Wednesday, April 4, 2012

CDC: Autism Rate is Now 1 in 88

This story hit the wire late last week and of course the Autism community has been all over it - for good reason.  There is a lot of commentary coming out and unfortunately just as much speculation and fear-mongering to match.  Because of this, it is important to discuss the facts.

According to the data, the U.S. Centers for Disease Control and Prevention (the CDC), indicates that roughly one out of every 88 American children are considered autistic. This includes children which have a condition such as Aspergers Syndrome which is considered an autism spectrum disorder (ASD).

• This most recent report is based upon data from 2008 that was collected from 14 communities and involved a total of 337,093 eight-year-old children.  Because of this sample size and the fact the data sample is several years old, it is possible the actual national rate could be higher or lower than the rate reported.

• Reported rates vary greatly from a high of one in 47 in Utah to a low of one in 210 in Alabama.  Experts said that variation likely reflected differences in awareness of the disorder (meaning how often it is recognized and/or diagnosed) rather than any true "hot spots" of autism.  It is also important to understand these rates do not mirror vaccination rates (a bit of a preemptive strike against those who will make unsubstantiated claims pertaining to vaccines causing autism).  In fact, in some cases such as the MMR and Rotavirus vaccines, vaccination rates in Alabama are actually higher than they are in Utah.  Overall the vaccination rates between the states is not statistically significant and bears no connection to the reported rates of autism.  (Refer to Table 2, pg 1174)  Sorry antivaxxers.

• From 2002 to 2008, the largest rate increases were among Hispanic (110%) and African-American (91%) children.  Yet white children are still at greater risk for being diagnosed with autism.  For the vaccine conspiracy theorists out there (aka Lowell Hubbs and his ilk), it is also important to note that vaccination rates have not changed significantly during this time period, not to mention that there is no significant difference in vaccination rates across races.  Sorry again antivaxxers - maybe it is time you developed a new theory?

• There is no definitive test to prove whether a child has autism.  Instead, physicians make their diagnosis based upon criteria laid out in the American Psychiatric Association's Diagnostic and Statistical Manual, or DSM.  These criteria have changed with time, again prompting many to suggest the perceived increase is not a "real" increase, but rather an increased based upon better diagnosis and recognition.

• CDC Director Thomas Frieden stated that "doctors have gotten better at diagnosing the condition and communities have gotten better at providing services, so I think we can say it is possible that the increase is the result of better detection."

Regardless of your take on the matter, it does seem clear we are getting better at diagnosing autism, and overall awareness is at an all time high.  Researchers continue to focus on autism, and data like this helps to keep autism at the forefront where hopefully it can attract additional funding for research, treatments, and perhaps one day an actual cure.

As I said previously there is a lot of commentary regarding this data at the time being, and I'll be adding additional data as further analysis is performed.  There are a lot of statistics available for analysis here, so I hope those with a vested interest take their time to review everything thoroughly and within the proper context before leaping to conclusions.

The moral of the story is, even though the headline makes it appear that the number of autistic children in our nation seems to be growing rapidly, all available data seems to add credence to the opinion that this growth is merely due to increased awareness and more accurate diagnoses.  In years past a child may have been simply considered to be "unique", or "reserved".  Often they were considered "strange" or a "loner".  In some cases these children were difficult to handle or even considered to be troublemakers, and in rare cases the child was simply written off as having a mental disorder or even simply referred to as "slow".  As physicians, teachers, therapists, and parents become better at recognizing the symptoms of autism hopefully we can become better at identifying it, and with identification can come treatment.

The original article that referenced the CDC data can be found here: Yahoo Shine - CDC: Autism Rate is Now 1 in 88.

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