Thoughts on the Autism "Epidemic"

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I think environmental factors that are a factor in the increase in autism diagnosis is that the world is a more autistic unfriendly place. More sensory bombardment, much more multitasking expected, more "people skills" expected in school and work. Those that were kind of functional 50 years ago now can't and need a diagnosis.

Also more expectations that children have to reach certain markers instead of acceptance that children mature at different rates.

I wonder how much of that comes from which might be described as, "My children have to hit those markers or they won't be 2 steps ahead of the others and that will make me a failure as a parent, and my children being less than superior won't do my own ego any good either"

I wasn't dxed till I was 62 in May last year. If I had not moved and come under a different set of mh professionals I'd still be undiagnosed. That's because the previous mental health team couldn't or wouldn't look beyond a severe mental illness as an explanation for everything.

At times, because of the wide range of abilities and experiences that are found on this forum, I end up thinking "I'm not like him or her. So how can I be on the spectrum" Maybe ASD is an umbrella term for similar but different things. What would be gained or lost in separating all those into newly formed diagnoses?

The way in which autism presents itself is very varied, as a missing brain connection can cause a veriety of different outcomes according to which brain connection is not made and what it is responsible for (If that makes sense?)

As I write this a theory popped into my mind. I wonder if those who under the old system would be classed as autism would simply have a brain connection missing (For the theory I will say a single brain connection. It maybe many) and those diagnosed with aspergers syndrome would have had a brain connection missing, but their brain would have compensated by developing another part of the brain instead?

It is just a thought. I know life is not that simple and it is only an idea that popped into my head.

We have had several parent posters come here in a panic because their baby missed a marker despite describing their kid as happy(SMH).

Well, looking through these responses I'm seeing a lot of people saying that we are now diagnosing a lot more people, who previously might have flown under the radar.

I don't deny that. I'm sure it's part of the story, maybe accounting for much of the increase. But how can you be so sure that is all there is to it?

I've heard that rates of classic autism in the moderate to severe range have risen a lot too. Kids with the more severe autism I wouldn't expect to fly under the radar, usually it's clear there's something going on with them.

So how would you explain this increase? These are kids who even 40 years ago would surely have been diagnosed, either with autism or some kind of intellectual disability, I would think.

It depends which autism people are referring to when saying numbers have gone up

People like me who scrapped through childhood as someone others just thought of as a bit different but didn’t stand out that much or children as young as 3 that look neurologically abnormal and that abnormality is damaging to them.

As far as natural genetic differences are concerned in many cases the cause is de novo mutations meaning the difference is likely for unknown reasons and bear no resemblance to the parents.

I think for all us there's something different going on from a very young age. With some it's clearly noticeable very early on. For others it becomes apparent when coping skills don't match up to increased demands.
I'd say going boarding school at the age of 8 was the point it became noticeable that I was different from the others. That difference increased on going to public school at 13.75. Prep school was from 1965-1970 & public school 1970-1975. Many years before Asperger's was a dx. You were seen as being odd but not disabled. Our local vicar wrote my housemaster about the bullying to be told -"Unfortunately he is the sort of boy that invites this sort of treatment" . My housemaster's recommendation being 'attack as the best of defence'

It also depends where one lives. Here in the UK, I read that in county of North Wales health board for that area refused to accept that autism even existed until they changed their minds in 1994, so it does not just make a difference of which country one lives in, but where in that country one lives.
Obviously many areas are still playing "Catch up" when it comes to assessments.
About a year or two ago, Wales was lagging so far behind England in regards to assessing mental issues that our Welsh assembly decided to allocate extra funding to address the issue. So what were six year waiting lists have now come down to just over two (My brother has been waiting for 12 + years now for emergency suicide counsilling and still has not heard when it will be).
The problem here in Wales is that with children, the schools are not allowed to put in extra support until an assessment has been done. Many parents go for a private assessment, but like my brother and his ex girlfriend found out, that the schools will not accept a private diagnosis, after they took out a large loan to pay for the private assessment. So things are not ideal. A year later after a six year wait the child was assessed. As one can appreciate, there has been a lot of work on behalf of the assessment teams in Wales to reduce the waiting list as things do not happen overnight if one gets an increase in Welsh assembly funding.
But what I am trying to say is that with the increase of awareness, along with the rather big job of trying to catch up with the long waiting lists, the numbers being diagnosed are only set to increase. This does not mean that the amount of cases of autism in people has increased. It means that the amount of people being assessed has increased.


But here is another possibility. Supposing someone marries another and they are both on the spectrum. Now autism normally passes down the family line. Supposing one parent pases on unintentionally one lot of traits and the other parent passes on another lot of traits, the children could end up with both sets of traits having been passed down. (This is all theory. I am not saying it happens). Could this explain why an increase in severity of autiam cases?

Also two other VERY significent differences in recent years. One is that todays children are taught via computers and "Live" on the internet. The second is that both in the USA and here in the UK along with Europe, the education systems are designed with communism built in where in the past they were not. (The change came in the UK when the GCSE's came in and corpral punishment was replaced with manipulated brainwashing. In the USA it came in a decade or two earlier).
Both these changes are more likely to expose ANYONE who happens to think outside the box or is different as they do not fit into todays "Tick box "Yes/No" " society, while under the past systems, if they could mask they could hide themselves better if they could keep themselves out of trouble.

Where are you hearing that classic autism is rising faster than before? I would like to know where you are getting this information. There is still an idea that vaccines cause autism and that is clearly untrue, yet you can find this information. You are clearly concerned about this situation, but I have not seen anything that suggests what you are suggesting.

Yes, previously, classic autism might have been misdiagnosed as an intellectual disability, which would to simply suggest that diagnosis is much better today. That does not mean people with more sever forms of autism are increasing, but simply they are not being misdiagnosed with something else. This also means older people with a misdiagnosis might be finally get the correct one. Also, women have been greatly underdiagnosed. That is starting to change. But none of this suggests an increase in autism, just better detection.

The CDC gave a autism prevalence estimate among adults in the US this year at 1 in 45 or about 2.2% of the population.

Key Findings: CDC Releases First Estimates of the Number of Adults Living with Autism Spectrum Disorder in the United States

All this does is simply point to the fact we understand autism better and can identify it with greater accuracy. If the CDC number is right, it also means that the prevalence of autism is around 2% and always has been, meaning there are a great many people trying to live with autism without knowing they have it and without any support or help. That to me is very concerning.

Sorry Jiheisho, I haven't saved the articles and forget where I read it. Not very rigorous of me, I know!
I just did a bit of a google search and found an interesting summary on autism prevalence worldwide.
I don't know how to post links See if this works:

http://www.hrpub.org/download/20180228/ ... 910947.pdf

Although it is not conclusive in terms of the reasons behind the increase in autism prevalence, it includes summary of some studies which sound interesting.
And here is a quote:

My understanding is that while many have stated the opinion that the apparent increase in prevalence is due to things like improved diagnosis, nobody has actually been able to show that there has been no true increase in prevalence, so it is really only conjecture.

I think we should take a rather more precautionary approach and be open-minded about the possibility of a real increase - as this has important ramifications.

I suspect all reasons are true in that each has its own contribution factor that accumulates to show a rise.

Makes me laugh when I read about “environmental pollution” have they ever read history what it was like in big cities and smog just a few decades ago.

I heard someone say in 1950’s London you could barely see your hand in front of your face a few inches away

Unless there is a delayed effect genetically?

I agree. We do want to make sure to catch any public health crisis as it starts to develop. I am certainly not trying to discount your concerns. I guess with all the reading I have done, I have not seen anything that is suggesting a type of epidemic in the autism population (beyond the problems of diagnosis). Certainly in countries with weak environmental laws, they may be impacting the lives of children with pollutants. So I agree health officials should be monitoring populations.

Since the whole debacle with autism and the MRR vaccine, I am also concerned we don't create something that is not there either. The anti-vaxx movement have created some sever consequences for many people and not just those with ASD. For example, in the study you link to (thank you, BTW), they point out that the stigma around autism in developing countries suggests under-diagnosis for people with autism. Those people not only cannot get support, but if they do, the stigma may create secondary effects such as marriage or employment discrimination. And of course, we have an under-diagnosis issue in women and older people like myself.

You seem to be very concerned. I think the the question is far more complex. Studies like the one you referenced does talk a lot about the limitations of trying to understand autism prevalence. Right now we really don't know what the natural prevalence is in a population for autism--figuring out heart disease and cancer is so much easier. So you question is a very important one--do we have an epidemic or are we just finding the people we should be finding? Unless we can solve the problem of prevalence, it is going to be difficult to answer.

I can neither agree, nor disagree. We just dont know.

Science is still trying to figure out what exactly autism is, and what it is not. The boundary line was expanded hugely in 1994 to include far more people than before. I am a text book example. The shrink I went to had never even heard of aspergers until my family members mentioned it to her, and she had to read up about it. And that was in the early 2000s (almost a decade after aspergers had been put into the DSM).

And one whole gender (half of the human race) was practically left out: females. They are only now getting good at finding autism in females.

But it is not impossible that there is something real hiding inside all of the noise. Its as hard to disprove that autism is increase is growing as it is prove that it is.

I had a hypothesis that it might be caused by the fact that more and more folks meet their spouses in college over the last three or four generations. Geniuses meet other geniuses in college and get a double dose of genes, and this causes more geniuses to be born, but it migh also more autistics to be born.Just a speculation.

The older parents theory might be the plausible.

Or maybe there is no autism epidemic after all.

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Last edited by firemonkey on 14 Nov 2020, 6:55 am, edited 1 time in total.

The reason for autism increase is because they have decided to make it be a spectrum and include more people on it.

Thinking back to the 1980's about this one book that was published in 1984 about kids with learning disabilities, about lot of them in there all sounded like they would have been diagnosed today than being labeled as being hyper sensitive or immature, developmental delayed, etc.