Zorba Paster: Thinking evolves on autism treatment, causes

Autism certainly is difficult – for the child, for the parent. Anything we can do to decrease it would be welcome.

But first, class, a brief lesson: Autism is defined as a neurological developmental disorder that interferes with a child’s ability to communicate with others. In addition, those with autism usually make repetitive movements, such as rocking.

Children, and adults, with autism usually restrict what they like, from food and entertainment to social activities and athletics. The result can be a serious impairment in all kinds of functioning, including school and work activities.

Any parent who works with their autistic child – and my hat is off to all of them – knows the trials and tribulations that go with the diagnosis. It requires work and love, lots and lots of love.

Autism is a spectrum, with the mild cases often called Asperger’s syndrome, a term that’s falling out of favor because it implies that this is a separate problem. Most psychiatrists and neurologists would say it’s part of a continuum.

We know that intensive treatment and ongoing care can make a huge difference in how an autistic child develops into an adult. What we don’t know is what causes it in the first place. We know that autism affects 1 percent of the population, but we don’t know why, or what the risk factors are.

Note: Those who believe in the ideas of that now-discredited British doctor who forged data suggesting immunizations were the cause of autism are absolutely wrong. If you’re one of those parents who thinks you’re doing the right thing by keeping your child from getting his or her shots, you are believing in science fiction, plain and simple.

So, it’s back to the drawing board – but there is hope.

When Penny and I first had our kids, we put them to sleep on their tummy, thinking that if they vomited they might choke and die. Little did we know that we were putting them at risk for sudden infant death syndrome. We now know that “back to sleep” for infants is the idiom that does the trick.

Just as that thinking has evolved, so too is it time to start looking for associations that might be linked to autism. That’s why a recent study published in the Journal of the American Medical Association is so interesting.

Researchers looked at the records of nearly 3 million babies born in Sweden from 1982 to 2010. They found that being born by Cesarean section was associated with autism at a 22 percent increased rate.

But before jumping to conclusions about a cause-and-effect relationship, let’s look a bit deeper. Maybe it’s the surgery, or maybe the anesthesia used during a C-section. Perhaps other medications used during the operation are a factor.

Or maybe, just maybe, children with autism are more likely to require birth by C-section. Maybe the need for a C-section is a signal, not a cause, of autism. Maybe autistic babies just get into trouble in the womb and need surgery to get out alive.

There are great big questions that need to be answered. Given that we now have great big data from the advancement of electronic medical records, we might just be able to make even more determinations and decisions.

But until all the answers are found, we’ll keep on searching. Stay well.

Dr. Zorba Paster is a family physician, professor at University of Wisconsin School of Medicine and Public Health, and host of the public radio program “Zorba Paster on Your Health,” which airs at noon Wednesdays on 91.1 FM, and noon Sundays on 91.9 FM. His column will appear twice a month in The Spokesman-Review.