Autism Awareness, Acceptance, and Action: It's Okay to Have Mixed Feelings

Autism Awareness, Acceptance, and Action...Can they coexist? I believe so!

In Episode 14, I'm covering the diagnostic criteria and rising rates of autism spectrum disorders, as well as the changes in formal diagnostic criteria in the DSM-5.

I'll be exploring various subtypes of autism, and the "communities" within the overall larger community of autism spectrum disorders (specifically the biomedical community, the neurodiversity community, and the traditional behaviorist community).

We'll talk about the difference between person-first language and identity-first language, and how the language we're using within the autism community really does matter... but it might matter differently to different communities within the larger autism community.

I share my own mixed feelings about Autism Awareness Month / day, and offer validation that it's okay for you to have mixed feelings too, if you do.

While there may be differences among the autism communities, I think everyone within the autism community really wants the same thing: For individuals with autism or autistic people, whichever that individual’s preference, to be able to live their best lives and be fully respected and loved.

Let's raise awareness. Let's teach love and acceptance of individuals where they are - always! But let's not forget: There's action to be taken for their individual health needs, and to move this conversation forward as a collective whole.

Push play below and listen in to Episode 14 to learn more!

Mentioned in the show:

BLOG: “Exploring Autism and Other Neurodevelopmental Disorders as Whole Body Conditions”

Episode 5: “Exploring Autism and Other Neurodevelopmental Disorders as Whole Body Conditions”

TACA Autism Statistics

Could Your Child’s Physical and Behavioral Symptoms Be Caused By the Food They’re Eating?

Could your child’s physical and behavioral symptoms be caused by the food they’re eating? There are a number of ways that foods can impact children's health, physically and bio-behaviorally.

If your child struggles with complex picky eating, this one is for you!

If your child has developmental delays or a known neurodevelopmental condition, like autism spectrum disorders, ADHDs, speech-language disorders, sensory processing disorders, etc. then this one is for you!

If your child is struggling with a host of chronic health issue symptoms, this one is for you!

Did you know that over half of American children and millennials today have a diagnosable chronic health issue? Food and environmental reactions are very much involved here...

In this episode, I'm sharing an overview of the difference between food allergies, food sensitivities, and food intolerances. We'll cover the most common food allergies and sensitivities, as well as what physical and behavioral symptoms are seen in children with food reactions.

I share what to do if you think your child is experiencing negative reactions to their foods, starting with "cleaning up the diet overall", then navigating food sensitivity testing, and guidance around food elimination/reintroduction diets for food reactions.

Enjoy the episode! I hope that it's insightful and supportive for where you are on your journey!

Mentioned in the show:

Dr. Doris Rapp on The Phil Donahue Show (1989)

Advice to Parents of Children with Dyslexia, From Adults Who Have Dyslexia.

The two women I love most in this world, my mother and younger (only) sister, both have dyslexia. 

With their permission and October being Dyslexia Awareness Month, as we wrap up the month I want to bring awareness to dyslexia by sharing a bit of their experiences and advice.

I polled my instagram audience on what questions they’d want to ask an adult with dyslexia and a mother of a child with dyslexia. The questions were all so good! I narrowed it down to the few that were the most recurring in nature.

My hope is that this reaches a parent of a child who has dyslexia and gives you a variety of perspectives and tips to consider.

A perspective that can only come from the adults living with the same condition. As well as a perspective that only a daughter and sister of someone living with dyslexia can offer. Similarly, keep in my that I'm a speech-language pathologist which also offers another unique angle to my own perspective.

“Dyslexia” falls under the umbrella diagnostic term of Specific Learning Disorder (SLD) which is a classification of a Neurodevelopmental Disorder (NDD). It’s important to note that both learning disorders and cognitive disorders fall under the umbrella of NDDs, but these are different conditions. A child with an SLD will not necessarily have dyslexia, but dyslexia falls within SLD category.

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For their privacy, I will refer to them as “My Mom” and “My sister” throughout this blog.

When I pitched the idea of interviewing them both, my Mom was super open to it as I expected. I wasn’t sure how my sister would feel about it. I am grateful for each of their vulnerability and willingness to be open and reflective with me for this collaboration! Additionally, I am grateful that you have taken the time to read more about dyslexia and the two women I love most.

My Mom and sister are both brilliantly bright and passionate women.

As you might expect, the topics and areas they are passionate about in are where they excel. They can both rattle off facts on facts for days about what they love and what genuinely lights them up!

For both of them, especially my sister, it’s horses. Horses have been their bond over the years and they both have this indescribable fearless grace, a “horse sense” that blows my mind.

My Mom can identify all sorts of trees, plants, dogs, horses, and wild animals. She can shout out the year of old car models when she sees them. Both of their intelligences are “normal” but their reading and writing are challenging. For example: I will be calling her to read this blog post to her once published and she’ll read along (or not) while I read it outloud.

My Mom doesn't like to read or write in long lengths because it’s a struggle for her, but she’s learned how to compensate for the areas she needs help with in her life. Shout out to my Dad for being the prominent person to help when and where she needs support. (He deserves recognition here too for his support of course!) My Mom’s dyslexia is more severe than my sister’s.

My sister is a poetic and gifted writer, a talented artist, guitar player, and all around made of pure magic. Every year I watch her step more into herself and grow into a young woman is a privilege. I have tears in my eyes writing it. She’s still learning her full greatness each day but my parents and I have always felt it.

I think you get the point here - I want you to know that dyslexia is just one piece of who they are. It is not who they are. I am intentionally using “first person language” (ex: “person with dyslexia” vs. “dyslexic person”) for those very reasons.

They happen to have dyslexia but they are not their diagnoses.

Please remember this when thinking of your children (and how you and others speak about them in front of them).

It is my honor to share their experiences to shed light on living with dyslexia.

Without further ado, let’s dive into my brief interview with each of them…

I texted my Mom a few questions to think about and told her she could text me back or we could talk about it. The process of typing her replies is too tedious and cumbersome, so she preferred to have me call her.

We spoke for about an hour and she told me stories that I hadn’t heard before. Including one where she was bullied and humiliated as an adult (like middle school style bullying) at a job for her spelling errors in front of the team. I was furious and hurt for her. I can’t imagine the audacity of these other adults...or how that must have made my Mom feel as a grown woman who thought she was done being bullied for learning differently.

She also enlightened me on some of her self talk and affirmations that she’s had on mental repeat and grown into over time. Below are her answers and takeaway messages paraphrased from our conversation.

What are the top tips you would tell a parent of a child who has dyslexia?

• “Be patient and understand that your child learns differently”

• “Find their strengths and maximize what they love when they’re struggling to learn”

• “Recognize when they need breaks and what resets them”

• “Be their voice and watch closely for overwhelm in the school system”

We talked about how children’s work loads in schools are already so overloaded. School looks very different than when we were children. When you add a learning disorder on top of that, it can turn overwhelming fast. Especially the transition from elementary to middle school, when academic demands increase.

My Mom emphasized being aware of the various ways that you can advocate for your child within the school even though you’re not there, including by putting IEP accommodations and supports in place. An “IEP” is an Individualized Education Plan that is a legally binding document that a child qualifies for through a Special Education evaluation. Goals and accommodations are discussed based on the child’s needs and grade requirements. This plan is meant to serve as the roadmap to helping the child receive access to fair and appropriate public education, their right by federal law (if qualified).

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As a clinician, I always want to empower parents to know and understand that they are just as important of a role as each of the professionals around the table of the IEP meetings. If your child has difficulty with phonology, reading, spelling, writing, etc., that’s all impacting their access to academics! You are able to add in your own ideas and thoughts into the language of the IEP. In fact, you should! They are the experts in their fields but YOU are the expert on your child! It’s up to you to advocate for them and teach them how to be the best advocate for themselves.

You are not required to sign an IEP until you agree with the document. If needed, find an advocate to support you with the school system. Thankfully in my sister’s case, this was never required and the school was always pretty supportive (although, didn’t always fully have the resources which is unfortunately common).

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If you could describe your experience while reading and learning, how would you best describe it?

When I asked her this, my Mom sighed a big breath and said,

“Reading...I don’t like to do because I struggle. For me to grasp it, I have to read it over and over and over and over again. People take reading for granted”.

When she said that it hit me deeply. I realized in that moment that I, as her daughter, do in fact take reading for granted too often.

She shared how even jobs that many would consider “simple” would be very difficult for her. Being a waitress, bank teller, cashier, gas station attendant, etc. Anything with reading letters and numbers is challenging, especially in a situation where there would be a time pressure.

My Mom is a trained and experienced dog groomer. We live in a rural area where these jobs aren’t plentiful. When I was growing up, my Mom stayed home and cared for us when we were very young, which I am so thankful for! When my younger sister entered school, my Mom worked as a dog groomer and held other various jobs throughout the years. My Mom learned to maximize her strengths throughout her life for the jobs she’s held. She’s very in tune with animals and is an incredibly patient woman, and a selfless caregiver. She has held roles caring for animals and people in varying capacities.

We discussed the idea of dyslexia being popularly simplified as “reading backwards”. Like my sister has also described to me: It’s not that they’re reading backwards, it’s that the letters and numbers “jump and scramble”. For example, my Mom almost always writes “talk” as “tlak”.

As a speech-language pathologist, I can’t help but be able to reflect on the language and phonological components of how she is receiving and expressing written language. I can only have sincere empathy for her experience, as I imagine it would be frustrating to experience throughout your life. I know it has been for her and I’m inspired by the way she doesn’t allow it to limit her in any way.

She took me to the library a lot as a child. During our call, she told me she always felt I was “in tune” with her. As I became a better reader than her growing up, she realized I was in tune with where/when she needed help with various tasks requiring reading and writing.

What strategies and strengths do you use in your daily life for your success? (Direct Quotes)

“I’ve learned not to be afraid to ask for help when I need it. I try not to make excuses for myself and recognize when I am.”

“I’ve realized I need to slow myself down and remove myself from situations when possible then re-entering before reacting. Sometimes I need to shut my brain off for a second and let it catch up with itself”

“I make lists and write things down a lot.”

My Mom leaves herself notes to remind her to do things and help her remember what order to execute tasks. I do this as well, personally.

She described herself as a very hands-on learner and noted preferring being read to vs. reading herself when learning and testing.

Words of wisdom to others who have dyslexia and/or other learning disorders:

• “Don’t beat yourself up and don’t let society tell you that you can’t learn”

• “Don’t ever be ashamed of who you are”

• “Know you’re different but that’s what makes you you” (the collection of everything about you - not just your learning difference).

“The biggest thing is accepting that you have limitations. I continue to work on this through out my life. Some days it frustrates me so bad. I don’t know if it’s the ADHD or the dyslexia, but sometimes my brain feels like it’s going faster than the body can handle.” 

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Without going into detail, I also want to note from an epigenetic perspective that my Mom’s childhood was not “all sunshine and roses”. She grew up in a home with limited resources and not the best nutrition for the beginning of her life. Additionally, she experienced events that would make anyone “grow up” faster than a kid is supposed to.

Knowing what I know professionally, while also being her daughter and knowing all she’s been through, I can’t even begin to articulate how infinitely proud and inspired I am to be her daughter. She’s faced hurdles every day that we can’t really grasp because we don’t live with dyslexia.

Can you imagine triple or quadruple checking everything that you read and wrote?Can you imagine always being self conscious and unable to trust yourself that you’ve read it and/or written it correctly?

My Mom is my best friend and my absolute idol. We have always been incredibly close. I’m blessed to say my family unit as a whole is very strong! We’re all very close despite living in separate parts of the country. My Mom has been a phenomenal guide and role model for my younger sister, who also has dyslexia.

During the call with my Mom she said, “I’m so glad your sister doesn’t have it as severe as I do”. There are so many variables to the spectrum of neurodevelopmental disorders and in this case, consider a spectrum of dyslexia. Imagine the ways my Mom must’ve supported her from a place of true understanding because she knew what it was like first hand.

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I have this image of my little sister doing her homework at the kitchen table, slamming her pencil down as she bounced up in her chair with a frustration sound…

If I could time travel back, I would hug her and whisper, “Don’t worry - Everything will be okay. Guess what - you’re going to grow up and work with horses like you’ll always dream of, live somewhere warm all year round, and you’ll be the most amazing woman!”

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I received my sister’s responses by text and she has given me permission to share her text unedited verbatim. Please keep in mind: She didn’t know that I was going to share in this way, so she may have further edited if she knew that.

We both thought it was appropriate to share her unedited, uncorrected, and natural response in honor of this being a Dyslexia Awareness post.

What are the top tips you would tell a parent of a child who has dyslexia?

“I’d tell the parents that patients is important, they can’t always trust to sound out a word or follow that math equation correctly because eyes lie to them so often.

Also being involved with your child’s school work at home, but also at school.

Sometimes kids don’t know how to be their own advocate and need that extra help. It’s important that the teacher work on different strategies in the classroom because your child may find it hard to follow.”

If you could describe your experience while reading and learning, how would you best describe it?

“The easiest way to describe my reading and learning experience is that I personally do much better with things hands on.

It’s hard to remember orders In which steps to follow.

When I was younger it was complicated and hard to trust anything I put down on paper. In fear that no other person could read and comprehend my work.”

Words of wisdom to others who have dyslexia and/or other learning disorders:

“Over the years I struggled with reading, learning a second language and math. It wasn’t until I got older and learned my own disability and how it worked for me.. to be able to cope with the every day struggle.

You’ve got to stop disliking yourself for being the way it is. Once I excepted that I was dyslexic, i was easier on myself.. though the biggest thing I can’t stress enough is patience.. with your children ^^ and with yourself.

Hope this makes sense and that it is useful. Let me know if you have questions.. Love you Shandy”

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When I read her replies it was a couple hours after having the phone conversation with my Mom. There is so much overlap between what my Mom said and her responses. Especially the emphasis of holding patience for yourself and your child, and accepting it vs. making it something negative about yourself.

My eyes welled with tears as I read her answers and thought about how proud and fulfilled our incredible Mother should be for raising such a resilient and radiant soul! My parents and I are so intensely proud of my sister.

My Mom, who happens to have dyslexia, has been happily married to her high school sweetheart and love of her life for over 30 years. They’ve raised two successful children and are doing great!

My sister, who happens to have dyslexia, has a job she loves working with horses and is thriving in the young prime of her beautiful life!

If your child happens to have dyslexia as well (or other learning disorder), I know that you’ve gained inspiration in some way from this blog post.

On the next tough day your little one has, I hope that you will remember this blog post about two women I love most in this world - my mother and younger sister, who happen to have dyslexia.

A gentle reminder from my family to yours:

Be patient with your child and with yourself.

(Couldn’t have said it better Mom and sister! xo)

To my Mom and sister - Thank you for letting me share our interviews and your words here on my site for others to learn. Thank you both for walking this life as your authentic selves and inspiring me to do the same. I’m honored to learn from and share your experience. I’m blessed and grateful for you both! (and Dad! And “the critters!”)

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Want to keep learning with me?

Listen in to the podcast:

Exploring Autism & Other Neurodevelopmental Disorders as Whole Body Conditions [Blog]

[Click here to listen to my accompanying podcast, “Exploring Autism & Other Neurodevelopmental Disorders as Whole Body Conditions”]

I will continue to build on this topic but for now (before I get too ahead of myself), let’s get into some foundational information about autism spectrum disorders & other neurodevelopmental disorders as whole body conditions.

I hope that this blog will be a good starting point to help evolve your perception of autism spectrum disorders (ASDs) and neurodevelopmental disorders (NDDs) in general.

ASDs are referred to as “spectrum” disorders to reflect the vast varieties of skills and symptoms of each individual, while also sharing similarities. Most autism researchers agree that we are beginning to be able to recognize different subtype groups of individuals on the spectrum, based on causes, treatments, and related commonalities.

There’s a quote in the world of autism, “If you’ve met one person with autism, you’ve met one person with autism” by Dr. Stephen Shore. Meaning, don’t think that you know what “autism looks like” because you’ve met one or a few children or individuals on the spectrum. I have personally worked with children on the spectrum for a decade and fully agree with this quote in a number of ways.

Since you’re here, you probably already know the common symptoms and signs of ASDs but just in case you don’t, let’s review them briefly.

According to the DSM-5 [1], the diagnostic criteria for ASDs are based upon symptoms/traits that include:

• “Persistent deficits in social communication and social interaction across multiple contexts”

• “Restricted, repetitive patterns of behavior, interests, or activities.”

• “Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.”

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For perspective, in the 70s / early 80s, it was said to be at 1 in 10,000 children. According to CDC data, autism spectrum disorders now impact 1 in 36 children [2]...or 1 in 59 [3] depending on which CDC data you chose... That’s a separate blog for a later time.

The point is that we’re at epidemic rates. Rates that are unsustainable for families, our nation, and the world if we are to truly help support these children/individuals and their families obtain the resources and supports they need access to!

Some argue that the rise in diagnosis can be attributed to better diagnosis, earlier diagnosis, and changes in diagnostic criteria. I find this implication oversimplified and relatively dismissive. As a pediatric SLP, I’ll be the first to admit I have witnessed some over diagnosis but the reality is that a change in or increased identification of ASDs cannot account for even half of the increased rates we’ve seen over time. Not only across our country but also around the world.

Per Hertz-Picciotto in a 2009 study published in Epidemiology, earlier diagnosis and changes in diagnostic criteria only accounted for ~1/3 of the increase in total rates of ASD [4].

When I am faced with the “it’s better diagnosis” response, I like to bring the conversation to the bigger picture. The rates of chronic illness in children and adults have increased significantly in the last 2-3 decades. Over half, (~54%) of both children [5] and millenials [6] have a diagnosed chronic health condition. With this information we can reflectively say that society at large is experiencing a health crisis.

ASDs are just one type of neurodevelopmental disorder. In NDDs, the brain and nervous system are impacted during critical development periods and they’re often diagnosed before the child enters preschool. Currently, 1 in 6 American children have a diagnosed NDD [7]. These are neurological conditions where the biology of the body has direct influence of the brain (a bi-directional relationship), mood, and overall health and functioning.

Other examples of neurodevelopmental disorders on the rise in addition to ASDs (and sometimes overlapping with) include but are not limited to [8];

• Attention-Deficit/Hyperactivity Disorders -  1 in 10 U.S. children diagnosed [9]

• Communication Disorders

  • Childhood Apraxia of Speech, Speech Sound Disorders, Language Disorders, Childhood-onset Fluency Disorders, and Social (Pragmatic) Communication Disorders

• Global Developmental Delay

• Intellectual Developmental Disorders

• Specific Learning Disorders

• and more...

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For so long, the mainstream thought was that ASDs and NDDs were brain-based psychological disorders, primarily caused by genetics.

While many still believe this outdated ideology, emerging literature continues to demonstrate ASDs and NDDs are biochemically influenced, all the way down to the molecular levels. [10] It is not a coincidence that the rates of ASDs have correlated with the rise of other neurodevelopmental disorders and chronic diagnoses, as many on the spectrum have underlying co-occuring NDDs and/or chronic health conditions. [11] That’s what I want the key points/“take away” from this blog to be! From my work in general. These are whole body conditions! When we address their underlying health challenges, many children experience improvements in their health and development.

Let’s pause here and spend a moment to think about this.

If a person is impacted at the molecular level, they’re impacted on the cellular level. [12] What are your tissues and organs made of? Cells! When cells are impaired, organs become impaired, systems become impaired. Whole body systems are becoming impaired!

These are whole body conditions that deserve attention accordingly! It is no longer a secret or surprise that children and individuals with ASDs have generally poorer health compared to their neurotypically matched peers. [13]

Below are some of the co-occurring conditions found to be overlapping in children and individuals with autism/ASDs:

ADHDs

Communication Disorders

Feeding Disorders

Sleep Disorders

Epilepsy / Seizures 

Asthma and Respiratory 

Eczema

Chronic Ear Infections

Anxiety Disorders

Obsessive Compulsive Disorder

PANS/PANDAS Conditions

Gastrointestinal Disorders

Autoimmune Conditions

Food Allergies and Intolerances [14]

Chemical Intolerances [14]

The rates of these comorbidities is certainly further evidence elucidating these conditions as whole body conditions.

Overlapping underlying commonalities these comorbid conditions above share: 

Genetic Predispositions

Sensitivity to Environmental Stressors

Impaired Detoxification

Oxidative Stress

Mitochondrial Dysfunction

Poor Digestion

Dysbiosis of the Gut

Intestinal Hyper-Permeability (“leaky gut”)

Systemic Inflammation 

Nutritional Deficiencies

Immune Dysfunction

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What has changed?

Why are we experiencing this global explosion of childhood epidemics?

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In the words of Richard Louv, “The health of children and the health of the Earth are inseparable.'' Genetics alone cannot account for the dramatic increase of chronic health epidemics across the board for children and adults. There’s no way to candy coat this, we live in an increasingly toxic world. When you’re walking through the store, most of us assume if something is on the store shelf “it’s safe”. WRONG. We live in a country that doesn’t exercise the precautionary principle [15], which implies that if there are any risks to public health or the environment it’s best to avoid and not release that product or ingredient. Instead, the U.S. has allowed thousands upon thousands of inadequately tested chemicals into our country and world.

Over the past few decades, we have over 80,000 man-made chemicals on the market today that have not been adequately tested for human and environmental safety.

I’m not trying to scare you but consider that plus the essentially infinite possibilities that these chemicals could have on each of our own unique bioindividuality! Now think about the fact that we don’t know how all of these substances interact with our biology and/or the synergistic interactions of each other! That’s only considering man-made chemicals.

That’s not accounting for our lifestyle factors, as well as the agricultural, medical, and birthing practices that have significantly changed over the course of the last 100 years. We are being impacted epigenetically - our environment, food, and lifestyle decisions impact our gene expressions and overall health. These epigenetic impacts are observed as the symptoms and conditions we see rising.

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What can we do for our families and the world?

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Start with what you CAN control!

Traditional therapies are important but addressing a child’s underlying health status is a key step!

We can help these children and individuals and simultaneously vote for a cleaner planet for our future generations.

Aim for small and sustainable changes that have great impacts on lowering your family’s “total load” (a.k.a body burden, allostatic load, toxic load, etc.) over time. Be mindful and intentional with your spending habits. This can improve the entire family’s health and the world around us. That’s a loaded statement - I recognize that and promise I’ll continue to elaborate across my media. I think it’s empowering to see each purchase as a vote you’re casting. For example: when I buy organic produce, I'm voting for organic farming practices and I’m consuming less agricultural chemicals. When we choose organic and/or pasture raised animal products, we are voting for better animal welfare and we’re also getting better nutrient intake from healthier animals!

While it may be more expensive in the store, studies have shown organic produce [16] and healthier animals have increased nutrient qualities! No poorly tested toxicant chemicals, lower agricultural product residues, better nutrient density, and you can choose to see these purchases as preventative healthcare! Another example, you could choose to buy unscented hygiene and household products (without “fragrance” or “perfume”) and/or make your own cleaning products from frugal options like baking soda, white vinegar, salt, and lemons.

You see where I’m going with this? It’s about our daily routines and decisions about what goes into and onto our bodies. When it comes to overhauling your child and families diet, nutrition, and lifestyle - have grace with yourself. It is a process. A marathon, not a sprint! Start with what feels manageable and where the most impact will be. For example, if your child is struggling with hyperactivity - you may consider looking at removing artificial flavors, dyes/colors, preservatives, flavor enhancers, etc. then slowly overtime move towards buying only certified organic processed foods, and so forth.

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So many parents from around the world are seeing incredible progress and improvements in their children and family’s health conditions by changing their nutrition and lifestyle habits. I have seen nutrition and lifestyle create miraculous changes in children that therapies alone cannot account for.

Think on it...Do you function at your best when you’re unwell? No! We all function optimally as our healthiest selves!

When we work to address their underlying biology and health, many children with NDDs and Special Needs can experience rapid progress that then supports the therapy and educational strategies they’re working on. While I personally know children who have lost their diagnosis, nutrition and lifestyle interventions are not a miracle “cure all” but they are certainly a foundational concept that we need to collectively take into account for each of these children and individuals as we move forward.

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Changing your family’s diet and lifestyle can be overwhelming, especially if you’re parenting a selective “picky” eater!

Remember, you don’t have to change everything overnight and you don’t have to do it alone!

Start small and go at your own pace! We’re building a community of like minded people across my social media pages of families who have already seen remarkable changes in their children through diet and lifestyle changes, and are sharing their experiences.

Have a look around the site, social media, and don’t hesitate to reach out if you need more 1:1 support! I’m here for you and would be honored to support you through your child and family’s health journey!

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Grab Your Free Guide:

The Dos and Don’ts for Parents of Complex Picky Eaters

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1. DSM-5 Criteria. Retrieved from: https://www.autismspeaks.org/dsm-5-criteria

2. Zablotsky, B., Black, L., (2017). Estimated Prevalence of Children With Diagnosed Developmental Disabilities in the United States, 2014–2016. U.S. Department of Human Health Services. Centers for Disease Control. NCHS Data Brief, National Health Interview Survey, 2014–2016. (No. 291). Retrieved from: https://www.cdc.gov/nchs/data/databriefs/db291.pdf

3. Baio, J., Wiggins, L., Christensen DL, et al.(2018). Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2014. MMWR Surveill Summ; 67(No. SS-6):1–23. DOI: http://dx.doi.org/10.15585/mmwr.ss6706a1external icon

4. Hertz-Picciotto, I., & Delwiche, L., et al.(2009). The rise in autism and the role of age at diagnosis. Epidemiology (Cambridge, Mass.), 20(1), 84–90. DOI:10.1097/EDE.0b013e3181902d15

5. Bethell, C., Kogan, M., et al. (2011). A National and State Profile of Leading Health Problems and Health Care Quality for US Children: Key Insurance Disparities and Across-State Variations. Academic Pediatrics. 11(3), S22-S33. DOI: https://doi.org/10.1016/j.acap.2010.08.011

6. Blue Cross Blue Shield Report (2019, April) The Health of Millenials. Retrieved from: https://www.bcbs.com/the-health-of-america/reports/the-health-of-millennials

7. Boyle, C., Boulet, S., et al. (2011). Trends in the Prevalence of Developmental Disabilities in US Children, 1997–2008. Pediatrics. 127(6).1034-1042; DOI: 10.1542/peds.2010-2989

8. Harris, C. (2014). New classification for neurodevelopmental disorders in DSM-5. Current Opinion in Psychiatry: 27(2), 95-9; DOI: 10.1097/YCO.0000000000000042

9. Nisser, S., Zablotsky, B., (2015). Diagnostic Experiences of Children With

   Attention-Deficit/Hyperactivity Disorder. U.S. Department of Human Health Services. Centers for Disease Control. National Health Statistics Reports. (81). Retrieved from: https://www.cdc.gov/nchs/data/nhsr/nhsr081.pdf

10. Randolph-Gips, M., & Srinivasan, P. (2012). Modeling autism: a systems biology approach. Journal of clinical bioinformatics, 2(1), 17. DOI:10.1186/2043-9113-2-17

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