Scientists baffled as autism cases soar in state, with no relief in sight

California’s mysterious explosion of autism cases worsened in 2004, disappointing researchers who had hoped the number of new diagnoses would level off as they searched for an explanation for the neurological disorder.

– Katherine Seligman, Chronicle Staff Writer
Friday, February 4, 2005

The number of people treated for autism at regional centers operated by the state Department of Developmental Services increased 13 percent last year from 2003, according to agency figures.

Autism now accounts for a little more than half of the new cases handled at the centers, which treat a variety of developmental problems. An average of nine new autism cases a day come to the state’s attention, the vast majority in children 13 and younger.

Scientists have various theories, but there is little agreement about what is driving the growth of autism cases in California. The number of autistic people getting services at the centers has increased from 5,000 in 1993 to more than 26,000 now.

“I’m really worried,” said Jim Burton, head of the state-funded Regional Center for the East Bay, which provides treatment referrals and services for people with autism. “The burden is huge, and it’s going to strain all our resources.”

His center has 1,600 clients with autism and is “short across the board” on services for them, Burton said. Treatment programs have long waiting lists, he said.

In San Francisco, schools have been so inundated with new cases that the school district has three specialists to deal with the autism curriculum — two years ago, there was one — and classes for autistic students from kindergarten to high school. The district has provided special training in autism for at least 50 speech therapists and teachers this year.

“I was expecting (the numbers) to level off,” said Ron Huff, a psychologist with the Department of Developmental Services who has been analyzing the numbers. “I don’t see any of it diminishing.”

Autism, a disorder characterized by difficulty in communicating and forming social relationships, was not widely recognized by the public until the 1990s. Autistic children can have trouble picking up emotional cues or interpreting facial expressions. Some develop obsessive interests or make repetitive movements such as rocking back and forth or flapping their arms. Parents often report that their autistic children seemed normal at birth but then regressed, losing speech and social skills.

The statewide increase does not include other disorders related to autism, such Asperger’s syndrome, sometimes called “little professor syndrome” because some children with it appear brilliantly accomplished in a single discipline or area, such as playing virtuoso piano or reciting a book from memory.

California, with its exploding number of autism cases, is not alone. The federal Department of Education reported 1,700 percent more schoolchildren with autism nationally in 2002 than in 1992.

Because it draws its numbers from centers that treat and refer new cases, California often is used as an indicator of the nationwide trend.

Robert Byrd, a pediatric epidemiologist at UC Davis who was the lead investigator in a study of a 10-year increase in autism cases in California through 1998, said researchers have looked into several theories to explain the increase. They include the possibility that the rising autism numbers were caused by improved and earlier diagnoses, or by childhood vaccines or other environmental causes.

Most researchers believe genetics play a role, but they aren’t sure what spurs the disorder. None of the other theories has been proved or ruled out.

“There is no one answer that says we can explain what we’re seeing,” Byrd said. “We’re still looking at these numbers with lots of questions.”

If vaccines played a role, said Byrd, scientists would have seen a decline or leveling off in cases after a suspect preservative containing mercury was removed from childhood immunizations. No such decrease was noted.

The state has used new, stricter criteria since 2003 for diagnosing autism, but that also has not made a difference. The number of new cases of mental retardation and cerebral palsy — which also are diagnosed using new criteria — fell since 2003.

Byrd and others say a greater awareness of autism may account for some of the increase. Parents, pediatricians and schools now recognize the symptoms earlier and refer children for treatment. But that doesn’t completely explain the increase, they believe.

“Some people who were skeptical of the original Department of Developmental Services report (looking at the 10-year increase) now believe this is a serious public health policy concern, that the increases are legitimate beyond just better diagnosis,” Huff said.

While epidemiologists continue to look for clues, parents whose children have autism try to manage the day-to-day challenges.

Kimberly Garrison, a member of a San Francisco school district autism task force, said she has yet to find the right classroom situation for her autistic sixth-grade son this year. He is frustrated in a special autism class where most of his classmates have trouble communicating verbally, Garrison said.

There is no classroom for children like him, who function at a higher level but have autistic-related behavior problems that keep them out of mainstream classes.

“There are all these kids out there,” Garrison said, “and the money is shrinking, shrinking, shrinking.”

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Puzzling disorder

Autism usually strikes children 13 and younger.

The characteristics:

Trouble reading social cues.

Difficulty making eye contact or forming relationships.

Repetitive behavior such as rocking or flapping arms.

E-mail Katherine Seligman at [email protected].