Saturday, August 02, 2008

Autism is Rising! Autism is Rising!

TV might cause autism. - By Gregg Easterbrook - Slate Magazine

    Clearly this study did not get much traction as I have heard nothing more about it in the nearly two years since it was released. However, it is still a nice starting point for a subject I have been thinking about for a while. The author, and the authors of the study, try to link an increase in the incidence of Autism with the increase in children's programing (and the following increase in television consumption by toddlers) in the early 1980's. It is, I admit, an interesting hypothesis. There is only one small problem. Before you prove a cause for the increase in the incidence of Autism shouldn't you first prove that Autism is on the increase?

    The study in question claims that the incidence of Autism has been increasing since 1980 and they look for a cause from external factors to explain the increase. In the article, however, there is no mention at all about changes in the definition, and diagnoses of Autism over the same period. Prior to 1980 only the most severe cases were diagnosed as Autism. Since 1980 the diagnosis of Autism has been expanded to a "spectrum" that runs from very mild to severe. While the article mentions that Autism diagnoses began increasing in 1980 they do not report the the DSM-III was published in 1980 with an expanded definition of Autism followed by a revision of the DSM-III in 1987 which further expanded the definition. The article also fails to mention that the "incidence" of Autism really began to skyrocket in the mid 1990s. Is it a mere coincidence that the DSM-IV was published in 1994 with yet another expansion in the definition of Autism?

    My youngest son, Jacob, was diagnosed with Autism Spectrum Disorder in 2003 when he was five years old. He is on the mild end of the spectrum and I am very certain he would not have been diagnosed as Autistic ten years earlier let alone twenty or 25 years earlier. I remain open to the possibility that the actual prevalence of Autism is increasing. However, at this time I have seen no evidence that proves the increased incidence is due to anything more than changes in "diagnostic practices, referral patterns, availability of services, age at diagnosis, and public awareness."

    I hope you will keep this in mind the next time you read an article or hear someone sounding the alarm of the increase of Autism. And the next time someone refers to the Autism epidemic ask them if it is worse than the schizophrenia "epidemic". The incidence of schizophrenia is about 10 per 1000 compared to Autism Spectrum Disorder which is around 6 per 1000. Perspective matters.

    For further reading Wikipedia has a couple of well written articles here and here.

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1 comment:

  1. I believe that you are quite on the mark here. The expansion of the defenition of autism has much to do with the so-called "epidemic." Note also that the instances of boys diagnosed with autism (at about age three) are higher (at a rate of 1 to 5 according to the NIH)than girls of the same age. This does not strike me as coincidental as boys are generally more rambunctious than girls at age three and would tend more often to exhibit some of the "behaviors" listed on the assessment. Moreover, shy children may also "exhibit" some of the behaviors used as indicators. As a child, I would certainly have qualified as "autistic." Let's also not forget that children spend much more idle time in front of the television than they once did and though I will not go so far as to blame the programs, it does appear to me that the hands-on teaching of proper behaviors and skills has been repalaced by TV time. It has also been suggested that television reduces the attention span (more so in youngsters than in adults). You can be sure as well that the drug industry has much to do with the escalation of the autism (and ADHD) "epidemic."

    A former colleague once told me that she had an autistic son (age eight). I felt horrible for her (because I know what autism looks like) until I met her boy. He was certainly lagging behind in school and still had trouble tying his shoes at age eight, though I soon realized the problem. The boy had no peers with which to socialize and his parents spent zero, and I do mean zero, time with him. Their response to his very presence was was "go away." I made a few attempts at discussing this with his mother and suggeted that she work with him on the lacking skills. Her respopnse was complete apathy as she was able to dismiss him as "autistic" and therefore beyond help (other than medicating him). Needless to say, I just let the acquaintance fade. However, I do wonder what become of the boy. Enough said. The epidemic is not autism.

    Best,
    Karen

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