AirTalk for March 29, 2012

Autism significantly more prevalent than previously thought

Families with autistic members take part in an Alabama Autism Family Camp Weekend.

The number of U.S. kids with autism has skyrocketed 78 percent since 2000, according to the Centers for Disease Control and Prevention. The new CDC numbers released today indicate that one in 88 American children is now on the autism spectrum, based on a 2008 snapshot of 14 monitoring sites. Among boys, it’s one in 54.

Dr. Larry Yin, medical director of the Boone-Fetter Clinic in the Institute of the Developing Mind at Children’s Hospital Los Angeles, said it’s difficult to say what’s driving the increase. He attributes rising numbers partly to better tools for diagnosis, earlier recognition of the signs and symptoms of autism spectrum disorders (ASD), and the changing criteria of ASD over time. Yin added that there’s also a broad range of prevalence among the 14 sites surveyed.

“I think what these numbers really represent is more children are being identified. I think that the range of prevalence across the sites—you can say this isn’t really representative of the United States as a whole,” he said.

Pediatrician, book author and child health advocate Dr. Ari Brown agreed that people analyzing the study should be wary of what the numbers mean.

“They weren’t divided by subtype, which is really important. You’re taking children on what’s called ASD. You have some children who are severely affected on one end and some who are mildly affected on the other,” she said. “If you look at numbers, you have a much higher percentage of children who are mildly who are affected. Which menas they do have communication skills. They are atypical, but they’re talking and cognitively a lot of these kids have normal IQs.”

However, Dr. Yin explained that there are visible correlations researchers can glean from the five years that the study has been going on. Correlation with maternal age, the age a child is born and some questions about the environment as well.

Geri Dawson, the Chief Science Officer for the advocacy group Autism Speaks, said “The CDC’s new estimate of autism prevalence demands that we recognize autism as a public health emergency warranting immediate attention. More than ever, these numbers compel us to redouble our investment in the research that can reveal causes, validate effective treatments and guide the effective delivery of services to all our communities.”

Dr. Brown concluded that drawing attention to the problem is more important than teasing out numbers perfectly. “At the end of the day, what’s important is that it’s common, we need to diagnose it earlier, and we need to know that services for these kids are covered (by insurance),” she continued. “If this is going to broaden awareness so that parents are more likely to bring questions up to their doctors so that they can be accessed earlier, that’s terrific. I just don’t want them to be scared by the numbers.”

What are the most likely culprits behind this rapid rise? Do we have an epidemic on our hands? What can and should be done about it?

Guests:

Dr. Larry Yin, is the medical director of the Boone-Fetter Clinic in the Institute of the Developing Mind at Children’s Hospital Los Angeles

Dr. Ari Brown, M.D., FAAP, is a pediatrician, book author and child health advocate; Dr. Brown's pediatric residency and developmental pediatrics fellowship were at Harvard Medical School/Boston Children's Hospital. She practices full-time in Austin, TX.


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