A LOST GENERATION: GROWING UP WITH AUTISM BEFORE THE "EPIDEMIC"
When she was born in 1968, autism was a diagnosis reserved for children with severe developmental delays.1 Experts believed autism affected only four or five out of every 10,000 children.2
Ms. Scriven was already an adult when American psychiatrists began expanding the borders of the diagnosis, moving first into the uncharted territory of atypical autism (Pervasive Developmental Disorder-Not Otherwise Specified), and later, in 1994, into the milder Asperger's syndrome.3 As the definition expanded, so did the number of people diagnosed with it. Now one in 68 children has autism spectrum disorder, or ASD.
You come to the table with this and expect me to take you seriously? After looking at this garbage there's no wonder why Joe was having trouble finding something to post, and was eventually forcefully backed into the liar's corner where he belongs. More than likely he looked at it himself and thought it too stupid to post.
Let's bring some real science/scientists to the table. Everyone who holds the position that autism is not an epidemic needs to have a listen to Dr. Walter Zahorodny, the Associate Professor of Pediatrics at the New Jersey Medical School at Rutgers University, and Director of the New Jersey portion of the latest autism prevalence study. The study as a whole included 350,000 children, approximately 8% of all U.S. children. Interview and transcript linked below:
https://safeminds.org/news/autism-prevalence-examining-the-myths-and-truths-video-transcript/
I cut and pasted some of what I thought were the high points of the interview as it relates to our discussion:
Heidi Roger: Can you give us your interpretation of the study dispelling any myths and revealing the truth?
Dr. Walter Z.: Well, I’ll give it a try. I can point to five things, which were most important to me from this report. One, that across the network and in New Jersey, autism prevalence
increased 20% between 2012 and 2014. Two, that
this increase is part of a larger trend that being since 2000, autism prevalence by this network has increased 150%, so this is a very significant change with a relatively small period of time. Three, New Jersey, which is the state with the most comprehensive effort in surveillance is showing autism at 3%. Three percent is among the highest autism prevalence estimates by a population based study.
Dr. Walter Z.: Four, even though many people speak about better awareness of autism, when we looked at, that is when we, ADDM network, looked at the age of autism diagnosis, we saw that it didn’t change in the last 14 years. It’s been approximately 53 months throughout this period.
If autism prevalence was affected by greater awareness, you would expect the age of first diagnosis or earliest autism diagnosis to decrease, which it hasn’t.
Heidi Roger: You said that you do not suspect that the increase is due to any of the changes in the diagnostic criteria or just any better awareness, better diagnosis.
Dr. Walter Z.: Yeah. The simplest thing to conclude,
the most obvious thing to conclude is that these estimates are not at all due to changing definition of autism. I’m still surprised how frequently the media reports that this could be due to better, wider definition of autism or changing diagnostic criteria.
Throughout the 14-year period of doing autism surveillance, we’ve only used one definition of autism, and that’s the one that was provided by the DSM IV. We never changed those criteria, so zero is due to shifting autism diagnosis.
Heidi Roger: Many people look at the ADDM data as the best source of prevalence over time, so if autism was one in 150 12 years ago, and is one in 59 now, is that a good estimate?
Dr. Walter Z.: It’s good from the perspective of
recording correctly that there’s been a significant shift upward in autism prevalence. That goes without saying, pretty much every indicator, IDEA data, data from the NHIS study, data from the ADDM network and other sources of population based information show a significant rise in autism across the United States in the last decade to 15 years. Where the findings are somewhat incorrect or important to interpret is that some states are completing their surveillance more comprehensively or more likely to find all the true cases of autism. When you mix sites where they’re not finding all the cases with those that are probably doing a very complete job of ascertainment, you’re watering down the composite or overall estimate.
Dr. Walter Z.: In my opinion, autism really is in U.S. metropolitan regions likely to be in the 3% range or higher. We find that in New Jersey. In New Jersey, I’m even inclined to say that even at 3%, we may be under-estimating autism prevalence. It’s not really that autism varies probably so dramatically across the United States as some sites are not as capable in finding all the true individuals with autism.
Dr. Walter Z.: I’d say we’re getting better at identifying and diagnosing children who are less severely affected, but we are also seeing that the increase in autism prevalence is pushed quite significantly by children with significant levels of impairment and with co-occurring cognitive impairments, so it’s not just slightly affected children that are making the estimates percolate upward.
Autism is increasing across the board and across all subtypes, I’d say.
Dr. Walter Z.: When we started doing surveillance, we looked at how long it took to get from first attention, the first visit with a professional to maybe identify a problem, when you first got to a neurologist or developmental pediatrician in comparison to age of diagnosis. It used to take about a year between the time you would bring your child for the first professional appointment to the time when he or she got an autism diagnosis. Now, in 2014, it was about seven months. Greater familiarity with autism, probably because more and more kids are coming with autism, gets the doctors to cut to the diagnostic inclusion a little bit faster.
Dr. Walter Z.: I have no doubt that autism prevalence at 3% is a very important public health concern, an urgent public health concern. I’m very disappointed that some of the leading media in the United States didn’t report our finding. It’s hard to justify or explain. If I were to try to explain it, I would say that with regard to the media, over 14 years, it seems like they’ve been one story or two stories.
Autism is higher than anyone ever expected, and it looks like autism prevalence is increasing.
Dr. Walter Z.: Yeah. Autism is a true public health crisis. Autism prevalence is a urgent public health concern, and while awareness is important, we’ve had now a decade of great efforts to awareness. Now, we have to take actions. Public health actions are necessary to try to understand the factors that are leading to this unprecedented rise in autism and to offer the right services to this generation and to those who’ve been affected by autism in the past.
Here's some science for you:
The interview above is in response to the first study:
https://www.cdc.gov/mmwr/volumes/67/ss/ss6706a1.htm?s_cid=ss6706a1_w
https://link.springer.com/article/10.1007/s10803-018-3670-2#enumeration
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4113600/
https://www.ncbi.nlm.nih.gov/pubmed/15504445
https://vaccinesafetycommission.org/pdfs/11-2014-Env-Health-Nevison.pdf
https://www.sciencedirect.com/science/article/abs/pii/S0890856709650243