Is There an Autism Epidemic?
May 7, 2007 by Kristina Chew, PhD
Filed under Health
No. Yes? No.
Today’s Chronicle of Higher Education examines the angles of this question—-which often leads to contentious debates in autism circles—via interviews with Paul T. Shattuck, a postdoctoral fellow at the University of Wisconsin at Madison; Roy Richard Grinker, a professor of anthropology at George Washington University and author of Unstrange Minds: Remapping the World of Autism; and Craig J. Newschaffer, a professor of public health at Drexel University. Excerpts:
Mr. Shattuck and his colleagues found that as autism rates rose, the prevalence of mental retardation and learning disabilities declined by roughly the same amount in the special-education data.
Such trends suggest that states were using the new autism category to classify children who would formerly have been included in the mental-retardation or learning-disabled groupings.
“We can’t use special-ed trends to validly argue that there is or isn’t an epidemic,” says Mr. Shattuck.
[Grinker] argues that many factors have conspired to give the false impression of an epidemic. Psychiatrists have broadened the diagnosis of autism to include more people; society now recognizes the disorder more readily, so children are getting diagnosed more often and at younger ages; and there are more child psychiatrists who are familiar with and can diagnose the disorder.
“I use the analogy of a perfect storm,” he says. “All of these factors coming together and acting together to give us a situation that feels in your gut like an epidemic.”
….. [Newschaffer] agrees that diagnostic changes and recognition are contributing to the rising rates, but he can’t rule out the possibility of a true epidemic.
“I spent a lot of time looking at the evidence for both sides, and my feeling as an epidemiologist is that I don’t have enough evidence on either side to say conclusively it’s one way or the other.” The data are simply not good enough to answer the question, he says.
Also in the Chronicle of Higher Education is a portrait of Prof. Grinker and his “personal journey” in understanding autism, in Autism Unveiled. Temple Grandin, a professor of animal science at Colorado State University is also quoted on sensory needs and services, and Dr. Morton Ann Gernsbacher, Professor of Psychology at the University of Wisconsin-Madison, on her collaborations with an autistic researcher via email, the benefits of advances in technology for her 11-year-old autistic son, and the rise in diagnoses.
Reading the words of these professors and parents, I do think there is a sort of epidemic concerning autism going on—-but it is not an epidemic of children diagnosed with autism, but an epidemic of understanding about what was once routinely labeled a mysterious, enigmatic, disorder.
Um, might all the abortions of Downs Syndrome kids have had something to do with lowering those numbers? If there’s no epidemic, you should be able to find the 1 in 150 76 year olds. I won’t hold my breath waiting for you to do that.
But, examining the rates of people with Down Syndrome and autism is like comparing apples to oranges. Down Syndrome can be identified through definitive medical tests, whereas autism isn’t identifiable (yet?) in the chromosomes. Someone either has or doesn’t have the missing chromosome–it doesn’t work the same way with autism.
Although I do think the fact that research shows that 90% of all fetuses diagnosed with Down Syndrome are aborted does raise legitimate concerns regarding prenatal testing for a developmental disability such as autism. Not in the manner that you suggest, GW, but for other reasons.
Hi Kristina
I agree with Dr Shattuck and Dr Newschaffer and appreciate the position of both of them, leaving the space to consider the picture to be incomplete at the present (and past) situation to have a conclussion.
I thought the Chronicle story did one of the better jobs at describing various viewpoints. Majia Holmer Nadesan in Constructing Autism shows how numerous cultural and sociological factors contribute in something like “autism” even being considered in regard to children.
I’m with Newschaffer on this one.
I don’t think that the data definitively shows that there is or is not an increase in the prevalence of autism. Certainly, the broadening of diagnosis criteria and increased recognition have led to a lot of the increase in reported prevalence, but I don’t think there is enough data to rule out a real increase in prevalence simultaneously occurring.
I do think that the data definitively rules out thimerosol/vaccination as the cause of any increase in autism.
And even if there is an increase in prevalence, that does not justify using experimental hogwash on children to try to “cure” them. Educational and societal supports are what are needed, no matter what the true prevalence or cause(s).