To think more people do have autism nowadays?

[malificent7]

Everyone says it's because more people are being diagosed which is true BUT I am waiiting for my assessment , my sdd ( not genetically related) has it and 2 of my close school friends have children with it severely enough so that they can't attend mainstream.
Obviously several members of my family have it as it is genetic but it does seem odd that my 2 close school friends ( who dont have asd) have children with it.

There has been an enormous increase in numbers of children with, or going through diagnosis. We have 11 children with a diagnosis of ASC in our 2 form Reception this year. There are over 50 children across the rest of the school with a diagnosis. I've been teaching for over 25 years and the number of children with ASC is increasing every year.

I think about this a lot. We're very lucky in that we are able to give my son a fairly chilled home life. He goes to school for 8.45 and is home at 3.30. He has no clubs in the week and a 30 min 1-1 swim lesson on a Sunday with a Sen instructor. Before starting school last month he was at a local park nursery 2.5 days a week, with me 1.5 days and with my parents 1 day a week.

We live near my parents and they really "get" him and he adores them. We know he doesn't cope well with loud, busy places so we do stuff like parks, woods, beach. Soft play and supermarkets at "quiet times". At home we bake, build Duplo, do endless Playmobil set ups where we know he already has it all mapped out in his head, right down to which figure always wears the red back pack etc.

He's actually doing really well in school so far, he thrives on the routine and structure. He's very anxious, but they are being amazing at supporting him and building his confidence. I dread to think how he'd be if he had to be in school 10 hours a day or had to rush around to different places every evening. I genuinely don't think he'd cope, but if we had less flexible jobs and/or no support network, what choice would we have?

But many of us getting diagnosed were born in the 60s, 70s, 80s etc and women plan so much better for pregnancy now. They have to with the cost of living. Information re drinking during pregnancy is everywhere and alcohol is soooo expensive. As a population women are not merrily getting pregnant and drinking heavily. It’s also v hard to get pregnant unawares now a days. 🤔

Also possibly because if intervention is early and good quality autistic children don’t fall behind in many areas of development like they might if undiagnosed because they are being taught/getting experiences in ways that work for them, which means there then isn’t a knock on affect on other areas of development. In addition if it’s done in a positive way and they aren’t shamed or made to feel like they are worth less than everyone else then their self esteem will stay high. Whilst there will always be some differences they have learned enough to be able to ‘pass’ eg an ADOS assessment.

I’m not sure if I believe that that is possible, I suspect it is more that unsafe diagnoses are being made at too young an age.

I wonder if there is some element of misdiagnosis of mental health issues in very young children, particularly following covid lockdowns.

IMO, it’s the other way round. Women are misdiagnosed with Borderline Personality Disorder, when in fact their mental health problems are due to struggling their whole life, but especially through school with undiagnosed ADHD and/or autism.

There is a correlation between difficult births and autism.

One theory is that autistic babies can find it harder to get into the optimum birthing position during labour causing more complications with EMCS or assisted births being the outcome.
This one sticks with me as I ended up with a long back to back labour resulting in EMCS with autistic, dyspraxic DS1.

Then again both my labours were back to back (the other was a fairly brutal forceps delivery, and DS2 is dyslexic) but an unrelated factor was my SPD making it very difficult to be mobile in late pregnancy and labour. 🤷‍♀️

DS1 would probably still struggle to find his way out of a birth canal without incident though 😂

Yep, precisely. And correlation obviously isn’t the same as causation.

it reminds me of the maternal obesity discussion. There seems to be a correlation between maternal obesity and neurodevelopmental disorders (which does include autism). One might therefore want to conclude that maternal obesity causes autism.
But individuals with autism and adhd are also more likely to experience obesity / autism and ADHD seem to be risk factors for obesity.

And seeing as ADHD and autism tend to run in families genetics are assumed to be relevant.

A mother with autism is therefore quite likely to also have children with autism. And she is also likelier to experience obesity than a neurotypical mother would be. But that doesn’t mean that obesity causes autism.

inflammation and air pollution (during pregnancy) are also discussed, btw.

=> There is a lot of uncertainty. And we really don’t know…

I agree that it's down to improved awareness and recognition.

I'm positive my DF was ND, along with one of his brothers. I'm on the waiting list for assessment.

One of my late DP's nieces is diagnosed ND. MIL was most indignant, "We've never had anything like that in this family", as though it's something shameful, but the girl's father, DP's brother, has loads of things about him that are consistent with being ND, as did their father. His other daughter is diagnosed EUPD, but I wouldn't be at all surprised if she was actually ND (it's not uncommon for ND to be misdiagnosed as EUPD in girls).

My DIL was working as an STLA, then an ELSA. She reckoned that around a third of the kids in that school were probably ND, but only around 10-15% diagnosed.

Advancing Paternal Age and Autism | Autism Spectrum Disorders | JAMA Psychiatry | JAMA Network

Advancing paternal age and risk of autism: new evidence from a population-based study and a meta-analysis of epidemiological studies | Molecular Psychiatry (nature.com)

Advancing Maternal Age Is Associated With Increasing Risk for Autism: A Review and Meta-Analysis - Journal of the American Academy of Child & Adolescent Psychiatry (jaacap.org)

My 3 kids are in their 20s and all NHS late diagnosed at secondary/ uni with both adhd and ASC. My dd has 2 friends from the same reception class who are also now diagnosed. None were picked up in pre school or reception or even primary school even though I’m pretty sure better informed teachers would pick them up now. Knowledge has improved within the NHS and education. All have struggled massively.

Can't read these at the moment but definitely will later. Thanks for that 🙂

@Bedbugdilemma

I got asked about the birth at my duaghters diagnosis and wasn't sure why that was. Whether to rule out other considtions or if they're seeing a link?

We want to see if there were any drugs/alcohol used during pregnancy (for eg FASD), traumatic birth (eg lack of oxygen), and then consider parental bonding (eg attachment). So looking more for differentials rather than links (as this information is rarely used for research).

Yes I agree with this. My son too is severe. He isn't a bit quirky. I was shocked that we needed to go to panel to agree to specialist in the first place.

It’s talking about the functioning of autistic children being improved with older fathers. You could infer that it’s due to the severity of the autism the child had, ie older fathers produce children with less severe autism (which is somewhat counter-intuitive if older fathers are more likely to produce autistic children) but there is also the possibility that older, more settled parents, are able to provide an better environment, stimulation, resources etc so an autistic child in their care can achieve higher levels of functioning. They mentioned Vineland. That covers everything from getting dressed to socialising.

I could be your mum! I don't think I'm autistic, but certainly neuro-diverse.
This thread has made me think about my school (1970s). I don't remember autism being talked about but there were two boys in my class who were a bit odd. One of them I can see now would be thought of as autistic. The other one thought he was a bus. He would make bus noises walking along, etc. When he was 16. ( I have since learnt that he DID fulfil his dream of becoming a bus driver! One happy man!) So neither of them were unable to function in the usual school, and they were just accepted as who they were, with their funny little quirks.

There are likely many factors but I wonder if the increase in children with very high needs with autism alongside a learning disability and/or physical disability is around better medical care and more children surviving difficult births.

My child had a traumatic birth and probably would have died had it not been for good medical care. He doesn’t have very high needs, but is in special school. He has the highest needs out of all the (undiagnosed) relatives in the wider family. I suspect his presentation is a mixture of genetics and oxygen deprivation at birth. His traumatic birth may partly have been caused by his physical differences (DCD, hypermobility) and he got semi-lucky in that he didn’t die but his birth wasn’t conpletely straight forward so he has some issues on top of the ‘mild’ autism seen in some family members.

It's the widening of the criteria. Like a pp wrote, it would have been people who're on the "severe" end that would have been diagnosed then as "ill". Those whose Autism is 'visible' or easier to notice.

Those who mask, therefore go unnoticed/those who some would say they have "mild autism"/those who some would call "high-functioning", etc would not have made the cut to be diagnosed. They may have been seen as a bit odd, eccentric, strange, weird, too quiet, too shy, too hyper, too disorganised, too rigid about things, etc but not have a "disorder" or condition to be diagnosed.

As the net has been cast wider (helpful for many), more have met the threshold and been diagnosed.

It’s a lot more visible now in schools because of the shut down of lots of sen schools and the push for inclusion. I went to a school for those with autism (and other ND issues) that school got shut down not long after I left and now the default is mainstream with parents having to fight for special schools which I’m not even sure are in the same county

There is probably a number of different factors, my son had a traumatic birth too he was back to back and delivered by ventouse ,he also has a rare chromosome disorder
This is controversial but I think communities that have a high level of interfamilial marriages play a part as any genetic condition, s will continue to be pased on through the generations

@Devilsmommy and @Startinganew32 Here is a link to med research in the USA regarding a slight increase in risk with age. It looked at over 90,000 children. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7396152/

There’s is also fledgling research in to linking an increase due to maternal and paternal obesity being a risk factor. Research takes years and needs multiple studies.

DH was a science researcher though not medical, I have been involved with research as well again not medical but social science. But it means we feel more at ease picking apart data and drawing conclusions.

I am not diagnosed but clearly have many traits, I had hyperplexia, hypermobile joints, very black and white thinking, obsessive behaviour and hyper focussing. I was born much later than my siblings, my Mother was 41 some are 18 years older. Then my Mother remarried and had a child at 45, no traits like mine at all but a different Father. I became Interested about 30 years ago when I was sent on a course for assisting students with disabilities and I sat there thinking hang on I do XY and Z.

Online communities can find each other of all descriptions. Friends DS diagnosed with ASD met a girl online. In the past he would probably have remained single, its going quite well. My friend is hopeful.

I am fascinated by this as I have one child with ASD and ADHD and one neurotypical. I also had a very late (40s) diagnosis of ADHD myself and would likely have got an autism diagnosis if I'd pursued that too. I had just about managed all my life but was a terrible daydreamer at school, always losing stuff, horrendous time management and procrastination. I developed coping strategies for most of those but they've remained a struggle and I've always been very socially awkward which made me almost suicidally unhappy when I was younger. It would never have occurred to my parents in the 1980s that I might be autistic, they just said I was "hopeless" and that they despaired of me (nice).

I was also dyspraxic - my mum did take me to the doctor for that and I was diagnosed with hypermobility which I've later found is often comorbid with ASD. I've always struggled with maths. I can do it but my brain processes it very slowly and the numbers on the page don't always "sound" the actual numbers in my head at first. For example 7, 8 and 9 have the same number value in my head for a split second. I don't know if that makes sense. But I think that probably means Discalcula (spelling?), another comorbidity.

My son was absolutely hyperactive and exhausted me and his teachers at primary age. I probed whether something was "wrong" with him and kept being told he just had a lot of energy, many boys were like this and he would calm down. By the time he was at secondary he was being referred to as "disruptive" . I pushed harder and lo and behold he (eventually) ended up with a diagnosis. In the 1980s he would just have been written off as "disruptive", end of story.

So a lot of the less severe ASD is now being diagnosed which would previously have gone under the radar. I've realised that my dad almost certainly has ASD. He is very odd socially and traumatised by the idea of any change in routine or environment. He's got through life because my mum has dedicated her life to enabling him basically. He retired in his 50s when his work systems became computerised and he couldn't handle it.

So a lot of it will be just better diagnosis, better recognition of different symptoms especially at the less severe end of the spectrum, less stigma about neurodiversity etc.

But I'm interested to hear that there are also many more diagnoses at the more severe end and curious about why that is. I had heard about paternal age being a factor - my husband was 44 when our eldest was born (though he was even older when we had our NT child).

We live in the Thames Valley where there it's a notably higher than UK average of ASD diagnoses. The theory is that there it's a huge IT industry in the Thames Valley which is an industry that attracts many on the spectrum (hope I'm not causing offence, I don't mean to) who then find their life partners in the industry and have children, who are more likely to have a genetic propensity for ASD from both sides.

There will likely be many other factors though which aren't yet known or understood. When my son was little doctors were still saying autism wasn't genetic but the reverse is true now.

Sorry for all the waffle, my hyperfocus got the better of me!

Regarding c sections , I can only speak for myself, but I have two children with diagnosed autism, and they were both natural births.

I think the challenge is that there are so many factors it's hard to separate them.

One big change over the past 20 or so years is the explosion of fertility treatments such as IVF etc. It will be a few years yet before there is any research into medium term effects and then many more years before longer term and intergeneration effects can be studied.

Regarding the increase in autism there is a hypothesis that as ND people are now more likely to get married and have children due to increased understanding and early interventions, and also to be attracted to other ND people the likelihood of their children having autism increases as the gene gets concentrated. It is more likely that all four grandparents will be ND.

this definately

Life is far more stressful than it used to be, far busier, nosier and over stimulated. If you need to reach a threshold before you mentally fall over, that is occurring far earlier and in far greater numbers than it would have done in the past.

Plus there needs to be some really experienced people involved in the diagnosis, as developmental/behavioural conditions and neurodivergence can often present so similarly. With the brain being so plastic it can have some big crossovers, but the support needed for each is very different. Its a real bug bear of mine how specialist schools often lump the neurodivergent and the behavioural in together, which has no benefit and often retraumatises the former group. Its lazy assumptions, going by outward expression of behaviour only, rather than understanding what is driving the behaviour.

I agree that the way our world is much busier and demanding now lhas contributed to the increase in ‘high functioning’ autism being diagnosed in children who might have managed better in the past.

I can see how much busier my DD’s life is compared to my 80s childhood - school seems more pressured, tv programmes are more fast-paced, events and activities are busier and more elaborate… Another poster has mentioned people having more routine lives in smaller communities, so had less to struggle with.

Parental age (fathers, I think) is a factor, and premature birth is also linked - more premature babies survive now compared to decades ago.