By Teresa Conrick
Individuals with Autism at Substantially Heightened Risk for Injury Death. That was all over the news just this past March.
Deaths in individuals with autism increased 700 percent in the past 16 years and were three times as likely as in the general population to be caused by injuries,......The average age at death for individuals with autism was 36 years younger than for the general population, 36 years of age compared with 72. Of the deaths in individuals with autism, 28 percent were attributed to injury, most often by suffocation, followed by asphyxiation, and drowning. Together, these three causes accounted for nearly 80 percent of the total injury mortality in children with autism. More than 40 percent occurred in homes or residential institutions.
...Our analysis reveals that children with autism are 160 times as likely to die from drowning as the general pediatric population.
Those are external tragedies - accidents - horrific and on the increase. Let' s also take a look at any changes over the years with the medical issues that shorten the lives of individuals diagnosed with Autism:
A recent meta-analysis of 23 studies found a pooled prevalence of epilepsy of 21.5% (2150 ⁄ 10 000) among participants with autism and intellectual disability compared with 8% (800 ⁄ 10 000) among participants with autism but without intellectual disability.6 Being female also increased the risk of having epilepsy.
The expected number of deaths is two to three times higher in populations with autism spectrum disorder than in the general population
Risk factors identified for increased risk of mortality in the participant studies were moderate to profound intellectual disability, having epilepsy, and female sex.
However, as for other chronic diseases, and for the population generally, the absolute risk of death for people with autism will increase as they age into middle adulthood and beyond.
Epilepsy accounted for only 7% to 30% of the deaths; a wide range of other conditions were also found to cause death, including circulatory, malignancy, and respiratory conditions, and external causes including drowning, motor vehicle accidents, and suffocation played a role.
The challenge for clinicians, parents ⁄ carers, and individuals with ASD is how to sensibly use this evidence that people with ASD are at an increased risk of having epilepsy or dying relative to comparison individuals without ASD. We would argue that this information alerts us to the need for health promotion and regular health surveillance of individuals with ASD,especially as children and adolescents with ASD transition into adulthood.
Without intervention, adults with autism spectrum disorder appear to be at significant risk for developing diabetes, coronary heart disease, and cancer by midlife.
Let's take a look at what is going on inside the body as health consequences can shorten the lives of our loved ones. This analysis of medical findings is very thorough and should be read by both caregivers and medical staff:
Recent large-scale studies have confirmed that several medical conditions are significantly more prevalent in people with autism compared to the typical population. A detailed assessment conducted by the US Centers for Disease Control and Prevention demonstrated that children with autism had much higher than expected rates of all of the medical conditions studied, including: eczema, allergies, asthma, ear and respiratory infections, gastrointestinal problems, severe headaches, migraines, and seizures (Kohane et al., 2012).
Abnormal clinical findings were common and additional investigations revealed a high prevalence of medical disorders or manifestations, making it clear that “an appropriately extensive medical assessment is essential in all cases” (Isaksen et al., 2012; Mazurek et al., 2012; Memari et al., 2012; Kose et al., 2013).
One study found that deaths from gastrointestinal and respiratory disorders were 40.8 and 24.5 times higher, respectively, in moderately to severely affected patients versus typical peers (Shavelle et al., 2001)
“Care providers should be aware that problem behavior in patients with ASDs may be the primary or sole symptom of the underlying medical condition, including some gastrointestinal disorders.” (Buie et al., 2010). Behaviours in the ASD population are often physical in origin, identifiable through investigation, and treatable or manageable through appropriate medical care.......symptoms and behaviours that frequently occur in autism have been erroneously assumed to be a result of autism itself, including anxiety, aggression, agitation, irritability, impulsivity, lack of focus, disturbed sleep, self-harming, self-stimulatory behaviours, lack of coordination, and visual, tactile and auditory oversensitivity. These so-called autistic behaviours have a substantial negative impact on not only the individual with autism, but also families and society as a whole (Sukhodolsky et al., 2008; Cheely et al., 2012; Geluk et al., 2011; Quek et al., 2012).
Prevalent Medical Issues:
Neuroinflammation and immune dysregulation in ASD
Allergic disorders in ASD: effects of allergies on behaviour, cognition and anxiety
Non-celiac food sensitivity and ASD
Autoimmunity in ASD
Immune system in ASD: translational research and clinical evidence
Abnormal bacterial flora and gastrointestinal comorbidities in ASD
Oxidative stress, acquired mitochondrial dysfunction and metabolic abnormalities in ASD
Autonomic nervous system dysfunction (dysautonomia) in ASD
Seizure disorders in ASD
Here is a study that used postmortem brain tissue of eight deceased Autism subjects. The results of the study- "a dysfunctional gut–brain axis associated with neuroinflammation in ASD,", significant, but for our purpose, cause of death and age might be pertinent to our investigation. Looking at these facts should be very sobering for so many who like to celebrate the "AWETISM" of this devastating diagnosis:
SINCE 1938, there have come to our attention a number of children whose condition differs so markedly and uniquely from anything reported so far, that each case merits-and, I hope, will eventually receive-a detailed consideration of its fascinating peculiarities. The most important introduction for AUTISM ever and it was written in 1943! Here are those eleven patients of Dr. Leo Kanner. NOTE that three are STILL alive today and most of them did not die at the age of 36.
Name, Born, Race, Sex, Died, Cause of Death, Explanation/Health History
Donald Triplett, Sept. 8,1933, W, M, Alive, N/A, Rheumatoid Arthritis then Gold Salts
Frederick C. Wellman III, May, 23,1936, W, M, Alive, N/A, Big head. Large and ragged tonsils when young.
William Ritchey Miller, Nov. 17,1937, W, M, July 8, 2011, Multiple Myeloma, Regressed in speech. Large tonsils and adenoids.
"Paul G.", unknown, W, M, unknown, unknown, Vomited a great deal during his first year. Tonsils removed at age 3.
Bridget Muncie, Oct. 30, 1933, W, F, Jan. 20, 1999, Cancer, Tube-fed five times daily up to 1 year of age.
Vivian Murdock, Aug. 29, 1931, W, F, Jan.1987, unknown, Unknown health history - Nonverbal
John Trevett, Nov. 16. 1937, W, M, Alive, N/A, He vomited all food from birth through the third month.
David Newcomb Speck, June 20, 1932, W, M, Oct. 19, 2000, unknown, Kept in bed often because of colds, bronchitis, chickenpox, strep infection, impetigo
"Charles N", Aug. 9, 1938, W, M, unknown, unknown, Not toilet trained.....had none of the usual children's diseases.
Lee Ruven Rosenberg, Sept. 19, 1937, W, M, 1966, " SUDDENLY", Frequent hospitalizations for feeding. Repeated colds and otitis media. Seizures.
"Elaine C.", Feb. 3, 1932, W, F, unknown, unknown, Febrile illness at 13 months..possible postencephalitic behavior. Seizures.
If we look at those original Kanner 11, we see a pattern of GI issues as well as bacteria and viral infections. Today we can say that it looks like the MICROBIOME was involved and the IMMUNE SYSTEM. We see that in the children and young adults today with this pattern of more SEVERE immune dysfunction generally means more SEVERE Autism. Remember too, that Autism in the 1930's was completely new compared to today, where the numbers are increasing in an epidemic fashion.
The other pattern is that these 5, born in the 1930's, who we know have died, lived longer than age 36, plus 3 are still alive which should be almost impossible according to research today:
William Ritchey Miller - age 73
Bridget Muncie - age 66
Vivian Murdock - age 56
David Newcomb Speck - age 68
Lee Ruven Rosenberg - age 29 (suddenly, possible seizure)
Should we be concerned that children and young adults who have an Autism diagnosis today, could die sooner than their historical peers from decades ago? YES, we need to be concerned. Why is this, some may ask, especially with modern medicine? I think the stark realization that what goes into the body -- chemicals and pesticides in food, increasing vaccines and pharmaceuticals, and toxins in our air and water -- the modernization of our world, is more damaging. It was just beginning back then when Kanner unknowingly diagnosed those first eleven, as shown here in Dan and Mark's pivotal research. Interesting to note that Kanner would have had no idea that Donald and Frederick (Creighton) would still be alive today, yet he had this to say about them as they both were lucky to have dodged the increasing health issues of a sick immune system and bad gut bacteria, never went into a state psychiatric hospital, and were able to speak and communicate fairly well as years went by:
Donald T. (Case 1) and Frederick W. (Case 2) represent the two real success stories. Donald, because of the intuitive wisdom of a tenant farmer couple, who knew how to make him utilize his futile preoccupations for practical purposes and at the same time helped him to maintain contact with his family, is a regularly employed bank teller; while living at home, he takes part in a variety of community activities and has the respect of his fellow townspeople. Frederick had the benefit of a similarly oriented arrangement in the framework of the Devereux Schools, where he slowly was introduced to socialized pursuits via his aptitude for music and photography.
Kanner of course, was incorrect. He blamed the parents harshly then. Many of the children went to Devereux or stayed with families. He missed the point that these two cases may have received medical help that stopped the progression of immune issues. We know Donald received gold salts. Their health was directly tied into their Autism. Kanner was always looking through the lens of PSYCHIATRY and missed so many important medical clues.
I worry about all of this often as I have a 24 year-old, nonverbal daughter, who has a history of seizures, with many immune and autoimmune lab results. Proper research and medical treatments can help change her fate and so many others. I have hope that we are getting closer:
Therapies to change the bacteria in the gut, through diet, pro-and prebiotic supplements, fecal matter transplants or antibiotics, could treat autism. A review of six decades of research linking the gut to brain development could pave the way for cheap and effective treatment....The message of this review is one of positivity. This could well be a breakthrough in the treatment of this disorder."
Teresa Conrick is Science Editor for Age of Autism.