When we first moved to San Luis Obispo in 1984, I quickly tired of having to repeat my “this is autism” lecture every time my youngest daughter, Karla, needed medical or educational services. None of the “experts” had any clue as to what they were seeing. Fortunately, having received my Ph.D. at UCLA where Mr. F’s weightlifting partner was none other than Ivar Lovaas, I knew a fair amount about the disorder and what my daughter needed in order to succeed. According to SLO County statistics, one local child was receiving services for autism in 1991 (it wasn’t Karla–we homeschooled her because the local schools just weren’t up to the task at all, so she remained out of the system and its statistics). This past year, the number of kids receiving services for autism or Asperger’s was around 250. Yes, our population has grown somewhat, but not that much.
Karla especially dazzles us with her art, like this family portrait. I’m the hummingbird….
According to a recent report in Scientific American, the U.S. Department of Education reports a 657 percent increase in rates of autism between 1993 and 2003. Does this increase represent a true increase in cases or just a loosening of the diagnostic criteria?
It might be helpful if we had a better idea of how and why autism occurs. In our case, the best hypothesis seems to be that of Simon Baron-Cohen. As you can see from Mr. F’s scores and my own, we are definitely off-the-chart systemizers. Our empathy scores are also above average, which probably accounts for our more typical social behavior. However, we still have a huge number of questions about the etiology of the disorder, and it seems likely that multiple trajectories may lead to the same type of outcome.
I noticed one hint that diagnostic criteria, explained thoroughly in the SciAm article, have morphed. When parents of children newly diagnosed with autism call my department, the staff often refer them to me. I typically start the conversation with a question about the child’s age. In the early 1990s, I was stunned to hear that the children were in “such and such a grade in school.” Excuse me? There is no possibility whatsoever that a child meeting strict DSM-III or IV criteria would ever make it into the public school classroom unnoticed.
On the other hand, we can’t rule out some weird environmental triggers that may be interacting with other risk factors. The history of science is all too full of things we thought were safe only to find out they were actually pretty risky, such as the 1940s practice of using x-rays to treat acne or current concerns about CT scans and cancer. In studies of nearly 200,000 military recruits, Swedish researchers found that having routine ultrasounds during pregnancy raises the rates of left-handedness 32 percent in the resulting fetus [1]. Handedness is normally considered to be very influenced by one’s genetics. Most parents (and MDs) view ultrasound as completely benign. However, anything that can influence something as sophisticated as the lateralization of brain functions and the resulting handedness might do more than meets our current eye.
In the meantime, we are watching the developing understanding of autism’s etiology with interest, while enjoying our daughter and her fun art.
1. Kieler, H., Cnattingius, S., Haglund, B., Palmgren, J., & Axelsson, O. (2001). Sinistrality–a side effect of prenatal sonography: A comparative study of young men. Epidemiology, 12, 618-623.
9 Comments
Vix · January 28, 2008 at 12:04 pm
I always have been homeschooled by my family. And I’m always spoiled and proud of it. Sorry if I have’nt had the chance to update my site or anything but I have currently been busy with video games and drawing. My site update is still currently under construction (Because I’m waiting for you guys to have the money and skill to help me get my own, new site domain where I can update it all by myself), but my old site (FrebergSports) still exists for viewing purposes. Thanks for putting up my animation as well. You’re very nice.
aoneil · January 28, 2008 at 11:02 pm
This article addresses the question of whether the 657 percent increase in rates of autism between 1993 and 2003 was a true increase or just a loosening of the diagnostic criteria. It’s possible that the increase is due to overdiagnosis that’s seen in today’s society. Recently, the Diagnostic and Statistical Manual of Mental Disorders has added new categories to its list of mental disorders. While this makes it easier for therapists to categorize symptoms, it also opens more opportunity for misdiagnosis. We have to be cautious when giving labels to patients, so as not to confuse serious mental disorders with normal problems. Often the symptoms overlap, so it’s up to the therapists to draw the line between an extreme case of mental illness or just a temporary act of abnormality. And, they should also be careful when prescribing medication to treat illnesses. Often, the FDA will approve a drug after it has only been tested a few months, and little is known about the long term effects when it enters the market.
nichol.myers · January 29, 2008 at 12:24 pm
Karla is obviously a very talented artist! I had to check out her page and the gallery a bit to see. I am impressed.
Also, I think (regarding media attention and autism) that this is a disorder just now getting the public attention it deserves because professionals have taken the time to educate themselves on the symptoms. It seems that the more we know, though, the more we don’t know. I’m hoping that research on autism will continue but that its popularity won’t cloud the DSM-IV criteria required for the diagnosis, simply because it’s garnering public attention.
bhidahl · January 29, 2008 at 9:57 pm
I found this topic very interesting. I’m not sure there has actually been an increase in autism rates as much as there has just been an increase in the number of children diagnosed. Often, less severe cases of autism are left un-diagnosed, especially in the first few years of life. It seems to be only recently that awareness of autism has increased and parents are starting to consider that there might be more behind their child’s stubborn behavoir and communication troubles. I took Developmental Psychology last quarter and through the class was introduced to the site autismspeaks.org, a site that is extremely helpful for recognizing possible signs of autism. The site even features videos of a “normally” developing child and of a child the same age who has autism. It was very interesting to see the seemingly subtle differences that are actually indicators of a more serious problem. But it is encouraging to see that with the correct care and love, children can overcome autism and any accompanying difficulties they may encounter.
biopsych · January 30, 2008 at 5:18 pm
It is unfortunate that it has taken this long for the public to be aware of the Autism epidemic that is occurring. Pediatricians are placing a strong emphasis on having children under the age of two tested for Autism. This would be wonderful if all kids actually were because the earlier that a child is diagnosed, the sooner they can be treated. Here is a link with an article on screening all children for Autism:
http://www.msnbc.msn.com/id/21515865/
HWesolek · February 3, 2008 at 11:31 pm
I was wondering how related asperger syndrome is to autism? I have a cousin who has been diagnosed with both ADHD and Asperber syndrome, but i do not know the full effects of these, as a child i was always just told it was a form of autism, which i didn’t understand because i was only aware of the very severe somewhat stereotypical versions of autism portrayed in the media. Do the statistics for asperger syndrome, with regards to schooling, mirror those of autism? Are the two treated in similar ways, or have similar causes?
Laura Freberg · February 4, 2008 at 3:30 pm
Asperger’s has its own set of diagnostic criteria, although it shares the category of Pervasive Developmental Disorders with autism. Look here for a list of the DSM criteria: http://web.syr.edu/~rjkopp/data/as_diag_list.html
Typically, we view Asperger’s as involving more of the social symptoms of autism and less of the language issues. Consequently, these individuals are likely to be in mainstream classrooms even before they receive a diagnosis.
Some psychologists argue that the distinction between autism and Asperger’s isn’t terribly useful, and that Asperger’s represents high functioning autism. The blurring of this distinction might play a role in the large numbers of new cases of autism.
Please contact me privately if you would like further information on this–I’d be happy to discuss this in more depth.
ccallag · March 14, 2008 at 10:29 pm
I really appreciate you sharing your personal story professor! It given me a better understanding of what autism is. I didn’t know too much about it before this class, now I will continue to research.
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