Increasing rates of autism in the US?

[Cain]

Something I came across in a BBC article on autistic schools:

For reasons that aren't fully understood, diagnosis rates for autism have gone steadily upward in America in recent years. New Jersey is at the forefront of the trend. Latest figures put the autism rates among boys in New Jersey at one in 29 (rates for girls tend to be much lower).

Despite its increasing levels of diagnosis, autism is still poorly understood. Indeed, it is not clear if the real rates of autism are climbing. Some say there are more cases due to improved detection, or, some believe, an overly expanded set of criteria.

1/29 still seems amazingly high.  Improved detection may play a role in this, but that would still be far above the average. 

The CDC statistics would seem to back me up, here.  http://www.cdc.gov/ncbddd/autism/data.html

About 1 in 88 children has been identified with an autism spectrum disorder (ASD) according to estimates from CDC's Autism and Developmental Disabilities Monitoring (ADDM) Network.

Studies in Asia, Europe, and North America have identified individuals with an ASD with an average prevalence of about 1%. A recent study in South Korea reported a prevalence of 2.6%.

It could be that an overly expanded criterea, plus increased detection methods are both contributing to the inflated numbers in New Jersey in particular.

We know ASD is mostly genetic, but the pre-natal environment may also play a role.  I doubt New Jersey varies highly from the rest of America in a genetic sense (guidos aside) or in terms of pre-natal care.

I guess I'm asking are there any valid theories beyond better detection and misdiagnosis which could explain such a large number of ASD attributions in the state?

[rong]

i recently heard on the radio there is a theory that perhaps diabeetus in the mother is a contributing factor.

[Elder Iptuous]

wow.
1 in 29 seems crazy.  did the bbc story give rates elsewhere in the US from their source?
and why do rates for girls tend to be lower?
hmm.. if they are including assburgers, then it would seem that the culture of the people in a location, and their tendency to seek special treatment for their special little snowflake, might have an impact on the rates?

[Nephew Twiddleton]

I can't offer any alternative hypotheses other than expanded criteria/overdiagnosis. It strikes me similar as everybody seeming to have ADD in high school. But then again, we don't know what really causes it, so I can't say one way or the other.

[Anna Mae Bollocks]

No idea. Thimerosal's been debunked, but I wouldn't be too quick to say it's just better screening/increase in diagnosis when there could be something else in the environment/food supply/whatever causing it.

[Cain]

wow.
1 in 29 seems crazy.  did the bbc story give rates elsewhere in the US from their source?
and why do rates for girls tend to be lower?
hmm.. if they are including assburgers, then it would seem that the culture of the people in a location, and their tendency to seek special treatment for their special little snowflake, might have an impact on the rates?

No, it was a piece by Louis Theroux, about a documentary he's going to be airing on the BBC soon.

As for the rates for girls....no-one knows, although it seems a well-established phenomenon.

And yes, I did wonder about Aspergers and how that might factor into all this.

[Doktor Howl]

My hypothesis is that it's caused by environmental factors.

One that comes to mind is that kids are raised by the Xbox and the TV now more than ever.

I have no proof for this being a cause, mind you.  It's just an idea.

[Elder Iptuous]

There's that Cornell study that found that:
autism-diagnosis rates began to increase dramatically around the same time that cable TV was introduced in the United States, and counties with greater access to cable TV saw greater increases in autism diagnosis.
autism-diagnosis rates have increased faster in rainier parts of the country, which have shown a positive correlation to early childhood TV exposure.

[Triple Zero]

As for the rates for girls....no-one knows, although it seems a well-established phenomenon.

One explanation I heard is that when it occurs in girls, the symptoms aren't as apparent as with boys. Also partly due to gender expectations, I think.

But going on the TV/xbox/computer angle ... How does that exposure compare between boys and girls? Do girls watch as much TV? (probably) but do they play as much video games? I'm fairly sure they don't spend as much time in front of the computer as boys. The gap's probably closing a bit in recent years with computers and Internet being very ubiquitous, though.

[Kai]

Something I came across in a BBC article on autistic schools:

For reasons that aren't fully understood, diagnosis rates for autism have gone steadily upward in America in recent years. New Jersey is at the forefront of the trend. Latest figures put the autism rates among boys in New Jersey at one in 29 (rates for girls tend to be much lower).

Despite its increasing levels of diagnosis, autism is still poorly understood. Indeed, it is not clear if the real rates of autism are climbing. Some say there are more cases due to improved detection, or, some believe, an overly expanded set of criteria.

1/29 still seems amazingly high.  Improved detection may play a role in this, but that would still be far above the average. 

The CDC statistics would seem to back me up, here.  http://www.cdc.gov/ncbddd/autism/data.html

About 1 in 88 children has been identified with an autism spectrum disorder (ASD) according to estimates from CDC's Autism and Developmental Disabilities Monitoring (ADDM) Network.

Studies in Asia, Europe, and North America have identified individuals with an ASD with an average prevalence of about 1%. A recent study in South Korea reported a prevalence of 2.6%.

It could be that an overly expanded criterea, plus increased detection methods are both contributing to the inflated numbers in New Jersey in particular.

We know ASD is mostly genetic, but the pre-natal environment may also play a role.  I doubt New Jersey varies highly from the rest of America in a genetic sense (guidos aside) or in terms of pre-natal care.

I guess I'm asking are there any valid theories beyond better detection and misdiagnosis which could explain such a large number of ASD attributions in the state?

I have a feeling that "better" detection and misdiagnosis, along with expanded criteria (Asperger's anyone?) is the cause. I can't think of any other reason New Jersey would be higher than the rest of the country.

[Rococo Modem Basilisk]

Autism in girls is very often misdiagnosed as schizophrenia (though cross-diagnoses with schizophrenia are actually common in both genders)*. The increasing stigma of schizophrenia and the decreasing stigma of autism may contribute strongly to the changing numbers.

Tangentially, in the coming DSM, all autistic spectrum disorders are being recategorized under a single heading. On the one hand, this eliminates more or less useless distinctions like those between Asperger's Syndrome, HFA, and PDD. On the other hand, this eliminates more extreme distinctions: someone with PDD and an IQ of 175 is classed the same as someone with Rett's Syndrome and an IQ of 60. As a result, autistics on the internet (a notoriously emotionally volatile group) are kicking up a shitstorm on both sides of the issue, and have been for several years.


* This is not as shocking as it might first appear. Use of neologisms and disordered speech are considered to be indicative of schizophrenia. Use of unusual words and elaborately structured speech are common among subjects on the high-functioning end of the autistic spectrum. Strange obsessions, emotional volatility, and flattened/wrong affect are associated with both. So, a shrink who is more familiar with schizophrenia than with autism is likely to diagnose a high-functioning autistic as a schizophrenic, and a shrink unfamiliar with the specialized terminology of a particular field of interest to an autistic subject is even more likely to misdiagnose. A shrink aware of this situation (as many now are) may compensate erronously, and diagnose a schizophrenic with a spectrum disorder.

[Mesozoic Mister Nigel]

Hmmm, LO was diagnosed with "an unspecified pervasive developmental delay" a few years ago. She seems to have a sort of sensory integration disorder which I suspect she inherited from her dad.

She doesn't really fit the criteria for anything in the autism spectrum, but I suspect she'll get lumped in there anyway.

[Elder Iptuous]

What problems is she experiencing, specifically?

[Mesozoic Mister Nigel]

What problems is she experiencing, specifically?

Extreme weirdness.

Hard to explain. You'd have to meet her. Nobody can figure out exactly what's "wrong" with her, only that she's definitely different from other children.

[Elder Iptuous]

I'd slap a ribbon on her, rather than a label, myself...