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.

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.



New Study Prompts Outrage Among Autism Researchers

New Study Prompts Outrage Among Autism Researchers

A recent study in the July 2021 issue of the Journal of Autism and Developmental Disorders has prompted outrage among many autism researchers.

Every researcher on the study (a study focused on autism prevalence and related costs in the US over the next 40 years) has connections to organizations that have wrongfully tied autism to vaccines. This is a conflict of interest that none of the researchers on the study properly disclosed.

About the Researchers

Mark Blaxill, the study’s research lead, is editor-at-large of Age of Autism, a website that promotes distrust of vaccinations and the long-debunked link between vaccines and autism. Blaxill has made national news for his anti-vaccine views.

Toby Rogers, a study co-investigator, is a political economist. Rogers has written for the Children’s Health Defense Fund, a website that seeks to discredit vaccine safety. Another co-investigator, Cynthia Nevison, is a research associate at the University of Colorado and a former board member of SafeMinds, an organization that has unsuccessfully sought to link vaccines to autism.

“It’s abundantly clear that this paper doesn’t follow the journal’s policies,” says David Mandell, associate professor of psychiatry and pediatrics at the University of Pennsylvania and editor-in-chief of the journal Autism. “If you reference the Journal of Autism and Developmental Disorders’ conflict-of-interest guidelines, it says that certain ideological commitments and personal beliefs, personal relationships, all those things have to also be disclosed.”

The failure to properly disclose ties to certain organizational interests has led many researchers to disregard the study. The study researchers mentioned they are not paid to write articles or publish studies for politically motivated organizations in defense of the study.

Misrepresentation of Data

Autism prevalence data from the state of California was used to forecast that 3 to 10 percent of children in the United States will have autism by the year 2060. Based on this figure, the study mentioned the future societal cost of autism could be as high as $5.5 trillion per year. A third analysis claimed to model how prevention might reduce autism prevalence in the future.

Outside researchers say the data is flawed “because it was calculated by looking at really old data, comparing it to new data, and then assuming an exponential function.” Many researchers mentioned this issue as numbers that increased exponentially due to two totally different sets of data will always be too large.

One outside researcher noted “The rise in autism prevalence in recent years can be attributed to better observation and increased diagnosis on the community level. The base rate of autism isn’t magically rising because there’s some toxin that causes it, which is the underlying assumption [the paper’s authors] have.”

Prevention calculation in the study also used “magic numbers,” says Madison Hyer, a biostatistician at Ohio State University’s Wexner Medical Center. “Magic Numbers” means it isn’t clear what the word prevention means or even what’s being measured. “Are they saying that this is the cost of supporting or treating individuals with autism across their life in some way? Or is this the cost above the cost of supporting someone without autism? Everybody costs something.”

Outside Researchers on Prevention Prediction

Other comments from outside researchers mentioned “[the study] made some really severe assumptions about productivity … It looks like they were assuming anybody with autism would have zero productivity, but many people with autism work.”

Many outside researchers without organization ties observe that some people with autism may have disabilities and challenges, but that we as a society should think about how to support them. They’re still quite productive members of society.”

Some outside researchers noted that some of the data used to calculate productivity may have also come from questionable sources, says Kristen Bottema-Beutel, associate professor of teaching, curriculum, and society at Boston College in Massachusetts. “The data they use appears to be from a non-peer-reviewed PDF.”

The Journal of Autism and Developmental Disorders was established in 1971, and its first editor-in-chief was Leo Kanner, one of the first clinicians to describe autism. Some researchers say the new study has diminished their perception of the journal, which has an impact factor of 3.047. (A journal’s impact factor reflects how often its articles are cited.)”

“[This paper] makes me question the peer review process,” says Brittany Hand, assistant professor at Ohio State University in Columbus, who also wrote a letter of protest to Volkmar. “How in the world does something like this get past [peer review]?”

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

The Journal of Autism and Developmental Disorders, July, 2021