Autism: Prevention

To prevent autism, attention must be paid to reducing individual risk factors.

Medications taken by the mother during pregnancy:

• Misoprostol – active substance used for stomach ulcers.
• Thalidomide – sedative / sleeping pill, which became known through the so-called thalidomide scandal.
• Valproic acid / valproate – active substance used in epilepsy.

Environmental pollution – intoxications (poisonings).

• Dichlorodiphenyltrichloroethane (DDT) – pregnant women had significantly higher blood concentrations of DDT and its major metabolite dichlorodiphenyltrichloroethane p,p′-dichlorodiphenyl-dichloroethylene (p,p′-DDE).
• Exposure to particulate matter and nitrogen dioxide during pregnancy and the first year of life.
• Air pollution (diesel particulates, mercury, and lead, nickel, manganese and methylene chlorides).
• Prenatal exposure (prenatal) to pesticides.
  • Polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs)Note: Polychlorinated biphenyls are among the endocrine disruptors (synonym: xenohormones) that, even in minute amounts, can harm health by altering the endocrine system.
  • Glyphosate (odds ratio 1.16; 95% confidence interval 1.06 to 1.27), chlorpyrifos (odds ratio 1.13; 1.05-1.23), diazinon (odds ratio 1.11; 1.01-1.21), malathion (odds ratio 1.11; 1.01-1.22), avermectin (odds ratio 1.12; 1.04-1.22), and permethrin (odds ratio 1.10; 1.01-1.20).

Prevention factors

• Genetic factors:
  • Genetic risk reduction depending on gene polymorphisms:
    • Genes/SNPs (single nucleotide polymorphism):
      • Gene: SLC25A12
      • SNP: rs2056202 in gene SLC25A12 [autism spectrum disorders (ASD)]
        • Allele constellation: CT (0.8-fold).
        • Allele constellation: TT (0.64-fold)
      • SNP: rs2292813 in the gene SLC25A12 [autism spectrum disorders (ASD)].
        • Allele constellation: CT (0.75-fold).
        • Allele constellation: TT (0.56-fold)
      • SNP: rs10513025 in an intergenic region [autism spectrum disorders (ASD)].
        • Allele constellation: CT (0.55-fold).
        • Allele constellation: CC (> 0.55-fold)

Secondary prevention (screening)

In the presence of any of the following risk factors, plus at least one symptom suggestive of autism spectrum disorder, screening should be considered:

• Genetic findings in which an increased rate of autism spectrum disorder has been described (e.g., mutation, microdeletion or microduplication, chromosomal aberration)
• Medication exposure during pregnancy
• Viral infections during pregnancy
• Birth weight < 1,500 g and/or birth < 32 weeks.
• Neonatal seizures
• Sibling with autism spectrum disorder

Screening procedure:

• AQ – Autism Spectrum Quotient
• CHAT – Checklist for Autism in Toddlers
• MBAS – Marburg Assessment Scale for Asperger’s Syndrome.
• FSK ( = SCQ) – Questionnaire on social communication.
• SCDC – Social and Communication Disorders Checklist