A new study from the British Medical Journal suggests that outside factors ranging from diagnosis methods to socioeconomic status may have inflated reports that suggest rates of autism are spiking. The Centers for Disease Control and Prevention’s March 2014 report showing a 30 percent rise in autism spectrum disorders (ASDs) over the span of a few years triggered widespread concern over one simple question: what is the cause? A new study in the BMJ suggests the answer may have less do with the actual number of autistic children and more with the nature of how we diagnose them. Despite an apparent rise in ASD diagnoses, the Swedish researchers found less direct evidence of a rise in the actual number of patients with symptoms of these disorders. To investigate this discrepancy, they used two different sets of data — both originating in Sweden. The first was part of a comprehensive study that included nearly 20,000 children, all twins, born in that country over a span of 10 years. The second came from a national patient register, which they used to look for diagnosis codes typically associated with ASDs. Looking at this data, the authors conclude that something other than an actual increase in the number of children showing signs of autism is responsible for the increased prevalence of the diagnosis. The correct explanation may, at least in part, be related to something other than the actual number of autistic children at all.
Among other conclusions reached by the researchers is the following: “We believe that our findings indicate that the prevalence of autism spectrum disorder is not increasing in childhood. The research and clinical resources currently devoted to dealing with these problems relate to the possibly mistaken notion that there is an actual increase. This allocation of specific resources to study “the epidemic of autism” should not be allowed to spiral out of proportion. Other developmental disorders, such as intellectual developmental disorder, language disorder, and attention-deficit/hyperactivity disorder may recently have become overshadowed and seem to be missed diagnoses in many instances, where now only autism spectrum disorder is diagnosed (even perhaps when the autism symptomatology is relatively mild). There is growing evidence that these other developmental disorders are at least as good as or perhaps even better indicators of outcome (and hence, sometimes, need for intervention) as autism spectrum disorder in itself. . . Children who are clinically impaired at an early age and who meet the criteria for autism spectrum disorder almost always have other developmental disorders and problems that need to be tackled.”
Source: BMJ 2015;350:h1961
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