The Washington Post reports that researchers at CDC and National Center for Health Statistics now believe the...
The Washington Post reports that researchers at CDC and National Center for Health Statistics now believe the incidence of autism has jumped to an astonishing 1 in 45. This alarming rise is due to a clerical change in the questionnaire used to survey pediatric diagnoses:
Lead author Benjamin Zablotsky, an epidemiologist at the NCHS, and his colleagues said that in previous years some parents of children diagnosed with autism spectrum disorder likely reported it as a developmental disability instead of or in addition to autism because it was listed first. The new questionnaire flips the two categories, which researchers said made the autism estimates more similar to ones from other sources.
As might be expected from this change, the prevalence of other developmental disabilities declined significantly from 4.84 percent based on 2011-2013 data to 3.57 percent in 2014.
Before we get too excited by these findings, let's bear in mind that criteria for an autism diagnosis have widened to the point of being meaningless. I wouldn't be surprised if everybody here on G+ is autistic according to current criteria, as is everyone in technology, science or any advanced profession.
Meanwhile, these new statistics will be widely circulated and believed by nonspecialists and will no doubt be used for fundraising.
If merely changing the order if questions affects the result so much, we need a more robust way to make a diagnosis. Genetic analysis has come a long way to identifying causative mutations linked to autism in about 30% of cases. As for the rest it's anyone's guess whether they're real or not.
https://www.washingtonpost.com/news/to-your-health/wp/2015/11/13/autism-cases-in-u-s-rise-to-1-in-45-a-look-at-who-gets-the-diagnosis-in-8-simple-charts/
Lead author Benjamin Zablotsky, an epidemiologist at the NCHS, and his colleagues said that in previous years some parents of children diagnosed with autism spectrum disorder likely reported it as a developmental disability instead of or in addition to autism because it was listed first. The new questionnaire flips the two categories, which researchers said made the autism estimates more similar to ones from other sources.
As might be expected from this change, the prevalence of other developmental disabilities declined significantly from 4.84 percent based on 2011-2013 data to 3.57 percent in 2014.
Before we get too excited by these findings, let's bear in mind that criteria for an autism diagnosis have widened to the point of being meaningless. I wouldn't be surprised if everybody here on G+ is autistic according to current criteria, as is everyone in technology, science or any advanced profession.
Meanwhile, these new statistics will be widely circulated and believed by nonspecialists and will no doubt be used for fundraising.
If merely changing the order if questions affects the result so much, we need a more robust way to make a diagnosis. Genetic analysis has come a long way to identifying causative mutations linked to autism in about 30% of cases. As for the rest it's anyone's guess whether they're real or not.
https://www.washingtonpost.com/news/to-your-health/wp/2015/11/13/autism-cases-in-u-s-rise-to-1-in-45-a-look-at-who-gets-the-diagnosis-in-8-simple-charts/
I may be callous, but I see no biological facts behind this change. I think what's changing are the absurd demands United States society places on little kids. These result in a lot of disappointed parents and their demands, which are quickly fulfilled, for "medical" explanations. Society is sick, not the additional kids. Some are, of course, handicapped and need help. But not all.
ReplyDeleteJoseph Moosman exactly. This absurdity is the result of medicalization of normal human variation.
ReplyDeleteLev Osherovich - can you explain why you think that is a bad thing? I think that some scientific basis for classic behavioral traits would be a good thing.
ReplyDeleteI do agree with you that we should try to do more to test genetically, and for sure, these kinds of questionnaires should only be the first of many steps to proper diagnosis.
Also, a lot of this is historic, and likely inescapable. All psychology was done by observation like this, and all mental illnesses were laid out from that process. Many of these, unsurprisingly, have not stood up to the test of time, and improved, more rigorous analysis. So we are kind of stuck with some of the names and groupings.
If the research I've read is correct, among the increasing rate of diagnosis, the HFA types are accounting for the majority of the increase. As an HFA myself, I can state that the majority in this category do not seek 'help' or treatment, and in fact would oppose it. It's actually a benefit.
Now, many have brought up real concerns that are related here, but let's not toss the baby out with the dirty water. Yes, people will most likely use this to fund raise, yes, others on the net will blame this on whatever scapegoat suits them, and yes, people will try to otherwise raise alarms for some social problem, etc. - but let's let the people gather the data.
IMO, there's a fair chance that we're going to find out that this is indeed normal genetic variation, and a case for seeing evolution at work first hand, directly effected by environmental inputs, as a way to counter said inputs' negative influence.
Malthus John alarming but unactionable information like this is not useful for patients or public health authorities. To me, this points to the broading of inclusion criteria for ASD when what's needed is narrowing to defined molecular causes. ASD appears to be a diagnosis of convenience to categorize kids (mostly boys) who don't behave well. I strongly suspect that many, if not the majority, of newly diagnosed ASD cases are spurious.
ReplyDeleteOrder-dependency bugs are highly underestimated in general, because rarely checked for, and are IMHO constitutive of the most elusive of awareness or knowledge horizons.
ReplyDeleteI do agree in general that media stories tend to do something wrong when reporting. Maybe this one falls under the heading of over-doing it.
ReplyDeleteOn the other hand, at least part of the reason for broader inclusion is from genetic & neurology studies. While we will probably improve greatly from where we are now, the fact remains that we are just scratching the surface of this issue. Did you read the study recently about a 1000 subject study of autistics that provided 1000 unique genetic profiles? It's hard to get more inclusive than that, though obviously "more studies need to be done".
Lev Osherovich
Also just saw this, which touches on my speculation about evolution in human population, vis a vis ASD.
ReplyDeletehttp://physics.aps.org/articles/v8/111
Malthus John yes, I'm familiar with this literature, but draw the opposite conclusion. See my articles on this topic:
ReplyDeletehttp://www.nature.com/scibx/journal/v3/n25/full/scibx.2010.752.html
http://www.nature.com/scibx/journal/v5/n16/full/scibx.2012.406.html
Lev Osherovich - thanks, I'll check those out.
ReplyDeleteI don't suggest that that study can lead to a specific conclusion so much as pointing out how hard it is (even with 'hard science') to make exclusions just yet. If we can't make exclusions, we shouldn't be too worried about an increase in inclusions. It's just the phase this topic is in, in a 'revolution' sense.
The Spectrum in ASD, conjures for me the idea of a knob or slider of inclusion/exclusion, and individual cases are grouping in sheets, corresponding each to a particular position of the slider at which these cases change status. Those sheets form stacks like onion peels. What's the optimal position of the slider if one must be picked for all purposes?
ReplyDelete