
U.S. autism rate surges, CDC reports (1 in 68) - ndonnellan
http://www.washingtonpost.com/news/to-your-health/wp/2014/03/27/u-s-autism-rate-surges-cdc-reports/
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cbhl
> _“It could be that doctors are getting better at identifying these children,
> there could be a growing number of children with high intelligence [who are
> autistic], or it could be both,” she said._

The article doesn't mention that the DSM-5 went into force last year. The
criteria for diagnosing Autism has changed since the DSM-IV, and this could
also explain the jump in diagnoses.

(This is alluded to with the line "Milder forms, such as Asperger’s syndrome,
are now considered to fall along the autism spectrum." \-- The entry for
"Asperger disorder" in the DSM-5 is now replaced with a pointer to see the
entry for "Autism".)

~~~
userbinator
Having seen a lot of very successful, but somewhat autistic people working in
tech (probably Asperger's), it seems a little strange to be classifying it as
a "disorder"...

~~~
fecak
Having seen a lot of children, including my own, (10 years old and unable to
speak), I think you should do a little more research on the entire spectrum
the disorder covers.

This is one of the major problems with the autism community and the diagnosis.
Someone who doesn't make eye contact and perhaps fixates on certain topics
(maybe comp Sci) has the same diagnosis as my child who will require lifelong
care and never live independently.

We need the public to understand both sides. To some autism is considered a
'gift', and this study suggested 46% of their numbers were at or above average
IQ. What they didn't highlight is that 31% have low IQ and are the ones (as I
mentioned earlier) that will require lifelong care and put an unimaginable
burden on families.

Edit spelling

~~~
rogert
As another parent of a child with autism who is barely verbal, I have to
agree, this is not the same as Aspergers. In fact, I think you'll agree, we
hope our kids will one day only be diagnosed with Aspergers!

The problem with classifying autistic as "intelligent" and "obsessive" and
"introverted" hides the truth that there are the other half of autistic people
on the low-functioning end of the spectrum cannot live independently. And no,
they're not exceptional at counting cards at Blackjack table either.

Young autistic children require many hours of direct speech and behavior
therapy everyday just to get them to basic level of communicating what they
want. This is the only known effective treatment for autistic children, but it
has to happen every day for years, and it is extremely expensive. Trivializing
autism causes insurance companies to put caps and limits on covering direct
therapy because they don't see it as essential, but parents of autistic kids
know that direct intense therapy is essential and makes a big difference.

~~~
fecak
This thread seems convinced that autism = intelligent and quirky. Maybe it is
Rain Man, or the character on the show Parenthood or that other lawyer
character (forget which show), or the prevalence of Asperger's in tech. People
really don't seem to see it until it happens to them or their family.

As I've said elsewhere in this thread, when the CDC chooses to highlight (1)
that 46% of these kids are average to above IQ, it says "don't worry". Why
didn't the CDC choose to highlight "31% of these kids are severely impacted,
unemployable, and will require lifelong care at an incredible expense to their
families (financial and emotional) and taxpayers"? 46% is not even a majority,
yet the CDC chose that group to mention as a highlight.

Why would the CDC make that choice?

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md2be
There is no "test" for autism, no blood market, no brain scan. What is the
false positive number? This sounds like the diagnosis for "hysteria" in women
50 years ago .

~~~
lallysingh
Two thoughts on this. Note that I'm not explicitly disagreeing to you, just
responding.

(1) No blood marker, no brain scan, true. But, it's something that does become
evident in people later, so the test has later symptoms that it can be checked
against for its error rate.

(2) It could be "hysteria", but it's still people acting unusually (at least
later in life). Perhaps it's something that's changed in the way we raise our
kids, or environmental, or changes in prenatal/birth-giving/etc practice. Any
way, it's a change in our population and is interesting enough to follow.

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Nitramp
I'm weary of diagnosing behaviour that used to be considered within the norm,
though maybe at the edge, as a medical condition.

Asperger's has no clear measurable part to diagnose, it is not treatable per
se, and its symptoms are all within the normal spectrum of human behaviour.

There's nothing wrong with saying that a particular kid might need more
support, but I wonder where it leads society if all not entirely within the
norm behaviours start to be classified and handled as medical problems.

~~~
XorNot
Studying academic outcomes would be a worthwhile goal here. But that's a 20
year goal - i.e. does the jump in diagnoses correlate with serious conditions,
or are we looking at problems which might simply blur out had they not been
diagnosed (perhaps with the offset that academic performance improves because
we focus our efforts for people who are diagnosed vs not).

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wozniacki
Direct link to the CDC report :

Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years — Autism
and Developmental Disabilities Monitoring Network, 11 Sites, United States,
2010 Surveillance Summaries March 28, 2014 / 63(SS02);1-21

[http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6302a1.htm?s_cid=...](http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6302a1.htm?s_cid=ss6302a1_w)

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fecak
The scary part to me is how the CDC chose to frame the new data. They put up a
"10 things to know" (1) list to distill the data for the media and readers
uninterested in looking at the full study.

One item in the top 10 highlights that 46% of these kids have average or above
average IQ. What the CDC doesn't highlight in the top 10 is the 31% that are
below! and the 23% that are 'borderline'. The glass half full (not even half)
optimism dismisses the large amount of these kids who have a very serious
condition. Kids that cannot speak, that wander and die, that will require
lifelong treatment. Why does the CDC choose to highlight the minority with a
future and not the majority that face a rough road ahead?

The second issue with the Top 10 is that it only alludes to better diagnosis
and awareness as a possibility for increases. It doesn't mention any other
possibilities, although most in the community are aware of well-publicized
studies pointing to environmental conditions that show connection. (2)

1
[http://www.cdc.gov/features/dsautismdata/](http://www.cdc.gov/features/dsautismdata/)
2 [http://time.com/25424/growing-evidence-that-autism-is-
linked...](http://time.com/25424/growing-evidence-that-autism-is-linked-to-
pollution/)

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thezach
As someone who comes from the "gifted side" of the Autism Spectrum, its not
that great. Having a brilliant mind is a great gift - but to be honest I would
rather be of normal intelligence and be able to better understand how to be
social than anything. Whats a brilliant mind going to do for you if your
alone? Humans, even autistic ones are social creatures and require social
interaction.

I do also agree with other posters that Autism diagnosis are on the rise due
to a higher push for screenings of children, and awareness of autism. However
I do think it still is possibly on the rise.

Aspergers is now Autism. I'm mixed on this, as even Aspergers has a spectrum.
I've seen people with Aspergers that are near normal functioning, and those
that are completley fixated on Star Trek to the point thats all they care
about. I've also seen non verbal classic autistics hold down employment in a
competitive employment atmosphere. The aspergers vs classic autistic has
nothing to do with functioning level, it has to do with verbal delay (or it
used to - its now the same).

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voidlogic
>>1 in 68

I would like to see a geographic distribution heat map? Does anyone know of
one?

~~~
fecak
This particular study focused only on a handful of states. The data is here.
[http://www.cdc.gov/features/dsautismdata/](http://www.cdc.gov/features/dsautismdata/)

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Spooky23
Autism is the new ADHD. If 1 and 70 kids have a disorder that wasn't a thing
20 years ago, something is wrong.

I had some speech issues when I was a kid that led to shyness and difficulty
making friends until I got a bit older. I'm sure that I would have been
classified in the spectrum on today's standards. It's a hot diagnosis.

~~~
kylebgorman
Not a psychiatrist, just a researcher, but you can't get a diagnosis of autism
spectrum disorder without a second cluster of symptoms related to repetitive
behaviors and restricted interests. Shyness and speech/language problems not
enough. (It is understood that many children with specific language
impairment, a separate condition, have problems with socialization early on.)

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ausjke
I read somewhere Silicon Valley has the highest Autism rate, it's likely high
IQ gene made a difference too? Speaking from experience, early intervention is
extremely effective.

~~~
kylebgorman
What makes you think higher average IQ is associated with autism? (Rain Man
doesn't count.)

The state with the highest reported rate of autism spectrum disorder is Utah,
followed by New Jersey. The states with the lowest reported rates are in the
Deep South (which is probably more about access to healthcare than actual
prevalence).

Edit: added "average"

~~~
fecak
The rates you are quoting (assuming you are using the study the 1:68 came
from) are from a single study that didn't account for all 50 states. It was
less than 20 states.

~~~
kylebgorman
I was quoting from earlier CDC reports. No study has looked at all 50 states
to my knowledge (though tell me if you know of one), and even between
participating states there are irregularities due to what kinds of records the
CDC has access to.

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mrcactu5
could this be just a shift in how we measure and disagnose behaviors which lie
outside the norm?

not long ago this behavior was not tolerated at all, and an autism diagnosis
was undesirable. now we have more resources to identify and tolerate a broad
range of behaviors

probably autism has not grown - it is as high (or low) as it has ever been.
maybe we can identify autistic behaviors in figure of the past; maybe our own
relatives.

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middleclick
Oh boy. My fear is how anti-vaxxers will use this news.

~~~
kylebgorman
Were anti-vaxxers bound by the rules of valid inference, this would be a
problem for anti-vax. Thimerosal, the compound supposedly responsible for the
vaccine/autism link, has been phased out in the west but incidence rates
continue to increase.

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insuffi
Well, how about not diagnosing your kid with autism just because he's an
uncontrollable little bastard, just to justify your bad parenting?(This
includes ADD, ADHD, ASD).

That should bring the stat down.

Qualifier: not all obviously, but it has certainly become a way to remove
personal responsibility as a parent.

~~~
mchanson
That is a very ungenerous/unkind position that many folks take when they don't
know WTF they are talking about.

~~~
insuffi
Right. Care to share the scientific details of how ASD/ADHD/ADD is classified,
since you're such an expert?

Abnormalities in a kid do not instantly indicate a disorder. Yet doctors are
quick to prescribe adderall to the first person that comes in their office and
claims they have "trouble concentrating".

~~~
indiv0
Overprescription is of course a serious problem in the developed world, but
that doesn't mean that doctors are using autism as a catch-all diagnosis.

There are specific, medical criteria which need to be met for a diagnosis, and
these criteria are outlined in the DSM V [1]. These are the details on how the
disorders are classified, since you asked.

[1]
[https://en.wikipedia.org/wiki/DSM-5#Neurodevelopmental_disor...](https://en.wikipedia.org/wiki/DSM-5#Neurodevelopmental_disorders)

