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Autism Prevalence on the Rise
March 30, 2012 5:02 AM   Subscribe

Since 2000, the Centers for Disease Control and Prevention has based its estimates of how many children in the United States have autism on surveillance reports from its Autism and Developmental Disabilities Monitoring Network. Every two years, researchers count how many 8-year-olds have an autism spectrum disorder in about a dozen communities across the nation. According to a new report released by the CDC yesterday, (pdf), the latest data estimate that 1 in 88 American children has some form of autism spectrum disorder. (1 in 54 boys and 1 in 252 girls.) That's a 78% increase compared to a decade ago. The report, which analyzed data from 2008, indicates a 23 percent rise in diagnoses of ASDs over a two-year period. (Last link has autoplaying video)
posted by zarq (42 comments total) 9 users marked this as a favorite

 
Good thing they buried this in the last two paragraphs:

"Doctors are getting better at diagnosing autism [...] How much of that increase is a result of better tracking and how much of it is a result of an actual increase, we still don't know."
posted by showbiz_liz at 5:06 AM on March 30, 2012 [24 favorites]


How much of that increase is a result of better tracking and how much of it is a result of an actual increase, we still don't know.

Jenny McCarthy knows.
posted by Thorzdad at 5:11 AM on March 30, 2012 [5 favorites]


This s a clear indictment of the dangers of childhood vaccines, which as everyone knows were first used in 2001.
posted by Holy Zarquon's Singing Fish at 5:21 AM on March 30, 2012 [16 favorites]


All they need to add now is Hyper-neurotypical Disorder and we'll be done.
posted by unSane at 5:26 AM on March 30, 2012 [2 favorites]


In our culture, it is comforting to be a victim.
posted by temporicide at 5:38 AM on March 30, 2012 [3 favorites]


on preview, what temporicide said.
posted by AElfwine Evenstar at 5:38 AM on March 30, 2012


If the exact same tests, protocols and definitions are used to define autism and ASD ten years ago as today, there is a 78% increase.

If those tests, protocols and definitions are different, then that statement is, at best, meaningless and at worst, an outright and deliberate distortion of fact.
posted by eriko at 5:40 AM on March 30, 2012 [5 favorites]


Did I phrase the FPP improperly or something? I tried to make clear that this is a rise in diagnoses and an adjustment in estimates, not necessarily a rise in incidents.

If that isn't clear to anyone, I apologize. It sincerely wasn't my intention to mislead.
posted by zarq at 5:54 AM on March 30, 2012 [2 favorites]


zarq, I think any criticism you are hearing is of the way the articles are laid out, not your post.
posted by gaspode at 6:00 AM on March 30, 2012 [10 favorites]


eriko, I don't understand your point. What statement are you referring to?
posted by AElfwine Evenstar at 6:03 AM on March 30, 2012


Ah. Ok. Carry on then. Thanks, gaspode.
posted by zarq at 6:05 AM on March 30, 2012 [1 favorite]


Well back when I was a kid my diagnosis was "wimp".

I can't follow directions. If you give me a map to somewhere 5 minutes from my house and then ask me to find that place I can take an hour. If you give me a list of things that need to be done and each of those things require steps and going differenet places to get things to accomplish other things I will be utterly confused and walk around in circles trying to do things and my brain just shuts down. I can't remember my own address.

I would really like to understand my brain, I am a fan of positive framing for different ways of brain functioning, but if there are areas of poorly developed brain functioning that make specific things in life difficult, the key is identifying those differences and finding solutions which should include both meds (if there are meds that actually fix the problem and for a lot of conditions theire aren't and meds make things worse)-- and structural supports for the specific areas of struggle rather than a label of "defective" and bunch of generalized supports that don't address the specific problems.I don't need three hours to take a test, I test awesome. This is why they never find impairments when they "test" me, because I kick ass at tests. Focus on this one thing, multiple choice, and there is a clear right or wrong answer and I have to find it through process of eliminaton? BAM. In the bag. Now if the had given me a stack of papers and asked me to organize them and not given me any framework about what they wanted, they would have gotten a very strange result indeed. The way I categorize things is utterly nonsensical. I have auditory processing problems and what this means is that I quite literally smile and nod and read peoples emotional expressions because I don't know what they're saying so I smile or look concerned as seems appropriate. These difficulties in functioning vary radically by situation and level of stress. I literally puff up like a balloon when stressed and my brain can stop functioning to the point I don't know what my name is. I can't fill out basic forms- Name. What does that mean. Name. Ok so... I write. My name, I KNOW THIS!

The ideal framework for this would be that the majority of people have strengths and weaknesses in overall functioning and some people simply have areas that deviate further than the average. Academic performance should incorporate helping any student master areas of struggle and work around areas that can't be mastered to the level of the average by focus on "best possible" performance in the area and other strengths.

There are currently no supports designed for people with the kind of impairments I have. Of course I'll turn up in the disability office with a huge stack of the ways various conditions affect brain functioning and various health conditions interrelatedness and they're like WTF, you can have three hours for your tests.

GAH! I hope that knowledge and assistance with extreme dysfuntion in college students becomes a thing, because I think there a lot of kids like me who don't even know they have impairments and just hate themselves and continually fail at school and then society keeps screaming, "Well let's educate the poor so they can have money"... Well let's make an education system that people with functional variance can actually use!
posted by xarnop at 6:14 AM on March 30, 2012 [21 favorites]


Statements like "That's a 78% increase compared to a decade ago" always bug me. It's a 78% change in the estimate, but not necessarily any change in the population. When you make a statement like that, you muddle the issue. They're using a statistical model to determine how many people have Autism spectrum disorders; periodically they revise the model, which this report (in part) represents.

It doesn't mean something's in the water that wasn't there 10 years ago.
posted by atbash at 6:14 AM on March 30, 2012 [2 favorites]


Some of this increase is likely due to the expanding awareness of ASD. In the past ten years, autism has invaded popular thought and children who would previously have been labeled as mentally retarded or slow or antisocial or odd are now being diagnosed on the spectrum. Further, more parents are getting their children assessed because an ASD diagnosis means their kid gets more resources and help from their school district. There may be new testing protocols as well, but I wouldn't be surprised if a sizable portion of the growth is attributable to awareness and the economic incentive of more resources for ASD diagnosed kids.
posted by Lighthammer at 6:20 AM on March 30, 2012 [1 favorite]


I think Allen Frances in temporicide's link unwittingly tips his hand on one of the more major fallacies of modern psychiatry and society:

Could it be that the surge in mental disorders is caused by our stressful society? I think not. There is no particular reason to believe that life is any harder now than it has always been-more likely we are the most pampered and protected generation ever to face its inevitable challenges.

This idea that a life lived as part of a small, tightly-knit community, spending lots of time outdoors and performing physical tasks - that it was so much tougher than being a meaningless TPS-reporting cog in a multinational corporate empire, an atomized member of a society now almost fully embraced to empty, unquestioned greed where everyone bowls alone. That material wealth and comforts are the main determinants of human psychological well-being

While I'm sure some of the etiology of autism can be understood in genetic or neurological terms, I can't help but feel that the rise of the disorder is primarily a maladaption to a society that's becoming increasingly anti-human
posted by crayz at 6:35 AM on March 30, 2012 [23 favorites]


I'm skeptical of "overdiagnosis" arguments. How many people out there have nasal allergies? Chronic indigestion? Issues with their feet hurting? Lots and lots and lots - there are a spectrum of treatments available, from over-the counter remedies to surgery, depending on the severity.

Are you trying to tell me, the one feature humans have really evolved the hell out of, the human mind, is somehow less susceptible to biological malady than its other human-specialized features, the foot, respiratory system and digestive tract?

The human brain is a very complicated and refined biological system. There is a lot that can go wrong with it. I think the biggest hurdle to mental health is the cultural perception that there's a difference between the mind and the brain, that the self exists apart from the messy collection of meats and fluids it floats around in... that when someone's emotions and perceptions are out of kilter, it's a matter of choice to bring them back online rather than a medical matter.

Willpower is itself a biological process, and hence subject to disorder.
posted by Slap*Happy at 6:38 AM on March 30, 2012 [9 favorites]


I'm skeptical of "overdiagnosis" arguments. How many people out there have nasal allergies? Chronic indigestion? Issues with their feet hurting? Lots and lots and lots - there are a spectrum of treatments available, from over-the counter remedies to surgery, depending on the severity.

Are you trying to tell me, the one feature humans have really evolved the hell out of, the human mind, is somehow less susceptible to biological malady than its other human-specialized features, the foot, respiratory system and digestive tract?


It's not that people don't believe it- it's that, well, the solution isn't necessarily 'cure it with pills', but the second something gets pegged as a medical condition, that is the solution people clamor for.
posted by showbiz_liz at 6:46 AM on March 30, 2012


Yeah ASD can be treated with occupational therapy on insurance and does not require that kids be medicated the way that other diagnosis are assumed to require. That is appealing for parents and likely better for the kids. But I just spent the last semester volunteering in an occupational therapy clinic so I could be biased. A lot of the kids I saw in treatement could just as easily have been diagnosed ADD and were extremely hyperactive. There was an emphasis put on body awareness and learning to see when your body "is very excited" and do a physical or other activity to bring the body and mind back into focus to do an activity. I observed a lot of kids come in with zero capacity or interest in sitting down and focusing on anything at all, and eventually be walking in and immediately picking up an activity they like and focusing on it for an entire session. It was really amazing to watch when you first see a kid who comes in literally bouncing off the walls hysterically. (Literally. Off the walls.)

I really think we need to make sure all kids get that kind of support before meds are considered an option especially in the light that the ADD meds don't actually repair biological dysfunction and cease to work immediately on ceasing treatment and further more often stop working for people over time. And their effects when used accross an entire life span have not been very well researched.

Slap*Happy- I agree with you. I think if the entire population of poor people were actually measured on functional measures that there would be a very clear pattern of dysfunction among those whose who are not making it at life. What we are learning with gene/environment interaction studies and epigenetics is that phenotypes are very environment dependant. Susceptability plus environmental triggers that are damaging for that susceptibility will usually yield poor outcome. Using environmental enrichment in early childhood, of the family and educational environment-- should be considered an essential tool even in a medical sense. These factors shape our biological development.
posted by xarnop at 6:50 AM on March 30, 2012 [8 favorites]


One of the primary theories explaining the increase in apparent rates of autism is that at least part of the apparent increase might be real and the result of more children ending up with one or more heritable risk factors. If you think about it, the generation that started having kids in the late 90s, and is having lots of kids now, was a lot better for people on the autism spectrum than previous ones. If, in this age where programing, abstract problem solving, and mathematical aptitude are valued, adults with mild forms of ASD are both more likely to produce children, and more likely to do it with other adults with mild forms of ASD, it all starts to make a bit more sense. This is especially when you consider that populations with high rates of ASD in adults, like Silicon Valley, have the highest rates of autism in children.
posted by Blasdelb at 6:50 AM on March 30, 2012 [5 favorites]


Are you trying to tell me, the one feature humans have really evolved the hell out of, the human mind, is somehow less susceptible to biological malady than its other human-specialized features, the foot, respiratory system and digestive tract?

It's actually the human immune system that causes allergies and the current most accepted theory for why that's increased in recent years is that we coddle it too much. And we've been working on upright posture for far longer than we have the whole big brain thing, and our spines are still what you'd get if you left one end of the Golden Gate Bridge in San Francisco and pointed the other end at the moon.

A better way to describe the brain is as a huge collection of half-assed kluges. You don't, for example, have wide angle full color high resolution vision, but your brain tells you that you do and you believe it.
posted by Kid Charlemagne at 7:11 AM on March 30, 2012 [7 favorites]


This is especially when you consider that populations with high rates of ASD in adults, like Silicon Valley, have the highest rates of autism in children.

Yeah. Plus there's the whole issue of conditions existing all along but not being perceived as a problem- nobody but a lunatic is unduly bothered by the preexisting condition of myopia; and the spike in diagnosis that must have come with the ability to effectively test for it, up until recently HPV wasn't anything we really paid much attention to except in the instance of cervical cancer and visible warts; herpes must have been taken for granted for centuries upon centuries (70% of the population); we just found the internal clitoris (Jesus Christ, the thing's on the scale with a damn cock, how did we miss it that long?!) and plenty of stuff we took for granted for centuries, like dental pressure from poorly fitted teeth, can now be sanded down by a skilled dentist.

Depression seems to be pretty darn old, if you look at all the stories of people dying of a broken heart or being struck down by melancholy. I'm not sure believe, given the frequency of war, the broad acceptance of child abuse and all the other things that make a human strung out and emotionally unhealthy, that humans are that much more loony tunes. Hell, the Little House series describes a family situation Laura boarded with, that while she considered the mother of the family a useless human being, would not be out of place on the green as a sure fire "you need therapy and your husband needs more charity with your health- you live in a freezing isolated shack in North Dakota, of course you spend all day 'sullenly' rocking and threaten suicide".

I also have to wonder how little a draw back Aspergers syndrome would be to subsistence farmers in a small inbred village, which seems to have been a popular strategy for human settlement for much of our history. I mean with all the first cousin marrying, how often did people accept that the Johnsons are mighty queer, though Goodwife Johnson turns out a good hand with the needle even if she does want to tell you about the eighty saints and martyrs attached to the parish regardless of your mood, and her boy John Johnson's like his father, throws a boot at the chickens when they get too loud, but can tell you if it's Jamie Johnson's lamed donkey or Mary-Beth's goats coming miles before anyone knows they're coming down the church road?

I have a clinical diagnosis of Aspergers. Looking at the reproductive strategies of other people's families with the disorder and my own, there seems to be a lot of people, not just maiden aunts and bachelor uncles, beavering away with model train sets or doll house kits, or being just a bit quirky and off. Most of these people were not magic programmer savants, but the disparate personality traits that make me, at least in part came from a collective line, there's some engineers in there, but lots of maids and bricklayers and shoemakers and farmers too. So honestly I can't even say that in Darwinian terms, the genes must be that poor for thriving through the centuries.
posted by Phalene at 7:35 AM on March 30, 2012 [21 favorites]


we just found the internal clitoris (Jesus Christ, the thing's on the scale with a damn cock, how did we miss it that long?!)

You'd be surprised how little attention is paid to female anatomy outside of the obvious big differences.
posted by EmpressCallipygos at 7:41 AM on March 30, 2012 [3 favorites]


It's actually the human immune system that causes allergies and the current most accepted theory for why that's increased in recent years is that we coddle it too much.

Right. Or look at the obesity epidemic, which we've tried solving by making foods with "low fat" and lots of HFCS, gym memberships, gastric bypass, a variety of chemical stimulants, weight watchers, half of all supermarket magazine advice ever written, irradiating the hypothalamus, etc. And people still come in every obesity thread on MeFi and argue about how it's all genetics

We have a culture of zero responsibility (for our own problems and the problems we help bring about in/for others), little thought to how symptoms we see in individuals can be the result of underlying problems in society - or belief that societal problems cannot be fixed, so a pill people can swallow is more practical, and obsession with "let's bring in an invasive foreign cat to eat the invasive foreign rat" pile-on type solutions to problems

What we are learning with gene/environment interaction studies and epigenetics is that phenotypes are very environment dependant. Susceptability plus environmental triggers that are damaging for that susceptibility will usually yield poor outcome.

Yeah, epigenetics is sounding more and more like "Lamarck was right, too", which along with environmental effects on gene expression and increasing understanding that DNA can perform complex logic operations almost like a computer program, it would be great if we could finally give up the idiotically simplistic, Mendelian pop culture conception of "genetics" as being like a series of multiple-choice selections: eyes: blue, height: 5'6", brain: autistic
posted by crayz at 7:51 AM on March 30, 2012 [2 favorites]


This article has a few interesting thoughts on ASD/ADHD and homework :

http://www.homeworktrap.blogspot.com/?m=1
posted by Katjusa Roquette at 8:05 AM on March 30, 2012


This s a clear indictment of the dangers of childhood vaccines, which as everyone knows were first used in 2001.

Are you serious?
posted by pianomover at 8:25 AM on March 30, 2012


pianomover: I would assume not.
posted by tippiedog at 8:30 AM on March 30, 2012


Or: saying autism is caused by genetics is like saying forest fires are caused by physics
posted by crayz at 8:34 AM on March 30, 2012 [4 favorites]


Are you serious?

I am serious! And don't call me Shirley.

...

Wait, that doesn't work.
posted by Justinian at 9:53 AM on March 30, 2012 [2 favorites]


I have come to understand that I am definitely somewhere on the spectrum. And I think had there been such focus on it when I was 5, then I think my life may have gone much differently. The truth is though, I am somewhat glad it didn't. I was definitely seen by doctors because I was a strange kid that didn't talk. But there was never any conclusion, and I was just sent to school to live like every other suburban kid. And so I think that I was forced to somewhat compensate. I have never 'felt' body language or other subtle social cues. Over the years I've learned to recognize them, but I am still incredibly awkward about every social situation. But not being treated as 'special' at least may have jammed some sort of social knowledge into me that would not have been there otherwise. When I was younger, if I spoke in a group environment, anything I said always came out as a sort of off-tone jarring statement and less like a voice in the conversation. So over time I've just had to try and mostly fail at blending in. Sometimes it works, sometimes I just sit there observing and watching other people act.

While everyone else just kind of ebbs and flows with conversation, social situations for me are usually something resembling a piece of BASIC code:
IF CONVERSATION
THEN
RESPOND "HI"
THEN
MAKE EYE CONTACT
THEN
TALK ABOUT SUBJECT
ELSE
CROSSED ARMS = OFFENDED
END IF

I just kind of have to THINK about how to act instead of just instinctually knowing it. That probably makes it more difficult, because on the outside for the most part I can appear to be mostly normal, if a bit weird. And because I'm not glaringly mentally ill there's just no rulebook for others to play by when interacting with me.

Whether the rates of diagnosis or recognition increase or not, it doesn't change who I am. I'm still gonna be autistic, just like I was when I was 5 and no one could figure it out. And again, I'm not so convinced that it's a good or bad thing. It would probably be good in that it will get the kids a little bit of instruction and maybe some comfort that they're not broken and just different, but when you're a kid in school, different is always going to bring you trouble. So being forced to blend in can do a lot to help the kids and prepare them to be functioning adults (if they're decently high-functioning).
posted by ninjew at 9:53 AM on March 30, 2012 [1 favorite]


Syntax Error: 'THEN' unmatched
posted by RobotHero at 11:29 AM on March 30, 2012 [5 favorites]


I'll just leave these here.
posted by AElfwine Evenstar at 11:37 AM on March 30, 2012 [1 favorite]


While you can do logic with DNA in a very very contrived system but to the best of my knowledge, there is no evidence that this takes place in anywhere in nature much less is somehow related to any disease or disorder. If this, or anything Lamarck hypothesized was going on, we would not be able to predict mRNA processing and post-translational modification from individual to individual much less between families, orders and classes.

And yet we can.

Reductionism is still wrong and I'll be the first one to say so (and have been).
posted by Kid Charlemagne at 11:39 AM on March 30, 2012 [2 favorites]


AElfwine Evenstar: "I'll just leave these here."

IOW, current research would seem to indicate that some autism spectrum disorders can manifest through a combination of genetic predisposition and environmental factors.
posted by zarq at 11:43 AM on March 30, 2012 [1 favorite]


Autism is interesting in that, for the high-functioning varieties at least, there's still debate about whether it should be viewed as an impairment (I'm thinking here of Tyler Cowen's Create Your Own Economy, among others). This can be seen in the way autism is presented in popular culture: often they're weird but lovable savants (e.g., Rain Man or Sheldon from The Big Bang Theory), and sometimes they even get magical powers. But I can't think of more honest portrayals of people with autism, ones that reflect both the real frustrations and the benefits, such as they are, of living with ASD. Any suggestions?
posted by Cash4Lead at 12:04 PM on March 30, 2012


Fiction doesn't do autism well (in my experience). Some blogs that are good for getting honest views from different perspectives:
Thinking Person's Guide to Autism
This blog has many contributors, including autistics, parents (both ASD and neurotypical), scientists and care providers.

We Go With Him and
Squidalicious
are blogs written by mothers of children who have intense autism.

Journeys with Autism
Ballastexistenz
Illusion of Competence
Autistic Hoya
are just a few of the excellent blogs written by autistic adults.
posted by Daily Alice at 12:43 PM on March 30, 2012 [3 favorites]


xarnop, do you have Sensory Processing Disorder? Have you ever been diagnosed? Does that sound like what you have at all?
posted by symbioid at 2:08 PM on March 30, 2012


Thank god the brain code isn't in LISP!
posted by symbioid at 2:22 PM on March 30, 2012


Well yes, that's one of the more common diagnosis at the occupational therapy clinic and I can only imagine what my life would have been like if I had gotten the kind of support the kids there were getting. (And that all kids who need it should have.)

Namely I think my mother had active PTSD and panic attacks throughout her pregnancy with me and used drugs at certain points during that, so I'm a bit, unique. There was a lot of emphasis put at the time on drug babies being "normal" and so professionals at the time really were averse to considering that maybe.. I just didn't form quite right.

I'm really interested in maternal stress and trauma and biological health variables and their affect on developing fetuses as it were.

I get the rocking at times. SPD is still a bit controversial and I'll be excited to see more info on it. It's hard to judge what the sensitivity I have now is because after the self esteem collapse and the terrible trauma and such I now have whatever I had before plus PTSD. So, that sucks.

Also, we're getting closer to being able to actually study factors that may contribute to de novo mutations and copy number varients associated with certain conditions and it would be cool if we could isolate factors that might increase risk of detrimental mutations in offspring.
posted by xarnop at 3:15 PM on March 30, 2012 [1 favorite]


symbioid: "Thank god the brain code isn't in LISP!"

Better than PHP.
posted by wierdo at 10:42 PM on March 30, 2012


I wonder how many diagnosed-but-not-formally kids like mine are missed in these studies? Our pediatrician, neurologist, occupational therapist, and others said that my son was an aspie. After consultations with parents with similarly diagnosed children, and seeing how our local school district dealt with diagnosed kids, we pulled back from having the formal diagnosis completed to avoid having our local school district get any legal control over our son's education. (He's early teens now, and doing fine, thanks, would probably not register on the scale if tested now.) We're not the only family I know that's done this. I wonder what the percentage of kids on the scale would be if those of us who'd ducked the diagnosis were counted? But I don't wonder enough to sacrifice my kid's development to the school board.
posted by theplotchickens at 4:51 AM on March 31, 2012 [1 favorite]


[a couple of comments deleted; if you value plain speaking, maybe just use that to communicate with another user, and dial back the insults?]
posted by taz at 1:23 AM on April 1, 2012 [1 favorite]


Autism mutations, scattered across genes, merge into network of interactions
posted by AElfwine Evenstar at 10:30 AM on April 5, 2012


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