A very cautious guess about the spike in autism
The CDC yesterday released a study showing that autism rates have spiked. 1 in 88 kids are affected. What the hell is going on?
People have speculated about possible environmental cause, as the president of Autism Speaks seemed (arguably) to suggest. Or better detection:
[CDC scientists] said that most if not all of that startling increase could be due to better recognition of the disorder by parents, doctors and teachers.
“There is the possibility that the increase in cases is entirely the result of better detection,” Dr. Thomas Frieden, head of the CDC, said at the briefing.
I have a very cautious guess about at least a part of the increase in prevalence that I brought up in the comments thread on Dr. Saunders’s post on the new autism guidelines. I have only anecdotal evidence for this. Simply put, part of it may be the case that it is in the interests of parents of kids with related (but different) disorders to get a diagnosis of ASD.
People with developmental delays (DD) often have some significant overlap with those with ASD. My DD kid has a severe language delay, sometimes zones off into his own world, rocks his head, pulls his hair, bites his arm, freaks out at certain sensory inputs and seems nearly immune to other sensory inputs. Kind of like a kid with autism. But he also tests at near age-appropriate for social and emotional skills (the only area of development where he comes even close). He makes eye contact, follows conversations, gets jealous when I pay attention to other kids, tries to get the attention of others, laughs at funny things, imitates his peers, understands and responds to others’ emotions. Not like a kid with autism.
But an ASD diagnosis gets much better services (such as speech and physical therapies) than does DD. (I gather this varies widely from state to state and county to county). It’s better studied than DD, and so there is more evidence that such therapies work. It is widely assumed that these therapies also work for DD, but DD kids don’t get as much. So parents of DD kids angle for an ASD diagnosis. They advise each other on how to get one, and usually there’s enough overlap with autism and a sympathetic doctor to get one, if a parent is persistent. I wouldn’t be surprised if a parent of kid with simply a speech delay would have a similar incentive.
I have absolutely no idea how prevalent this is or if it is prevalent enough to actually affect the statistics. I note with interest that despite a hugely increased awareness, the average age for diagnosis of autism is 4 years old. That seems pretty old. I wonder if part of that is because people have tried and failed to get their kids services without a diagnosis of ASD. So then they go for it. I suspect that the new autism guidelines are put in place in part to stop this. Yet I haven’t heard it mentioned as a possible reason for the recent spike in diagnoses.
The incentive exists. The increased detection might not be better, just more inclusive.