Read | Permalink | Email this | Comments

Permalink | Email this | Comments

A number of emergency room visits are for mental reasons. Credit: Corbis

Read | Permalink | Email this | Comments

Imagine dealing with the vacillations and contradictions of someone else's bipolar disorder when you're a kid. Credit: Getty Images

Read | Permalink | Email this | Comments

Parenting a child with autism raises many questions. Credit: Corbis

Permalink | Email this | Comments

People who are both epileptic and autistic have an 800 percent higher chance of dying than people who just have one or the other. Credit: Getty Images

Read | Permalink | Email this | Comments

Credit: Getty Images

Permalink | Email this | Comments

Studies show a link between migranes and heart defects. Credit: Getty Images

Read | Permalink | Email this | Comments

Permalink | Email this | Comments

Next fall, kids with asthma may be able to put down their inhalers and pick up a new asthma treatment. Credit: Getty Images

Read | Permalink | Email this | Comments

Ellen and her son Max. Courtesy of Ellen Seidman.

Permalink | Email this | Comments

Just because you've been waiting the longest doesn't mean you'll be the first donor organ. Credit: Leon Neal/AFP/Getty Images

Permalink | Email this | Comments

Kids with autism learn life and business skills by running their own coffee shop. Credit: Getty Images

Permalink | Email this | Comments

Permalink | Email this | Comments

There appears to be a big drop off in the use of services for young adults with autism after they graduate from high school. Credit: John Dowland, Getty Images

If your child has been identified as having an autism spectrum disorder, you're likely well aware of the range of medical, mental health and case management services available to help meet your family's needs.

However, the use of these autism support services by young adults with spectrum disorders appears to decline after high school, according to a report published today in the Archives of Pediatrics & Adolescent Medicine.

The number of young adults in the U.S. with an autism spectrum disorder is rapidly increasing as ever-larger groups of children diagnosed with the condition are now getting older and passing through adolescence, according to background information cited by the authors.

The authors note this trend is especially visible in special education enrollment figures, where the number of students aged 12 to 17 years classified in the autism eligibility category increased dramatically from 15,480 in 1998 to 99,893 in 2007.

Though it is unclear whether this surge in numbers reflects an actual increase in children afflicted with autism spectrum disorder or an improvement in diagnostic practices, the authors say the distinction need not be addressed in the current study.

"Regardless of the root cause, the facts remain that treated prevalence is increasing and that the implications of this trend for service systems are poorly understood," the authors write.

The data was taken from a nationwide telephone survey of parents and guardians of young adults, aged 19 to 23 years, who have an autism spectrum disorder; the survey was conducted from April 2007 to February 2008.

The report revealed the rates of service use ranged from 9.1 percent for speech therapy to 41.9 percent for case management. Other services utilized by survey participants included medical services (23.5 percent) and mental health services (35 percent). Strikingly, over 39 percent of youths in the survey had not received any of these surveys.

The rates reported for the young adults included in the survey are lower than figures gathered six years earlier, when all the patients polled were still in high school. At that time, 46.2 percent received mental health services, 46.9 percent received medical services, 74.6 percent were getting speech therapy and 63.6 percent reported having a case manager.

The authors also found that African American youths were three times less likely than white youth to receive any of the services in question, and families with incomes of $25,000 or less were nearly six times less likely to receive any services when compared with those making $75,000 or more.

In addition, those making $25,000 or less were nearly six times less likely to use case management services, compared to those with incomes of $75,000 or greater.

"Rates of service disengagement are high after exiting high school. Disparities by race and socioeconomic status indicate a need for targeted outreach and services," the authors conclude. "This study represents an important step in the process of building a foundation of evidence that can help improve services and foster independence and health among youths with autism spectrum disorders."

Want to get the latest ParentDish news and advice? Sign up for our newsletter!

Permalink | Email this | Comments

c

Food allergies could be causing your child's ADHD symptoms. Credit: Achim Sass, Getty

Permalink | Email this | Comments

Ryan Lamantia loved Spider-Man. The boy died, but his heroic spirit lives on. Courtesy Mary Lamantia

Walter Wetzel hugs Sarah Lamantia as her father, Todd, watches on January 5, 2011, in Lake in the Hills, Illinois. Wetzel, who has been in remission from Leukemia for four years, visited the Lamantias to tell them their son Ryan inspired him to battle his illness and survive. Credit: Keri Wiginton, Chicago Tribune / MCT

Permalink | Email this | Comments

Pregnant women living near freeways were almost twice as likely to have a child later diagnosed with autism, the neurodevelopmental disorder characterized by deficits in social interaction and communication.

The freeway hypothesis sounds reasonable: Pollution bad and fetuses fragile, alas, autism.

What better place to test it than California, land of abundant freeways, environmental awareness and celebrity autism activist Jenny McCarthy. Our freeway study comes from a larger project on the origins of autism, CHARGE -- The Childhood Autism Risks from Genetics and the Environment Study. The researchers pulled data out for over 500 preschoolers around Los Angeles, Sacramento and San Francisco. Then they calculated how far the mothers lived from a freeway or major roadway at each trimester in pregnancy. The children whose mothers lived the closest to the freeways during the third trimester were 86 percent more likely to be diagnosed with autism.

Sounds alarming.

But notice third trimester. It wasn't any riskier near highways in utero during the beginning or middle of pregnancy. I bet the researchers checked several other time periods (e.g., before pregnancy, after birth, each month thereafter). This report only includes the trimesters so I suspect the others didn't pan out. Nobody holds back significant results that bolster their case.

Now look at closest. These kids were gestated less than one-fifth of a mile from freeways. They were more at risk than those almost a mile away. But here's the weird part. Living near a heavily-traveled road, which might include a freeway, didn't raise the risk. How close? Within 46 yards. That's less than the width of a football field, from say produce to poultry at the supermarket. Apparently sleeping on the shoulder of a major roadway is not any riskier. Freeway pollution from a further distance seems more harmful than major road pollution practically in your bedroom. Doesn't make a lot of sense.
!--START POLL CODE-->


Maybe it's simply a matter of traffic volume and thus freeways producing more traffic and air pollution.

Air pollution.

Study didn't measure it. Not around freeways, neighborhoods or wombs. Nor the level of traffic, noise or population density. What do we often find next to interstates around urban areas? Apartment buildings, condos, and housing developments. That's plenty of people per square mile. If lots of folks live near highways we can't be surprised to find more kids with autism too.

We need to know more about the origins of autism, but, I'm always wary when data get pulled from larger studies. A wealth of numbers and such means it's easier to find significant results. With each analysis there's an increased chance of a false positive, in other words, a freak significant result. It's an epidemiological grab-bag, a fishing expedition. Oh look, we got one!

I'm also suspicious because there's only one significant result. Throw in the lack of higher risks nearer the major roads, the missing estimates for air pollution and population density and I'm not convinced this research is on the right path, road or route. It's messier than the 101 at rush-hour.

My advice? Don't start packing yet if you live just off the interstate.

Permalink | Email this | Comments

A note from a 10-year-old boy lies in the memorial for Rep. Gabrielle Giffords outside her Tucson, Arizona, office. Credit: Gina Ferazzi, Los Angeles Times/MCT

A columnist in the Philadelphia Daily News asks the following: "At the risk of sounding harsh, how could the parents of accused shooter Jared Lee Loughner have missed so many signs that their son was a major safety threat?"

Permalink | Email this | Comments

There was a terrible thing that happened in Arizona last weekend. A terrible thing.

The person who caused that terrible thing to happen appears to suffer from some type of serious mental illness. Things this person had written, which were nonsensical and bizarre, spread like wildfire, thanks to their easy accessibility on the Internet. Former friends and classmates shared stories of odd behavior. Then, like clockwork, many in the media began tossing around words like "crazy people" and "nuts" and "lunatic" and "madman."

Did they talk about the mental health system? No. Did they share statistics on mental illness and violence? No. Did they think twice about how their words might prevent people from seeking help? No. The media never give a second thought to furthering stigma.

They speak as though violence and mental illness are directly correlated. They aren't. As Vaughan Bell explained in his piece on the Arizona shooting on Slate.com, " ... your chance of being murdered by a stranger with schizophrenia is so vanishingly small that a recent study of four Western countries put the figure at one in 14.3 million. To put it in perspective, statistics show you are about three times more likely to be killed by a lightning strike."

I'd add that you are probably more likely to be killed by lightning than hear a reporter correctly report a story on mental illness, but ...

I've been thinking a lot about what I would write about the terrible thing in Arizona. The murder of innocent people on a sunny day. The death of a promising young girl born just three days after my own son. It became difficult to find the right words, though, with my head swimming with broadcast accusations and finger pointing.

Then I read a post from Heather Armstrong at her blog Dooce. Heather put into words EXACTLY what's been going through my own mind. Not political parties. Not even guns. Not anything but sadness, and Heather's words. She writes, "If any good dialogue comes out of this mess, please let part of it be about mental illness and access to treatment." I had been so confused by all the talk of politics and party discourse that I almost lost the idea that the root of this story is mental health. Heather brought it back to me.

I don't know exactly what brought Jared Loughner to do the terrible thing and rob the world of so many beautiful lives. It seems mental illness may have played a large part, but other things may have been involved as well. While I know that the overwhelming majority of mentally ill people do no harm, a very small few with severe illnesses can if they're not being helped.

I would hope that if people learn anything at all, it's that we have a crappy mental health system in this country, and that's being nice. While pockets of greatness and amazing psychiatric professionals and organizations certainly exist, many people do not have access to them.

For those living in rural or poor areas, there aren't enough health care providers of any stripe, much less mental health professionals, nor are there enough services. The Huffington Post reported that in Pima County, Arizona, where the shooting occurred "... more than 45 percent of its mental health services recipients [were] forced off the public rolls" last year.

Some people do not have mental health insurance coverage. If they do have it, it's often limited, with the insurance company -- and not a trained psychiatrist or therapist -- deciding how many mental health visits a person should have. In fact, insurance companies' limitations and controls over mental health have gotten so out of hand that many of the best mental health professionals in our country no longer accept insurance of any kind.

On top of that, the stigma that exists -- the stigma that is carried along so willingly by the media -- makes people afraid to seek whatever help they can get. What if someone thinks they're a horrible person for having a mental illness? Could they lose their job? Their friends? What if this is used against them in some way? If they say they are suffering, will it ruin their lives? One has to wonder whether Jared Loughner's family sought help for him, or if these same thoughts crossed their minds as well and prevented them from doing so.

As Steve Lopez, Los Angeles Times columnist and author of "The Soloist" (think Robert Downey Jr. in the movie based on the book -- that's Steve), wrote this week, "What the Arizona tragedy ought to spark is not a hysterical conversation about politics, but an honest conversation on the need for earlier diagnosis and better education about mental illness."
Not only an honest conversation, but an informed conversation that's not peppered with harmful words and overblown rhetoric. A conversation that recognizes the sorry state our mental health system is in. People need help. With it, most of them can be well.

Permalink | Email this | Comments