Schools of thought
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Special education: Enrollment differences in school programs could account for the rise in autism rates.
Autism diagnoses have increased since the early 1990s: that's a fact. What is hotly contested is whether this is a true epidemic.
As my colleague Deborah Rudacille reported in August, changing diagnostic standards and increasing awareness have contributed greatly to the rising numbers.
A new study, published in the November Pediatrics, adds another dimension to this argument. The researchers show that since 2002, cases of autism in some high-risk areas have been leveling off.
Many studies on autism prevalence base their numbers on data from special education programs. But these programs didn't include autism until 1991, and many schools are lagging behind in adopting the new standards, the authors note.
The researchers looked at the number of children with autism enrolled in special education programs in Wisconsin public schools between 2002 and 2008. They grouped these schools into eight clusters based on their autism prevalence, and found a huge variation in the rates.
If higher rates of autism are the result of schools adopting special education programs early, the high-rate schools would plateau, and the low-rate schools would catch up — and this is, in fact, exactly what the researchers found.
The overall prevalence of autism rose across the whole school district from 4.9 to 9.0 cases among 1,000 students. However, the rate of increase in the low-risk schools was nearly six times that of high-risk schools.
The schools with the highest number of cases of autism in 2002 increased from a prevalence of 11.2 to 12.3 cases of autism in 1,000 students, a difference that is not statistically significant. In contrast, the schools with the lowest number of cases in 2002 increased from 0.5 to 12.4 cases among 1,000 students.
The study injects a note of caution about interpreting data on autism prevalence: A closer look at individual regions contradicts the picture created by data from a larger geographic area.
Comments
If you throw out too wide a net you catch all the wrong kinds of fish. This year has seen new studies showing autism overlapping with schizophrenia, ADHD. Now included among the autism spectrum phenomena are anorexia, speeech and language disorders of childhhod, Tourettes syndrome, intellectual disability, serial murderers and gender identification disorders.
Physchologists in Europe are making a good living in 'diagnosing the dead' writing books and giving lectures where they claim to have retrospectivelly diagnosed the giants of science with autism, including Isaac Newton, Albert Einstein and in celebrating the 200th anniversay of his birth even Charles Darwin has been diagnosed with autism by these hucksters.
It is a wothless exercise in futility to interpret prevelance rates in autism.
Kanner had it exactly right when he wrote in 1965:
“While the majority of the Europeans were satisfied with a sharp delineation of infantile autism as an illness sui generis, there was a tendency in this country to view it as a developmental anomaly ascribed exclusively to maternal emotional determinants. Moreover, it became a habit to dilute the original concept of infantile autism by diagnosing it in many disparate conditions which show one or another isolated symptom found as a part feature of the overall syndrome. Almost overnight, the country seemed to be populated by a multitude of autistic children, and somehow this trend became noticeable overseas as well. Mentally defective children who displayed bizarre behavior were promptly labeled autistic and, in accordance with preconceived notions, both parents were urged to undergo protracted psychotherapy in addition to treatment directed towards the defective child's own supposedly emotional problem. By 1953, van Krevelan rightly became impatient with the confused and confusing use of the term as a slogan indiscriminately applied with cavalier abandonment of the criteria rather succinctly and unmistakably from the beginning. He warned against the prevailing “abuse of the diagnosis, declaring that it 'threatens to become a fashion.” A little slower to anger, I waited until 1957 before I made a similar plea for the acknowledgment of the specificity of the illness and for adherence to the established criteria.” ( Kanner 1965).