a mother hugging her sonMany parents admit that raising a child with autism is difficult. Is the challenge of caring for children with autism encouraging families to have less children? A study from the University of California San Francisco and health provider Kaiser Permanente finds that parents of a child with autism are less likely to have more children, compared with families with no autistic children. The results may suggest the need for greater society-wide support for families affected by autism.

The study, one of the largest on reproductive behavior for families affected by autism, used data from 56,000 California families. Families of over 19,700 children with autism born between 1990 and 2003 were included in the analysis as well as families of more than 36,200 children without autism. The children were demographically matched for age, sex, maternal age, and more.

Parents of children with autism often choose to stop having children: they are 33% less likely to have no more children than parents with no autistic children. Furthermore, women with autistic children who change partners are around half as likely to have another child. Indicators of autism spectrum disorders like motor and communication deficits often manifest around age two, which is when families of children with autism elect to have no more children.

The researchers also found that prior studies about familial trends in autism may be underestimating the connection between family relationships and autism. Because other studies did not account for the many families with an autistic child that stop having children, the risk for autism spectrum disorders among family members may be higher than previously thought.

The reasons that families affected by autism have fewer children were not surveyed. The researchers speculate that the difficulty of caring for a child with autism and reluctance to care for multiple children with autism are primary factors motivating this trend.

This research is published in JAMA Psychiatry.

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