Autism is a complex developmental disorder that appears in the first three years of life. It affects a person’s ability to communicate and interact with others. It is a spectrum disorder, so it affects individuals in a variety of ways. You may see a person with autism who is unable to speak, intellectually disabled, rocking or flapping, or you may see a person with autism who is a highly articulate professor with some behavioral rigidity and social interaction problems, with many variations in between. Autism is a whole body disorder, often with symptoms in the gastrointestinal tract and the immune system. But it is most known as the expression of a differently developed brain.
Autism is the fastest growing developmental disability in the U.S. It has increased 600% in the last two decades (1). 1.5 million Americans are living with autism (2). One in 110 children born today will have autism and 1/70 boys will have autism (3). Autism manifests in complex ways and is often referred for behavioral rather than medical treatment. It lacks the traditional public health model for escalating attention to an epidemic through hospital admissions and outcomes. After decades of basic and applied research, it remains a critical, burgeoning, and misunderstood medical, educational and psychological enigma.
This epidemic within one generation cannot be solely accounted for by genetic causes or wider diagnostic criteria or even increased awareness. Both past twin studies, in which twins have the same genes, but different environments (4), and current research efforts (5) implicate environmental exposures and gene- environment interactions in the development of autism. Researchers are focused on the effects of environmental exposures both on parents and on their unborn child. There is much more work to do to uncover the mechanisms, but the concept is this: developing fetuses, young children and their parents are exposed to many more chemicals now than in the 1970s, when TSCA became law.
The developing brain is exquisitely sensitive to environmental exposures from conception through childhood
Today, to a mother carrying BPA, mercury, phlatates, and brominated flame retardants is born a baby with 200 contaminants already in cord blood (6). The developing brain is exquisitely sensitive to environmental exposures from conception through childhood, and infants and toddlers are often more highly exposed to toxic chemicals by virtue of their small body weight, faster metabolisms, tendency to mouth objects and proximity to the ground, where some chemicals reside in dust. Toys, baby care products, crib mattresses, baby bottles and even nursing pillows are imbued with toxic substances unregulated and untested for human safety as well as for their effect on the developing brain. For example, lead, methyl mercury, arsenic, and toluene have been identified as known causes of neurodevelopmental disorders, yet are poorly regulated, widely available in the manufacturing channels, and not tested in small constant doses or in combination. “In the years since TSCA became law, we have learned that lead, mercury and other neurotoxic chemicals have a profound effect on the developing brain at levels that were once thought to be safe (7).” Exposure to these chemicals at even minute doses during development can cause lifelong effects. Add to this early life constellation: traces of toxic residue in air and water, more viruses, more processed foods, and weakened links in the immune system if one is vulnerable to autism. In some complex combination of insults, little brains reach a tipping point.
Researchers continue to tease out the aspects of this multifactorial breakdown. Meanwhile, we live, breathe and start our families in the presence of toxic chemical mixtures and constant low level toxic exposures, in stark contrast to the way chemicals are tested for safety. In Mind Disrupted (8), a 2010 biomonitoring study from the Learning and Developmental Disabilities Initiative, we tested 12 Americans living near nothing unusual. All 12 showed evidence of toxic chemicals in their blood and tissues: mercury, arsenic, triclosan, BPA, phthalates and more. No one is exempt. Some are more vulnerable.
Failing to remove known neurotoxicants and other harmful chemicals from the delicate and complex autism equation risks severe financial, emotional and social costs long beyond childhood. Families living with severe autism have full time care of a person with disabilities. Parents are exhausted by work responsibilities plus care for a child who often tantrums, stays up all night and tries to bolt from the home. Siblings suffer as family energy revolves around the needs, expenses, appointments and restricted interests of the child with autism. Educational support services end at age 18 and employment options are scarce. Aging parents typically assume lifelong care and support of an adult with autism in the family home for the duration of the parents’ lifetime. The cost to family life, parental freedom, marriages, family budget, retirement savings and home equity is extreme. Autism is the parents’ final concern as they come to us with the request of “What happens to my child when I die?”
Families and government pay the price. Autism supports, services and treatment cost $60 billion annually (9). Services and supports expenses for one person with autism can cost up to $72,000 per year (10). The cost to support a person with autism throughout their life is $3.2 million (11). The cost of special education for a person with autism is 2.1 times that of a neurotypical student (12).
We need chemical policy that protects our most vulnerable citizens. We need to cradle the unborn in an environment safe for brain development and welcome them to a world which removes threats to their healthy continued growth. Because autism is a whole body condition, removing toxic chemicals from the environment of a person with autism also means their persistent medical problems like gut disease, allergies, rashes and seizures may settle to a better quality of life. Improved regulation of toxic chemicals is a progressive and efficient solution expected to impact a devastating, lifelong, publically expensive condition.
References:
- Hertz-Picciotto and Delwiche, “ The Rise in Autism and The Age at Diagnosis,” Epidemiology: 20:1, Jan 2009.
- Based on the autism prevalence rate of 1 in 150 (Centers for Disease Control and Prevention, 2007) and 2000 U.S. Census figure of 280 million Americans.
- “Prevalence of Autism Spectrum Disorders – Autism and Developmental Disabilities Monitoring Network, United States, 2006.” Department of Health and Human Services, Centers for Disease Control and Prevention. Morbitity and Mortality Weekly Report, 18 December 2009.
- Hallmayer et al, “Population Based Study of Twins in California,” presented at INSAR 5/21/2010.
- Hertz-Picciotto and Delwiche, “The Rise in Autism and The Age at Diagnosis,” Epidemiology: 20:1, Jan 2009 and Herbert, “Autism and Environmental Genomics,” Neurotoxicology. 2006 Sep;27(5):671-84
- http://www.ewg.org
- Learning and Developmental Disabilities Initiative, “The Health Report,” 2011.
- http://www.minddisrupted.org
- Autism Society of America estimate based on UK Study by Jarbrink K. Knapp M. 2001 London School of Economics. “The economic impact on autism in Britain,” 5(1): 7-22.
- Michael L. Ganz, MS, PhD. “The Lifetime Distribution of the Incremental Societal Costs of Autism.” Arch Pediatr Adolesc Med. 2007;161(4):343-349.
- Autism Society estimate.
- Autism Society estimated average cost to educate a typical student: $9,688. Average cost to educate student with Autism: $22,500 U.S. Census Bureau May 2007.
