Monday, April 7, 2014

The New Autism for Boys- Where are the real deficits?

        For some time now in our culture, the words “attention deficit” have been liberally applied to children and most predominantly with boys.
The pharmaceutical industry receives billions in profits from child prescriptions that help “manage,” these deficits and disorders. With that “management”, the incidence seems to still be on the rise.
And now we have an astonishing new study and report that says autism in children and particularly for boys has seen a dramatic rise.
Here’s the latest news from the US government’s Center for Disease Control and Prevention
In the U.S. about 1 in 68 children (or 14.7 per 1,000 8 year olds) were identified with what is now called ASD (Autism Spectrum Disorder) in 2013 based on data collected on 8-year-old children living in 11 communities. This new estimate is roughly 30% higher than the estimate for 2008 (1 in 88), roughly 60% higher than the estimate for 2006 (1 in 110), and roughly 120% higher than the estimates for 2002 and 2000 (1 in 150).
Boys were almost 5 times more likely to be identified with ASD than girls. About 1 in 42 boys and 1 in 189 girls were identified with ASD.
The Center for Disease Control does not know what is causing this increase. They say that some of it may be due to the way children are identified, diagnosed, and served in their local communities, but exactly how much is unknown.
About 80% of children identified with ASD either received special education services for autism at school or had an ASD diagnosis from a clinician. This means that the remaining 20% of children identified with ASD had symptoms of ASD documented in their records, but had not yet been classified as having ASD by a community professional in a school or clinic.

In a recent AP article, investigators have said that autism is now used as a diagnosis for a broader array of learning disorders and conditions than it used to be. And that could be a factor in explaining why autism is exploding along with claims we are getting “better” at diagnosing. As with “attention deficit disorder” or “attention deficit hyperactive disorder,” it seems to me that we may run some risks when we create what some physicians have called “garbage can” diagnoses, or the gathering up of a wider and wider pool of symptom descriptions, trying to fit them into one category, then coming up with a one size fits all treatment model based on the new disease category rather than a full examination of an individual boy’s life.
I’d like to take a look at some of the health and social deficits that are affecting boys, that could be at the root of what at least some if not all of the boys behind the new statistics are actually experiencing.

The Nutrition and Exercise Deficit

Obesity is beginning to drop in all populations with the exception of young boys. Faux food (aka junk food) still on school cafeteria menus and predominant in lower income families with less access to whole healthy foods is a known factor in creating the obesity epidemic. Obesity puts many of the body’s systems on overload and creates systemic inflammation that can affect brain function in the young as well as old. Nutritionally empty calories are more dangerous than formerly thought as they can affect brain chemistry leading to social and behavioral problems.
There is a race to create uniform academic standards everywhere but no physical education standards based on the latest research in exercise physiology that I am aware of, at least not one that has gained national recognition and support.

Nature Deficit

This generation of modern industrial world boys spends the least amount of time outdoors than any other known in history. More is now known about some of the health consequences of Vitamin D3 deficits caused by limited exposure to natural sunlight. We know that kids that play outdoors regularly get more exercise. We also know that regular contact with the outdoors and nature has a powerful affect on our brain chemistry and can boost the immune system.

Father Deficit

Dr. Gregory Ramey, Executive Director of Dayton’s Children’s Pediatric Center for Mental Health Resources tells us that 47 percent of kids report that moms are their most influential relationships, compared to only 20% for dads. This may be due in part to the fact that 75% of single parent homes are headed by moms, so these kids just don’t have much access to dads. Even in two-parent families, children have little routine contact with their fathers. Despite a dramatic change in the last 50 years, moms still spend twice as much time caring for kids than dads. Dads are still somewhat of a mystery for sons and daughters.  And kids feel they get in more trouble with dads cast in the disciplinarian role. Even when dads are around, many kids don’t feel connected to them as they don’t seem emotionally available. Children complain about their fathers watching TV, using smart phones or sleeping after a long day at work.

Classroom Deficit

Crowded classrooms still based on the old factory model of education with a lot of seat time and less individualized attention may be at the root of much of what has been diagnosed as “attention deficit” in individual boys. Boys are routinely disciplined more than girls with more attention focused on “bad behavior” and punishment than the fostering of pro-social behaviors. The developmental needs of boys are still poorly understood and addressed in the classroom and on the playground.

So, what can be done to eliminate these deficits and bring our boys back from the brink of these diagnoses, both real and socially constructed?

There is more awareness than ever before about the obesity epidemic with better food available in some chain grocery stores that make available whole healthy real food. Both families and schools are waking up to the vital role nutrition plays in physical and mental health as information is readily available in print and virtually.

Dr. Mark Hyman, MD has clinical experience with eliminating some conditions labeled as autism with non-pharmaceutical as well as non-behavioral management approaches. A pioneer in functional medicine, he and a growing number of physicians are looking to address multiple health and social factors in treating the individual rather than a symptom complex or diagnosis.

Schools with smaller classrooms, state of the art classroom management techniques and refined special education programs that understand and address the whole student stand a better chance of success. Supporting teachers to balance the need for meeting academic standards with the need to address each student on the basis of their passions, interests, cognitive, affective and behavioral skills acquisition is key. 

Nationally and internationally implemented programs such as Healthy Play As A Solution and The Passion-Based classroom derived from The Passion Test for Kids and Teens program can help create nurturing and nourishing learning environments that create more safety, joy, student and teacher satisfaction and achievement.
Providing more school counselors and integrated programs that provide students with close case management by teams composed of educators, classified staff and parents could make a real difference and do where put into practice.

Fathers can provide more emotional support when they are not automatically cast as the bad guys. Consequences for kids can be discussed and implemented by both parents. Dads can turn off their electronic devices and go outside to play with their kids as well as reacquaint themselves and their kids with nature, whether it’s the park down the street or further afield. They can ask more questions and get to know their kids while letting their kids get to know them.

Perhaps the word “spectrum” in the newer term Autism Spectrum Disorder can be even more useful in that each individual child or boy needs to be viewed as somewhere on a spectrum, not of disease, but where he can and is moving toward greater health and function through our more careful examination and engagement with a full spectrum of deficits our society has created that undermines the health and well being of our boys. When we take all deficits into account and correct them, our society will be on the road to bringing up healthier boys who can become healthier, more positively engaged and responsible young men.

Links to references:

Center for Disease Control and Prevention:

"Don't be a Distant Dad" Dr. Gregory Ramey
Dayton Children’s Pediatric Center for Mental Health Resources

Mark Hyman, MD   (Case studies in his book The UltraMind Solution)