Health Wanted: Autism
HEALTH WANTED, a weekly radio show and podcast produced in partnership with WABE, brings need-to-know public health headlines and breaks down the science behind trending topics.
The Episode
The topic: Autism spectrum disorder (ASD) is a neurodevelopmental disorder that affects how people communicate, learn, and interact. This week on Health Wanted, host Laurel Bristow and guest Daniele Fallin, PhD, talk about ASD and what could be behind its rising prevalence across the world.
The takeaway: ASD affects individuals in different ways, and everyone with autism is unique and experiences the disorder differently. Providing support and open communication can be key to helping individuals with ASD lead healthy, fulfilling lives.
- Symptoms and experiences of autistic people vary widely. ASD encompasses a wide range of traits and abilities, from those who need daily support to those who function independently. In general, ASD is characterized by having social challenges, repetitive behaviors, and sensory sensitivities.
- ASD diagnoses have increased recently, which is likely primarily due to improved recognition and diagnostic tools, and secondarily due to an actual rise in cases. Researchers are not sure why ASD is rising, but it may have something to do with more people having children later in life, which is known to increase the chance of ASD, genetics, or environmental exposures during early gestational development.
- Despite persistent myths, there is no scientific evidence linking vaccines, especially the MMR vaccine, to ASD. The origin of this misconception stems from a discredited 1998 study, and extensive research since then has found no credible connection between vaccines and ASD.
- Media portrayals of autism, though often well-intentioned, can sometimes perpetuate harmful stereotypes. Shows like Love on the Spectrum and The Telepathy Tapes have faced criticism for oversimplifying or misrepresenting the experiences of autistic individuals, focusing on “special abilities” or framing autism as something to be “overcome,” rather than embracing neurodiversity.
The Interview
The guest: Daniele Fallin, PhD
The key takeaways:
- The rise in ASD diagnoses in the U.S. is partly due to increased awareness and reduced stigma around the disorder, which makes more people comfortable seeking diagnoses. There has also been a global increase in ASD diagnoses, though the exact cause remains unclear. Theories like increased parental age and environmental factors have been proposed, but they have not yet been proven with scientific evidence.
- The criteria for diagnosing ASD continue to evolve, and there's no single test for it. Diagnoses are based on careful observation and interviews, which rely heavily on the skill and experience of the evaluators. While there has been some progress, improving standardization and improvement in diagnostic practices is an important area of further development.
- Early interventions such as behavioral therapy, occupational therapy, and educational support systems have proven beneficial for autistic children’s development. Increasingly in the workplace, employers are working to create accommodations so that autistic people feel more comfortable and supported at work.
- Autistic people often face greater physical and mental health challenges, yet health care providers are not always equipped to support them effectively. This gap in care leads to poorer health outcomes for autistic people, emphasizing the need for more awareness in the health care community surrounding the health of and communication with neurodiverse patients.
The Listener Questions
Is H7N9 a new type of bird flu?
H5N1, H5N9, and H7N9. There are so many bird flu possibilities, which is unsurprising as there are around 16 H types and nine N types so there are a lot of available combinations.
But we have seen this H7N9 version before. It first emerged in China in 2013, infecting both humans and birds and unfortunately, again, had a very high fatality rate for the human cases that were recorded.
This is the first time we’ve seen an outbreak of this particular strain since 2017. It was detected on a farm in Mississippi and the birds were “depopulated” which is a nicer way of saying the flock was culled, which is a nicer way of saying “all the birds were killed.”
Again, this strain does not currently have mutations that make it more transmissible to or between humans, so hopefully, like the H5N9 outbreak we saw in California ducks earlier, this is a contained incident of a wild bird infecting farm birds and not evidence of widespread infection.
Brooke Rollins, the secretary of agriculture, announced a $1 billion plan to “reduce the price of eggs.” Some of the proposed items are good, like funding to help improve biosecurity on farms and grant money for vaccine development.
Some of the items are less great, like reducing regulations. One example of a regulation to do away with is a California proposition that sets minimum space per chicken requirements. The idea would be that farmers can then cram more chickens onto a farm, but that’s a great way to spread a virus.
The biggest issue, though, is that this is, as stated, a plan to reduce the price of eggs. It’s not a plan to stop the spread of bird flu. It makes no mention of how to address infections in dairy cows, or wild animals, or plans to respond to a potential increase in human cases.
It’s a start, but still missing the mark for addressing a disease with such high pandemic potential.
How does genetic testing impact insurance policies and how preventative screenings are treated for those with increased cancer risk?
In 2008, the Genetic Information Nondiscrimination Act was passed, which prevents discrimination based on genetic information in both health coverage and employment.
This means that your health insurance can’t use genetic information when making decisions about coverage or eligibility. However, this does not apply to life insurance policies, which is why people need to get one before being tested to see if they are at increased risk for a condition.
But, just because health insurance companies can’t deny you coverage because of genetic information, doesn’t mean they have to consider it when approving the services they pay for.
This is why, even though your doctor and the CDC can both recommend that you need increased or different screening, whoever is reviewing your claims might not have the medical expertise to realize the benefit, or they are simply following the company’s algorithm which says you should be denied.
It might make sense for them to approve and cover these screenings to catch cancer earlier, but maybe they’re gambling on the fact that an increased risk isn't a guaranteed risk and if you even get cancer then they paid for all those screenings for nothing. It’s unclear.
There’s a lot about how insurance in this country operates that doesn’t make sense, which is why 73 million in-network insurance claims were denied in 2023.
Catch all the listener questions and Laurel’s answers on the full episode of Health Wanted by:
- Streaming at wabe.org or the WABE app
- Subscribing on Apple or Spotify
- Watching on WABE's YouTube channel
