Is Autism On The Rise?

The CDC released a report last month that suggests that 1 in 88 children suffered from Autism Spectrum Disorders (ASDs) in 2008. The new number represents an increase prevalence from 1 in 110 ASD sufferers in 2006. This report May alarm new parents health care providers and those in government however the news deserves some discussion. The report itself recognizes that there is an opportunity for clarity in the reasons why the numbers are going up. The government website for National Institute of Health (NIH) states that It is unclear whether this is due to an increasing rate of the illness or an increased ability to diagnose the illness. referring to ASDs.

What parents should know is that:

  1. The prevalence range doubled. This indicates a problem in standardization of the either the collection or interpretation of the criteria needed to be considered ASD.
  2. That when educational information is available it correlated to higher rates. This is information from guidance councilors teachers special education instructors and is not necessarily from a doctor or health care provider.

The study maintains that Autism spectrum disorders (ASDs) are a group of developmental disabilities characterized by impairments in social interaction and communication and by restricted repetitive and stereotyped patterns of behavior. This report relied on The American Psychiatric Associations Diagnostic and Statistical Manual-IV Text Revision “Disorders Usually First Diagnosed In Infancy Childhood or Adolescence” n.d(DSM-IV-TR) diagnostic criteria for any of the following conditions: Autistic Disorder; Pervasive Developmental Disorder–Not Otherwise Specified (PDD-NOS including Atypical Autism); or Asperger Disorder to define the disability. So when a child is placed in this group they could be between a new born and eight years old and they could be severely disabled or a child who gestures instead of uses words or one who has a short attention span.

The degrees to which ASD has become an acceptable diagnosis is very wide and it might be getting wider since the descriptors are used by non-health professionals in non-malicious ways to document a childs behavior. The other consideration in this regard is that the ages of diagnosis range from days to years old. Having eight years to develop a history where the case could be made for an ASD diagnosis increases the likelihood that one will be diagnosed.

How the study was done

The information used in the report was gathered by data sources that are categorized as either

  1. Education including evaluations to determine eligibility for special education services or
  2. Health including diagnostic and developmental assessments from psychologists neurologists developmental pediatricians physical therapists occupational therapists speech/language pathologists and other providers.

The study is a surveillance report conducted by the Autism and Developmental Disabilities Monitoring Network (ADDM) and does not rely on professional or family reporting of an existing ASD diagnosis or classification to ascertain case status. Instead information is obtained from childrens evaluation records to determine the presence of ASD symptoms at any time from birth through the end of the year when the child reaches age 8 years. ADDM focuses on children aged 8 years because a baseline study conducted by CDC demonstrated that this is the age of identified peak prevalence.

The data is the then reviewed in two phases.

The first phase requires a trained clinician to comb through the data provided by the data sources looking for -->serif;">’-->serif;">”triggers-->serif;">’-->serif;">” (e.g. child does not initiate interactions with others prefers to play alone or engage in solitary activities or has received a documented ASD diagnosis).

In the second phase a child is included as meeting the surveillance case definition for ASD if he or she displays behaviors at any time from birth through the end of the year when the child reaches age 8 years as described on a comprehensive evaluation by a qualified professional that are consistent with the DSM-IV-TR diagnostic criteria for any of the conditions listed above.

Prevalence of Autism

The data collected in this 2008 report compared to the 2006 report has an increase in the range of prevalence per 1000 children (from 4.2-1.1 to 4.8-21.2) which indicates that some change or variation exists in 2008 compared to 2006 either in the data collected or in the interpretation. The major factor in variation in estimated ASD prevalence was associated primarily with sites having access to education records and also appeared to be associated with improved identification among children without intellectual disability according the the study.

My Opinion

Dont be alarmed by this study.

What I think is happening is that our school systems are documenting more kids with short attention spans and that this is acting as a trigger for labeling. Parents have been threatened with having their children removed from school unless they agree to place the child on some prescription medication.

A side-effect of all this is that harmful drugs will be prescribed and more children will be numbed by them during this time of explosive cognitive and creative development.

 

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