Posted by: Chris Maloney | April 3, 2012

World Autism Awareness Day: Just Better Diagnoses, Or Global Pandemic?

Subject: Quinn, an ~18 month old boy with auti...

Subject: Quinn, an ~18 month old boy with autism, obsessively stacking cans. Date: Late 2002. Place: Walnut Creek, California. Photographer: Andwhatsnext. Scanned photograph. Credit: Copyright (c) 2003 by Nancy J Price (aka Mom). This is an edited version of Image:Autism-stacking-cans.jpg. (Photo credit: Wikipedia)

World Autism Awareness Day: Those with autism no longer invisible – WPMT.

One of the stunning things is that  we now think that one in 88 children has this illness?  Is this simply a matter of diagnosing, or is this spreading rapidly?

The news from Western Australia is that mild and moderate autism diagnoses are increasing, while severe is dropping.  But they concluded that they didn’t really know if it was just an increasing diagnosis or an increasing number of cases.

But if you are like me and watching the increase of ADHD as well as Autism Spectrum because there is an overlap in behaviors and brain activity, we are clearly seeing an increase in overall incidence.  This year’s Canadian study found a doubling of ADHD in the last ten years in both boys and girls.  So clearly it isn’t simply a diagnostic phenomenon.

Currently the debate rages over vaccination, with both sides shouting rather than focusing on the greater issue.  If it isn’t vaccines, then what is it?

Int J Epidemiol. 2009 Oct;38(5):1245-54. Epub 2009 Sep 7.

Autism spectrum disorders in young children: effect of changes in diagnostic practices.

Nassar N, Dixon G, Bourke J, Bower C, Glasson E, de Klerk N, Leonard H.

Source

Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, West Perth, WA, Australia.

Abstract

BACKGROUND:

It is unclear whether the increase in autism over the past two decades is a real increase or due to changes in diagnosis and ascertainment of autism spectrum disorders (ASDs), which include autism, Asperger syndrome and pervasive developmental disorder not otherwise specified (PDD-NOS). The aim of this study was to examine the trends in ASD over time in Western Australia (WA) and the possible effects and contribution of changes in diagnostic criteria, age at diagnosis, eligibility for service provision based on ASD diagnoses and changes in diagnostic practices.

METHODS:

A population-based study was conducted among the cohort of children born in WA between 1983 and 1999 and diagnosed with ASD between the age of 2 and 8 years up to December 31, 2004. The trend in ASD diagnosis over the study period was assessed by investigating birth cohort and period effects, and examining whether these were modified by age of diagnosis. ASD diagnosis corresponding with changes in diagnostic criteria, funding and service provision over time were also investigated. A subgroup analysis of children agedID) and to investigate the role of changes in diagnostic practices.

RESULTS:

The overall prevalence of ASD among children born between 1983 and 1999 and diagnosed by age 8 was 30 per 10,000 births with the prevalence of autism comprising 21 per 10,000 births. The prevalence of ASD increased by 11.9% per annum, from 8 cases per 10,000 births in 1983 to 46 cases per 10,000 births in 1999. The annual incidence of ASD, based on newly diagnosed ASD cases in each year from 1985 to 2002, increased over the study period. The increase in incidence of ASD appeared to coincide with changes in diagnostic criteria and availability of funding and services in WA, particularly for children aged <5 years. The age-specific rates of autism and PDD-NOS increased over time and the median age of diagnosis for autism decreased from 4 to 3 years of age throughout the 1990s. For children aged

CONCLUSIONS:

The rise in incidence of all types of ASDs by year of diagnosis appears to be related to changes in diagnostic and service provision practices in WA. In children aged

PMID: 19737795

Can J Psychiatry. 2012 Feb;57(2):93-101.

Prevalence of prescribed attention-deficit hyperactivity disorder medications and diagnosis among canadian preschoolers and school-age children: 1994-2007.

Brault MC, Lacourse E.

Source

Student, Département de sociologie, Université de Montréal, Montréal, Québec; Student, Research Unit on Children’s Psychosocial Maladjustment, Université de Montréal, Québec; Student, Ste-Justine’s Hospital Research Centre, Montreal, Quebec.

Abstract

Objective: To describe trends in the prevalence of prescribed attention-deficit hyperactivity disorder (ADHD) medication by Canadian preschoolers and school-age children and to compare these with trends in the prevalence of the ADHD diagnosis between 1994 and 2007. Methods: Subjects participated in the National Longitudinal Survey on Children and Youth, a Canadian prospective survey collecting data biennially. Three cross-sectional samples of nonreferred children, aged 3 to 9 years and representative of Canadian children for 1994-1995 (n = 12 595), 2000-2001 (n = 13 904), and 2006-2007 (n = 14 655), were selected for the analyses. Information on prescribed medications and ADHD diagnosis was reported by each child’s parents. Prevalence was estimated at each cycle, taking the child’s age and sex into account. Results: The estimated prevalence of prescribed medications and ADHD diagnosis in Canada was generally low (less than 3%), but higher for boys (less than 4%) and school-age children (less than 5%). Preschoolers’ prevalence of both prescribed medications and ADHD diagnosis stayed stable between 1994 and 2007 (1% or less), while that of school-age children increased nearly 2-fold. Boys’ prevalence was higher than that of girls, but girls show the steepest increase over time, up to 2.1-fold. The association between prescribed medications and ADHD diagnosis has strengthened during the 2000s: a greater number of medications were used for children with ADHD (from 43% in 2000 to 59% in 2007) while off-label use of prescribed medications decreased among school-age children. Conclusions: The upward trend in the prevalence of prescribed ADHD medications and ADHD diagnosis currently observed in contemporary societies is also occurring in Canada, except with preschoolers.

PMID: 22340149

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