition, ASD occurs in all racial, socioeconomic, and ethnic groups.
If you are concerned your child could have autism, you should immediately address it with the child’s primary care provider. Please visit the website of the American Academy of Family Physicians, aafp.org, for more information.
Yours in Service,
Denise Hooks-Anderson, M.D.
Assistant Professor
SLUCare Family Medicine
yourhealthmatters@stlamerican.com
