Reviewing the Autism Prevalence (The Epidemiology: Part 2)
If upon reviewing the evidence, we take the stance that there is no epidemic of autism, we can be asked the totally reasonable question of why there appears to be an increase. I have already made some answers concerning the use of the IDEA and California DDS data; in this post I will discuss the change in the epidemiology statistics.
The first thing to note is the difference between studies over the years. In fact wide discrepancy can be observed in the Autistic Disorder specific prevalence per 10,000 persons in the whole world. This includes (.7) calculated by Treffort (1970) using criteria established by Dr. Kanner’s (The person who first described Autism) observations. Sugiyama & Abe (1989) calculated (13) using The Diagnostic and Statistic Manuel-III (DSM) criteria. This can be compared to the greater prevalence of (72.6) calculated by Kadesjo, Gillberg, & Hapberg (1999) using The DSM-III and the Revised International Disease Classification-10 (ICD).
The ICD-10 and the DSM-IV have some discrepancies and although close, are not totally comparable. When viewing studies that offer a rate of all the Pervasive Developmental Disorders, a range can be found from (11.2) per 10,000 persons (Fombonne, & du Mazabrun, 1992), through (67.4) (Bertrand et al., 2001). The problem with these data is that they are calculated from different diagnostics, some of which are more stringent and that they used population samples of different sizes.
Fombonne (2003) lists the prevalence rates of 32 Autism Epidemiology studies from (1966-2001). These are listed in tables (I, III) within (Fombonne, 2003). These data are taken on world wide epidemiology. I calculated the means of these studies by decade, because an increase can be observed this way. It should be noted that the specific decade mean, that a study was placed in this paper, was determined by the year it was published and not the year of the actual data collection.
Fombonne (2003) lists the prevalence rates of 32 Autism Epidemiology studies from (1966-2001). Based on this I calculated the mean in the 1970’s at (3.27) per 10,000 (Standard Deviation =2.24). I calculated this in the 1980’s at (6.98) per 10,000 (SD=5.12). I calculated this in the 1990’s at (19.26) per 10,000 (SD=22.5). I calculated this in the year’s post 1999 at (21.06) per 10,000 (SD=11.78).
The standard deviations are very large in comparison to the means. In the 1990s the standard deviation exceeded the mean. This is an indication of the very discrepant results within this decade. In years post 1999 the standard deviation decreases, showing a greater consistency of the studies.
Using table (3) in the Fombonne (2003) display of studies that calculate Pervasive Developmental Disorder, I calculate the mean in the 1970’s at (13.7) per 10,000 (SD=10.61). I calculated this in the 1980’s at (8.5) per 10,000 (SD=2.96). I calculated this in the 1990’s at (13.75) per 10,000 (SD=3.61). I calculated this in the year’s post 1999 at (49.8) per 10,000 (SD=20.2). In this case the 1970s research seems to have more variation than the more recent decades.
This analysis does not include the most recent epidemiology, specifically Chakrabarti & Fombonne, (2005). However, this study should not significantly affect the standard deviation and mean. It will raise the mean slightly towards the prevalence predicted in Chakrabarti & Fombonne, (2005).
References
American Psychiatric Association. (1980). Diagnostic and Statistical Manual of
Mental Disorders, Third Edition. Washington, DC: American Psychiatric
Association; 1980.
American Psychiatric Association. (1987). Diagnostic and Statistical Manual of
Mental Disorders, Third Edition, Revised. Washington, DC: American
Psychiatric Association; 1980.
American Psychiatric Association. (1994). Diagnostic and Statistical Manual of
Mental Disorders, Fourth Edition. Washington, DC: American Psychiatric
Association; 1994.
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of
Mental Disorders, Fourth Edition, Text Revision. Washington, DC: American
Psychiatric Association; 1994.
Arvidsson, T., Danielsson, B., Forsberg, P., Gillberg, C., Johansson, M., & Kjellgren, G. (1997). Autism in 3-6 year-old children in a suburb of Goteborg, Sweden. Autism, 2, 163-173.
Autism Diva. Sunday April 27, 2005. http://autismdiva.blogspot.com/
Accessed April 27, 2005
Baird, G., Charman, T., Baron-Cohen, S., et al. (2000). A screening instrument for autism at 18 months of age: a 6 year follow-up study. Journal of American Academy of Child and Adolescent Psychiatry 39, 694-702.
Bertrand, J., Mars, A., Boyle, C., Bove, F., Yeargin-Allsop, M., & Decoufle, P. (2001). Pediatrics, 108, 1155-161.
Boyle CA, Yeargin-Allsop M, Doernberg NS, Holmgreen P. Murphy, CC & Schendel, DE. (1996) Prevalence of selected developmental disabilities in children 3-10 year of age: The Metropolitan Atlanta Developmental Disabilities Surveillance Program. MMWR Morbidity and Mortality Weekly Reports. 45 (SS-2):1-14.
Bryson, S. E., Clark, B. S., & Smith, I. M. (1988). First report of a Canadian epidemiological study of autistic syndromes. Journal of Child Psychology and Psychiatry, 4, 433-445.
Burd, L., Fisher, W., & Kerbeshan, J. (1987). A prevalence study of pervasive developmental disorders in North Dakota. Journal of the American Academy of Child & Adolescent Psychiatry, 26, 5, 700-703.
Chakrabarti, S., & Fombonne, E. (2001). Pervasive developmental disorders in preschool children. Journal of the American Medical Association, 285, 3093-3099.
Chakrabarti, S., Fombonne, E., (2005). Pervasive developmental disorders in preschool children: confirmation of high prevalence. American Journal of Psychiatry, 162(6), 1133-41
Cialdella, P., & Mamelle, N. (1989). An epidemiological study of infantile autism in a French department. Journal of Child Psychology and Psychiatry, 30, 1, 165-175.
Day, J. C. (1996). Population projections of the United States by age, sex, race, and Hispanic origin: 1995 to 2050. US Bureau of the Census, Current Population Reports, P25-1130, U.S. Government Printing Office, Washington, DC.
Department of Developmental Services. Changes in the population of persons with autism and pervasive developmental disorders in California's Developmental Services System: 1987 through 1998. Report to the Legislature March 1, 1999 19 pages. http://www.dds.ca.gov1: 1999
Deykin, E. Y., & MacMahon, B. (1979). The incidence of seizures among children with autistic symptoms. American Journal of Psychiatry, 136, 10, 1310-1312.
Ehlers, S., & Gillberg, C. (1993). The epidemiology of Asperger syndrome. A total population study. Journal of Child Psychology and Psychiatry, 34, 1327-1350.
Fombonne, E. (1996). Is the prevalence of autism increasing? Journal of Autism & Developmental Disorders, 6, 673-676.
Fombonne, E. (1997). The prevalence of autism and other pervasive developmental disorders in the UK. Autism, 1, 227-229.
Fombonne, E. (1999). The epidemiology of autism: a review. Psychological Medicine 29, 769-786.
Fombonne, E. (2001). What is the prevalence of Asperger syndrome? Journal of Autism & Developmental Disorders, 31: 3, 363-364.
Fombonne, E. (200l). Is there an epidemic of autism? Pediatrics 107, 411-413.
Fombonne, E. (2002). Prevalence of childhood disintegrative disorder (CDD). Autism 6, 2, 147-155.
Fombonne, E. (2003). Epidemiological surveys of autism and other pervasive developmental disorders: an update. Journal of Autism and Developmental Disorders. 33, 365-382.
Fombonne, E., & du Mazaubrun, C. (1992). Prevalence of infantile autism in 4 French regions. Social Psychiatry and Psychiatric Epidemiology, 27, 203-210.
Fombonne, E., du Mazaubrun, C., Cans, C., & Grandjean, H. (1997). Autism and associated medical disorders in a large French epidemiological sample. Journal of the
American Academy of Child & Adolescent Psychiatry, 36: 11, 1561-1569.
Fombonne, E., Simmons, H., Ford, T., et al. (2001). Prevalence of pervasive developmental disorders in the British national survey of child mental health. Journal of the American Academy of Child & Adolescent Psychiatry 40, 820-827.
Gernsbacher MA, Dawson M, & Goldsmith HH. (2005). Three reasons not to believe in an autism epidemic. Current directions in psychological science. In press.
Gillberg, C. (1984). Infantile autism and other childhood psychoses in a Swedish region: epidemiological aspects. Journal of Child Psychology and Psychiatry, 25, 35-43.
Gillberg, C., Steffenburg, S., & Schaumann, H. (1991). Is autism more common now than ten year ago? British Journal of Psychiatry, 158, 403-409.
Individuals with Disabilities Education Act. (1990). Public Law 101-476, U.S.C.
Individuals with Disabilities Education Act Amendments of 1997, P.L. 105-17, 20 U.S.C. 1400 et seq.
Kadesjö, B., Gillberg, C., & Hagberg, B. (1999). Autism and Asperger syndrome in
seven-year old children. A total population study. Journal of Autism &
Developmental Disorders, Vol 29(4), 327-331.
Kielinen, M., Linna, S. L., & Moilanen, I. (2000). Autism in Northern Finland. European Child and Adolescent Psychiatry, 9, 162-167.
Lotter, V. (1966). Epidemiology of autistic conditions in young children: I. Prevalence. Social Psychiatry, 1, 124-137.
Lotter, V. (1967). Epidemiology of autistic conditions in young children: II. Some characteristics of the parents and children. Social Psychiatry, 1, 4, 163-173.
Magnusson, P., & Saemundsen, E. (2001). Prevalence of autism in Iceland. Journal of Autism & Developmental Disorders 31: 153-163.
Mason-Brothers, A., Ritvo, E. R., Pingree, C., Petersen, P. B., Jenson, W. R., McMahon, W. M., Freeman, B. J., Jorde, L. B., Spencer, M. J., Mo, A., & Ritvo, A. (1990). The UCLA-University of Utah epidemiologie survey of autism: prenatal, perinatal, and postnatal factors. Pediatrics, 86,514-519.
Matsuishi, T., Shiotsuki, M., Yoshimura, K., Shoji, H., Imuta, F., & Yamashita, F. (1987). High prevalence of infantile autism in Kurume City, Japan. Journal of Child Neurology, 2, 268-271.
Ritvo, E. R., Freeman, B. J., Pingree, C., Mason-Brothers, A., Jorde, L., Jenson, W. R., McMahon, W. M., Petersen, P. B., Mo, A., & Ritvo, A. (1989). The UCLA-University of Utah epidemiologic survey of autism: prevalence. American Journal of Psychiatry, 146, 2, 194-199.
Rutter, M. (1970). Autistic children: infancy to adulthood. Seminars in Psychiatry, 2, 435-450.
Sponheim, E., & Skjeldal, O. (1998). Autism and related disorders: epidemiological findings in a Norwegian study using ICD-10 diagnostic criteria. Journal of Autism & Developmental Disorders, 28, 217-227.
Steffenburg, S., & Gillberg, C. (1986). Autism and autistic-like conditions in Swedish rural and urban areas: a population study. British Journal of Psychiatry, 149, 81-87.
Steinhausen, H.-C., Göbel, D., Breinlinger, M., & Wohlloben, B. (1986). A community survey of infantile autism. Journal of the American Academy of Child Psychiatry, 25, 2, 186-189.
Sugiyama, T., & Abe, T. (1989). The prevalence of autism in Nagoya, Japan: a total population study. Journal of Autism & Developmental Disorders, 19, 1, 87-96.
Tanoue, Y., Oda, S., Asano, F., & Kawashima, K. (1988). Epidemiology of infantile autism in Southern Ibaraki, Japan: Differences in prevalence in birth cohorts. Journal of Autism & Developmental Disorders, 18, 155-166. 001
Treffert, D. A. (1970). Epidemiology of infantile autism. Archives of General Psychiatry, 22, 431-438.
Volkmar, F. R. (1992). Childhood disintegrative disorder: issues for DSM-IV. Journal of Autism & Developmental Disorders, 22, 625-642.
Volkmar, F. R., & Nelson, D. S. (1990). Seizure disorders in autism. Journal of the American Academy of Child & Adolescent Psychiatry, 1, 127-129.
Volkmar, F. R., Klin, A., Siegel, B., Szatmark, I., Lord, C., Campbell, M., Freeman, B. J., Cicchetti, D. V., Rutter, M., Kline, W., Buitelaar, J., Hattab, Y., Fomhonne, E., Fuentes, J., Werry, J., Stone, W., Kerbeshian, J., Hoshino, Y., Bergman, J., Loveland, K., Szymanski, L., & Towbin. (1994). Field trial for autistic disorder in DSM-IV, American Journal of Psychiatry, 151, 9, 1361-1367.
Webb, E. V. J., Lobo, S., Hervas, A., Scourfield, J., & Fraser, W. I. (1997). The changing prevalence of autistic disorder in a Welsh health district. Developmental Medicine & Child Neurology, 39, 150-152.
Wing, L. (1980). Childhood autism and social class: a question of selection? Britishjournal of Psychiatry, 137, 410-417.
Wing, L. (1993). The definition and prevalence of autism: a review. European Child and Adolescent Psychiatry, 2, 61-74.
Wing, L., Yeates, S. R., Brierly, L. M., & Gould, J. (1976). The prevalence of early childhood autism: comparison of administrative and epidemiological studies. Psychological Medicine, 6, 89-100.
World Health Organization. (1992). International Classification of Diseases, 10th Revision (ICD-10). Geneva, Switzerland: World Health Organization; 1992.
Yeargin-Allsopp, M., Rice, C., Karapurka, T., Doernberg, N., Boyle, C., Murphy, C. (2003). Prevalence of autism in a US metropolitan area. Journal of the American Medical Association, 289, 49-89.
The first thing to note is the difference between studies over the years. In fact wide discrepancy can be observed in the Autistic Disorder specific prevalence per 10,000 persons in the whole world. This includes (.7) calculated by Treffort (1970) using criteria established by Dr. Kanner’s (The person who first described Autism) observations. Sugiyama & Abe (1989) calculated (13) using The Diagnostic and Statistic Manuel-III (DSM) criteria. This can be compared to the greater prevalence of (72.6) calculated by Kadesjo, Gillberg, & Hapberg (1999) using The DSM-III and the Revised International Disease Classification-10 (ICD).
The ICD-10 and the DSM-IV have some discrepancies and although close, are not totally comparable. When viewing studies that offer a rate of all the Pervasive Developmental Disorders, a range can be found from (11.2) per 10,000 persons (Fombonne, & du Mazabrun, 1992), through (67.4) (Bertrand et al., 2001). The problem with these data is that they are calculated from different diagnostics, some of which are more stringent and that they used population samples of different sizes.
Fombonne (2003) lists the prevalence rates of 32 Autism Epidemiology studies from (1966-2001). These are listed in tables (I, III) within (Fombonne, 2003). These data are taken on world wide epidemiology. I calculated the means of these studies by decade, because an increase can be observed this way. It should be noted that the specific decade mean, that a study was placed in this paper, was determined by the year it was published and not the year of the actual data collection.
Fombonne (2003) lists the prevalence rates of 32 Autism Epidemiology studies from (1966-2001). Based on this I calculated the mean in the 1970’s at (3.27) per 10,000 (Standard Deviation =2.24). I calculated this in the 1980’s at (6.98) per 10,000 (SD=5.12). I calculated this in the 1990’s at (19.26) per 10,000 (SD=22.5). I calculated this in the year’s post 1999 at (21.06) per 10,000 (SD=11.78).
The standard deviations are very large in comparison to the means. In the 1990s the standard deviation exceeded the mean. This is an indication of the very discrepant results within this decade. In years post 1999 the standard deviation decreases, showing a greater consistency of the studies.
Using table (3) in the Fombonne (2003) display of studies that calculate Pervasive Developmental Disorder, I calculate the mean in the 1970’s at (13.7) per 10,000 (SD=10.61). I calculated this in the 1980’s at (8.5) per 10,000 (SD=2.96). I calculated this in the 1990’s at (13.75) per 10,000 (SD=3.61). I calculated this in the year’s post 1999 at (49.8) per 10,000 (SD=20.2). In this case the 1970s research seems to have more variation than the more recent decades.
This analysis does not include the most recent epidemiology, specifically Chakrabarti & Fombonne, (2005). However, this study should not significantly affect the standard deviation and mean. It will raise the mean slightly towards the prevalence predicted in Chakrabarti & Fombonne, (2005).
References
American Psychiatric Association. (1980). Diagnostic and Statistical Manual of
Mental Disorders, Third Edition. Washington, DC: American Psychiatric
Association; 1980.
American Psychiatric Association. (1987). Diagnostic and Statistical Manual of
Mental Disorders, Third Edition, Revised. Washington, DC: American
Psychiatric Association; 1980.
American Psychiatric Association. (1994). Diagnostic and Statistical Manual of
Mental Disorders, Fourth Edition. Washington, DC: American Psychiatric
Association; 1994.
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of
Mental Disorders, Fourth Edition, Text Revision. Washington, DC: American
Psychiatric Association; 1994.
Arvidsson, T., Danielsson, B., Forsberg, P., Gillberg, C., Johansson, M., & Kjellgren, G. (1997). Autism in 3-6 year-old children in a suburb of Goteborg, Sweden. Autism, 2, 163-173.
Autism Diva. Sunday April 27, 2005. http://autismdiva.blogspot.com/
Accessed April 27, 2005
Baird, G., Charman, T., Baron-Cohen, S., et al. (2000). A screening instrument for autism at 18 months of age: a 6 year follow-up study. Journal of American Academy of Child and Adolescent Psychiatry 39, 694-702.
Bertrand, J., Mars, A., Boyle, C., Bove, F., Yeargin-Allsop, M., & Decoufle, P. (2001). Pediatrics, 108, 1155-161.
Boyle CA, Yeargin-Allsop M, Doernberg NS, Holmgreen P. Murphy, CC & Schendel, DE. (1996) Prevalence of selected developmental disabilities in children 3-10 year of age: The Metropolitan Atlanta Developmental Disabilities Surveillance Program. MMWR Morbidity and Mortality Weekly Reports. 45 (SS-2):1-14.
Bryson, S. E., Clark, B. S., & Smith, I. M. (1988). First report of a Canadian epidemiological study of autistic syndromes. Journal of Child Psychology and Psychiatry, 4, 433-445.
Burd, L., Fisher, W., & Kerbeshan, J. (1987). A prevalence study of pervasive developmental disorders in North Dakota. Journal of the American Academy of Child & Adolescent Psychiatry, 26, 5, 700-703.
Chakrabarti, S., & Fombonne, E. (2001). Pervasive developmental disorders in preschool children. Journal of the American Medical Association, 285, 3093-3099.
Chakrabarti, S., Fombonne, E., (2005). Pervasive developmental disorders in preschool children: confirmation of high prevalence. American Journal of Psychiatry, 162(6), 1133-41
Cialdella, P., & Mamelle, N. (1989). An epidemiological study of infantile autism in a French department. Journal of Child Psychology and Psychiatry, 30, 1, 165-175.
Day, J. C. (1996). Population projections of the United States by age, sex, race, and Hispanic origin: 1995 to 2050. US Bureau of the Census, Current Population Reports, P25-1130, U.S. Government Printing Office, Washington, DC.
Department of Developmental Services. Changes in the population of persons with autism and pervasive developmental disorders in California's Developmental Services System: 1987 through 1998. Report to the Legislature March 1, 1999 19 pages. http://www.dds.ca.gov1: 1999
Deykin, E. Y., & MacMahon, B. (1979). The incidence of seizures among children with autistic symptoms. American Journal of Psychiatry, 136, 10, 1310-1312.
Ehlers, S., & Gillberg, C. (1993). The epidemiology of Asperger syndrome. A total population study. Journal of Child Psychology and Psychiatry, 34, 1327-1350.
Fombonne, E. (1996). Is the prevalence of autism increasing? Journal of Autism & Developmental Disorders, 6, 673-676.
Fombonne, E. (1997). The prevalence of autism and other pervasive developmental disorders in the UK. Autism, 1, 227-229.
Fombonne, E. (1999). The epidemiology of autism: a review. Psychological Medicine 29, 769-786.
Fombonne, E. (2001). What is the prevalence of Asperger syndrome? Journal of Autism & Developmental Disorders, 31: 3, 363-364.
Fombonne, E. (200l). Is there an epidemic of autism? Pediatrics 107, 411-413.
Fombonne, E. (2002). Prevalence of childhood disintegrative disorder (CDD). Autism 6, 2, 147-155.
Fombonne, E. (2003). Epidemiological surveys of autism and other pervasive developmental disorders: an update. Journal of Autism and Developmental Disorders. 33, 365-382.
Fombonne, E., & du Mazaubrun, C. (1992). Prevalence of infantile autism in 4 French regions. Social Psychiatry and Psychiatric Epidemiology, 27, 203-210.
Fombonne, E., du Mazaubrun, C., Cans, C., & Grandjean, H. (1997). Autism and associated medical disorders in a large French epidemiological sample. Journal of the
American Academy of Child & Adolescent Psychiatry, 36: 11, 1561-1569.
Fombonne, E., Simmons, H., Ford, T., et al. (2001). Prevalence of pervasive developmental disorders in the British national survey of child mental health. Journal of the American Academy of Child & Adolescent Psychiatry 40, 820-827.
Gernsbacher MA, Dawson M, & Goldsmith HH. (2005). Three reasons not to believe in an autism epidemic. Current directions in psychological science. In press.
Gillberg, C. (1984). Infantile autism and other childhood psychoses in a Swedish region: epidemiological aspects. Journal of Child Psychology and Psychiatry, 25, 35-43.
Gillberg, C., Steffenburg, S., & Schaumann, H. (1991). Is autism more common now than ten year ago? British Journal of Psychiatry, 158, 403-409.
Individuals with Disabilities Education Act. (1990). Public Law 101-476, U.S.C.
Individuals with Disabilities Education Act Amendments of 1997, P.L. 105-17, 20 U.S.C. 1400 et seq.
Kadesjö, B., Gillberg, C., & Hagberg, B. (1999). Autism and Asperger syndrome in
seven-year old children. A total population study. Journal of Autism &
Developmental Disorders, Vol 29(4), 327-331.
Kielinen, M., Linna, S. L., & Moilanen, I. (2000). Autism in Northern Finland. European Child and Adolescent Psychiatry, 9, 162-167.
Lotter, V. (1966). Epidemiology of autistic conditions in young children: I. Prevalence. Social Psychiatry, 1, 124-137.
Lotter, V. (1967). Epidemiology of autistic conditions in young children: II. Some characteristics of the parents and children. Social Psychiatry, 1, 4, 163-173.
Magnusson, P., & Saemundsen, E. (2001). Prevalence of autism in Iceland. Journal of Autism & Developmental Disorders 31: 153-163.
Mason-Brothers, A., Ritvo, E. R., Pingree, C., Petersen, P. B., Jenson, W. R., McMahon, W. M., Freeman, B. J., Jorde, L. B., Spencer, M. J., Mo, A., & Ritvo, A. (1990). The UCLA-University of Utah epidemiologie survey of autism: prenatal, perinatal, and postnatal factors. Pediatrics, 86,514-519.
Matsuishi, T., Shiotsuki, M., Yoshimura, K., Shoji, H., Imuta, F., & Yamashita, F. (1987). High prevalence of infantile autism in Kurume City, Japan. Journal of Child Neurology, 2, 268-271.
Ritvo, E. R., Freeman, B. J., Pingree, C., Mason-Brothers, A., Jorde, L., Jenson, W. R., McMahon, W. M., Petersen, P. B., Mo, A., & Ritvo, A. (1989). The UCLA-University of Utah epidemiologic survey of autism: prevalence. American Journal of Psychiatry, 146, 2, 194-199.
Rutter, M. (1970). Autistic children: infancy to adulthood. Seminars in Psychiatry, 2, 435-450.
Sponheim, E., & Skjeldal, O. (1998). Autism and related disorders: epidemiological findings in a Norwegian study using ICD-10 diagnostic criteria. Journal of Autism & Developmental Disorders, 28, 217-227.
Steffenburg, S., & Gillberg, C. (1986). Autism and autistic-like conditions in Swedish rural and urban areas: a population study. British Journal of Psychiatry, 149, 81-87.
Steinhausen, H.-C., Göbel, D., Breinlinger, M., & Wohlloben, B. (1986). A community survey of infantile autism. Journal of the American Academy of Child Psychiatry, 25, 2, 186-189.
Sugiyama, T., & Abe, T. (1989). The prevalence of autism in Nagoya, Japan: a total population study. Journal of Autism & Developmental Disorders, 19, 1, 87-96.
Tanoue, Y., Oda, S., Asano, F., & Kawashima, K. (1988). Epidemiology of infantile autism in Southern Ibaraki, Japan: Differences in prevalence in birth cohorts. Journal of Autism & Developmental Disorders, 18, 155-166. 001
Treffert, D. A. (1970). Epidemiology of infantile autism. Archives of General Psychiatry, 22, 431-438.
Volkmar, F. R. (1992). Childhood disintegrative disorder: issues for DSM-IV. Journal of Autism & Developmental Disorders, 22, 625-642.
Volkmar, F. R., & Nelson, D. S. (1990). Seizure disorders in autism. Journal of the American Academy of Child & Adolescent Psychiatry, 1, 127-129.
Volkmar, F. R., Klin, A., Siegel, B., Szatmark, I., Lord, C., Campbell, M., Freeman, B. J., Cicchetti, D. V., Rutter, M., Kline, W., Buitelaar, J., Hattab, Y., Fomhonne, E., Fuentes, J., Werry, J., Stone, W., Kerbeshian, J., Hoshino, Y., Bergman, J., Loveland, K., Szymanski, L., & Towbin. (1994). Field trial for autistic disorder in DSM-IV, American Journal of Psychiatry, 151, 9, 1361-1367.
Webb, E. V. J., Lobo, S., Hervas, A., Scourfield, J., & Fraser, W. I. (1997). The changing prevalence of autistic disorder in a Welsh health district. Developmental Medicine & Child Neurology, 39, 150-152.
Wing, L. (1980). Childhood autism and social class: a question of selection? Britishjournal of Psychiatry, 137, 410-417.
Wing, L. (1993). The definition and prevalence of autism: a review. European Child and Adolescent Psychiatry, 2, 61-74.
Wing, L., Yeates, S. R., Brierly, L. M., & Gould, J. (1976). The prevalence of early childhood autism: comparison of administrative and epidemiological studies. Psychological Medicine, 6, 89-100.
World Health Organization. (1992). International Classification of Diseases, 10th Revision (ICD-10). Geneva, Switzerland: World Health Organization; 1992.
Yeargin-Allsopp, M., Rice, C., Karapurka, T., Doernberg, N., Boyle, C., Murphy, C. (2003). Prevalence of autism in a US metropolitan area. Journal of the American Medical Association, 289, 49-89.
posted by Interverbal at 5:43 PM
4 Comments:
If there is an epidemic, then there must be a cause that is not genetic. The cause has to cover the time and the geography of the epidemic. Aside from vaccines, the medical community has nothing that fits that criteria. If it can't be vaccines, the CYA manual says that there can't be an epidemic.
So where are the older autistics? The states should be overwhelmed by autistics who have reached the age when their parents can no longer take care of them. Where are they?
I keep hearing about these wonderful peer reviewed studies that show that there is no relationship between autism and mercury or autism and vaccines. Show me the one with a control group, the group that did not have vaccines. What was the autism rate in that group compared to the group that was vaccinated with thimerosal laden shots. Where is it? What was the rate in the control group?
When I am shown manipulated statistics, I feel that someone is trying to manipulate me.
Hi Ed,
This post was about how we know that an epidemic of autism exists or doesn't. It was not an argument about a cause of autism (I did write such an argument yesterday on this blog though).
My interest is epidemiology, not thimerosal, that said, I think thimerosal advocates have attached themselves so closely to an "epidemic", that I am not sure that their theory can stand in the absense of an epidemic.
You wondered where the all the older autistics were. Possibly recieving services (or not) under a different category. Also, please check out tbis post http://interverbal.blogspot.com/2005/10/reviewing-autism-prevalence-use-of.html
and click on the graph with the heavy red line. Now follow that red line as it follows the 6 year old cohort in 1996 as they become the 13 year old cohort in 2003.
All the studies I cited are peer reviewed, but all they do is show the prevalence rate based on the the definitions the authors used, not a valid/invalid mercury connection, which is a seperate issue.
I can not quite tell, but I infer that you are referring to my statistics when you speak of "manipulated statistics". I had this hope that, because I was religiously citing and refering all my sources, that anyone who disagreed would check those first, before speaking of manipulation.
There is nothing to stop you from checking out my sources and running calculating the same stats to double check my work, you should probably do that.
What I refer to are the "peer reviewed studies" that I have seen coming out of the medical community. The first example was the Danish study, which was cited by the IOM. If you believed the statistics, then thimerosal helps prevent autism. It reached the right conclusion and was not questioned by the peers. When I see studies that are clearly flawed and still pass peer review, I have to question the legitimacy of the peer review.
So again, I ask for something simple - a control group. You have obviously looked at more epidemilogical studies than I have. Does such an item exist? What was the autism rate in the control group, the one that never got vaccines? I would expect to see it on the front page if the control group showed the same autism rate as the general population. I haven't seen a control group, but I have seen references to studies where the people who had not received vaccines were thrown out of the study. That just adds to my doubts.
I don't question your homework. But the medical community produces these statistics and they have their oar deep in the water. And yes, they have manipulated the statistics to show that there is no connection. The peer reviewed studies had the statistics I was referring to.
I am frustrated and I gave you the blunt end of it. For that I apologize. But there are so many things that require research by the medical community - leaky gut, leaky blood brain barrier, low levels of glutathione, metallothionine, processing of heavy metals by autistic children, just to name a few. Each of these is measurable. But it might point to an autism mercury connection. The medical community will not touch it. That leaves the autism community hanging from a cliff while they sit there.
As for the epidemic, let's turn that around. If there is an epidemic, genetics might contribute, but there has to be something more. And that something more has to fit into the geography and the timing of the epidemic. It can't be vaccines therefore it can't be an epidemic.
Hi Ed,
The Danish studies are correlational, they do not establish or fail to establish mercury causality. I am aware there a conflict of interest in the Danish studies. If I remember correctly this has been indicated, as is proper procedure. Also, conflict of interest is not, in and of itself enough to invalidate a study.
In any kind of post event study, we can include a control group, but the design would still be correlational in nature. This provides limited evidence either way.
I have looked at mostly epidemiology of prevalence or incidence, as opposed to correlational studies looking at thimerosal and autism (which are sometimes called epidemiology).
Can you tell me more about the studies where folks without vaccines were tossed out.
Remember, it is not only the medical community, but also the psychological community who produces the epidemiology. There is no reason to think they have been manipulated, in fact most persons think upon first looking at them, that they show an epidemic.
Blunt speech never offends me by the way. I do demand precision from other scientists though, I think this is a “responsibility” issue for those folks and for me.
I agree that all those things you mention can be studied, but on whom does the burden of proof fall?
I have noted your statement “It can't be vaccines therefore it can't be an epidemic”, several times now, both here and on your own site. However, in my case, it is just the opposite. I got into epidemiology first, and it remains one of my primary interests.
I don’t know if thimerosal causes autism, but I have problems with an un-researched treatment to remove mercury and I take the stance that the facts indicate there is no epidemic of autism.
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