The reported increase is largely attributable to changes in diagnostic practices, referral patterns, availability of services, age at diagnosis, and public awareness.[1][3][17] A widely cited 2002 pilot study concluded that the observed increase in autism in California cannot be explained by changes in diagnostic criteria,[19] but a 2006 analysis found that special education data poorly measured prevalence because so many cases were undiagnosed, and that the 1994-2003 U.S. increase was associated with declines in other diagnostic categories, indicating that diagnostic substitution had occurred.[20] A 2007 study that modeled autism incidence found that broadened diagnostic criteria, diagnosis at a younger age, and improved efficiency of case ascertainment, can produce an increase in the frequency of autism ranging up to 29-fold depending on the frequency measure, suggesting that methodological factors may explain the observed increases in autism over time.[21] A small 2008 study found that a significant number (40%) of people diagnosed with pragmatic language impairment as children in previous decades would now be given a diagnosis as autism.[22] A study of all Danish children born in 1994-99 found that children born later were more likely to be diagnosed at a younger age, supporting the argument that apparent increases in autism prevalence were at least partly due to decreases in the age of diagnosis.[23] A 2009 study of California data found that the reported incidence of autism rose 7- to 8-fold from the early 1990s to 2007, and that changes in diagnostic criteria, inclusion of milder cases, and earlier age of diagnosis probably explain only a 4.25-fold increase; the study did not quantify the effects of wider awareness of autism, increased funding, and expanding treatment options resulting in parents' greater motivation to seek services.[24] Another 2009 California study found that the reported increases are unlikely to be explained by changes in how qualifying condition codes for autism were recorded.[25] Several contributing environmental risk factors have been proposed to support the hypothesis that the actual frequency of autism has increased. These include certain foods, infectious disease, pesticides, MMR vaccine, and vaccines containing the preservative thiomersal, formerly used in several childhood vaccines in the U.S.[1] Although there is overwhelming scientific evidence against the MMR hypothesis and no convincing evidence for the thiomersal hypothesis, other as-yet-unidentified contributing environmental risk factors cannot be ruled out.[3] Although it is unknown whether autism's frequency has increased, any such increase would suggest directing more attention and funding toward changing environmental factors instead of continuing to focus on genetics.[26]
Several contributing environmental risk factors have been proposed to support the hypothesis that the actual frequency of autism has increased. These include certain foods, infectious disease, pesticides, MMR vaccine, and vaccines containing the preservative thiomersal, formerly used in several childhood vaccines in the U.S.[1] Although there is overwhelming scientific evidence against the MMR hypothesis and no convincing evidence for the thiomersal hypothesis, other as-yet-unidentified contributing environmental risk factors cannot be ruled out.[3] Although it is unknown whether autism's frequency has increased, any such increase would suggest directing more attention and funding toward changing environmental factors instead of continuing to focus on genetics.[26]
Examining the increased incidence of autism
Autism rates have been rising steadily over the past two decades, causing much concern. Now a study in Epidemiology rules out diagnosis criteria and early diagnosis as possible reasons for that increase. Rates of autism, a developmental disorder that affects communication and social skills, are on the rise. Earlier in the 20th century, the incidence of the disorder was around four or five cases per 10,000 children; currently, it's more than an order of magnitude greater, being closer to 80 per 10,000. This precipitous rise is obviously quite worrisome, more so since we're no closer to knowing the reason for the increase. Autism is usually diagnosed in early childhood, prior to the age of three. There's been a lot of (very ill-founded) controversy over a link between vaccination and autism, since diagnosis often occurs around the same time as childhood vaccinations. That link, suggested by a UK clinician, possibly working in concert with lawyers attempting to sue vaccine makers, has been thoroughly discredited by the scientific community, but it has made an impression on the public, as childhood diseases such as mumps, measles, and rubella have wreaked havoc in communities where vaccination rates dropped. In looking for answers as to the increased incidence, fingers have been pointed at the methods of diagnosis, with the idea being that a more vigilant medical community, in conjunction with an expanded spectrum of autism diagnosis criteria, has resulted in greater numbers of cases. A pair of researchers from UC Davis and the Medical Investigations of Neurodevelopmental Disorders Institute in Sacramento have attempted to determine whether increased diagnosis is at fault, and have published the results in the journal Epidemiology. Using data gathered by California's Department of Developmental Services (DDS), they examined a number of potential causes. Data gathered from 1990-2006 showed that the incidence of autism has been rising steadily, with a cumulative incidence (per 10,000 births) of 8.9 in the 1990 cohort, 22.2 in the 1994 cohort, rising to 40.4 for the 1998 cohort. The first possible cause they rule out is that of changes to diagnosis criteria. Although the Diagnostic and Statistical Manual of Mental Disorders (commonly referred to as the DSM) was revised in the late 1980s and a new edition published in 1994, changes in the criteria for autism could only explain a 2.2-fold increase in rates, far below what has been observed. Early diagnosis was also not sufficient to explain the increase; although 12 percent more cases were diagnosed in children under the age of five in the 1996 group compared to 1990, there was no concurrent decrease in diagnosis of children aged between five and nine in the latter sample, which would be expected if we were simply detecting the condition earlier in the same children. Migration was also ruled out as a factor.
Rates of autism, a developmental disorder that affects communication and social skills, are on the rise. Earlier in the 20th century, the incidence of the disorder was around four or five cases per 10,000 children; currently, it's more than an order of magnitude greater, being closer to 80 per 10,000. This precipitous rise is obviously quite worrisome, more so since we're no closer to knowing the reason for the increase.
Autism is usually diagnosed in early childhood, prior to the age of three. There's been a lot of (very ill-founded) controversy over a link between vaccination and autism, since diagnosis often occurs around the same time as childhood vaccinations. That link, suggested by a UK clinician, possibly working in concert with lawyers attempting to sue vaccine makers, has been thoroughly discredited by the scientific community, but it has made an impression on the public, as childhood diseases such as mumps, measles, and rubella have wreaked havoc in communities where vaccination rates dropped.
In looking for answers as to the increased incidence, fingers have been pointed at the methods of diagnosis, with the idea being that a more vigilant medical community, in conjunction with an expanded spectrum of autism diagnosis criteria, has resulted in greater numbers of cases. A pair of researchers from UC Davis and the Medical Investigations of Neurodevelopmental Disorders Institute in Sacramento have attempted to determine whether increased diagnosis is at fault, and have published the results in the journal Epidemiology.
Using data gathered by California's Department of Developmental Services (DDS), they examined a number of potential causes. Data gathered from 1990-2006 showed that the incidence of autism has been rising steadily, with a cumulative incidence (per 10,000 births) of 8.9 in the 1990 cohort, 22.2 in the 1994 cohort, rising to 40.4 for the 1998 cohort.
The first possible cause they rule out is that of changes to diagnosis criteria. Although the Diagnostic and Statistical Manual of Mental Disorders (commonly referred to as the DSM) was revised in the late 1980s and a new edition published in 1994, changes in the criteria for autism could only explain a 2.2-fold increase in rates, far below what has been observed. Early diagnosis was also not sufficient to explain the increase; although 12 percent more cases were diagnosed in children under the age of five in the 1996 group compared to 1990, there was no concurrent decrease in diagnosis of children aged between five and nine in the latter sample, which would be expected if we were simply detecting the condition earlier in the same children. Migration was also ruled out as a factor.
WalMart has pulled all infant's products containing phthalates and BPA out of an abundance of caution.
As the Dutch said while fighting the Spanish: "It is not necessary to have hope in order to persevere."
geographical, state by state?
are the diagnostic protocols for autism similar or identical here in europe?
s. america? other developing nations? perhaps in some places some children are thought of as 'a bit dim' or even mentally handicapped, but without the label of autism.
i'm guessing prenatal stress will be found responsible eventually, environmental (proximity to Very Toxic Situations) and/or possibly nutritional, (GM?). mercury has a possible role, from coal fired plants, not only those producing in america, but also that blown by global winds from china.
they could quite easily be 'mistaken' about the vaccines too, considering how it's such a huge business for Big Pharma. i certainly wouldn't_ find it unthinkable that tests are biased, or some covering up couldn't happen, wouldn't be the first time, pretty SOP...
clearer stats may help sherlock out the truth, especially geographic, nutritional and socioeconomic. ~"When an inner situation is not made conscious, it appears outside as fate." Karl Jung~
The point of the original article is that these concerns have been around since the '90s, the EPA was requested to perform studies of the effects of trace chemicals in the food chain and/or household environments for which there has been plausible for some concern. This was quashed and slow rolled under Bush, (perhaps the chemical industry is also concerned), and has now been given a substantial amount of funding. I think it is better to do the science and see what we are dealing with. Personally, I also strongly suspect that, when the studies are done, we will see that we have been poisoning ourselves for the convenience of certain industrial sectors and the product distribution process. As the Dutch said while fighting the Spanish: "It is not necessary to have hope in order to persevere."
Be thankful for the future effects of REACH. A man of words and not of deeds is like a garden full of weeds; a man of deeds and not of words is like a garden full of turds — Anonymous
This link from your link shows concerns similar to those expressed in my original comments. I don't think the work subsequent to Sept. 2006 has served to diminish concerns about these chemicals. My own concerns usually go to the tendencies of "serious" people to minimize concerns rather than to risk their "serious" status. As the Dutch said while fighting the Spanish: "It is not necessary to have hope in order to persevere."
A set of mostly voluntary initiatives recently announced by the U.S. Environmental Protection Agency (EPA) to identify and manage the risks of thousands of chemicals will provide far less protection than the more comprehensive approach taken under the European Union's new REACH Regulation, according to Environmental Defense Fund (EDF). EDF is presenting its critique of EPA's Chemical Assessment and Management Program (ChAMP) at a meeting being held today by EPA to receive input on its initiatives. "ChAMP just doesn't have the reach of REACH, despite EPA's efforts to claim otherwise," said Dr. Richard A. Denison, EDF Senior Scientist. "It will yield far less data on far fewer chemicals. In its haste to catch up with other global initiatives, EPA intends to make decisions about risk using incomplete or poor quality information, especially with respect to how chemicals are used and how people and the environment are exposed to them."
EDF is presenting its critique of EPA's Chemical Assessment and Management Program (ChAMP) at a meeting being held today by EPA to receive input on its initiatives.
"ChAMP just doesn't have the reach of REACH, despite EPA's efforts to claim otherwise," said Dr. Richard A. Denison, EDF Senior Scientist. "It will yield far less data on far fewer chemicals. In its haste to catch up with other global initiatives, EPA intends to make decisions about risk using incomplete or poor quality information, especially with respect to how chemicals are used and how people and the environment are exposed to them."
"The ECHA will handle registration applications and safety data for around 30 000 widely used substances as Reach is phased in over the next 11 years." You can't be me, I'm taken
It's not a powerful lobby by any stretch of the imagination. But it's there. And it's had no scruples trumping up vaccination scares that have actually killed people.
- Jake If you only spend 20 minutes of the rest of your life on economics, go spend them here.
It's actually a pity that a subject like autism gets mixed up in the discussion. Because hormonal disturbance caused by exposure to environmentally foreign chemicals is a real and serious problem, and is in and of itself sufficient to warrant caution in the employment of those chemicals. Tagging on dubious connections to autism only makes it easier for those who insist to see no evil, hear no evil and speak of no evil to dismiss the entire issue of hormonally disrupting chemicals.
