Opposing Views: NEWS:Study Says 1 Out of Every 91 Kids Has Autism Spectrum Disorder

Study Says 1 Out of Every 91 Kids Has Autism Spectrum Disorder

By Dr. Gwenn , Founder, Pediatrics Now - October 06, 2009

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By now you’ve likely heard about the new Autism study out today in Pediatrics.

It’s a solid study that adds great value to the Autism landscape. To help clarify questions raised by the study, the American Academy of Pediatrics has put together a very comprehensive Q&A that is worth checking out.

What’s important to understand about this study is that it represents an evolving understanding of the entire field of Autism. Keep in mind that Autism is not just one condition but a spectrum of disorders. It can be very difficult to diagnose and the goal over the last few years has been to attempt to screen children as young as 18 months and intervene as early as possible with behavioral modalities. This is the type of condition where early identification and intervention does make a huge difference.

So, has there been a true increase in Autism, as the study suggests? Maybe, may be not. Because of our better understanding of Autism and our better screening tests, we are certainly picking up more kids at younger ages. Whether this is a true increase in rate we don’t know yet but we do know we are doing a better job in identifying kids who may have Autism, and that is very important.

And, it’s equally important we remember that not all children initially diagnosed with Autism actually have it. The study notes that 38% who are initially diagnosed with Autism “lose the diagnosis over time.” I can think of 2 reasons for this.

1. Our diagnostic criteria are constantly evolving so some kids stop meeting the criteria for Autism but are found to actually have other behavioral disorders.

2. Our screening tests for Autism are working as they should. A good screening test will always pull in kids who on further testing are found to not have the test they are screened for but have something else.

For either of this situations, this is still good news for these 38% of children because they are still identified as having a behavioral issue that needs pursuing and intervention. That’s significant even if the final diagnosis turns out not to be Autism.

More studies will need to be conducted to tease out where we truly are in numbers but studies like this help us see that we are making progress in a very confusing situation.

Regarding Article

NEWS:Study Says 1 Out of Every 91 Kids Has Autism Spectrum Disorder

Dumb Headlines

I hate dumb headlines like this. This gets parents and ignorant people who don't realize that this refers to autism spectrum disorders, many of which include only mild learning disabilities which can be overcome through extra attention at home and in school at a young age (leading me to question whether they deserve to be classified as disorders, but that's another debate). Stats like this start to scare parents for no reason and that's why I hate these headlines.

Also, I can't comment on the validity of the studies numbers anyway since my school doesn't have an access code to that journal and I'm not paying $12 for it (I pay enough in journal access fees - academic journals are the biggest rip-offs ever).

- caelum October 6, 2009 11:59AM

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- Headline Correction
  
  Ed's Note: The headline has been changed.
  
  - The Big Kahuna October 6, 2009 1:59PM
  
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- it must be nice that if you have healthy children!!!
  
  I really feel that people who do not have a child with autism or that do not have a child that is on the spectrum really has no place to make such a foolish comment. I love that you say some extra attention is all some of these children need... wow... I wish it was that simple. I invite all to really educate themselves and maybe pay for a book before making comments like this. STATS should SCARE parents!!! When are people going to wake up and see what is happening to our children!! I have a child with autism and let me tell you, if it were as easy as giving some extra attention to these children then nobody would mind getting the diagnoses. Do you have a clue what we as parents have to deal with when it comes to fighting for any help for our children? Do you think we are just so over diagnosing now that 15 years ago when it was 1 out of 10000 children that there is no way it has dramatically "really" gone up to 1 out of 91? Seriously??? We need to come together as a communtity and help our children. THIS IS REAL!!! It is bad enough parents have to figure out so much on their own when it comes to therapy, diets, SI and biomedical but, now we have to debate with the general public who are not going through what we are that it is real.... when you can walk one day in a parent's shoes that has a child with autism then and only then should you comment.
  
  - jaxsonsmom October 6, 2009 2:15PM
  
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  - laughable
    
    The CDC redefined autism years ago. The numbers for classical autism are the same as they were 15 years ago. You apparently don't understand the difference between classical autism and autism spectrum disorders.
    
    And what do you think the treatments are for the majority of the children in this number who are at the very borderline of the autism spectrum? Extra attention with development at schools and homes. Classical autism needs very intensive therapy, the borderline spectrum disorders which this study is talking about don't.
    
    It's not really a matter of opinion, NIH and CDC studies will support exactly what I'm saying. So if you are so concerned about autism, trying learning at least a sliver about it.
    
    - caelum October 6, 2009 2:50PM
    
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    - laughable!!
      
      Name a couple of those studies that you can get at your school at support your point of view!!
      
      - bobby October 7, 2009 2:44PM
      
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  - Different diagnostic criteria
    
    Today the huge numbers of children that have some form of Autism were said to be hyperactive or different etc. That is why so many are diagnosed now. I have made a study of Aspergers Syndrome (one of the spectrum disorders) since my, to me, normal grandson was diagnosed with it. Guess what? I have it. The symptoms fit me to a tee but I was never diagnosed. There have been countless millions like me over the past years undiagnosed. In the past only the most severe forms were diagnosed. The rest were ignored.
    
    - tbcass October 7, 2009 11:33AM
    
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  - Walk a mile in the childs shoes
    
    Parents who simply do not get Asperger, and then decide that they actually know how to deal with us, really annoy me. We aspies, regardless of age, will never fit your world and simply do not want to.
    
    If your child is Asperger, then he/she is smarter than you, and most likely smarter than the so called experts, you are inflicting on him/her.
    
    The reason so many parents of these gifted children have no idea what to do with them, is you want them to talk to you, be interested in what you see as interesting, play with other kids , in other words be everything they are not.
    
    As an Aspie, I still don't play well with others according to them, I still don't do talking if I am not interested in the topic, and I still hate it when you NT insist we look at you all the time, and I am 59.
    
    I have walked my whole life in the shoes of an undiagnosed Aspie, so I know what your child knows and feels, the hurt and anger at having to be what others want, to be involved in things that hold no interest for me, to have to communicate with kids and adults when they have nothing to say that could ever hold my attention.
    
    So while you are feeling sorry for yourself, being a parent of a highly intelligent child, who happens to have a personality that you don't understand, how about walking a mile in your child's shoes and see how you like what you are doing to him/her.
    
    The only cure required for Aspies is an NT vaccine, that way we will not have to play their silly games, to fit in.
    
    - littlbit October 7, 2009 4:53PM
    
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Is Autism the New Diagnosis Duh Jour?

I am a psychologist with over 30 years of experience. My primary field of practice has been pediatric. I have worked in schools and private practice. For the past four years, I have worked with children under three years old. I am a member of the National Honor Psychology for Psychology, and have been president of my state School Psychology Association. I guess that this qualifies me as a sort of expert.

I have seen mental health fads come and go. The biggest debacle in my honest professional opinion has been the over medication of children for ADHD, with subsequent finds that these children may be Bipolar, or have sleep disorders. I generally regard my mental health brethren with a healthy grain of salt, and have still managed to keep my blood pressure down.

Now, as to autism spectrum disorders. There has been a huge increase in referrals for this disorder, primarily because of advertising. The questions exists about whether we need to turn a deaf (or at least partially hearing impaired) ear to Autism Speaks. Some research indicates that many of those identified as autistic today, would simply have been identified as being language impaired years ago.
Part of the problem with autism is related to impaired social skills. I think that we should leave that one alone (lol). During my job, I make home visits. I'd say that over 90% of the homes that I visit have a television on and a child standing or sitting within a foot of the 32 inch to 60 inch flat screen. They are not interacting with people. The television is the newest social milieu. That is something needs to be severely curtailed. The fact that the American Academy of Pediatricians recommends no television or a maximum of an hour of television per day for the small kiddos has not made it into the world.
There are issues of chemical causation or attachment disorders. Attachment disorders in very small children can resemble an autism spectrum disorder.

Final conclusion - The epidemiological statement that 1 in 91 children is born with autism is ill-considered. Get to work on the cause of autistic behavior (not all of which is directly physical). Teach adults how to parent again.

- Rashi18 October 7, 2009 10:49AM

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- Yes and no
  
  It is conceivable that autism rates are increasing (perhaps due to ever newer forms of chemical pollution in the environment ). It it is also indisputable that doctors are including more and more people with less severe symptoms who in the past would not have been given that diagnosis.
  
  For example, I have mild Asperger's Syndrome (which is itself a mild form of autism). I was never diagnosed with a problem as a child because I was easy to care for, obedient, and did well in school ; later I was able to work for a living, marry and raise a family. Yet, I have no doubt that a developmental disorder left me completely without the extravesion and interpersonal skills that would have allowed me to get a hot date for the high school prom, pick up women in singles bars, or rise through the ranks of corporate management -- despite having a decent physical appearance and an extremely high IQ. This is a neurological disorder that left me without the capability of ever developing a decent handwriting or hitting softball into the outfield; a disorder that has made me extremely absentminded, bored to tears by small-talk, obsessed with a few topics of special interest, and perceived as cold and weird by my peers.
  
  It is conceivable that there may be more children like me today than there were fifty years ago (I cannot recall knowing _any_ other children who were like me when I was in school). But even if there were, we would not have been diagnosed -- our problems would have been dismissed as mere personal failings.
  
  - fsilber October 7, 2009 12:56PM
  
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- Profession du jour?
  
  Actually you demonstrate your lack of understanding of autism and therefore raise a question as to your true background. You stated that "you make home visits and that 90% of the homes have a television and a child standing or sitting withn a foot..." blah blah blah. Care to demonstrate how many of those children showed signs of autism before they started watching T. V.? There aren't statistics held on that, so be careful before you answer. In the recent Autism Vaccine Trials it was interesting how the initial children were demonstrated to be suffering from autism BEFORE they were likely to be watching T. V. for any length of time.
  
  Guess what, with every autistic child I have met (over 300 in four countries), the one single symptom that made them similar was that 100% all had a special toy or material given to them that they would not leave behind. All of them! They all carried that toy all the time. I guess that means that the parents were bad parents because they gave the child a toy rather than playing with the child.
  
  You also bring up ADHD? care to explain how ADHD relates to autism other than in the press? What medical or physiological or psychologial relationship exists?
  
  If you have been in business for 30 years, then you know that the biggest issue facing parents of autistic children are people trained by Bettlehiem that believe that hysterical women are to blame for the rise in autism. What a bozo idea!!!
  
  Were is your distain for the medicos that charged desperate parents $20,000 for a single vial of $100 secretin? Where is your anger at teachers who deliberably create antagonistic situations to force the removal of autistic people? Why are you not outraged at psychologists and psychiatrists who put their agenda before the needs of the child?
  
  Shame.
  
  - bobby October 7, 2009 3:27PM
  
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  - Psychologist Bozo Replies
    
    Has anyone read "A Dose of Sanity" by Sidney Walker, III, MD? Great book! The author is/was a psychiatrist who clearly, in plain English describes how 40% of all mental health diagnoses are incorrect! He also wrote the "Hyperactivity Hoax" another great book.
    
    I wonder how much research the respondent has really done. Some lay people are real suckers. Let's consider some interesting things related to autism . Has the respondent ever heard of Smith-Lemli-Oppitz Syndrome? I doubt it. This is a genetic disorder that is almost always fatal. It has all the characteristics of autism. However, it can be treated with cholesterol supplements. That's correct, there are disorders of low cholesterol. A clever scientist at the Kennedy Krieger Institute of Baltimore studied 100 people who were diagnosed with an autism spectrum disorder, and found that 25 had low cholesterol. Supplement the cholesterol (as in eggs and bacon with butter and cheese for breakfast every day OR cholesterol pills) and the autism symptoms diminish or disappear.
    
    I saw a child who had many of the characteristics of autism and would have been diagnosed with it had I not referred to a neurologist because of suspected Acquired Epileptiform Aphasia (aka Landau-Kleffner Syndrome).
    
    Lets try another example of potential misdiagnosis that was spotted by me. A 9 year old girl from another state was fidgety, and unable to pay attention. She move around frequently. Her school wanted her referred to a psychiatrist for an ADHD evaluation. The girl's grandmother, realized that if you are a hammer, you see everything as a nail (love that). She knew me. She had her flown in, and paid cash for the evaluation (I hate dealing with insurance companies). I saw her problems and referred her for an appropriate evaluation. She had an arterio-venous malformation of the kidneys, which when corrected, reduced her frequent need to use the restroom (fidgetiness and hyperactivity). She also had an extra bone in her writing hand, which, when removed made her much more willing to write and pay attention. If she had taken Ritalin, Concerta, or similar meds, she might never have gotten the help that she needed.
    
    So, my friend, who is the untrained bozo now?
    
    - Rashi18 October 7, 2009 6:50PM
    
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    - I'm sticking to the point
      
      Once again you prattle on about everything other than Autism. Why is that? Do you have nothing to say about the rate of autism ? The likelihood of its occurrence, comments on the 1 in 92 rate?
      
      Oh, and yes, I am not part of the saintly brotherhood of psychiatrists or trick cyclists. I am a lay person, so what?
      
      As to my research, not a lot, some 500-1000 articles in the 16 years since my first child was diagnosed. I’ve read more than 30,000 idiotic notions from a bunch of snake oil charmers, many in the autism community. I and my family have participated in more than 10 research projects. And, pray tell, what research have you done on AUTISM?
      
      Smith-Lemli-Oppitz syndrome I have heard of as it was one of the things that both my children were tested for, and as you mentioned, it is testable, and therefore is not likely a cause of the number of children diagnosed with autism. Not sure why you bring it up other than to prove you know something more than me. I also know three children in the same family who have Landau-Kleffner. So again, lets get back to the point. What does letting children watch television have to do with autism?
      
      Remember, your boorish statement was that autism was caused by bad parenting . Not that there was massively poor diagnosis skills in the psychiatric community, excluding you of course. According to your comments you are the genius that saves children from a fate worse than death.
      
      But again, let’s get back to the point. Your statement “I make home visits. I'd say that over 90% of the homes that I visit have a television on and a child standing or sitting within a foot of the 32 inch to 60 inch flat screen”.
      
      Sure sounds like you have a clear cause for autism. If only the parents would parent. To me, it doesn’t look like you have anything in there about bad diagnosis. You blame the parents.
      
      It’s then that you prattle on about kids with extra bones in their hands and malformation of the kidneys. Again these are testable features. What do they have to do with the rise in autism rates? All of your examples were never included in the autism numbers. So now what? You really are living up to your moniker on the previous post.
      
      - bobby October 13, 2009 1:30PM
      
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      - Brutal Bettelheim was not the answer
        
        Promoted disorders create panic.
        
        Last night, I attended a workshop put on by the American Academy of Pediatrics. The topic was New Screening Guidelines for Autism. They bought the attendees dinner. Here are some pertinent points:
        
        The rate of autism has risen to 1 out of 100.
        The disorder is genetic but there are 22 identifiable genes associated with autism.
        There are secondary diagnoses. SLOS (Smith-Lemli-Oppitz Syndrome is one).
        The darling diagnostic tool of Peds is the MCHAT which has a high number of false positives.
        The three post screening diagnostic aids mentioned were The Childhood Autism Rating Scale (CARS), The Autism Diagnostic Interview, and the Autism Diagnostic Observation Scale.
        Genetics conveys susceptibility but does not guarantee that a person will be autistic .
        Pediatricians need to be aware of local agencies that would complete the diagnosis.
        
        The food served was delicious.
        
        Rejoinder.
        
        Think about whether the secondary diagnoses are, in fact, the primary with autistic characteristics being the primary.
        Every instrument mentioned contains the word "autism" in the title, setting up a response bias . I personally like the Infant Toddler Social Emotional Assessment (ITSEA). It does not set up a response bias, but enables the differential diagnosis of other problems.
        Television interferes with social development. Social skills and behavior are an important part of the autism diagnosis. Parents leave a television on every day sometimes all day. Not all parents do this, but many do. There is real research out that demonstrates that the presence of a playing television reduces parent-child interactions which are the sine qua non of early social development (Brutal Bettelheim did not know of such things - he died long before that research was done).
        
        I am sorry if you think that I believe that parents are the only problem - autism is too complex a construct to blame one cause. I believe that thinking on the matter has been too narrowly focused on disorder promotion rather than prevention.
        
        - Rashi18 October 14, 2009 6:52AM
        
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Study validity

The link you posted does not link to the actual questions used in the telephone interviews. Also, telephone interviews are not reliable sources for studies. The CDC study is far more representative in that it actually looked at medical records from a fairly large population. It's a testimony to the ineptitude of the press that studies like this consistently make the headlines .
I place more credence in the comments by Rashi18. It appears that he has at least had first hand professional experience with the issue.

- Heretic October 7, 2009 11:12AM

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So?

Autism is most likely an evolutionary mutation, not a disorder. Why do some people think they can or should try to cure people of the process of evolution ? Doesn't that smack just a bit of prescriptive eugenics?

The traits associated with autism have been around a VERY long time, thus so too have the genes involved been in the human gene pool a very long time... and they're not being eliminated! If anything, they are becoming more prevalent, if "studies" like the one quoted here are to be believed.

Why is that? Why aren't the traits disappearing? Could it possibly be that not ALL the traits expressed by those genes are actually an evolutionary advantage? Could it possibly be that some of them are actually advantageous to success? If we "cure" autism by excising the responsible genes, don't we also risk excising those advantageous traits from the gene pool as well? Can we really afford to lose a tendencies toward advanced reasoning, problem solving, and ability to focus narrowly on one subject over a lifetime? Would we have missed some of the great breakthroughs in science and mathematics if we had succeeded in curing autism centuries ago?

Certainly not every expression of these genes in individuals is identical, and there is often some yang to endure along with the advantageous yin. However, isn't that really the same challenge faced by EVERY living creature: to learn to use its strengths to its best advantage and cope with its weaknesses? How about we simply help people with that process rather than trying to "cure" the evolutionary process that made them unique in the first place?

Attempting to "cure" autism is EUGENICS. Is our knowledge of ourselves, our brains, and our bodies so advanced that we can reasonably take prescriptive control of our own evolution and do a good job of it, like we've been doing such a good job managing our environment ?

This is a case where the cure might actually be far worse than the "disorder". As a high-functioning autistic person myself, I quite frankly view my fellow neurotypical humans as the ones who deserve to be called "disordered". How about you let autistic people themselves declare their own status, rather than having that declaration and diagnosis forced upon them by the tyranny of the neurotypical majority?

- VulcanTourist October 7, 2009 1:32PM

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- Interesting position
  
  Being the father of two girls with autism , and a likely sufferer myself, I can well feel the need to "Help" our children through any means necessary. However, I do think that those who are to be "helped" need to be involved in the decision making process. I can not decide for my 19 year old daughter what she may or may not do. However, in the recent Auton case conducted in B. C., and ultimately the Supreme Court of Canada, it is interesting that the court decided that the participation of Autistics was to be prevented. To me that says the problem is not one of Eugenics, but is rather a condition of human rights.
  
  For most, we have the right to decide. We even debate the right of those in extreme pain or decrepetude the right to decide their own lives. They have a chance to be involved in that discussion and may even create living wills. But anyone classed as an Autistic can not in any way be involved in a case that is clearly trying to determine their right to choose their own lives.
  
  Michelle Dawson and others have been far more elequent than I, but it really is time that autistic people were no longer discriminated against. Not in terms of having vast sums of money to support questionable services. Rather, they need to be able to participate in the decisions and actions the determine their lives.
  
  - bobby October 7, 2009 2:58PM
  
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We shud check for autism early...

Autism, if detected early and treated can be
reduced/minimized so that a child can develope
and mature without being condemned to a life of
abnormal stimulation, confusion, etc...We can
fix or control other disorders and deformities;
why not autism ?..Aaron Allen..

- Aaron October 7, 2009 11:57PM

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- others
  
  What we can do for a disorder depends on how well it is understood. Most disorders (such as Downs Syndrome) can only be treated, not fixed.
  
  The mechanism behind ASD is still not well understood, though there is strong evidence to support a genetic origin. Counseling and other focused does help develop people with ASD, but it really is not a 'cure'
  
  - MrBook October 8, 2009 6:30AM
  
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  - I agree with you [no 'cure'] but...
    
    Hi Mr Book: I agree with you that there is not
    really a 'cure' but early detection and treatme
    nt/therapy can make a great differece in a pers
    on's life--who wants an undiagnosed and neglect
    ed childhood, adolescence and adult life under
    such a curse as autism ?..Many victims can help
    themselves [when the learn 'what is wrong' with
    them] and learn methods of coping with overstim
    ulation, bright lights, excessive noise, etc...
    I notice now that some TV programs and films po
    st the warning, "contains bright light-flashes,
    noise, etc. [like warnings about visuals, langu
    age, situations]. I wonder if someone who is en
    lightened and informed about autism and similar
    disorders is in charge?..Aaron Allen..
    
    - Aaron October 8, 2009 12:08PM
    
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  - Genetic Origin?
    
    A book that I recently read, "The Neurobiology of Autism" Second Edition, edited by Margaret L. Bauman, MD and Thomas L. Kemper MD and published by Johns Hopkins University Press has an entire section on this containing seven chapters. The introductory chapter states that there are at least 15 DIFFERENT genes that appear to have something to do with genetic susceptibility to autism . That is a big number, huh? Those of you who are sophisticated enough to understand ought to know that genes do not guarantee that someone will inherit anything. Those of you who are sophisticated ( education and training) enough to know are also aware that methylation causes changes in gene and chromosomal structure. Most of the impact of this is associated with the environment . Geez, is nothing sacred anymore? How do you tell the difference between a male and female chromosome? Easy (not!). You just pull down their genes.
    
    - Rashi18 October 8, 2009 12:11PM
    
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More On Knowledge and Epidemiology

One of the places that I serve is a Group Home for clients that are identified as being autistic . There are four adolescent clients/consumers in the home. Two are not autistic. This is based on prior diagnoses. However, all four would count in a census of who is autistic in the world/USA. One has a confirmed diagnosis (medically/physiologically) of Citrulinemia, and the other has a confirmed (genetically) diagnosis of Smith-Magennis Syndrome. Pediatricians should know that Citrulinemia is a urea cycle disorder that, caught early enough, can be treated without an excess of ill effects. Smith-Magennis Syndrome is another story. I first met that person when he was six years old and no one thought that anything was wrong with him. In both cases, there are behaviors that present as autistic characteristics. Treating each strictly as autism would be inappropriate. I am glad that I deal with the behaviors rather than the diagnoses. However, I'd bet that one could find lots of folks who should not have a primary diagnosis of autism.

The increased identification of autism generates loads of money , publicity, and pity.

- Rashi18 October 8, 2009 6:44AM

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News Coverage

I think news media coverage of autism has greatly impacted our understanding or misunderstanding of autism. While I'm not expert on autism, and do not have an autistic child, I think its obvious that there has been a lot of speculation and misinformation surrounding autism. Like many other have said- if anything studies such as these are important to gain awareness about autism and hopefully secure more funding for research in the future. For a good recap of this issue, and to see how its been recently covered by the media check this out: http://www.newsy.com/videos/autism_on_the_rise

- ChiChica October 9, 2009 12:24PM

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