Elizabeth Mumper, MD, FAAP*

Emerging research suggests that the timing of environmental factors in the presence of genetic predispositions has influenced the increase in autism spectrum disorders over the past several decades. A review of the medical literature suggests that autism may be impacted by environmental toxicants, breastfeeding duration, gut flora composition, nutritional status, acetaminophen use, vaccine practices and use of antibiotics and/or frequency of infections. The author reports her retrospective clinical research in a general pediatric practice (Advocates for Children), which shows a modest trend toward lower prevalence of autism than her previous pediatric practice or recent CDC data. Out of 294 general pediatrics patients followed since 2005 there were zero new cases of autism (p value 0.014). Given the prevalence of autism for that cohort of 1 in 50 children in the United States, it is important to consider implementing strategies in primary care practice that could potentially modify environmental factors or affect the timing of environmental triggers contributing to autism.

Key Words: primary care, autism, prevention strategies

Elizabeth Mumper, MD, FAAP^*
2919 Confederate Avenue, Lynchburg, VA
*Corresponding Author: 2919 Confederate Avenue, Lynchburg, VA 24501.
(Email: drmumper@rimlandcenter.com)

CONFLICT OF INTEREST
None.

ACKNOWLEDGEMENTS
Many thanks to the staff at Advocates for Children and Advocates for Families for their hard work and dedication: DeAnna Barnett, Lisa Coleman, Vickie Gardner, Susan Robinson and Sherry Taylor.
Derek Cate provided data mining services.
Thanks to Randy Beck, Randall Dunn, Brianne Friberg, Dean Moore and Katrin Schenk for help with statistical analysis.
Thanks to Julie Buckley, Mike Cooper, Tara Dunne, Gail Szakacs, Nancy O’Hara and Jill Roberts for editorial assistance.