Is Autism on the rise?

by Dr. Andy Oakes-Lottridge / May 17, 2011

Earlier this month, I awoke to the news that a recently published study had examined the prevalence of autism spectrum disorders in a novel way.  They had looked at over 55,000 kids in a suburb of Soul, South Korea, and had found that the prevalence was MUCH HIGHER than they had imagined.  Autism is on the rise, and while most of us have heard that before, this report apparently offered something new.

According to the news, this study showed that autism spectrum disorders exist in about 2-3% of middle school kids.  It also demonstrated that almost two-thirds of the kids diagnosed with autism may be in mainstream schools without previously being noted for having trouble.

So does that mean we need to screen even more kids to catch everyone with autism spectrum disorders?  What about those kids that were not previously recognized to be having any trouble?  Are we over-diagnosing them perhaps?  If they aren’t having problems in school or at home, then does it matter if we call them autistic?  Those of you who are regular readers know where we’re going next J.  Let’s take a closer look at what the study authors really said.

Published on May 9th by the American Psychiatric Association, the authors selected this suburb of Soul with just over 55,000 kids 7-12 years old.  Some schools chose not to participate, leaving roughly 36,500 children in regula r schools and 300 kids in separate special education schools. 

The authors noted that in Korea, more so than some other parts of the world, a significant stigma is attached to autism.  A child with autism is seen by some to bring dishonor on the family as a whole since it is considered a genetic illness, and can even affect the marriage prospects of other siblings.  Due to this, the authors expected there to be an underestimation of children with the diagnosis.

Nevertheless, while current estimations of autism range from 0.04% to over 1.5%, the authors found that in this suburb or Soul roughly 2-3% of kids (as many as 1 in 40) were diagnosed with some form or autism spectrum disorder.  More surprisingly, many of the children diagnosed through the study were in regular schools and functioning normally. 

The primary recommendation as I read it, was to emphasize the importance of more proactive screening of children to better identify at an earlier age to then be in a position to offer more effective interventions for these children. 

Unfortunately, while the initial study population included almost 36,000 children, less than 300 actually completed the entire evaluation process for a diagnosis of autism spectrum disorder.  However, the power of the study is still significant considering how many children completed the basic screening.  Unfortunately, the basic screening may have been more likely to over diagnose developmental disorders. 

While not perfect, no study is, this report highlights several key points.  Autism spectrum disorder is likely more prevalent then we realize, and goes under recognized due to parental and physician failure. Better education of all of us on the early warning signs is critical, and earlier treatment is most effective.  As the classification of autism spectrum disorders is given a more broad definition by the American Association of Psychiatry, we should certainly expect even more children to be diagnosed in the future.

Some of the earliest warning signs are developmental delays in speech, repetitive behaviors, lack of appropriate emotional or social interactions.  Early referral to specialists for further testing when indicated is crucial.