Reducing the risk of autism or its severity
Our infant is at very high risk for autism. Based on available evidence, we want to widely share what have done to potentially help him (see list in Figure 1). Since birth, this has included extensive eye contact, back and forth communication and play (Rogers 2010 & 2012). Importantly, he has also had < 2 minutes of screen time per day and no background TV or other similar exposures (AAP, WHO).
​
There are a number of factors reported that may increase or decrease the risk of autism (e.g. Gialloreti 2019). The research to determine which interventions are effective has not yet been done, but several of the factors can be effectively addressed.
We did our best to identify and do everything possible for our baby based on current evidence (Figure 1). Even if autism was not preventable in our son, our interventions were also done to reduce its severity if he has it. Our approach has huge potential benefit and no known risks.
​
Screen time and air pollution reduction are two examples of correctable risk factors. A growing body of evidence links screen time exposure at an early age to symptoms of autism symptoms (Hefler 2020, Slobodin 2019) and reversal of symptoms when it is stopped (Harle 2019, Sadeghi, 2019). Air pollution has been reported as a risk factor in several studies (Gialloreti 2019). One type of pollution (PM2.5) can be readily corrected by filtering air and using face masks. There are several other factors associated with autism (e.g. Gialloreti 2019). We are taking action with each possible risk we can correct in our son’s in environment (Figure 1).
I believe all children at high risk, and ideally all children, should have all environmental risks identified and corrected if possible. The approach should also include close developmental monitoring, teaching of skills and a plan to “Act Early” if milestones are missed or other warning signs develop.
​
1. Extensive eye contact, communication and play
2. No screen time, background TV, etc.
3. Perinatal vitamins, iron, omega 3/6
4. No potential toxins during pregnancy (e.g. drugs)
5. Vaccines up-to-date, maternal influenza vaccine
6. Breast feeding
7. Filtered air for pollution reduction
8. Closely tracking development
9. Teaching skills at the right time
10. Prepared to "Act Early"
​
Screen Time Limits
All children should have screen time limits. Screen time has no benefit for young children and has clear risks. Screen time is associated with many adverse effects, including developmental delay, behavioral problems, obesity and more (e.g. AAP, Slobodin 2019). The body of evidence about the risks is large and is continuing to grow. Leading authorities recommend limits (AAP, WHO):
​
-
< 18 months, NO screen time (includes no background TV or similar exposures)
-
2-5 years, < 1 hour/day of parent supervised high quality programming
-
>5 years, consistent limits
Our 14 month-old has 2 minutes/day (to communicate with grandparents). Our 4 year-old has about 20 minutes per day (talking with grandparents and learning from family pictures/videos).
Development Monitoring and Support
I believe all children deserve to have their developmental milestones tracked starting at birth. We have been using the US CDC milestone tracker (Act Early). Had we understood and used this for our son with autism, we would have intervened much earlier. We are using other tools such as MCHAT-R/ASQ3 (available at A365.vn) and the Early Start Denver Model check list in combination. Based on when our son should be reaching a milestone, we teach it if it is not already present. Example early milestones include pointing, responding to name, playing peek-a-boo, and identifying body parts.
Act Early - Early Intervention
When a child misses milestones or has unusual behaviors, it is time for immediate action. Rapid action leads to better outcomes!!