- There's a upswing in the number of cases should be looked into. There is cause for concern
- There's a upswing in the number of cases. Prove there is cause for concern and we may looked into it.
More and More Autism Cases, Yet Causes Are Much Debated
By ERICA GOODE
To one disputes it. Cases of autism, the baffling and often devastating neurological disorder that strikes in early childhood, are rising sharply.
In California alone, the number of children receiving special services for autism tripled from 1987 to 1998 and doubled in the four years after that. National figures tell a similar story.
The upsurge has lent urgency to calls for more research on autism and more government spending to educate autistic children and has inspired federal officials, who late last year held an "autism summit" meeting in Washington, where they presented a 10-year plan of action.
But what lies behind the increase in cases is sharply debated. To some, the upswing has all the hallmarks of an epidemic and indicates that autism itself is increasing rapidly.
To others, the rise can in large part be explained by increased public awareness of autism in recent years, changes in the way the disorder is diagnosed and the incentive of tapping into federally mandated services for autistic children.
Neither side can prove its argument, because the types of studies that could tease out a true increase have not been done.
But the question is crucial, experts say, because its answer has significant implications for how federal money is spent, how afraid parents should be and how much effort scientists should devote to tracking down environmental factors in addition to genetic influences.
Advocacy groups, many of them founded by parents of autistic children, have tended to line up on the side of an epidemic. And some autism experts also believe the illness is increasing.
"To me, it's a huge public health emergency, a crisis," said Portia Iversen, a founder of Cure Autism Now, an organization based in Los Angeles that finances research. Ms. Iversen said she was certain that the number of children with autism was rising sharply.
But epidemiologists cluster on the other side of the debate.
They do not rule out the possibility of a true increase in autism. But they point to flaws in the way that the rising numbers — especially those in California — have been presented to the public. And they say the small size and widely varying findings of epidemiological studies of autism make it impossible to say what is going on.
For example, Dr. Eric Fombonne, an epidemiologist and a professor of child and adolescent psychiatry at McGill University, said most of the increase was probably a result of diagnostic changes and statistical anomalies.
What everyone agrees on is that autism is being diagnosed more frequently than in the past. The disorder, which is believed to be strongly influenced by genes, is marked by a profound impairment in the ability to relate to other people, a delay in language development, or repetitive behaviors.
Before the mid-1980's, most studies estimated the prevalence of autism at fewer than 5 cases for every 10,000 children. Over the last decade, epidemiological studies have come up with wildly disparate estimates, from 5.2 cases per 10,000 (in a large Norwegian study) to 72.6 per 10,000 (in a small Swedish study). But the trend has been upward, with most experts agreeing that at least 10 children out of every 10,000 are autistic.
Last year, in a review of all available studies of autism rates, Dr. Fombonne concluded that the findings "point toward an increase in prevalence over the last 15 years."
Posted by P6 at January 26, 2004 10:01 AM
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Comments
Wow, the advocates vs. the epidemiologists. If this was Bush and he sided with the advocates wouldn't you being screaming?
Statistically it is certainly worth investigating. I note that children are diagnosed at a much earlier age. Could that effect the statistics? Also the definition has been somewhat broadened. Could that effect the statistics? I'm completely willing to believe that autism may be on the rise, yet I would be surprised if the statistics aren't much like the ones for Alzheimers. It used to be a very rare diagnosis, now it is very common. But that was a definitional change, I don't think anyone suggests that the incidience has really gone up.
Also, isn't autism now considered a cluster of diseases much like the fact that their isn't just one cancer? Is California tracking each form of autism separately? If they did we might find certain types that are being caused by the environment while others remain static. That would be really useful to know.
I guess I would state my position as: there seems to be an upswing in autistic diagnoses. We should definitely investigate it so we can find out if there is a cause for concern.
Posted by Sebastian Holsclaw at January 27, 2004 07:48 PMI'd react the way I do regardless of who isn't doing their job. I'm issues-oriented, political rather than partisan.
That said, you don't seem far from my own position. "Cause for concern," in an area wherein all parties agree not enough work has been done to determine true causes, means that work must be done.
And just to show how smart I am, it HAS been suggested that the incidence of Alzheimers Disease has increased. In fact, since aluminum concentrations in the brain seems to be the one commonality in the autopsied cases, it's been suggested the disease didn't even exist pre-Industrial revolution.
Posted by P6 at January 28, 2004 12:35 AM