With one in 88 children in the USA and One in every 100 being diagnosed with autism in the UK, the debate has been raging in the media whether the number of children with autism is, as it seems to be on the rise, or if it is improvements in diagnostic tools that is accountable for the dramatic rise.
Mark Twain, the famous author wrote
There are lies, damn lies, and then there are statistics.
Of course he was talking about politics, and the way that statistics are thrown around to prove a point.
It seems that every health board, in every district of the evolving world wants to put a number on the amount of children diagnosed with some form of Autism or ASD. Is it really a case of more children being born per annum with autistic traits? Or has the world of modern medicine actually evolved to detect autistic traits earlier and more effectively than ever before?
The term autism itself did not exist until the 1940s deriving from the Greek words for self and isolation.
In the 1940s, researchers in the United States began to use the term “autism” to describe children with emotional or social problems. Leo Kanner, a doctor from Johns Hopkins University, used it to describe the withdrawn behavior of several children he studied. At about the same time, Hans Asperger, a scientist in Germany, identified a similar condition that’s now called Asperger’s syndrome.
Autism and schizophrenia remained linked in many researchers’ minds until the 1960s. It was only then that medical professionals began to have a separate understanding of autism in children.
During the 1980s and 1990s, the role of behavioural therapy and the use of highly controlled learning environments emerged as the primary treatments for many forms of autism and related conditions. Currently, the cornerstones of autism therapy are behavioural therapy and language therapy. Other treatments are added as needed.
It is true that the statistics have risen sharply between 1996, and 2013, but so has the interest, funding and understanding of life sciences. Scientists now better understand genetics than they did even ten years ago. Also that many sub branches of ASD have been identified, which all fit under the umbrella terms of autistic spectrum which never existed until the late 1980s.
Some scientists believe it’s on the rise
Thomas Insel, the director of the National Institute of Mental Health; David Amaral, research director at the MIND Institute at the University of California at Davis; and Peter Bearman, a social sciences professor at Columbia University have all come out in direct support of the idea that Autism really is occurring more commonly in children.
They argue that without specific evidence to believe the contrary, or that no reason for the cause of Autism, it must therefore be a regularly occurring phenomenon and that society should adapt itself to numbers of autistic and ASD diagnosed individuals to boom over the next few years.
Dr Insel, talking at an Autism convention recently said:
“Without being able to explain the other half [of the growth in numbers], most of us are left with the conclusion that there is a real increase.
“There is a large proportion of people with this disorder who are so disabled that it is unthinkable to me that they weren’t detected in the past. If you have a 12-year-old in diapers who is head banging and has no language, it’s hard for me to believe these kids existed in 1980 and were not being labelled.”
David Amaral also thinks the autism increase is real, but he declined to put a number on it.
“My sense from talking to lots of people who have been in the field for a long time is that there really has been an increase in the number of people with autism, but there are so many confounds — the change in the criteria, the fact we’re identifying people with much more subtle changes, and the fact that when I was a kid they might have just been called odd or quirky.”
And some scientists don’t
Terry Brugha of the University of Leicester in England argues that many adults remain undiagnosed to this day, but children are diagnosed quicker because of improvements in diagnostic tools during the past decade. He said:
“Overall our findings suggest that prevalence is neither rising nor falling significantly over time. This favours the interpretation that methods of ascertainment (case finding) have changed in more recent surveys of children compared to the earliest surveys in which the rates reported were considerably lower”.
Professor Brugha also drew attention to the newly reported finding that none of their cases of autism were already known to have the condition:
“It is very concerning that none of the cases we confirmed using rigorous diagnostic assessment methods in the community knew that they had the condition or had an official diagnosis. As in all community surveys it is of course likely that most of the cases we found were relatively mild and few were severe. We know that severe autism particularly when accompanied by learning disability is much more likely to be recognized. We are beginning to provide training to psychiatrists in the diagnosis of autism spectrum conditions in adulthood through the Royal College of Psychiatrists Education and Training Centre, London.”