We are often consulted by parents whose first child has received a diagnosis of autism and who are considering having a second child. These parents are concerned about the increased risk that their second child would also be diagnosed with the condition. While they may love and appreciate their first born, they wonder how they will cope if their second child also has this diagnosis.
There is strong evidence that having an older sibling who has received a diagnosis of ASD does increase the risk that subsequent siblings may share this disorder. For example, a 2013 Danish study put this increased risk at 7%. This figure is lower than some other studies, but the Danish results may be a more accurate as this is from a population-wide study, while other studies tend to be based upon families which present at clinics.
There is indeed evidence that an awareness of this risk is affecting parents’ decisions to have a second child. A study reported in JAMA Psychiatry last year suggested that parents whose first child has received a diagnosis of autism may be a third less likely to have a second child. The study looked at birth rates in 19,710 Californian families in which the first born had received an ASD diagnosis. The researchers compared the incidence of second births in this group, with 36,215 families in which the first child was developing normally. Second births happened with the same frequency in both groups for the first three years, but then decreased in frequency by a third after that for families with the autistic first child. The significance of three years is that this may be the point at which a diagnosis of ASD was confirmed for the first child and that following this some parents decided not to have a second child.
Parents are understandably concerned when they consider whether or not to have a second child following a diagnosis of autism for their first child. They are aware of the risk that the second child may also receive this diagnosis. They also may be concerned that in meeting the needs of their first born, they will not have the necessary emotional and other resources needed for a subsequent child. Alternatively, they may fear that the demands of a second child may have a negative impact upon the care that they are able to give to the first.
However, many parents in this situation do have a second child. No matter what the needs of this second child, these parents can come to appreciate the special qualities of both their children. What remains important is to see each child as a unique individual who can make her or his own contribution to the family. It is also important, of course, to seek advice and help at the earliest stage if there are concerns about any child.
The results of the Californian study are briefly discussed in Medscape (free registration required to view article).
Do contact our clinic if you have any concerns about your child.
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