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Defining Autism: Is the Increase Real?

Defining AutismChatter about Autism is everywhere. And anyone who is a parent has heard of and probably spent some time worrying about the skyrocketing statistics on Autism Spectrum Disorder (ASD) in children. You hear about it in schools, coffee shops, restaurants, mom's groups, family gatherings and in our pop culture. In fact, ASD has become so prevalent that the diagnosis is ubiquitous and pervasive. Everyone is suddenly an expert at seeing the characteristics of Autism in themselves or others around them. Former Facebook Director of Engineering, Yishan Wong stated that Mark Zuckerberg has, "a touch of the Asperger's." Dr. Drew Pinskey of MTV and Celebrity Rehab fame suggested that quirky, hyper focused, former professional NBA player Dennis Rodman was a prime candidate for an Asperger's diagnosis. Time alluded to the idea that intensely socially awkward computer genius Bill Gates has Autism. Craigslist founder, Craig Newmark blogged that Asperger's symptoms seemed, "uncomfortably familiar" and Dan Harmon creator of NBC's Community said of the symptoms of Autism, "the more I looked them up, the more familiar they seemed." The list goes on causing many to wonder, "What is happening? Does everybody, or every male fall somewhere on the spectrum?"

Every generation has a defining psychiatric malady that causes speculation and chatter among armchair non-psychiatrists. However, ASD is not that new. In fact, researchers in the United States have used the term Autism to describe certain behavioral characteristics since the 1940s. Despite the fact that it has been around for a while, there is no medical test that can be used to diagnose Autism. Every child should be routinely screened by their pediatrician between birth to at least 36 months to assure that they are achieving appropriate developmental milestones. When there are concerns about a child's development, the physician will usually refer the family to a specialist, and many times a diagnosis will involve a team of experts including a pediatrician, speech and language pathologist, occupational therapist and specifically trained physicians and psychiatrists who administer autism-specific behavioral evaluations. However, diagnosing ASD can be tricky since the definition continues to shift making the tracking of ASD-related data controversial.

Every child should be routinely screened by their pediatrician between birth to at least 36 months to assure that they are achieving appropriate developmental milestones.

The Center for Disease Control first began keeping statistics on the disorder from 2000-2002, and during that year 1 in 150 children had a diagnosis of ASD. In 2006, that rate rose to 1 in 110, and last year diagnosis spiked an astounding 25% to 1 in 88. Interestingly, boys are almost five times as likely as girls to get an ASD diagnosis. The ever-increasing prevalence and likelihood of an ASD diagnosis causes many to wonder if this increase is real or just an indication of improved diagnostic and early detection procedures?

Mark Roithmayr, president of advocacy group, Autism Speaks acknowledges that, "There is a great unknown. Something is going on here, and we don't know." More widespread awareness, better diagnostic procedures and broader definitions of Autism may account for much of the increase, according to experts. However, these broader definitions may soon change, resulting in what some worry will be restricted services for children with an ASD diagnosis. Doctors working to revise the Diagnostic and Statistical Manual of Mental Disorders plan to make substantial changes to the definition of Autism that will take effect in 2013. Some families fear that a new definition may mean that children are no longer eligible for special services and programs. However, many experts argue that a change in definition is necessary, since the definition has not been updated since 1994, and will not adversely affect services because a diagnosis of Autism is not a requirement for services in most cases. Time will tell what the result will actually be, but one can only hope that statistics such as these will lead to more research and a greater understanding of what children and adults with ASD experience. Despite the disparity of opinions on most topics related to ASD, experts do seem to agree on one thing, early detection and intervention is key.

For more information on the upcoming changes to the definition of Autism in the DSM please visit my Fredericksburg Parent Blog.

Nina Parrish has an M. Ed and is a certified Special Education teacher. She and her husband own a tutoring business and live with their daughter in Spotsylvania.

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