Increased Prevalence Of Autism Research Articles

Public attitudes to people with ASD: contact, knowledge and ethnicity

PurposeThe increase in autism prevalence and presentation in the media suggests a rise in public awareness. This paper aims to explore what factors (contact, knowledge and ethnicity) may be associated to positive attitudes towards individuals with autism spectrum disorder (ASD).Design/methodology/approachAn online survey examined contact with and knowledge of ASD among Black, Asian and White ethnic groups to predict public attitudes to people with ASD.FindingsIn multiple regression models, the results suggested that the level of contact predicts positive attitudes towards autism when demographic factors were accounted. The level of knowledge about autism were significantly associated to attitudes, but not consistently when demographic factors were accounted. However, differences in knowledge and attitudes to people with ASD were identified amongst Black, Asian and White ethnic groups.Research limitations/implicationsThese findings have implications for policy and public health and education campaigns, including ensuring contact and knowledge of autism among the public.Originality/valueThese findings have implications for policy and public health and education campaigns, including ensuring contact and knowledge of autism among the public. Additionally, further effort is required to target public knowledge and attitudes to autism, particularly among ethnic groups. Institutional support tailored to encourage structured and unstructured contact across public domains such as education, health, social and care practices could effectively reduce prejudice between the public and people with ASD over time.

On the Horizon: Older Adults With Autism in a Changing Health Care Environment

For many years, our health care system has been in a state of change, with most changes occurring as a result of economic issues and not clinical issues. Clinicians working in skilled nursing facilities (SNFs) have navigated a complex web of regulations and processes that are expected to change from a volume-driven system to a value-driven system. Such issues are challenging enough when clinicians are working with disorders with which they have received training and gained practical experience, but the growing population of residents in our facilities who are aging with autism will further complicate the SNF landscape. Because of the increases in prevalence of autism in the general population, the number of patients who will be entering our SNFs will only grow. New regulations and processes will require practice-based evidence and functional outcomes, data which do not exist with adults with autism. This article will discuss the impact of changes in our health care system, specifically in the SNF, and how these changes may impact the provision of care to a growing population of elders with autism.

Dramatic Increase in Autism Prevalence Parallels Explosion of Research Into Its Biology and Causes

Dramatic Increase in Autism Prevalence Parallels Explosion of Research Into Its Biology and Causes

The Highs and Lows of Counting Autism

The Highs and Lows of Counting Autism

Möbius Sendromunda Otizm: Eştanı mı, Rastlantı mı?

Pervasive developmental disorders are neuropsychiatric disorders that start in early years of life, last lifelong, and characterized by delay and abnormality in social relationship, communication, behavior and cognitive development. Moebius syndrome is a clinical condition characterized by unilateral or bilateral eye-face palsy associated with muscle or bone malformations in the upper or lower limbs. Most accepted clinical criteria to characterize the sequence are the involvement of the VI and VII cranial nerves. Though some authors suggest a causal relationship between autism and some medical conditions, to draw such result is quite complicated and difficult. Case reports and articles draw attention to the comorbidity of autism in Moebius syndrome. Despite arguments favoring a strong relationship between autism and Moebius syndrome, some questions about this relationship are still left unanswered and controversial. There are some research findings suggesting higher prevalence of autism among patients with Moebius syndrome, however some others did not report an increase in autism prevalence in Moebius syndrome. Clinical features of Moebius syndrome comprise difficulties in making diagnosis of autism. Long term follow-up of larger number of cases are necessary to understand whether the presence of both autism and Moebius syndrome in a patient represents comorbidity or only a coincidental condition.

Commentary: Effects of diagnostic thresholds and research vs service and administrative diagnosis on autism prevalence

King and Bearman are to be congratulated on their sophisticated analysis of the Californian Department of Developmental Services (DDS) database. In contrast with previous attempts to examine diagnostic substitution and diagnostic accretion (both in the same data source and in national administrative data sources), which allowed time trends but not individual child-level diagnostic substitutions and accretions to be examined, they demonstrated that children previously classified with ‘mental retardation’ account for one-quarter of the measured increase in autism prevalence in the DDS. However, King and Bearman highlight the fact that this leaves nearly three-quarters of the increase to be explained by other factors. The information available in administrative databases such as the DDS do not allow for any test of what these ‘other factors’ might be. Thus, their analysis does not answer the ‘great questions’ that have engaged both the scientific community and the general public: has there been a real increase in incidence and, if so, why? What has been the impact of changes in diagnostic practice, public and professional awareness of autism and other methodological factors (e.g. broadening of our concept of autism, different methods of ascertainment, inclusion of individuals with average IQ and those with other neuropsychiatric and medical disorders) that likely account for much of these dramatic time trends? Service administration databases are not prevalence studies and changes in recorded need might reflect changes in entitlement or availability of particular services, rather than true changes in prevalence. However, over the past 10 years epidemiological studies have also found much higher rates of autism than previously; so the administrative increase identified in the DDS data has also been reflected in the findings from prevalence studies. For several decades following Lotter’s seminal study, the autism prevalence figure that he reported of 4.5 cases per 10 000 was broadly accepted, although 20 per 10 000 children was noted as showing the broader ‘triad of impairments’ characterized by Wing and Gould. Over the past decade, prevalence rates for autism in the range of between 20 and 40 per 10 000 have been reported. The rates for the broader autism spectrum have ranged from 60 per 10 000 to close to and even over 100 per 10 000. However, quantifying the effects of the various methodological factors that might help explain the higher figures found in more recent studies is difficult. Williams et al. conducted a systematic review of autism prevalence studies and found that diagnostic criteria [higher prevalence in studies using International Classification of Diseases (ICD-10) or Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)], age of the sample (higher prevalence in younger samples) and study location (higher prevalence in Japanese vs US studies), are systematically related to the prevalence figures reported across 37 studies. A significant proportion (61%) in the variance in prevalence rates across studies could be explained by these factors. However, Williams et al. concluded that the three factors identified might be acting as a proxy for other study characteristics that affect prevalence rate. In a univariate analysis, they found that decade of study had the largest

Trends in Autism Prevalence: Diagnostic Substitution Revisited

There has been little evidence to support the hypothesis that diagnostic substitution may contribute to increases in the administrative prevalence of autism. We examined trends in assignment of special education codes to British Columbia (BC) school children who had an autism code in at least 1 year between 1996 and 2004, inclusive. The proportion of children with an autism code increased from 12.3/10,000 in 1996 to 43.1/10,000 in 2004; 51.9% of this increase was attributable to children switching from another special education classification to autism (16.0/10,000). Taking into account the reverse situation (children with an autism code switching to another special education category (5.9/10.000)), diagnostic substitution accounted for at least one-third of the increase in autism prevalence over the study period.

Trends in Special Education Code Assignment for Autism: Implications for Prevalence Estimates

There is considerable controversy over reasons for observed increases in the prevalence of autism spectrum disorders. We examined trends in British Columbia education database coding of children with autism from 1996 to 2004. There was a significant linear increase in autism prevalence. The proportion of children identified by age 6 increased significantly from 1996 to 1999. When we calculated prevalence assuming onset prior to age 3, previously unidentified cases, particularly among girls in 1996 and 1997, accounted for substantial increases in estimated prevalence. The magnitude of under-identification decreased from 1996 to 2000, and rose slightly in 2001. Analyses of prevalence trends must take into account effects of earlier age at identification and inclusion of previously undetected cases on prevalence estimates.

Investigating Diagnostic Substitution and Autism Prevalence Trends

In this issue of Pediatrics , Dr Shattuck presents findings from his intensive statistical analysis of diagnostic substitution in US special education data.1 Diagnostic substitution is one factor potentially contributing to the large observed increase in autism prevalence and, unlike many other possible factors, empirical evaluation of this factor can actually be approached by using existing administrative data. However, analyses of this sort are not without their challenges and complexities. When considering diagnostic substitution in US special education data, we are limited to group-level comparisons. We do not know whether individual children have switched classifications, and of course we can never know whether a given child in a particular birth cohort would have been classified differently had they been born either earlier or later. At best, analyses of this type are merely trying to determine if trends in one classification have the potential to offset those in another. Although Shattuck's models incorporate a number of advantageous features, they essentially distill the assessment of this … Address correspondence to Craig J. Newschaffer, PhD, Department of Epidemiology, Center for Autism and Developmental Disabilities Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Room E6030, Baltimore, MD 21205. E-mail: cnewscha{at}jhsph.edu

To sleep, perchance to speak

Few disorders provoke such intense anxiety and fear among parents as does isolated language regression and language regression with autistic regression among young children. The possible increase in prevalence of autism in the United States1 has helped focus attention on our inability to treat or prevent autism.2 Case series describing improved language function after treatment of Landau-Kleffner syndrome (LKS) and electrographic status epilepticus in sleep (ESES)3,4 have been a source of hope for parents of children with language regression and normal hearing, but no treatment has been proven effective in improving language function. Child neurologists and developmental pediatricians often perform all-night sleep recordings on children with language regression hoping to find this devastating, yet theoretically treatable, condition. Experts have debated whether these language regression disorders represent a spectrum of phenotypes with common features that allow them to be grouped together for clinical studies, or whether they are distinct phenotypic syndromes that should be considered separately.5,6 In this issue of Neurology, …

Measles-mumps-rubella vaccine and the development of autism

The measles-mumps-rubella (MMR) vaccine has been postulated to cause a form of autism characterized by regression and bowel symptoms, and onset occurring shortly after vaccination. It is also claimed that, as a result, there has been a dramatic increase in autism prevalence. These hypotheses have now been tested in a number of epidemiologic studies that are reviewed in this article. None has found any evidence of the existence of a phenotypically distinct form of autism in children who received the MMR vaccine or of a clustering of onset symptoms in children who are autistic after receiving the MMR vaccine. There is no proof that the overall risk of autism is higher in children who were vaccinated with MMR or of an increase in autism prevalence associated with the use of the MMR vaccine. No epidemiologic evidence suggests an association between MMR vaccination and autism. Moreover, epidemiologic evidence against such an association is compelling.

The changing prevalence of autism in California.

We conducted a population-based study of eight successive California births cohorts to examine the degree to which improvements in detection and changes in diagnosis contribute to the observed increase in autism prevalence. Children born in 1987-1994 who had autism were identified from the statewide agency responsible for coordinating services for individuals with developmental disabilities. To evaluate the role of diagnostic substitution, trends in prevalence of mental retardation without autism were also investigated. A total of 5038 children with full syndrome autism were identified from 4,590,333 California births, a prevalence of 11.0 per 10,000. During the study period, prevalence increased from 5.8 to 14.9 per 10,000, for an absolute change of 9.1 per 10,000. The pattern of increase was not influenced by maternal age, race/ethnicity, education, child gender, or plurality. During the same period, the prevalence of mental retardation without autism decreased from 28.8 to 19.5 per 10,000, for an absolute change of 9.3 per 10,000. These data suggest that improvements in detection and changes in diagnosis account for the observed increase in autism; whether there has also been a true increase in incidence is not known.