Sunday, April 01, 2012

Autism Rates Reach New Epidemic Levels? Round Up the Usual Suspects!

"The usual suspects

The people habitually suspected or arrested in response to a crime. The phrase is usually used in regard to scapegoats rather than actual perpetrators of the crime in question.

This expression has a specific and unambiguous origin. It was spoken by Captain Louis Renault, the French prefect of police, played by Claude Rains in the 1942 U.S. film Casablanca. The context was a scene in which the Nazi, Major Strasser is shot by Humphrey Bogart's character, Rick Blaine. Renault was a witness to the shooting but saves Rick's life by telling the investigating police to "round up the usual suspects"."

-The Phrase Finder

CDC Director Dr. Thomas Frieden, playing the part of Captain Renault from the film classic Casablanca, rounds up the usual suspects as the CDC announces stunning new autism rates in the US of 1 in 88 children, 1 in 54 boys:

"DR. THOMAS FRIEDEN, director, Centers for Disease Control and Prevention: 

There are a few things that we know for certain and there are some things that we don't know. And we always want to be up front about what we do and don't know.

We know for certain that doctors are getting better at diagnosing autism. We also know for certain that communities are getting better providing services to children with autism and that at CDC we've gotten better at tracking all of the children in a community who may have been diagnosed or identified with autism.

So we know that some of the increase is certainly because we're detecting more cases of autism. Whether that's all of the increase or not, we simply don't know. But we do know that there are many children with autism and that many of them need services and that diagnosis is often too late.

So whether this is a real increase or not is really secondary to saying that this is a big problem, lots of people are out there who need services and would benefit from services."

There is no dispute that diagnostic change, increased awareness and better detection probably explain some of the repeated and astonishing increases in autism diagnoses.  There is, however, no definitive study, or group of studies, which assigns 100% responsibility for the pre-2012 increases entirely to these factors.  There is absolutely no credible basis for anyone to state that the recent increase from 1 in 110 to 1 in 88 over a period of a few years is entirely attributable to diagnostic and social factors.  

Autism research funding has historically been directed overwhelmingly towards genetic autism research.  Only in recent years has any significant support been provided for environmental causes or triggers of autism, causes and triggers which might, and probably are, involved in these stunning increases in the numbers of children diagnosed with autism.  

The safe route to take in the face of such astonishing numbers is to invest more monies in treatment, education and residential care of those affected by autism disorders and to invest substantially more research dollars in exploring the environmental causes of autism disorders.  We must search for all the possible suspects as we try to determine what is causing the epidemic of autism disorders that increasingly affect more and more of our children.  


Paul Whiteley said...

The Nature paper from last year discussing prevalence pretty much said it all: 46% of the increase was due to 'factors unknown' outside of things like greater awareness, wider diagnostic categories and diagnostic substitution:

farmwifetwo said...

All we need to do is remove the non-disabled autistics off the list and the numbers will come down in a hurry.

I truly, truly, truly... hope that the 5 removes the children/adults like my eldest. I have NEVER held him up as a poster child for autism - yet I have a 2" binder full of reports/IEP's/report cards.... NEVER even allowed him to describe himself as autistic - heck, he didn't know until someone ratted at the start of Gr 7 and I shut that down quickly. He has issues and we're dealing with them... his bro is autistic not him. AND, on the 10th we go for a re-dx etc and he'll probably be dx'd as ADHD now... Geez... no longer speech delayed... no longer academically delayed... can take part in social activities... not very autistic is he anymore.... no repetitive behaviour...

Did I ever mention just how much I truly dislike this month b/c it's no longer about the disabled/funding/services etc but about "a way of being".

Erica Bandanna said...

@farmwifetwo: for every child who could come off there are several in a classroom who haven't even yet been diagnosed.

Every classroom I've taught in has students (I'm talking two or three, never just one) who fit the criteria yet aren't allowed to be specially programmed because their parents are in denial or desperately want them to be 'normal'. The education system is where you can see what's happening at the coalface.

This is a serious epidemic, and removing diagnosis for some won't stop it increasing next year and the year after that.

Only intervening in exposure to whatever triggers autism can stop the increase. Everything else is moving deckchairs on the Titanic. By all means place yours somewhere more comfortable, but the boat is still going to slide into the Atlantic.

— Something causes autism.