Have you and your partner considered the chances of having a child with autism?
And what are the chances of having another child with autism if your first child has autism?
Every parent knows all too well that having a child completely changes your life for ever.
For the better, for sure!
Though there are moments when you are cleaning up poop, listening to 3rd hour of continual crying, or being called to the school for your child’s bad behaviour when you seriously wonder if you could do this all over again!
If you happen to have a child with autism, you know already the extra demand on your energy levels, your sanity, your finances with extra therapy, special schools and doctors appointments.
And while you love your child completely and unreservedly, some parents admit “feeling guilty” if they secretly hope their second child does not have autism.
There are also feelings of “will you have enough time?” for the second child as your first child already takes up so much time.
There is a lot to unpack and consider here.
This is complicated of course by the fact that there is not one clear cause for autism
What Are The Chances Of Having A Child With Autism? And Does This Go Up For A Second Child?
In general, for any random couple, the chances of having a child with autism spectrum disorder(ASD) is approx. 1 in 68 or 1.5%.
But the risk does go up dramatically to 20% for families who already have a child with ASD.
If the family already has more than one child with ASD, the chances of another child having ASD increases to 30%. And the risk is even higher, if that child is a boy.
So it is clearly something parents must think about carefully before plunging in without thought.
Risk Factors For Chances Of Having Another Child With Autism
There are several factors that will raise your chances of having a child with autism. A lot of the data has been studied extensively by Sven Sandin, statistician and epidemiologist at the Karolinska Institute in Stockholm, Sweden, and the Icahn School of Medicine at Mount Sinai in New York City.
He studied health records of more than 5.7 million children born between 1985 and 2004 in Sweden, Denmark, Norway, Israel and Western Australia.
The data showed increased chances of having a child with autism if these factors are present:
Less time between births
You are more likely to have a child with autism with 1 year between siblings than 3 years for example
If the mother is over 40years old the chances of having a child with autism rise steeply.
And its not just the mother. Fathers who are over 50 years old increase the chances 66% higher chance due to defects in sperm quality.
There is a link with teenage parents and increased risk of autism. Teenage girls are 18% more likely to have a child with autism than women in their 20s.
Large gap in age of the parents
If there is over 10 years in age gap between the parents there is increased chance of having a child with autism.
Children are least likely to have autism if both parents are in their 20s or 30s at the time of birth.
Do Genetics Increase The Risk Of Having A Child With Autism?
There is no know cause of autism but in approximately 10% -15% of cases, there is a known genetic cause for autism found through genetic testing. Though in some families, autism does appear without any family history.
In instances where a genetic cause is unknown, different types of studies have found varying rates of recurrence risk.
Studies by Gronborg et al., 2013, have found that 4-7% of families had more than one child with a ASD.
The highest rate of recurrence found by Ozonoff et al., 2011, was almost 19%, was found in a large, prospective study of younger siblings of children with an ASD.
On average, for a couple with one child with ASD of unknown cause, the current best estimate of recurrence in a subsequent child is approximately 10% based on the most recent and well-designed studies.
Because this is much higher than the 1% chance of any random couple in the general population having a child with ASD, the younger siblings of a child with ASD should be monitored closely and screened for ASD .
If you already have two or more children with ASD, the chance of a subsequent child having an ASD may be as high as 32-35% (Ozonoff et al., 2011).
If you currently have a child with autism, you may consider genetic testing to see if there is a known genetic link with autism.
Of course, if the testing comes back negative, it does not mean that there is no genetic link, it just means the current test did not identify anything
What To Do If You Think You Might Have An Increased Chance Of Your Next Child Having ASD?
It’s a big decision, and as there is no guarantee either way, you won’t know for sure, until it happens!
It is a good idea to have some serious talks with your partner and with your family (especially if they help provide support, child care or help with finances for your first child).
Here are some important discussion points:
How would you both feel about having another child with special needs?
How would it affect our family?
How would it affect us as a couple?
Do we have the financial stability and capacity to give another child the care and support they need?
How would you both feel about not having another baby?
Is There Any Way To Reduce The Likelihood Of Having A Child With Autism?
Sadly, there is not too much you can actually do to reduce the risk of your next child being autistic.
Of course, the usual advice for every healthy pregnancy applies – such as excellent nutrition, rest, exercise, check ups, positive thoughts and feelings.
But you cannot change your age.
You cannot change your DNA.
If there is a known genetic link, some parents consider IVF and use an embryo to reduce the chances of having a child with autism. In some countries, sex selection of the child is not allowed except to prevent known genetic disorders like ASD, muscular dystrophy and fragile X syndrome.
Rules differ in different countries and states, so discuss your options carefully with your doctors.
If you do decide to have another child when your first child have been diagnosed with autism, you do have increased chances of having a child with autism.
So make sure it is a conscious decision. There is a lot to consider and a lot of factors to weigh up.
After the new baby is born, be very vigilant about early screening and diagnosis so that if your next child does have autism, they can have early intervention and ensure the most positive outcomes for both your child and the whole family.
It is not be a good idea to become pregnant “hoping” for a certain outcome and then being disappointed and suffering increased stress and strain. That does not help the new child or the existing family dynamics.
Also remember that if you do decide to have another child, there is still a 70-80% chance that they will not be born with autism. If you are mentally, financially and emotionally prepared for either outcome, then you will be fine and delighted with the new addition to your family.