Increase in Autism Diagnosis

[Emergent]

The latest vaccination thread got me curious about autism and its higher rates of diagnosis today compared to past years. The link below discusses this. One theory is that autism is not actually increasing, but diagnosis of it is. That theory basically negates any links to environmental causes, such as vaccines, for instance.

The Increase in Autism Diagnoses: Two Hypotheses « Science-Based Medicine

This second link is to a academic study that is harder to read.

Social Demographic Change and Autism

I'll admit, I haven't thoroughly read it, only scanned it for interesting tidbits. It discussed social demographics of those with the autism.

This paragraph popped out at me, which essentially says that a diagnosis of autism is more socially acceptable than one of mental retardation (terminology from article, not me) See quote below, I bolded the idea I wanted to bring up.

In broad sweep, three ideas motivate most of the current accounts of the increased prevalence of autism. The first account is that increased prevalence stems from diagnostic dynamics, driven by process of diagnostic change, substitution, and drift (Shattuck 2006). Support for this hypothesis arises from the fact that early on in the epidemic, one could not observe the classic socioeconomic status–health gradient and that autism spectrum disorders (ASD) appeared to be a diagnosis of choice for middle- and upper-class parents whose children would be otherwise diagnosed as mildly or severely retarded, a disorder still associated with increased stigma. King and Bearman (2009) estimated that roughly 25% of the increased prevalence of autism is associated with diagnostic change on the mental retardation (MR) pathway.

I've wondered about this. I'm just a dispassionate observer in this topic, I follow the news and lean toward the theory that Autism is diagnosed more today, probably for more than one reason. I never bought the theory of it being caused by things like vaccines. I've seen too many trends of increased in diagnosis of other diseases such as ADHD, Bipolar, Fibromyalgia, all conditions that were previously not recognized.

I'd love to hear from folks, especially those with family members or friends with this condition. The second article also mentions that the diagnosis is more common in children born to older mothers. Of course, older mothers tend to have a higher socioeconomic status, but have higher rates of genetic mutations as well. I want to read the study thoroughly, but have to get ready for work. Very interested in feedback here.

[KatieMI, BSN, MSN, RN]

conviniently,

Data & Statistics | FASD | NCBDDD | CDC

So, estimated prevalence of alcohol fetal syndrome fell from estimated up to 1.5/ 1000 kids to 0.3/1000 in some 25 years. Do American women really start to drink so much less, or part of these kids are simply accounted for as "autistic"?

I noticed also that The All Mighty Customer Service Satisfaction Passion might have some effect on diagnostic decision makings. Patients regularly seen with full set of ailments caused by ETOH abuse but they deny it and nobody even thinks of encouraging or educating them about importance of medical workers being informed; I inquiried about this after catching a case of late development DT, and was told that the new definition of truth in that particular ER is whatever patient is stating, and any additional questionings are now strictly prohibited so that not to upset "customers".

Reg. trend of uniformity-right here there is a topic about a nurse being abused and mistreated for her being the only one African American at the place, with the collective quair of "not prejusted" singing to her every day. I experienced the same and worse treatment for being a single immigrant more than once. While most people lament this and think about such facts as illegal or close to illegal, we all know that mistreatment of "different" ones is just one sucking reality of life from kindergarten to the grave. No studies or research are needed to prove it.

[elkpark]

conviniently,

Data & Statistics | FASD | NCBDDD | CDC

So, estimated prevalence of alcohol fetal syndrome fell from estimated up to 1.5/ 1000 kids to 0.3/1000 in some 25 years. Do American women really start to drink so much less, or part of these kids are simply accounted for as "autistic"?

It may well be that some of the FAS kids are being called "autistic" now, but it is also true that, during that 25 years, there was a huge increase in understanding of the risk of FAS and publicity about not drinking during pregnancy. The rate of American women drinking may not have dropped, but the rate of American prenant women drinking certainly has. I recall when people thought drinking during pregnancy was no big deal. I was in nursing school in the early 1980's, and it was comparatively new at that time that there was any focus or emphasis on the risks of drinking during pregancy, and FAS was a relatively new dx.

[KatieMI, BSN, MSN, RN]

I thought it could be so but still... I work in inner city, and among this population ETOH (and other substances' abuse) is still very much a problem among women of childbearing age.

[elkpark]

I thought it could be so but still... I work in inner city, and among this population ETOH (and other substances' abuse) is still very much a problem among women of childbearing age.

Yes -- but, nowadays, the problem is pretty much limited to that population.

[sasha19]

Hi! I liked this original post quite a lot, as I have often thought about this question myself. I found the excerpt from the article intriguing and would love to read the whole thing if I can find it. I am a graduate registered Nurse about to sit for my boards, and for the past 4 years have been working my way through school as a paraprofessional in a middle school and high school autistic support classroom. I would tend to agree that perhaps the dx of "autism" is simply more "acceptable" to the majority of parents than being told your child is "retarded". Our school has both autistic support and lifeskills (class with kids dx'd with mental retardation and Downs Syndrome). Guess which class gets WAY more money/consultants/services..?? I think that for many parents, a dx of autism allows them (they are also encouraged in this by those who stand to profit from it) to cling on to the hope that their child can be fixed/cured....mental retardation though, by definition is not "fixable". I'm not saying this is wrong or passing judgement, after all who wouldn't want better for their child? And yes, I know there are those of you out there saying, "my child doesn't need fixed, there is nothing wrong with him, he just learns differently".. This is misleading, it may be true for those kids that are dx'd with what used to be called Aspergers, but the majority of kids with autism are in far worse shape. Every classroom I have worked in so far the parents of all of those children would have (and sometimes already have) given everything they own to cure their child. When your child is pulling out her hair and eating it, or biting through the skin on her arm, or biting/punching/kicking people and screaming randomly for no discernible reason, or pulling out her own permanent teeth, that isn't just different. Its heart breaking. Its the type of thing that used to fall under mental retardation or other personality disorders... Some one also mentioned about whether or not autistic kids have cognitive delays.. 5 out 6 children in every class I worked in had significant to severe cognitive delays in varying areas, PLUS social deficits on top of that.

[klone, MSN, RN]

Is it possible that we, as a society, are less accepting of differences in behavior over all? Is there more of a need to categorize everybody? Do we need to label and pigeon hole people?

I don't know.

For me, knowing what was wrong, and being able to put a label on it, was extremely reassuring. I knew from when she was 4 months old that there was something wrong, and as she got older, the "wrong" got more profound. So to be able to be able to identify what the issue was after many years, and be able to read about it, and talk to other parents and identify with their issues, was like a weight was lifted off my shoulders.

[Libby1987]

Hi! I liked this original post quite a lot, as I have often thought about this question myself. I found the excerpt from the article intriguing and would love to read the whole thing if I can find it. I am a graduate registered Nurse about to sit for my boards, and for the past 4 years have been working my way through school as a paraprofessional in a middle school and high school autistic support classroom. I would tend to agree that perhaps the dx of "autism" is simply more "acceptable" to the majority of parents than being told your child is "retarded". Our school has both autistic support and lifeskills (class with kids dx'd with mental retardation and Downs Syndrome). Guess which class gets WAY more money/consultants/services..?? I think that for many parents, a dx of autism allows them (they are also encouraged in this by those who stand to profit from it) to cling on to the hope that their child can be fixed/cured....mental retardation though, by definition is not "fixable". I'm not saying this is wrong or passing judgement, after all who wouldn't want better for their child? And yes, I know there are those of you out there saying, "my child doesn't need fixed, there is nothing wrong with him, he just learns differently".. This is misleading, it may be true for those kids that are dx'd with what used to be called Aspergers, but the majority of kids with autism are in far worse shape. Every classroom I have worked in so far the parents of all of those children would have (and sometimes already have) given everything they own to cure their child. When your child is pulling out her hair and eating it, or biting through the skin on her arm, or biting/punching/kicking people and screaming randomly for no discernible reason, or pulling out her own permanent teeth, that isn't just different. Its heart breaking. Its the type of thing that used to fall under mental retardation or other personality disorders... Some one also mentioned about whether or not autistic kids have cognitive delays.. 5 out 6 children in every class I worked in had significant to severe cognitive delays in varying areas, PLUS social deficits on top of that.

What did this used to be called?

I'm very ignorant and still think of retardation as the sweet and innocent but with low IQ.

Can you elaborate?

[Gooselady, BSN, RN]

This thread has some amazing insightful and intelligent posts!!

My grandson is on the spectrum, and his primary 'symptom' has been the lack of obvious social skills, like verbal speech and playing with other children. He's now almost six and for the last two years his speech and social interaction have begun flowering. He doesn't have sensorimotor issues (thank goodness).

His older half sister is on the spectrum and has his same delays. Along with the hypothetical environmental 'causes' of autism there is a subset of kids with a genetic component, and I think that's what we have here. We have a history of ADHD and depression in my family, but no one stands out as autistic. The common parent between these two children is their father, but this isn't 'sex linked', as the children are of different sexes -- I only know basics about inheritance and genetic expression and epigenetics blah blah blah. But two different kids, raised by two different moms in two completely different lives and environments end up with children with very, very similar manifest symptoms of autism . . .

He could read and write before he could speak. He's bright but not a savant, whatever that is. He just doesn't chatter and eagerly seek to interact socially. All other milestones were on target. He would get utterly lost in a mainstream classroom now, but they way he's catching up, not for long.

My daughter has avoided immersing him in 'services' and testing and all that. I have not always agreed with her on this. She's taken over that role by educating herself (and him). We have this totally happy, well adjusted-emotionally little boy who might not respond to you when you ask him a question or look at you when you call his name. I hint around VERY diplomatically and respectfully 'Oh, he's getting interested in playing with other kids? I bet he'd enjoy a play group!' (LOL!) .

Aside from the modern aversion to the word 'retarded', my grandson is SO not 'retarded'. Speech and social delays? I guess that falls under the auspice of 'retardation', in the true sense of the word, but practically on his own, he's continuing to develop, albeit a few years behind the norm. Maybe by the time he's 30 he'll just be nerdy and quiet? What he IS (the symptoms he manifests) just don't line up with 'retardation', and I think it is THIS new diagnostic angle that created and conditioned our awareness of autism as a 'newish' entity. I'm on board with the angle that we're just recognizing it as a discreet entity as opposed to others. Autism emerged from beneath the umbrella into it's 'own', so to speak.

[RainMom]

Gooselady, my son is not diagnosed but your description of your grandson is near identical to my almost 4 yr old. While his speech is slowly coming along, by 2 yrs he knew his alphabet, colors, shapes, & could count to 13 forwards & backwards. At a meeting with his teachers this week (early childhood program), it was mentioned that at times it even seems as if he is reading some words.

I agree that autism is not more prevalent but has simply been screened for routinely the way kids are screened for vision & hearing deficits & thereby more frequently diagnosed.

I think it's the same with cancer. While I don't doubt that we live in a world with more carcinogens, I believe cancer was very prevalent in the past as well. It simply was not recognized & with so many types/variations it isn't until modern medicine that we lump them all into the heading "Cancer". Same with autism. There is now the "Spectrum" that includes so many more kids that would have previously just been deemed slow, touched, special, daft, different...

[RNsRWe, ASN, RN]

I have to admit that I have never heard of a concern regarding children being diagnosed with autism instead of mental retardation.....the implication/statements in the OP is that since it's a 'preferential' dx somehow, there is a recognized percentage of MR children who are instead regarded as autistic.

That doesn't make much sense to me; having been "in" the autistic community for more than 16 years, I can honestly say I've never come across an individual who is labeled "autistic" who seems (to me, of course) to actually be MR. The presentation of these two dx's is really quite different, so it hardly seems like an easy confusion. Or even an easy "exchange" of one less preferred dx for another.

While it's true that there are certainly autistics who could ALSO be categorized as MR, I really don't see such a misdiagnosis as prevalent at all. Like.... at all.

Just my own experience, but....I've seen SO MANY kids/adults on the spectrum (and therefore observed these behaviors) that I just don't see the potential for confusion as put forth.

[RN_2012, BSN, RN]

I have a child on the autism spectrum with an IQ of 70, so on the cusp. If he had an average IQ he wuld be considered Aspergers, but he doesn't so he is PPD-NOS. I believe more children are diagnoses due to more information. My son wasn't diagnosed till 3rd grade after finally taking him to the Dan Marino center in Florida where we lived. It was at my insistence that he had more going on than ADHD, OCD, ODD, Anxiety disorder, speach/language delays. I did research on the internet that led me to getting him the proper evaluation. Support groups online has allowed parents to pick up on these issues more than in the past, educated parents seek proper diagnosis and are not put off to "oh this is just immaturity". I personally do not know anyone with an MR being given an autism diagnosis, two different things. People just don't say MR anymore anyway, I say LOW IQ or intellectual disability. I don't think any of it has anything to do with social status.

[messymissy]

My son was diagnosed with ASD a little more than 15 years ago. He is textbook Aspberger's. We know that my SIL is autistic, so we feel confident in the notion that the "autism gene" was passed down. Back about 15 years ago, ( lived in CA) we were invited to participate in a study UCLA was doing. They were trying to find a link between pregnant mothers, positive AFP test results and autism. I was 19 when I had my son. But due to having to relocate, we were not able to participate in the study. I've always wondered if they ever did the study, and what the results were.