Study supports theory rise in autism related to changes in d

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Public release date: 8-Apr-2008
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Contact: Craig Brierley
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Wellcome Trust

Study supports theory that rise in autism is related to changes in diagnosis

Research funded by the Wellcome Trust suggests that many children diagnosed with severe language disorders in the 1980s and 1990s would today be diagnosed as having autism. The research supports the theory that the rise in the number of cases of autism may be related to changes in how it is diagnosed.

Professor Dorothy Bishop, a Wellcome Trust Principal Research Fellow at the University of Oxford, led a study which revisited 38 adults, aged between 15-31, who had been diagnosed with having developmental language disorders as children rather than being autistic. Professor Bishop and colleagues looked at whether they now met current diagnostic criteria for autistic spectrum disorders, either through reports of their childhood behaviour or on the basis of their current behaviour. The results are published this month in the journal Developmental Medicine & Child Neurology(1).

Developmental language disorders, which include specific language impairment, are diagnosed when a child has unusual difficulty in his or her grasp of the spoken language, despite normal development in other areas. This may range from a child who has very limited ability to produce or understand spoken sentences, to one who does speak in long and complex utterances, but nevertheless has problem communicating effectively because of problems in conveying a point or grasping what others mean.

Autistic spectrum disorders, which include autism and Asperger syndrome, are developmental disorders affecting how a person communicates with and relates to other people and how they make sense of the world around them.

Participants in the study were drawn from a pool of children who had participated in a series of studies of developmental language disorder conducted during the period 1986 to 2003 and about whose conditions detailed information was known. All attended special schools or classes for children with language impairments, and would have been diagnosed by educational psychologists, paediatricians or speech therapists as having developmental language disorders and none had previously been diagnosed as autistic. However, when reassessed by Professor Bishop and colleagues using current criteria, around a quarter were identified as having autistic spectrum disorder.

In recent years, the criteria for diagnosing developmental language disorders and autism have changed. This has coincided with a marked rise in the rates of diagnosis of autism. According to the Special Needs and Autism Project(2), the figure until the 1990s was widely accepted as being about 5 people per 10,000; even using the narrowest definition of autism, this rose to almost 40 in 10,000 by 2006

There are two main hypotheses to explain this rise: the "autism epidemic" hypothesis and the "diagnostic substitution" hypothesis. Whilst the former says that the rise is genuine, the latter maintains that the true prevalence of the disorder is constant but that changes in diagnostic criteria mean that more children are being diagnosed as autistic. The latter theory is supported by a UK study(3) using the General Practice Research Database, which found that the rise in autism was mirrored by a decline in frequency of language disorders, and now by Professor Bishop's study.

"Our study shows pretty direct evidence to support the theory that changes in diagnosis may contribute towards the rise in autism," says Professor Bishop. "These were children that people were saying were not autistic in the 1980s, but when we talk to their parents now about what they were like as children, it's clear that they would be classified as autistic now.

"Criteria for diagnosing autism were much more stringent in the 1980s than nowadays and a child wouldn't be classed as autistic unless he or she was very severe. Now, children are being identified who have more subtle characteristics and who could in the past easily have been missed."

However, Professor Bishop cautions against using the results to suggest that the prevalence of autism is not genuinely rising.

"We can't say that genuine cases of autism are not on the increase as the numbers in our study are very small," she says. "However, this is the only study to date where direct evidence has been found of people who would have had a different diagnosis today than they were given fifteen or twenty years ago."

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--
Ari Ne'eman
President
The Autistic Self Advocacy Network
1101 15th Street, NW Suite 1212
Washington, DC 20005
http://www.autisticadvocacy.org
732.763.5530

Gee, really?! Diagnoses increase when you start diagnosing something... that's a huge surprise.

Well, this has to do with a change in understanding, and shows that the rate of autistics has not changed, but the diagnostic criteria has.

That's exactly what I've been thinking lately!!

A Dx of language disorder brings expensive therapy, calling it Autism means saving money, for there is no cure for Austism so why teach them to speak.

I see Autism as a catchall and excuse for doing nothing.

I would agree that the cheap Dx is being used, and a half dozen conditions that used to call for therapy are now called Autism, with no treatment.

It becomes Autism, not AS, HFA, LFA, it is economics not Science.

When locking people away was the business it was called infantile schozphrenia,

When that was declared illegal in 1974, it was called learning disability, and a mandate was put on the schools to educate all children. They got all kinds of money for Special Education, therapy and education combined, and once they had all the money they could get, cut service, and got the same money.

Special Ed became where the gang bangers the teachers feared were sent, so they could bully the ret*ds.

Autism means incurable ret*d. Special Education means pre jail detention.

There was always a forced dropout rate in schools, graduation rates and grades were kept up by getting rid of people in the ninth, tenth, eleventh grade, which made the Senior class look good.

Now schools are tested for performance, they are crying unfunded mandates. The strict tests they have to prepare children to pass, in twelve years of training, is about the same as a GED, half way through the Eight Grade with a C-.

Teacher means having a goverment job and a union.

Since the great discovery that there is no cure, that excuses no treatment, no education.

Psychology tries to make a buck, but has little to show for it.

Extirminate them has raised the most money, and few are working on treatment.

We are more of a human rights problem, we are like blind people, not troublesome, but not very useful.

Blind people get a double tax deduction, $1200.

In general we are considered a burden on real people.

We are being privatized, dumped on the parents.

People are not getting the treatment they need to become productive, which proves they are not productive, which proves doing nothing is the same as doing what you are paid to do.

We have networks of teachers, social services, who have government jobs and unions. Your welfare dollars at work.

I once read that 93% of the budget for the aged blind and disabled was spent on social workers, offices, file cabnets, and only 7% was sent to the aged, blind and disabled, including their medical care. The aged do not get younger, the blind rarely recover sight, and the disabled have been declared disabled for life.

93% of the funds set aside for Widows and orphans met the same fate, living off the poor is what some unions do.

We went into the Information Age with the worst school system in the industrial world, sent our factories to Red China, so there is no learning on the job. There is nothing left but self employment, and taxes and regulations do their best to stop that.

Autism is only part of selling people a lesser life. We are all being treated like a disabled minority, who it would be a waste to teach, train for work, or have around.

When the new poor complain they will be claimed to have Socio-economic disorder Syndrome.

This is economic and political mental health, as developed by Stalin.

We have not changed, but America has.

Ok, so how do you think we could solve this?