Autism and Air Quality

COULD AIR POLLUTION BE A CONTRIBUTING FACTOR TO THE RISE IN AUTISM?

As any experienced Job Coach can tell you, working with adults who have special needs can be extremely rewarding and challenging at the same time. Potential behavioral episodes from consumers or clients can range from violent outbursts and seizures to going AWOL and leaving the group without permission for hours where eventually the police may need to be involved. It’s a job where a professional Job Coach is constantly on alert.

One of the areas of supervision that requires great patience and diligence is working with clients who are autistic.

What is Autism?

Autismspeaks.org is very helpful in answering that question.

Autism spectrum disorder (ASD) and autism are both general terms for a group of complex disorders of brain development. These disorders are characterized, in varying degrees, by difficulties in social interaction, verbal and nonverbal communication and repetitive behaviors.

ASD can be associated with intellectual disability, difficulties in motor coordination and attention and physical health issues such as sleep and gastrointestinal disturbances. Some persons with ASD excel in visual skills, music, math and art.

EARLY ROOTS

Autism appears to have its roots in very early brain development. However, the most obvious signs of autism and symptoms of autism tend to emerge between 2 and 3 years of age. Autism Speaks continues to fund research on effective methods for earlier diagnosis, as early intervention with proven behavioral therapies can improve outcomes.

ASD affects over 2 million individuals in the U.S. and tens of millions worldwide. Moreover, government autism statistics suggest that prevalence rates have increased 10 to 17 percent annually in recent years. There is no established explanation for this continuing increase, although improved diagnosis and environmental influences are two reasons often considered.

In the presence of a genetic predisposition to autism, a number of non-genetic, or “environmental,” stresses appear to further increase a child’s risk. The clearest evidence of these autism risk factors involves events before and during birth. They include advanced parental age at time of conception (both mom and dad), maternal illness during pregnancy and certain difficulties during birth, particularly those involving periods of oxygen deprivation to the baby’s brain. It is important to keep in mind that these factors, by themselves, do not cause autism. Rather, in combination with genetic risk factors, they appear to modestly increase risk.

RISK FACTORS

While there is no concrete evidence that air pollution is not the sole or primary cause, there is a growing body of study that increased air pollution is a risk factor.

Cbsnews.com reports exposure to air pollution while pregnant may increase a woman’s risk that her unborn child will eventually develop autism.

Researchers looked at more than 116,000 women to determine whether they were exposed to pollution during pregnancy. They found certain chemicals and pollutants were linked to heightened risk for the neurodevelopmental disease that affects one in 50 U.S. schoolchildren. Exposure to pollutants including diesel particulates, lead, manganese, mercury and methylene chloride has previously been shown to affect a developing baby’s brain, according to the researchers.

They determined women who lived in 20 percent of the studied areas with the highest levels of diesel or mercury air pollution were two times more likely to have a child with autism when compared to children of mothers who lived in the 20 percent of locations with the lowest levels.

Women who lived in the locations with the highest levels of the other pollutants — lead, manganese, methylene chloride and other combined metals — were about 50 percent more likely to have a child with autism compared to women living in areas with the least exposure.

The link between pollution and autism was stronger in boys than girls, but the researchers pointed out there were few girls in the study, so more research is needed to determine if male children are at more risk.

Autism spectrum disorders are about five times more common in boys than girls.

Livescience.com states it is not clear how heavy metals or other chemicals found in air pollution may affect a developing fetus, but studies have shown traffic-related pollutants, such as diesel, can induce inflammation of the brain in animals, the researchers said.

In the study, the researchers looked at 325 women who had a child with autism and 22,000 women who had a child without autism. Using air-pollution data from the U.S. Environmental Protection Agency, the researchers estimated levels of pollutants at the time and place of each child’s birth.

The results showed that women living in areas with the highest levels of diesel or mercury in the air were twice as likely to have a child with ASD, compared with those living in the areas with the lowest levels.

The website Nydailynews.com supports the above findings by adding pregnant women who were exposed to high levels of air pollution were twice as likely to have a child with autism as women who lived in low pollution areas, a Harvard University study reported.

According to researchers, this is the first large national study to examine links between the prevalence of pollution and the development of the developmental disorder.

The findings are published in the journal Environmental Health Perspectives.

For the analysis, researchers isolated 325 women who had a child with autism and 22,000 women who had a child without the disorder.

To estimate exposure to pollutants while pregnant, they used air pollution data from the Environmental Protection Agency, and adjusted for factors like income, education, and smoking during pregnancy.

The analysis found that women who lived in locations with the highest levels of diesel particulates or mercury in the air were twice as likely to have a child with autism as those who lived in the areas with the lowest levels.

Even if these studies are not conclusive they could be an indicator that occurrences of autism may be on the rise and the related governmental and private support systems should be in financial preparedness mode since the individual family’s cost of raising a child with autism is staggering.

A Newyorktimes.com article entitled “Dealing with the Financial Burden of Autism” acknowledges autism trends, treatments and therapies routinely make headlines. Often overlooked, though, is the financial burden for many families with autistic children.

Treatment is extremely expensive. Direct medical and nonmedical costs can add up to as much as $72,000 a year for someone with an extreme case of the disorder, and even $67,000 a year for those on the lower end of the spectrum, according to a study from the Harvard School of Public Health.

That figure includes medical costs like doctor visits, prescriptions and occupational and speech therapy, as well as expenses for things like special education, camps and child care, said Michael Ganz, the author of the study, who is now a health care consultant.

“It can cost $3.2 million to take care of an autistic person over the course of his or her lifetime,” the study said.

Money.cnn.com relates while medical costs, such as outpatient care, home care and medicine, contribute significantly to the total expense, non-medical expenses, including special education, therapy, daycare and care and housing for adults who age out of school and can no longer live at home with their parents, account for the largest proportion of autism costs, according to the study.

Altogether, the total annual cost to the U.S. is estimated to be $137 billion, according to Autism Speaks, as more children than ever before are being diagnosed with autism spectrum disorders, or ASDs.

About one in 88 children in the United States are now affected, according to a recent tally by the Centers for Disease Control and Prevention, that’s up 23% from the CDC’s last report in 2009.

Adding to the severe financial strain, families with autistic children also earn 28% less overall compared to families whose children do not have health limitations, according to a recent report in the journal Pediatrics. For mothers, the disparity is even starker, with earnings that are 56% less than those of mothers of children with no physical or mental limitations.

WHAT CAN BE DONE TO HELP COVER FINANCIAL COSTS?

Please check your insurance coverage for autism treatments. Coverage is not common but improving. Some large employers offer policies that cover treatment, and 15 states have passed laws mandating at least some autism-related coverage. The Autism Society’s Web site lists the relevant states. (That section of the site may still be under construction, but you can scroll down to see the states.)

Some states offer Medicaid coverage for children with autism without taking the family’s income into account; only the child’s diagnosis. This is usually reserved for fairly serious cases but is worth exploring. Remember, nothing ventured, nothing gained.

The above cited New York Times article offers many autism advocacy organizations, including Autism Speaks and the Autism Society of America, are affiliated with local chapters throughout the country. In addition, most states, counties, towns and cities provide lists of local autism resources and support groups.

It is people in the local groups who will know all the resources available. They can also help you keep up with the latest research, so you don’t spend time and money chasing the many unsubstantiated “cures” out there. They will also have lots of practical advice, like which dentists, optometrists and even barbers are good with autistic children.

A handful of organizations like Easter Seals and the National Autism Association offer financial help to struggling families. Autism Family Resources and United Healthcare Children’s Foundation also offer grants to pay for autism treatments.

Please put your tax dollars to work.

The U.S. Department of Health & Human Services provides this information.

The Affordable Care Act contains important provisions for individuals with autism and related conditions and their families. Under the new health care law:
• Job-based and new individual health insurance plans are no longer allowed to deny, limit, or exclude coverage to any child under age 19 based on a pre-existing condition, including children on the autism spectrum. Starting in 2014, these protections will be extended to Americans of all ages.
• New health insurance plans or insurance policies must cover preventive services without cost-sharing, including autism screening for children at 18 and 24 months.
• Insurance companies will no longer be able to impose lifetime dollar limits on coverage. Prior to the Affordable Care Act, many plans set a dollar limit on what they would spend for covered benefits during the time individuals were enrolled in the plan, leaving individuals on the autism spectrum and their families to pay the cost of all care exceeding that limit. The law also restricts annual dollar limits and will prohibit them for new plans altogether starting in 2014.
• Young adults can remain covered under their parents’ insurance up to the age of 26. Already, 3.1 million more young people have been insured through this provision of the new law. For a young adult with autism or related conditions and their family, that means more flexibility, more options and greater piece of mind.
• Starting in 2014, individuals on the autism spectrum and families of children on the autism spectrum will have expanded access to affordable insurance options through new Health Insurance Marketplace and expansion in Medicaid.
• Also starting in 2014, new health plans sold in the individual and small group markets, including the Marketplace, will cover “essential health benefits” to help make sure that health insurance is comprehensive. Health insurers will also have annual out-of-pocket limits to protect families’ incomes against the high cost of health care services.

In our circle of influence we have an associate who has served as a Job Coach and understands the challenges first hand of assisting a client with autism but also understands the Coach has the ability to go home and live a different life. The family involved has to manage the situation over a lifetime.

Female Competition International hopes that this information may be of some help.

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Sources: autismspeaks.org, cbsnews.com, livescience.com, nydailynews.com, huffingtonpost.com, hhs.gov/autism, autismsupportnetwork.com, nytimes.com, money.cnn.com, brainyquote.com, Photos thanks to Wikimedia Commons.