I've often heard parents and teachers comment "back when I was a kid/first began teaching there were no kids with autism in my class. Now, most classes have at least one child on the spectrum. Doesn't that prove that there's an autism epidemic?"

Actually, the answer to that question is "no."

< When I was a kid, there were no kids with autism in my class. Nor were there kids with deafness, learning disabilities, cerebral palsy, down syndrome or spina bifida. In fact, there were no kids with significant differences or disabilities in any mainstream classroom.

That's not because deafness, CP, and so forth were unheard of. It's because the law did not encourage or require any type of inclusion. As a result, children with differences and disabilities were placed in special classrooms and school, sequestered from typically developing peers. Occasionally we'd see a group of "special" kids trooping down the hall -- but we were never encouraged to interact with them in any way.

Then came the IDEA (Individuals with Disabilities Education Act) in the early 1990's. The IDEA requires that schools offer a free and appropriate education (FAPE) in the least restrictive environment (LRE). The IDEA meant that kids with all sorts of problems were now to be educated -- if at all possible -- in the general education classroom with their typical peers.

At first, it was only kids with near-normal abilities whose settings changed. But soon parents became more sophisticated in their understanding of special education law, the Individualized Education Plan (IEP) and the rights of disabled individuals.

In the last ten years or so, many more parents have pushed much harder to have their children with disabilities (especially autism) included in general education classrooms. And they've succeeded. Many kids with mild to profound autism (and other disorders such as Tourette's Syndrome, ADHD, etc.) are in typical classrooms. Sometimes they're accompanied by aides, sometimes they are only partially included, and sometimes general education teachers are expected to just "make it work."

Overall, there's no doubt that there's more autism in the classroom. There's also more... Tourettes, ADD, ADHD, OCD, ODD, dyslexia, dyscalculia, you name it. Does that mean we're including more kids with learning and behavior problems? Does it mean we have a cultural need to enforce a "happy medium?" Does it mean the laws and diagnostic criteria have changed? Does it mean that parents are more aware of educational law and more willing to push for adherence to the letter of the law?

The answer to these and other questions is almost certainly yes.

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In a shockingly obvious finding, researchers have discovered that it's more stressful to raise a child with autism than to raise a child with non-autism-related delays. According to an article in Science Daily:

Researchers at the University of Washington's Autism Center asked mothers about their experiences and found that moms of children with autism had higher levels of parenting-related stress and psychological distress than mothers of children with developmental delay.

A related finding notes that behavioral issues are more likely to cause stress than life skills issues. That is, it's more stressful to manage a screaming child in a mall than to help that child put his pants on. And it's more stressful to watch a child bang his head against the wall than it is to brush his teeth for him. Who knew?!

Researchers conducting this not-so-groundbreaking study also made a "no s**t Sherlock" recommendation, often heard and rarely acted upon:

How to help families is important because high levels of stress and psychological distress can interfere with early identification of autism and interventions which are delivered by parents. There's another good reason to do this: Parents who feel supported can better support their children.

Yup, autism is stressful -- and its symptoms generally do include behavior problems. Yup, family support is a great idea. And of course, it's nice for families raising kids on the autism spectrum to be validated in their concerns by the good folks at the University of Washington's Autism Center!

• Understanding and Managing Autistic Behavior
• Behavior Specialists and Autism
• Drugs Used to Manage Autistic Behaviors

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Applied Behavior Analysis (ABA) is probably the best-known and best-researched therapy for autism. Its purpose, in essence, is to teach children with autism to act, speak and engage as typically as possible. In theory (and often in fact), when children with autism can engage with the world like other people, they are also able to take part in typical classes, make friends with typical children, and generally become a part of the world at large.

Given that ABA is not a panacea, and that it works better for some people than for others, it is still considered the gold standard for autism treatment.

The problem: when ABA is provided as prescribed (up to 40 hours per week of 1:1 therapy), it can cost as much as $70,000 per year. As a result, insurance companies are balking at the cost. An article in the LA Times describes a mutiny on the part of California health insurer who refuse to cover the treatment.

The argument made by the health insurers is that ABA therapy is not medical, but rather educational.

Of course, ABA does much more than teach academic content - and parents feel strongly that a therapy intended to build functionality should be considered medical. But it's understandable that medical insurers would make the "educational" argument to save money, and expect to be heard by the courts. Here's why:

• ABA is often provided by school districts. In fact, many kids with autism are placed in "ABA classrooms."
• ABA is often used to teach academic, social and life skills - none of which are, strictly speaking, medical concerns.
• ABA does not directly treat medical symptoms sometimes associated with autism, such as motor issues or mood disorders.

What's your feeling? Is ABA a medical treatment or an educational tool? Should it be covered by health insurers, or offered by and through schools? Or - should it be considered just one of many autism treatment options that parents can choose for their child and pay for on their own?

Physical awkwardness, low motor tone and other gross motor issues have always been among the symptoms of autism spectrum disorders. Up until now, though, there's been little research conducted to figure out why this is the case. Now, an intriguing study conducted by the Kennedy Krieger Institute and Johns Hopkins sheds some light on the subject:

The findings suggest that children with autism appear to learn new actions differently than do typically developing children. As compared to their typically developing peers, children with autism relied much more on their own internal sense of body position (proprioception), rather than visual information coming from the external world to learn new patterns of movement. Furthermore, researchers found that the greater the reliance on proprioception, the greater the child’s impairment in social skills, motor skills and imitation.

Based on findings in this study, researchers plan a follow-up study:

Potential next steps include the use of neuroimaging to investigate whether or not proprioceptive versus visual feedback is actually associated with abnormal patterns of structural and functional connectivity in the brain of children with autism. Additionally, researchers may study if patterns of motor learning can be altered to increase visual connections in specific regions of the brain. Through interventions such as cortical stimulation, biofeedback and behavioral approaches, researchers are looking to investigate if there is an improvement in children with autism’s ability to rely on visual input to guide how they learn a range of behavioral skills.

This is one of the few recent findings I've read of which seem to actually suggest directions for useful treatment of challenging symptoms. In essence, it may be possible to put these findings to work as a tool for rebuilding connections in the brain, thus improving physical, emotional and behavioral skills.

Sounds good to me!