Thursday, November 30, 2006

The Autism Numbers That Add Up to 1 in 166

Today's Wall Street Journal Online carries this important column analyzing recent research and claims about the prevalence of autism spectrum disorders in the United States. (The Journal website is subscription only, but you can read selected stories for free, including this one for a limited time. Click here.) The piece is important because it was prompted by "several skeptical readers" who said they doubted the claim that one in 166 children in America have autism. The writer, Carl Bialik, concludes that research evidence supports the estimate, but that claims that there's an "autism epidemic" are not supported.

Autism is a hot media story right now. You can search Google News for autism and come up with more than 1,000 hits any day of the week. Around the world, there are conferences, coverage of research papers, press releases. In the U.S., small newspapers profile a local school or program or educator or parent working with children on the autism spectrum. Major newspapers and magazines pick up on trends, cover court cases and political battles over funding for special education, research and insurance benefits. National magazines and broadcast outlets pick up on the big-picture of what is happening. (To read a summary of Newsweek's recent cover story, click here. To hear a National Public Radio show on autism this week, click here.) Radio show host Don Imus talks about the Combat Autism Bill in Congress. Comedy Central, Jay Leno and other entertainers host high-profile benefits that receive coverage.

With all this attention, there's bound to be a backlash of skepticism. It's easy to imagine that people who don't live with autism every day, who don't understand what's involved could start to think it's a hyped-up, overrated, problem. (Some cynics suggest that parents actually seek an autism diagnosis for their child so they can win sought-after services. If you want to get a whiff of this dynamic, check out the comments section of this Freakonomics blog entry on autism from September, but do so with the knowledge that it's anything but uplifting.)

These kinds of responses are a natural byproduct of media reports about autism. And they need an answer if a national discussion about autism is to move beyond arguments over how big a problem the nation faces and on to responses. Today's Journal piece cites experts at the Centers for Disease Control (click here and here) to back up the claim that between 1 in 166 and 1 in 500 kids in the U.S. are diagnosed with ASD.

What makes claims about the rise in autism cases difficult to substantiate is the fact that the diagnostic criteria is relatively new. It's based on the DSM-IV, the 1994 American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. This suggests that more children are receiving the autism diagnosis because the definition includes a spectrum of problems so that, for example, it encompasses some very verbal children who may have Apserger's to children who communicate without words. It also suggests that, as awareness of autism grows, pediatricians and doctors are more apt to recognize developmental delays that lead to an autism diagnosis. (The Journal notes this flier distributed to pediatricians from 2004.)

As parents and other advocates continue to push for more research into the causes and potential treatments for autism, and more resources for needed services and supports, look for more reports like today's Journal article, to continue building awareness. It's awareness of the problem that can lead to support for solutions.

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