Considering Future Children
It is difficult, if not impossible, to advise a couple on whether or not they should consider having more children if they already have a child on the autism spectrum. So many factors are involved and it is a very personal decision. It is not a decision a couple can rush into or let others make for them.
Genetics or Unknown
If the ASD your child has is a proven genetic disorder, such as Rett Syndrome or Fragile X Syndrome, genetic testing is in order to determine the risk factors for a future pregnancy. If one child has been born with a genetic disorder, the odds are high another will be as well. In this case a genetic counselor and perhaps family counseling can help you reach a difficult decision.
The cause of other disorders within the autism spectrum is unknown. They could be caused by genetics, the result of unknown disease processes, or something in the environment—the bottom line is: no one knows. No matter what testing is done, there is no way to know if another child would develop autism.
There are many cases of families with a child with autism who have a child with another developmental disability. For example, ADD/ADHD is common in the siblings of a child on the autism spectrum.
Mental, Emotional, and Financial Impacts
Not only should a couple consider the mental and emotional impact of having a special-needs child, they should also consider the financial and long-term issues involved with raising children on the spectrum. It is rare for private insurance companies to cover any treatment that is needed for autism and related disorders, but this situation should improve under the new health insurance law.
If your child has private insurance and sees his doctor for a condition unrelated to autism, be certain that the insurance forms do not indicate the diagnosis of autism. If a child is seen for an ear infection, it is not necessary to include the autism diagnosis, which may block benefits, but under the new law it should not.
There are government programs to help parents who meet certain guidelines. SSI, or Supplemental Security Income, is a program managed by the Social Security Administration. It was put in place to assist blind, aged, or disabled individuals who meet certain financial criteria. Benefits are paid directly to families to help with the expenses of daily living. Autism is an automatic allowance for benefits if your family meets certain qualifications such as income level and value of assets.
Be certain before you apply for SSI that you are able to thoroughly document the diagnosis of an autism spectrum disorder by physicians, a child psychologist, therapists, and even school personnel. Regardless of a child's age, the school system should help with early intervention. Even if your child is under school age, contact the school district to find out what programs and resources are available.
It is also important to remember that financial planning must be in place to protect and provide for any special-needs children if a parent dies. Life insurance, trust funds, and wills that provide for guardianship of a child are not luxuries. They are necessary and must be kept up-to-date at all times.
It's Your Decision
There are many well-meaning people, such as extended family, friends, and in-laws, who often feel it is their place to advise a couple on their family planning. Although it is difficult, you must stress, very kindly, that this is a personal decision and let the matter drop. If people persist in advising you against your wishes, be firm but polite in asserting your right to privacy.
If you decide not to have any more children, be at peace with that and do not allow others to make you feel guilty or inadequate. Many people feel it is their business to advise other people on childbearing and raising their children. It is no one's business but yours; just politely thank them for their interest and change the subject. If you decide you do want more children, again do not let others spoil your joy. These decisions are yours; you and your spouse will make the best decision for your family.