Autism awareness is increasing both nationwide and globally. April 2, 2009, was this year’s World Autism Awareness Day.  As the name implies, an increasing awareness of Autism Spectrum Disorders has accompanied what appears to be an increase in diagnoses of ASDs worldwide.

The World Health Organization (WHO) does not specifically maintain global statistics on autism prevelance.  However, its 2007 Global Burden of Disease report on neurological and mental disorders did illustrate that mental and neurological disorders have been underestimated because traditional tracking methods focus on mortality, not on disability rates.

The Autism Society of America reports the following autism incidence rates of the estimated number of individuals with autism in 2007:

Clearly, ASDs do not discriminate based on culture, geography, ethnicity, or socio-economic status, nor does the need for diagnosis, treatment, and intervention.

Bob Wright, co-founder of Autism Speaks reports that “Approximately 67 million people are affected by autism around the world, and we believe the solutions will come from a community of science and research without boundaries. The work of Autism Speaks in global science and research is an important path to investigate causes, prevention, treatments and a cure for autism; increase international awareness of autism spectrum disorders; and advocate for the needs of all individuals with autism and their families in our global community.”

Clearly, autism is not just an issue for the United States, but one of global concern as well.

So, if it seems like you hear a great deal about autism now, that’s both because of the media saturation regarding Autism Spectrum Disorders (ASDs) and because more children are being diagnosed with ASDs now than ever before.

But just because we hear more about autism and an increase in diagnoses, does that mean that ASDs are on the increase in the United States? Or are more children simply being diagnosed with this complex disorder?

Likely the answer is somewhere in between. Autism is not a new disorder: while it has probably been around for centuries, it was not given a name until 1943, according to the Centers for Disease Control and Prevention (CDC). Since the disorder was first named in the middle of the last century, the criteria used to diagnose ASDs have changed many times. There is no medical test for ASDs, so diagnosis is made by observing behavior and symptoms in those affected.

The CDC reports that about 17 percent of children under age 18 are affected by a behavioral, developmental, or learning disability, and that the incidence rate for ASDs is as high as 1 in 150 children. These figures make ASDs the fastest growing developmental disorder in the United States and a disorder more prevalent that many other childhood diseases or disabilities.

The American Academy of Pediatrics (AAP) argues that the reason ASDs seem more common now than they were once thought to be is related to a number of factors: broader diagnosis criteria, increased public and professional awareness of symptoms, and, perhaps, a “true rise in prevalence.” As for one possible cause of ASDs, the AAP states that “sufficient evidence now suggests that vaccines and thimerosal are not likely responsible for the apparent rise in prevalence” of ASDs.

Yet, at least in California, the numbers are increasing: from 205 cases in 1990 to more than 3,000 in 2006. A recent study by researchers at the MIND Institute at the University of California-Davis has found that, while factors such as broader diagnosis criteria and increased awareness of ASDs do contribute to this increase, they do not fully explain the increase. The study found that “Younger ages at diagnosis, differential migration, changes in diagnostic criteria, and inclusion of milder cases do not fully explain the observed increases.”

While known causes of ASDs have not been determined, the MIND Institute study suggests that further investigation of possible environmental factors, as well as study of gene-environment interactions, are in order.

So is autism on the rise in the US? The number of diagnoses is, and yet more investigation is needed to determine whether the increase is related to an increased awareness or to a true rise in the number of children affected.

References and Additional Resources:

Information that parents need regarding their child’s development goes beyond height, weight, and body mass index for age.  There are developmental milestones and developmental screening tools used to determine a child’s development at ages 3 months, 7 months, 1 year, 2 years, 3 years, 4 years, and 5 years.  A child’s failure to reach certain milestones may mean the presence of a developmental delay or a disorder such as Autism Spectrum Disorder (ASD).

Development encompasses the physical, cognitive, social and emotional, and language skills of children. Because these skills develop on a continuum, milestones are guidelines or approximations of where a child should be at a certain age.

Physical

Physical development encompasses actions such as rolling over, sitting, crawling, standing without support, walking (forward and backward), running, jumping on one leg, climbing stairs, carrying objects, and throwing and catching a ball.  Obviously, these skills build on each other over time.

Cognitive

Cognitive development encompasses how the brain processes information.  Starting at about 6 months, babies explore things with their hands and look for hidden objects.  This progresses to imitating gestures and experimenting with how their actions affect objects.  Testing parental reaction to their actions, beginning to follow directions, sorting colors and shapes, playing make-believe and pretend games, and solving puzzles are all cognitive skills.

Social and Emotional

Social and emotional development is measured by things such as baby’s smiles, reaction to tone of voice, imitation of others, a sense of “mine” and “yours,” taking turns during play, being excited to be around other children, becoming independent in doing things like dressing oneself, negotiating solutions to problems, and developing a sense of oneself as a whole:  body, mind, and emotions.

Language

Language development encompasses first coos and babbling, then the “telegraphic” language of toddlers that is often two-word sentences, repeating words, recognizing names, understanding what is said and being able to follow directions, using pronouns correctly, and ultimately being able to speak so that anyone outside of the family can understand.

Development Varies

Talk to your child’s healthcare provider about what is appropriate development for your child’s age.  Not all children develop exactly alike, and there is room for variation within the guidelines.  Not meeting certain developmental milestones does not automatically mean your child has a delay or disorder.  For more information on developmental guidelines, visit the Centers for Disease Control’s page here.