Pregnancy, Acetaminophen, & Autism

Pregnancy, Acetaminophen, & Autism

Acetaminophen has always been the go-to drug for pain relief during pregnancy. Doctors often prescribed acetaminophen as an OTC drug for mild to moderate headaches due to the low risk associated with pregnancies. The widespread use of acetaminophen for pregnant women in pain, however, may be coming to an end.

Recent research conducted by both university researchers and the US National Institutes of Health links excessive acetaminophen use to autism and ADHD. While the conclusions of the initial studies need additional research for a definitive conclusion, the studies had eye-opening results.

Studying the Effects of Acetaminophen on Pregnancy Risks

A National Institutes of Health-funded study conducted by doctors from Johns Hopkins University called the Boston Birth Cohort Study was used for acetaminophen research. Part of the study examined 24,000 participants, 996 of whom were tested for acetaminophen levels and associated byproducts at birth.

The results of the study on acetaminophen were stunning. Children in the study were checked in on 8.9 years after birth. Of the 996 births, 25.8% had been diagnosed with ADHD, 6.6% had been diagnosed with autism, and 4.2% had been diagnosed with both. This correlates to 2.9X the risk for ADHD and 3.6X the risk of autism (compared to the lowest third of diagnoses in participants).

Researchers in the study noted the results supported earlier research linking acetaminophen to increased autism & ADHD risk during pregnancy. They also noted that future studies will be needed for a definitive conclusion. Some factors not used during the test (health of the mothers, preexisting conditions of the mothers, etc) may also need to be factored in for future research.

Is it Safe to Take Acetaminophen During Pregnancy?

This is definitely a question best left to your doctor. While the answer may be somewhere along the lines of ‘use very sparingly,’ some unanswered questions make this difficult to answer. Researchers and doctors are questioning and studying the impact of acetaminophen and other drugs taken early during pregnancy versus late in pregnancy.

Without conclusive research, there is no ‘recommended dose’ for doctors to prescribe. Talking to your doctor is the only way to get a good answer to this question. Your doctor knows you and your needs better than general internet information ever will. If you are experiencing pregnancy-related pain, please talk to your doctor before taking any OTC medications!

ABA Therapy from IABA Consultants

If you have questions regarding autism treatment, education, or plans to use ABA therapy, we are here for you! Our goal is to make sure no family is turned away due to financial constraints. Our therapy team would love to talk to you. Find the location closest to you and give us a call. We’re here for you.

Autism Diagnosis Criteria Reference

Autism Diagnosis Criteria Reference

Note: This short article was primarily put together for reference. The actual process for diagnosing ASD is much more complex than just the steps and areas of note published in the DSM-5. Only medically-licensed professionals are able to properly diagnose ASD and any co-occurring conditions. This article is meant for reference use only and is not intended to provide medical advice.

Getting a proper autism (ASD) assessment or diagnosis may seem complicated, but in reality, only a few specialists need to be contacted in order to set up an evaluation. Autism diagnoses can only be given by a select group of medically-licensed professionals. The professions that can give an autism diagnosis include:

  • Developmental Pediatricians
  • Pediatric Neurologists
  • Child Psychiatrists
  • Child Psychologists

The American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes guidelines professionals use to look for signs of ASD.

What is Observed for an Autism Diagnosis

The DSM-5 specifies five areas that need to be evaluated for an ASD diagnosis.

Persistent Deficits in Social Communication  and Social Interaction Across Multiple Contexts

The first area observed by doctors looking at a potential ASD diagnosis focuses on social issues. Please note that this is a list for reference–only medically licensed professionals can make a proper diagnosis for ASD. There are a few specific things that need to be carefully observed:

  • Deficits in social-emotional reciprocity.
    • Abnormal social approaches
    • Failure to have a reciprocal conversation
    • Lack of sharing interests
    • Lack of emotions
    • Failure to respond to social queues and interactions
  • Deficits in nonverbal communicative behaviors.
    • Poor communication (nonverbal and nonverbal in tandem with verbal)
    • Lack of eye contact
    • Abnormal body language
    • Lack of facial expressions
    • Unable to interpret gestures
  • Deficits in developing, maintaining, and understanding relationships.
    • Difficulty adjusting to varying social situations
    • Difficulty with play or making friends
    • Lack of interest in peers

Restricted, Repetitive Patterns of Behavior, Interests, or Activities

Doctors look for specific patterns or combinations of behaviors, interests, and activities to help guide an autism evaluation.

  • Repetitive motor skills, movements, speech, or use of objects.
    • Repeated gestures or motions
    • Specific, repetitive organization
    • Repeated idiosyncrasies 
  • Insistence on sameness.
    • Inflexible to routine changes
    • Ritualized patterns
    • Rigid thinking or action patterns
  • Highly restricted or fixated interests.
    • Strong attachments or preoccupations with unusual objects
    • Excessive use or focus on a specific object
  • Hyperactivity to sensory input.
    • Indifference to pain or extreme temperatures
    • Adverse reactions to specific sensory stimuli
    • Excessive fascination with sensory stimuli

ASD Symptoms Over Time

ASD symptoms must be present in early development but may not manifest fully until social demands exceed limited capacities or are masked by learned strategies later in life. The DSM-5 notes that some symptoms of ASD can only become apparent later in life, as an individual is forced to interact with more of the world. These symptoms alone may not be enough for an ASD diagnosis if no symptoms were present in an individual as a child.

Significant Social Impairments

Records of ASD symptoms causing clinically significant impairment in social, occupational, or other areas of functioning. Medical professionals performing ASD diagnoses will look at social interactions and any impairments. Accepted social queues, communication, and other social stimuli will be used to evaluate.

No Evidence of Intellectual Disability

ASD evaluations must have evidence to rule out other diagnoses of intellectual disabilities. Although ASD frequently occurs alongside other intellectual disabilities, the diagnoses must be made separately. Social factors such as communication are commonly used to differentiate ASD from intellectual disabilities but are not always the case.

Use of Autism Diagnosis Criteria Reference

This short article was primarily put together for reference. The actual process for diagnosing ASD is much more complex than just the steps and areas of note published in the DSM-5. Only medically-licensed professionals are able to properly diagnose ASD and any co-occurring conditions.

The guidelines in the DSM-5 are also useful as a quick reference for things to notice in a young child’s development. Again, only medically-licensed professionals can diagnose ASD, but parents must take note of any developmental abnormalities as a child ages.

ABA Therapy from IABA Consultants

If you have questions regarding autism treatment, education, or plans using ABA therapy, we are here for you! Our goal is to make sure no family is turned away due to financial constraints. Our therapy team would love to talk to you. Find the location closest to you and give us a call. We’re here for you.

The Differences Between ASD and Social Anxiety

The Differences Between ASD and Social Anxiety

On the surface, social anxiety disorder and autism spectrum disorder (ASD) may look the same. Both people with autism and those with social anxiety can experience social situations differently than others.

While social anxiety and ASD can occur together, they are very different conditions. In some cases doctors even get the two mixed up, leading to misdiagnosis.

Let’s take a look at both the similarities and differences between ASD and social anxiety.

Similarities of ASD & Social Anxiety

A major similarity between social anxiety disorder and ASD is that both conditions look different in every person. With that said, there are plenty of similarities, including symptoms and treatment services offered. It’s also important to understand that social anxiety is not a form of autism and vice versa.

Similar Symptoms

One reason social anxiety and autism are sometimes confused is that some symptoms appear the same.

According to some educational psychologists, overlapping symptoms of autism and social anxiety disorder can include:

  • Limited social communication
  • Nervousness
  • Difficulty adapting to changing plans
  • Lack of eye contact

ASD & Social Anxiety Diagnosis

A psychologist can diagnose autism and/or social anxiety disorder using the Diagnostic and Statistical Manual of Mental Health Disorders 5th Edition (DSM-5). The DSM-5 is a handbook published by the American Psychiatric Association that helps healthcare professionals make diagnoses.

A healthcare professional will ask about symptoms and may observe a person in social situations before making a diagnosis. Sometimes a pediatrician or physician will recommend seeing a healthcare professional who can properly diagnose ASD, social anxiety, or other specific mental conditions. Ask your doctor for more information.

The DSM-5 diagnostic criteria for autism include:

  • Persistent differences in social communication, including but not limited to lack of back-and-forth conversations and differences in eye contact
  • Repetitive patterns of behaviors, such as lining up toys
  • Symptoms were present in early development, even if they went unnoticed
  • Symptoms interfere with daily functioning, such as schoolwork

The DSM-5 diagnostic criteria for social anxiety disorder include:

  • Fear of judgment in social situations
  • Consistent anxiety in social situations that does not fit the context
  • Avoidance of social interaction
  • Fear of social interaction that impedes day-to-day life
  • Having fear for at least 6 months (and the fear cannot be attributed to another mental health condition, such as panic or substance use disorder, or a disease like Parkinson’s)

Note that social anxiety can develop in children or adults.

ASD & Social Anxiety: Brain Functions

The amygdala, which affects the brain’s response to fear, may play a role in both ASD and social anxiety disorder. Research is still ongoing. Ultimately, however, brain functioning is very different in social anxiety and ASD. The neurological causes of autism aren’t yet fully understood.

Treatment for ASD & Social Anxiety

There’s no cure for social anxiety or autism. In addition, not everyone wants to “manage” or “fix” characteristics associated with autism. People can live fulfilling lives with customized support and treatment tailored to their goals.

Treatment and support options for ASD include:

  • Applied behavioral analysis (ABA) therapy
  • Occupational therapy
  • Social skills training
  • Cognitive behavioral therapy
  • Occupational therapy*

*Occupational therapy is often a first-line service for autism. It may also be used to help people cope with social anxiety in some cases.

High-Functioning Autism Vs. Social Anxiety Disorder

The current diagnostic process for ASD involves three potential levels of support needed:

level 1: requiring some support

level 2: requiring substantial support

level 3: requiring very substantial support

Autism is neurologically based, which makes it different from social anxiety disorder, regardless of communication abilities or any overlap in symptoms.

Differences Between ASD & Social Anxiety

The main difference between ASD and social anxiety is that autism is a neurodevelopmental condition, while social anxiety is a mental health condition. Experts say it’s essential to get the diagnosis correct.

Though a formal diagnosis is best made by a licensed professional, understanding the differences between social anxiety and autism can empower parents to seek an evaluation. Because autism and social anxiety are distinct conditions, they have nuanced symptoms and diagnostic criteria.

ASD & Social Anxiety Symptoms

People with autism and those with social anxiety alike may seem to avoid eye contact. Importantly, however, autistic people aren’t necessarily “avoiding” eye contact out of nervousness or fear. They’re simply not making eye contact in the first place, which is a distinct difference.

Researchers have suggested that individuals with autism look toward a person more slowly, while people with social anxiety look away faster. ASD is a spectrum, meaning people may communicate in different ways. Some may not speak at all, while others may engage in one-sided conversations or miss social cues.

On the other hand, people with social anxiety intentionally avoid conversations because of fear.

Social anxiety can be the result of trauma. A brain dealing with social anxiety may be compensating for something that happened or trying to prevent something from happening reoccurring. Social anxiety is different from autism because autism isn’t triggered by an event, experience, or trauma.

ASD & Social Anxiety Brain Functions

The amygdala may be implicated in both autism and social anxiety disorder, but current research supports the idea that autism is neurodevelopmental. There are comprehensive conclusions available concerning what causes ASD, but research is ongoing.

Social anxiety, on the other hand, is mental-emotional.

Please note that all of this information is for reference only. If you are concerned about your child, please contact your pediatrician or a mental healthcare specialist.

ABA Therapy from IABA Consultants

If you have questions regarding autism treatment, education, or plans using ABA therapy, we are here for you! Our goal is to make sure no family is turned away due to financial constraints. Our therapy team would love to talk to you. Find the location closest to you and give us a call. We’re here for you.

Originally Posted as How to Tell the Difference Between Social Anxiety and Autism at

A Decade of Work, A Decade as a BCBA

A Decade of Work, A Decade as a BCBA

Over the course of the past year, I’ve been writing to you about standing in your own worth, your truth. I’ve taken you down many paths in the forest of life and shared both challenging and joyful paths that I have walked down. Through writing to you about personal experiences I have healed and still seek to heal further. Life is full of encounters and experiences that can deliver this; for us to hold each moment of being human in our hearts to live a life of freedom. 

What I haven’t written to you about in detail is my career and the work that started my journey. This past week I was recertified by Board Certification as a Behavior Analyst for a fourth time marking a decade as a BCBA. This summer I will celebrate a decade as a BCBA entrepreneur as the owner of Instructional ABA Consultants. It was emotions and injustice that brought me to my career and success. This week I’d like to share my professional journey.

Starting a Career Helping with ASD

My work in the field of autism began fifteen years ago when I was obtaining my bachelor’s degree at the Ohio State University (OSU) in human development focusing on early childhood. I was curious about how environments shaped the developmental outcomes of children. During my time at OSU, I worked in their preschool program and was a home-based therapist for two children with autism using applied behavior analysis (ABA).

This was back in the early 2000s and in both cases, the children were accessing services but their ASD symptoms were not being treated. The ABA program I was working under was state-funded and both children I worked with had high levels of physical aggression. Neither child had a treatment plan that actually alleviated the aggression. I was passionate about the kids and knew from my undergraduate work that environments mattered. In the fall of 2009, I began my master’s degree in Applied Behavior Analysis at The Chicago School of Professional Psychology.

My choice to begin a master’s degree stemmed from a desire to understand why aggression, as well as other aberrant behaviors, occurred in children. I also wanted to understand how applied behavior analysis treated autism symptoms in early childhood. During my master’s degree, I worked as an early childhood line therapist and joined the Illinois Crisis Prevention Network (ICPN) as my internship. I had to work during my degrees to pay my bills and at the time was focused on nothing outside of my career. I was thirsty to learn so I could create change for children.

Working at the ICPN

As I began working on the ICPN I was introduced to adults with mental illness and developmental disabilities. I quickly fell in love with the population and saw how lack of access to quality treatment affected their lives. In spending the first five years of my career focused on children I had never really thought about where they would go when they grew up. I had never thought about the adults with disabilities who had never gained access to care as children themselves. Most of the adults I served at the time had been raised in state-run institutions. Through my work with the adults, my eyes were opened to not only what happens immediately with small children with autism who do not have access to care, but also what can happen in adulthood.

During my time at the ICPN, I worked to gain my associate certification first and followed it up with BCBA board certification. I was given the opportunity of a caseload of clients (from children to geriatrics) who needed immediate crisis support; first under supervision, then as my own caseload. During this time I was wildly in love with my job but fiercely angry at the lack of care my clients received.

As a young woman, I cannot tell you the number of parents’ hands I held as we talked about their child’s (young or adult) experience that led to a crisis. The stories they told me both broke my heart and filled me with a fire to change their experience. Time after time the constant theme that led to a crisis was lack of intervention due to either a lack of funding or an unethical & uncaring therapy team. I worked with each client and family to stabilize their loved ones from crisis to community-functioning. Without access to outside care of the crisis team, success was usually not sustainable.

Changing the Game

In 2012 I decided to change that. I had met my own personal mission to understand aberrant behaviors and the impact of the environment on childhood development. Now, I know through science that the environment is the key predictor of outcome. I also knew that applied behavior analysis provided a scientific approach to at-risk symptoms of autism as well as behaviors.

With my own hands, through applied behavior analysis, I was able to change the outcome of lives for the better. I wanted to open a private practice that used these skills to close the gap in services based on funding sources. I also wanted to challenge my field ethically to create a place where all of our clients received quality care. A decade ago this was not the case. Even today ABA has mountains to climb regarding regulating quality care for all families.

It’s been a decade since I sat for my boards and I still have a fire burning in me fueled by what our science can do to help serve clients who otherwise would not have access to therapy. I went from just me to five locations, across three states, with a team of professionals who have the same passion. Each day I wake up knowing that we (not just me) are creating lasting change. Learning to run a company is for a different blog but as a BCBA I know I have a decade to be proud of.

To the next decade of service. Wherever we may go.



ASD & Gender Comorbidities

ASD & Gender Comorbidities

The likelihood that a person with autism has another condition correlates strongly with the age at which they received their autism diagnosis, according to a new study. The study also noted that girls with autism are more likely than neurotypical girls to have other conditions, to a degree not seen in boys.

Study factors included whether a person with autism’s age at ASD diagnosis or birth sex changed their chance of having any of 11 common comorbid conditions (including epilepsy, anxiety, and ADHD). The study drew on data from around 16,000 people with autism and more than 650,000 neurotypical people up to 16 years old.

Among people included in the study who received late ASD diagnoses (11 to 15 years old) 26% of girls and 13% of boys were also diagnosed with a comorbid condition. The trend for intellectual disability in the study was the opposite with 40% of people with an early autism diagnosis having an intellectual disability, compared to just 10% percent of people with a late autism diagnosis.

Looking at Gender and ASD Comorbidities

For 11 co-occurring conditions considered by study researchers, the age of autism diagnosis was the single biggest predictor of whether a participant had that condition. Gender was another major factor.

Among individuals with autism, girls were 2.2X more likely to have anxiety than boys. By contrast, anxiety is about 1.4X higher in neurotypical girls than neurotypical boys. And while neurotypical boys are 2.6X more likely to have ADHD than neurotypical girls, the ratio dropped within the ASD population. Boys with Autism are just 1.6X more likely than girls with autism to have ADHD.

Looking at the ASD Spectrum Index

86 percent. That is the proportion of people with autism who show “a fair to very good level of objective psychosocial functioning,” according to a study that tracked the jobs. The happiness and close friendships of 917 adults — 425 men and 492 women — were tracked over a six-year period. These study results appeared in the journal Autism in June 2021.

The results of recent studies have started taking closer looks at both the age of ASD diagnoses and the gender of people with ASD. The early data shows promising results in the differences between boys and girls with ASD.

ABA Therapy from IABA Consultants

If you have questions regarding autism treatment, education, or plans using ABA therapy, we are here for you! Our goal is to make sure no family is turned away due to financial constraints. Our therapy team would love to talk to you. Find the location closest to you and give us a call. We’re here for you.

Sources, Community Letter

Journal of Autism & Developmental Disorders, July 2021

Acta Psychiatrica Scandinavica, July 2021

Health Services Research, July 2021