Having another child when your child has autism spectrum disorder

Having another child when your child has autism spectrum disorder

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Thinking about having another child?

If you have a child with autism spectrum disorder (ASD), thinking about having another child can stir up many emotions - from excitement to worry. For example, you might:

  • worry that you'll have another child with ASD
  • be OK about having another child with ASD
  • feel guilty for wanting a child without ASD
  • feel excited at the thought of having a child with typical development
  • worry that you won't have enough time for your child with ASD if you have a newborn
  • worry that you won't have enough support to raise more than one child with ASD
  • worry about the impact of another child with ASD on your family relationships.

Risks of having another child with autism spectrum disorder

In general, the risk of having a child with autism spectrum disorder (ASD) is about 1 in 68, or 1.5%. But the risk goes up to approximately 20% for families who already have a child with ASD.

If a family has one child with ASD, the chance of the next child having ASD is about 15%. If the next child is a boy, that child is 2-3 times more likely to have ASD than if the child is a girl.

If a family has two or more children with ASD, the risk that the next child will also have ASD increases to about 30%. Again, the risk for boys is about 2-3 times higher than for girls.

The risks of having another child with ASD quoted above are estimates from a high-quality research study. They're not predictions for individual families. If you're not sure whether to have another child, it can help to talk to a genetic counsellor. Genetic counsellors can look at your individual situation, explain your risk and talk with you about your options. Ask your GP for a referral.

Risks of autism spectrum disorder characteristics

Younger siblings of children with autism spectrum disorder (ASD) are more likely than other children to have ASD-like characteristics.

This means that younger siblings are more likely to have language delays, difficulties with social communication, repetitive behaviour or narrow interests, learning difficulties and sensory sensitivities.

The risk of younger siblings having some ASD-like characteristics is about 20%.

Timing, birth order and parental age: influence on ASD risk

The less time there is between births, the higher the risk for autism spectrum disorder (ASD). This means there's a higher risk if there's one year between births, compared with three years, for example.

Birth order might have an effect on the severity of ASD. Second-born children with ASD seem to be more severely affected with ASD and more affected intellectually compared with first-born children with ASD.

The age of both mothers and fathers affects the risk of having a child with ASD. Just as the risk of having a child with a genetic disability such as Down syndrome increases as parents get older, so too does the risk of having a child with ASD.

We don't know exactly what causes ASD, but in about 10% of cases, there's a known genetic cause. Genetic influences can be inherited, but they can also happen spontaneously. For some families, ASD seems to 'run in the family', but for others, it appears out of nowhere.

Talking with your partner about having another child

If you're thinking about having another child, the first step is to talk with your partner. Here are some questions that you could talk about:

  • How would you each feel about having another child with special needs?
  • What would it mean for your family?
  • How would you each feel about not having another baby?
  • Would you consider in-vitro fertilisation (IVF)?
  • Would you consider adoption?

There are other things to think about as well, like:

  • your age - the risk of having a child with a genetic disorder increases with maternal and paternal age
  • your personal or religious beliefs
  • your resources for social and financial support
  • the age gap you want between your children.

Reducing the risk of having another child with autism spectrum disorder

Some families decide to try IVF so that they can choose the sex of their baby, and opt for a female embryo to reduce the risk of autism spectrum disorder (ASD).

The laws on sex selection vary across Australia. Australian guidelines state that sex selection must not be undertaken except to reduce the risk of transmission of a serious genetic condition. These guidelines are not legally binding.

Victoria, Western Australia and South Australia have passed laws covering sex selection. They allow sex selection to prevent disorders that occur mostly, or only, in one gender - for example, muscular dystrophy, Fragile X syndrome and ASD:

  • Victorian Assisted Reproductive Treatment Authority - Preimplantation genetic diagnosis
  • WA Reproductive Technology Council - Consumer information (click 'RTC fact sheets & publication' and download the brochure Preimplantation Genetic Diagnosis (PGD) in WA)
  • SA Health - Assisted reproductive treatment legislation.

The Library of Congress outlines sex selection law across Australia.

There's no right or wrong answer about having another child. It comes down to deciding what will be best for you and your family.