Let me preface this diary by saying that having known families who support children diagnosed within the autism spectrum and having had a parent who worked for a long time with a very wide range of autistic children, I am profoundly sympathetic and realize I do not know the first thing about how difficult it must be to care for an autistic child. The emotions involved in the many autism debates and discussions run high.
A new study performed in Sweden, comparing the "annual prevalence of the autism symptom phenotype and of registered diagnoses for autism spectrum disorder during a 10 year period in children" has concluded:
The prevalence of the autism symptom phenotype has remained stable in children in Sweden while the official prevalence for registered, clinically diagnosed, autism spectrum disorder has increased substantially. This suggests that administrative changes, affecting the registered prevalence, rather than secular factors affecting the pathogenesis, are important for the increase in reported prevalence of autism spectrum disorder.
The study used two sets of Swedish children born between 1993-2002. One set consisted of twins and the other set consisted of all children born in Sweden during that time. The reason for the study is important. Is autism an epidemic, being caused by something in our environment, or not? The implications are very important in how funds should be allocated in figuring out the best ways to handle it.
Using unique, large Swedish population based resources, we found that the annual prevalence of the autism symptom phenotype was stable over a 10 year period when investigating 9 and 12 year old children, while simultaneously the annual prevalence of clinically diagnosed autism spectrum disorder in a service based register steadily increased. In summary, our data do not support a secular increase in the rate of the autism symptom phenotype, suggesting that administrative factors that affect the registered prevalence may account for much of the rise in the reported prevalence of autism spectrum disorder.
The study's conclusions and inferences of policy changes needed are interesting:
We believe that our findings indicate that the prevalence of autism spectrum disorder is not increasing in childhood. The research and clinical resources currently devoted to dealing with these problems relate to the possibly mistaken notion that there is an actual increase. This allocation of specific resources to study “the epidemic of autism” should not be allowed to spiral out of proportion. Other developmental disorders, such as intellectual developmental disorder, language disorder, and attention-deficit/hyperactivity disorder may recently have become overshadowed and seem to be missed diagnoses in many instances, where now only autism spectrum disorder is diagnosed (even perhaps when the autism symptomatology is relatively mild). There is growing evidence that these other developmental disorders are at least as good as or perhaps even better indicators of outcome (and hence, sometimes, need for intervention) as autism spectrum disorder in itself.42 Research and clinical practice need to refocus on the child’s overall clinical situation and to acknowledge that autism is but one of the many Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations (ESSENCE). Children who are clinically impaired at an early age and who meet the criteria for autism spectrum disorder almost always have other developmental disorders and problems that need to be tackled.44 Clinics specialising in autism spectrum disorder are unlikely to be able to cater to all the needs of affected children and their families.