Wednesday, October 24, 2007

Do Old Teachers Claim an Epidemic

One of the more interesting claims from our friends in the biomedical advocacy camp is “That if one talks to a veteran special education teacher then they will tell you that the rise in autism is real and not due to changing criteria”.

I certainly have seen this claim a number of times and I suspect that many of my readers will have as well. It seems fair to put this to a test. After all, the way the point is usually written tries to reflect the opinion of most/all the special educators and not just one or two special educators.

Recently I attended a meeting with 20 or so special education teachers. A total of 6 of them had 25+ or more years of experience. The opportunity as not lost on me and I took a moment to ask: “Is the prevalence of autism increasing, decreasing, or staying static and why do you think this is the case?” The answers are summarized below.

Teacher 1: The prevalence seems to be increasing. She had no ideas why, and didn’t care to speculate.

Teacher 2: The prevalence is truly increasing. Unspecified environmental toxins are most likely to blame

Teacher 3: Prevalence seems to be increasing. No ideas why, claimed not be very familiar with the issues. Didn’t want to guess.

Teacher 4: Prevalence is static. Political issues related to special education law, allow parents to choose a more desirable autism label compared to what the testing says. Claimed she had seen it before with ADHD in the late 80s. She also mentioned that placement is a IEP category does not constitute diagnosis.

Teacher 5: Prevalence is static. Better diagnostics and broader definitions are the cause. Claimed that no one heard of Asperger’s Disorder before 5 years or so ago.

Teacher 6: Prevalence is increasing. No ideas why and didn’t care to speculate.

So the total is 4 who didn’t know why and/or refused to try to guess.
1 person who thought that the increase was due to IEP issues.
1 person who thought that the increase was due to better diagnostics and definitions.
And 1 person who thought that environmental toxins were the cause.

So, what does all this prove? Well, very little to be honest. This type of informal survey can tell us almost nothing about popularity or what the majority veteran special educators think. The only thing is proves, is that bowling up to a special education teacher and asking if the autism increase is real or not, is not for sure, going to be met with a certain answer. This is contrary to claim or myth as it is usually given. The morale here is: “Don’t buy it!”

5 Comments:

Anonymous Anonymous said...

A similar claim is that pediatricians think true prevalence has increased. But, "Most pediatricians (71%) believed that ASD prevalence has increased, and nearly all attributed this to changes in diagnostic criteria and treatment" (Dosreis et al., 2006).

It's possible that changes in labeling alone, plus earlier diagnoses, could construct different perceptions.

If you look at the 8 and 9 year-old IDEA population, it's basically unchanged in the last 14 years.

8:02 AM  
Blogger Casdok said...

Interesting,
And no i dont buy it!

11:08 AM  
Anonymous Anonymous said...

Hi Interverbal -

In regards to the fairness post you had earlier, one wonders had your sample showed that four of six special ed teachers thought that prevalence was static, would the tone of your post been the same?

Is there ever a point when we are able to give the conclusions of professionals any credence? Given the nebulous nature of an autism diagnosis and the likelyhood that the criteria will change again at some point, it occurs that there may never be a reliable, rock solid set of numbers on which to run statistical analysis. (?) This would seem to leave us without ever having a mechanism to know if the prevalence is increasing.

I one time floated the notion of (eventually) being able to use a set of biomarker tests for this kind of thing, but got no responses. The stored neonatal blood samples used to track levels of BDNF would seem to come to mind as an example; I have no idea how far back they go, however.

Anyways, take care!

- pD

2:08 PM  
Blogger Patrick said...

Wow, sounds like time for a phone survey (eek, dare I mention by who?)

11:21 AM  
Blogger Interverbal said...

Hi PD,

Yep, tone would have been the same, even with different results.

But I had an unfair advantage going in. I both personally know and I am related to multiple veteran special education teachers. They are some of the most opinionate people I know.

These people can't even agree whether a school should be decorated for holidays or not. I knew that there was no way in Hell, that they were going to agree about the cause of the rise in autism.

I don't agee with appealing to the majority opinion of people even when they are experts. This is the fallacy of the appeal to authority.
I have seen both sides of the autism debate make this mistake.

You write "Given the nebulous nature of an autism diagnosis and the likelyhood that the criteria will change again at some point, it occurs that there may never be a reliable, rock solid set of numbers on which to run statistical analysis. (?) This would seem to leave us without ever having a mechanism to know if the prevalence is increasing."

DING! DING! DING! [Confetti bursts forth] Yes, this is what some of us, myself included, have been arguing for years.

However, there might be a caveat to this. If one does a geographic epidemiology study (studies all people of a certain age within a set boundary) and uses the exact same standards and the exact same assesements, then it would be possible to see if autism truly icnreased.

5:31 PM  

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