Being a pediatrician, Dr. Bianka Soria-Olmos knows how to identify the signs of autism spectrum disorder (ASD) in her patients. When her own son was diagnosed, she learned the very personal challenges that come along with being a parent of a child with ASD. On this episode of Raising Joy, we talk to Dr. Soria-Olmos about how the diagnosis and how it has impacted her work as a doctor and as a mom.

Raising Joy is part of Cook Children’s Health Care System’s Joy Campaign, a communications initiative aimed at preventing youth suicides. For more information about the Joy Campaign, visit cookchildrens.org/joy.

New episodes of the Raising Joy podcast will be available each Tuesday. It is currently available on all major streaming platforms including Apple, Spotify and Google Podcasts.

Released earlier this year, the survey looked at more than 3,500 school-aged kids with either ASD, intellectual disability and or developmental delay; and found that children on the autism spectrum disorder were more prone to wander, or elope, from home. Of the parents surveyed, more than 26 percent had eloped in the previous year.

The number of kids who stray from the safety of their homes increases even more dramatically when you look at kids as young as 4 years old and up.

“Elopement is a common and dangerous behavior seen in about half of children with autism,” said Joyce Mauk, M.D., a Cook Children’s pediatrician/CEO and medical director of the Child Study. “It occurs more commonly in children with more severe developmental delays. When this happens it’s of great concern because children can face dangers of drowning or traffic injury when they run away.”

Dr. Mauk says children with ASD most frequently run away from the home, but can escape their caregivers in various community settings. Dr. Mauk says she has seen teen-aged patients run away and cross several busy urban intersections before finally being found. But even when someone tries to help, it may not guarantee safety for the children who have eloped.

“Because children with autism may have poor communication skills, they may not give reliable parental contact information when they are found,” Dr. Mauk said.

Dr. Mauk recommends the following for parents to safe-guard their children with ASD:

• Use a medic alert bracelet or tag for children who are known to elope.
• Look into GPS trackers that can be worn attached to shoes.
• In cases where this is a severe problem of the child bolting from his or her parents, the child may even need to be contained in large strollers when the family is out.
• At home closed and locked doors are helpful.

But in the end, Dr. Mauk stresses that nothing beats close care-giver supervision.

Joyce Mauk, M.D., CEO and medical director of the Child Study Center, believes the increase in more kids being diagnosed is because examiners are now more aware of the autism spectrum than ever before because of the attention autism has gotten in recent years.

So what exactly is the spectrum?

Dr. Mauk, who is a Cook Children’s pediatrician and board certified in pediatrics and neurodevelopmental pediatrics, says that most human characteristics aren’t spread evenly across the public.

She compares it to the ability to draw. A few people are excellent. Some are natural artists. The majority of us do Ok and some of us have no skill at all.

Dr. Mauk says that’s also the way to look at the autism spectrum, and some other disorders as having a range or continuum. Children are generally diagnosed with an autism spectrum disorder in the preschool years. Those at the severe end of the spectrum are diagnosed at an earlier age and those at the milder end are diagnosed later. Dr. Mauk says this is because the severe end is associated with more severe developmental delays such intellectual disability or mental retardation.

More severe problem behaviors (self-injury, aggression) are likely to be nonverbal and more likely to have a known genetic cause (etiology).

At the milder end are children whose cognitive abilities are in the normal range and have less significant problem behaviors (rhythmic, repetitive movement, or stereotypies, and rigid behaviors).

“An experienced clinician will make the determination of degree of severity,” Dr. Mauk said. “There is no specific test that will alone determine the diagnosis or the level of severity. In the past children at the milder end of the spectrum would not have been diagnosed with autism. They may have had a diagnosis of Asperger Disorder or a language disorder with atypical features. In general those on the mild end have a better prognosis and will need less lifetime supports.”

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But the research may simply be a matter of parents being more mindful of autism than they were previously.

“What is telling is that the overall prevalence of developmental disabilities hasn’t increased,” said Joyce Mauk, M.D., CEO and medical director of the Child Study Center. “Some of this is diagnostic substitution. Many more children with language disorders and some unusual features of behavior are now being diagnosed with autism.”

Dr. Mauk, who is board certified in pediatrics and neurodevelopmental pediatrics, said examiners are more likely to diagnose children with more subtle or mild symptoms of the autism spectrum than ever before because of the attention autism has gotten in recent years.

The Centers for Disease Control and Prevention and National Center for Health Statistics stated reported that 1 in 45 children were diagnosed with autism in 2014, a leap of nearly 80 percent from 2011 to 2013 (1 in 68 children were diagnosed during that time period).

“The survey changed from 2013 to 2014 and the categories for autism were more inclusive in the most recent study,” said Lena Zettler, director of Psychology at Cook Children’s. “They included other developmental delays. The incidence isn’t necessarily changing, but awareness is.”

Both Dr. Mauk and Zettler agree that the focus should remain on the science we know.

Autism is more common if there other family members who are on the spectrum. Higher incidence in autism can occur if:

• The father is older
• Pregnancies are less than two years apart
• Preemies are at a higher risk for developmental delays (including, but not limited to the autism spectrum)

The survey found that the majority of children diagnosed were boys than girls, with a 75 to 25 ratio. Fifty-nine percent were identified as non-Hispanic White.

Another key factor that some point to is the fact that more than 67 percent of the children who were diagnosed had at least one parent with more than a high school education, which could mean they are more likely to be aware and educated of the symptoms of autism, making for quicker identification.

“There is of course a lot we still don’t know about the underlying factors that cause autism, but I think the fact that people are becoming more aware is a great start,” Zettler said. “It makes for quicker diagnosis and care for the child.”