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MrsPeel
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17 Jan 2021, 7:09 am

Yes, personally I think the word "epidemic" is not appropriate, which is why I put it in quotation marks.

And I find most here would agree with you that the increase is due to wider diagnosis - but I am interested in how we can know this as the cause? Where is the evidence? What do the experts say?

When I started looking into it, wider diagnosis (although a significant factor) seemed not to be the whole story.



kraftiekortie
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17 Jan 2021, 7:24 am

No doubt!

No doubt we must enquire.

It’s not the “whole story”—but it is many chapters of it.

There is the recognition of the possible existence of the Broad Autism Phenotype, where a genetic causation is implied.



Dylanperr
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07 Apr 2021, 7:29 pm

Autism is both underdiagnosed and overdiagnosed.

A lot of people who have "autism" are called autistic because they happen to have a low iq or can't speak. I actually saw people who don't even have a trait of autism in them and are diagnosed as autistic because they simply can't talk, and it is estimated that 30 percent of people diagnosed with autism didn't even have autism in the first place. Autism is also very underdiagnosed as well because most females with autism go undiagnosed so it is likely that 30 percent of autistic people who are undiagnosed should be.



Edna3362
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07 Apr 2021, 9:44 pm

Dylanperr wrote:
Autism is both underdiagnosed and overdiagnosed.

A lot of people who have "autism" are called autistic because they happen to have a low iq or can't speak. I actually saw people who don't even have a trait of autism in them and are diagnosed as autistic because they simply can't talk, and it is estimated that 30 percent of people diagnosed with autism didn't even have autism in the first place. Autism is also very underdiagnosed as well because most females with autism go undiagnosed so it is likely that 30 percent of autistic people who are undiagnosed should be.

Not sure how often or widespread...

But I do know there are places where cases that are knowingly not really actually autism cases, gets autism diagnosis for support access.

The autism diagnosis is just a formality or for legal purposes. Likely to access medical facilities, educational and social accomodations.
While the real condition isn't in the spectrum and may remain unknown.


I wonder myself how many systems around the world would do this? And the odds of this vs genuine misdiagnosis.


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carlos55
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08 Apr 2021, 7:58 am

Autism is just a 1940’s parking space to dump people and give a label to those who’s brain works in a non NT way with deficits in function.

There’s at present no biological marker for autism so it’s just diagnosed on subjective traits, often to access disability services.

One day things may be different and they will be split into the relevant causes but for now I suppose we just have to deal with it.


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09 Apr 2021, 8:02 am

If they are going to go with this why not “autism pandemic”, autism is not limited to Europe and America.(sarcasm).


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MrsPeel
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14 May 2021, 8:57 pm

A new study of autism incidence / diagnoses out of Japan:
https://jamanetwork.com/journals/jamane ... le/2779443

Quote:
A recent large-scale birth cohort study in Denmark reported that the diagnosis of autism spectrum disorder (ASD) is increasing and that its future cumulative incidence could exceed 2.8%.1 In Japan, 3 recent cohort studies2-4 have consistently reported prevalence or incidence of ASD exceeding 3%. The question may arise: do these relatively high figures compared with worldwide data (eTable in the Supplement) represent the nationwide incidence in Japan? To answer this question, we analyzed the data from the National Database (NDB) of Health Insurance Claims of Japan.5 We examined the geographical variations in the incidence of ASD and calculated the nationwide cumulative incidence of ASD in Japan.


Quote:
This study found that the nationwide cumulative incidence of ASD was comparable with what has been reported in local cohorts2,4 and that the diagnosis of ASD increased in Japan between 2009 and 2019. Expanding public awareness may have contributed to the increased nationwide incidence, whereas the regional variation may be because of other etiological and nonetiological (eg, accessibility to services) factors. Our findings indicate an important need for further health services and etiologic research.

Several limitations must be noted.(deleted by me for conciseness)

Despite the limitations, this study found that the incidence of ASD in Japan was higher than what has been reported worldwide. The results bring attention to the necessity of developing support systems to meet the needs of an increasing number of individuals diagnosed with ASD.


I think they're putting incidence in Japan at around 2.4% (about 1 in 44) - but there's no assessment of causes of the increase except mention of expanding public awareness as a possible contributing factor.

The authors all have links with pharmaceutical companies.



Jiheisho
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14 May 2021, 9:21 pm

MrsPeel wrote:
A new study of autism incidence / diagnoses out of Japan:
https://jamanetwork.com/journals/jamane ... le/2779443

Quote:
A recent large-scale birth cohort study in Denmark reported that the diagnosis of autism spectrum disorder (ASD) is increasing and that its future cumulative incidence could exceed 2.8%.1 In Japan, 3 recent cohort studies2-4 have consistently reported prevalence or incidence of ASD exceeding 3%. The question may arise: do these relatively high figures compared with worldwide data (eTable in the Supplement) represent the nationwide incidence in Japan? To answer this question, we analyzed the data from the National Database (NDB) of Health Insurance Claims of Japan.5 We examined the geographical variations in the incidence of ASD and calculated the nationwide cumulative incidence of ASD in Japan.


Quote:
This study found that the nationwide cumulative incidence of ASD was comparable with what has been reported in local cohorts2,4 and that the diagnosis of ASD increased in Japan between 2009 and 2019. Expanding public awareness may have contributed to the increased nationwide incidence, whereas the regional variation may be because of other etiological and nonetiological (eg, accessibility to services) factors. Our findings indicate an important need for further health services and etiologic research.

Several limitations must be noted.(deleted by me for conciseness)

Despite the limitations, this study found that the incidence of ASD in Japan was higher than what has been reported worldwide. The results bring attention to the necessity of developing support systems to meet the needs of an increasing number of individuals diagnosed with ASD.


I think they're putting incidence in Japan at around 2.4% (about 1 in 44) - but there's no assessment of causes of the increase except mention of expanding public awareness as a possible contributing factor.

The authors all have links with pharmaceutical companies.


In 2020, the CDC estimated the prevalence of autism in the US adult population at 1 in 45, or 2.2 percent. So, the Japanese number is not much different.

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

Also, there is not a lot of research to whether certain countries have different ASD rates. The CDC showed that ASD prevalence varied in the US.



Jiheisho
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14 May 2021, 9:23 pm

MrsPeel wrote:
The authors all have links with pharmaceutical companies.


Here are the authors affiliations:

Department of Psychiatry, Shinshu University School of Medicine, Matsumoto, Nagano, Japan

Department of Child and Adolescent Developmental Psychiatry, Shinshu University School of Medicine, Matsumoto, Nagano, Japan

Mental Health Clinic for Children, Shinshu University Hospital, Matsumoto, Nagano, Japan



MrsPeel
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17 Sep 2021, 7:20 pm

I'm not sure if I mentioned this before, but I've seen a few studies which are linking herbicides or pesticides with autism, specifically the more severe (presumably non-hereditary) types. I think this is an area to watch.

https://www.sciencedaily.com/releases/2 ... 215818.htm



MrsPeel
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17 Sep 2021, 7:27 pm

Or maybe not?
Found this review:

Quote:
Relationship between Autism Spectrum Disorder and Pesticides:
A Systematic Review of Human and Preclinical Models

Quote:
This review provides a comprehensive synthesis of the available evidence from various
sources and evaluates the link between exposure to a wide range of pesticides and ASD
and associated symptomatology. Our search, however, revealed that OCs have been the
most widely studied type of pesticides to date. In particular, the review of preclinical
studies highlights that:
- The relation between exposure to different pesticides and the ASD-like phenotype concerning the core symptomatology of autism is relatively under-explored in preclinical
research. Even in the case of those compounds for which there is a significant amount
of empirical research regarding sociability and/or communicative outcomes (e.g.,
Int. J. Environ. Res. Public Health 2021, 18, 5190 25 of 30
CPF), the considerable differences between studies regarding exposure protocols (e.g.,
gestational vs. postnatal or early vs. medium vs. late gestational) make it impossible,
in the end, for us to draw any solid conclusions.
- There is a significant gap in the literature as only one study included in the review
used rats. Although the relevance of the use of mice is unquestionable, it is known
that rat models are closer to humans in terms of genetic background and behavioral
regulation, particularly with regard to social behaviors [96].
- Future preclinical research should focus on a more in-depth analysis of exposure to
developmental CPF and other pesticides concerning the core (sociability and USVs)
and secondary (e.g., neuromotor development) clinical signs of ASD, with a special
emphasis on the gestational period around GD12, whilst it will also be necessary to
include rat models along with the work carried out with mice.
- The study on wild-type mice should be complemented with the systematic analyses of
the interactions of this exposure with the various genetic backgrounds of vulnerability
associated with the ASD-like phenotype.
In relation to clinical studies:
- It is difficult to draw solid conclusions as there are a wide variety of studies that differ
in many aspects such as route, age, or source of exposure.
- The study of exposure to a single pesticide in humans lacks ecological validity, due to
the fact that humans are constantly exposed to a wide range of pesticides through a
range of routes such as diet, house fumigation, or agriculture. This wide variability
of compounds and environmental exposure could contribute to the heterogeneity of
results found in the literature.
- Pesticide exposure appears to co-exist with other factors that may be harmful or
beneficial for the development of the nervous system. Examples of other factors that
could explain the association between pesticides and ASD are lifestyle, socioeconomic
or educational status as well as ethnicity or gender. Moreover, maternal age is an
important factor to consider, as the concentration of pesticides in the body increases
with age, and so higher maternal ages are more strongly associated with an increased
risk of autism in their offspring [107].
- Pesticide exposure did not always show harmful effects when authors considered
different covariates, suggesting the existence of certain genetic polymorphisms which
could interact with environmental factors and amplify the adverse effects of pesticides
in relation to ASD (gene-environment interaction).
- Further clinical research is needed to homogenize exposure in human studies, particularly in terms of exposure to specific pesticides, consideration of other risk factors,
as well as the use of a more well-defined follow-up period and validated tools for
measuring behavioral outcomes.



MrsPeel
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17 Sep 2021, 7:46 pm

Hm.
Some interesting graphs in here.
A good reminder that correlation does not equal causation, I guess.

https://geneticliteracyproject.org/2016 ... nic-foods/



MrsPeel
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17 Sep 2021, 8:03 pm

And here's a summary that makes a lot of sense.
https://www.elemy.com/studio/autism-cau ... ce-in-2020



grace_raffensburg
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05 Nov 2021, 2:16 pm

This is probably a faux pas to revive an older post on my first post but I couldn't help but notice how different my perspective is on this. We need to remember that the diagnostic criteria is not based on inner experiences, but on objective criteria that may or may not be observable in someone at any given point in their life depending on the environment they are in and the norms and expectations of others in that environment.

I think a lot of common sensory symptoms associated with autism are a function of living in a post industrial technological society coupled with a greater awareness/sensitivity in the autistic person. EVERYONE would prefer an environment changed to suit autistic sensitivies. everyone is suffering on some level from the noise lights, and stress, but neurotypicals are able to compartmentalize, maintain normative behavior and repress awareness. Studies also show that All children would also benefit from child centred ore individualized education.

Second neurotypical people post trauma can also demonstrate many "autistic" traits whatever happens in the psyche shakes up the compartments, dislodges the internalized symbolic order in ways that make previously tolerable things intolerable - both sensory and social. This change can also last long after ptsd symptoms subside. There is literature on this but I've observed it first hand. A friend of mine who lost a baby used to be the classic girl next door and was a social savant, years after the PTSD she still can't handle "going with the program", has a tendency to inadvertantly annoy people/misread situations, or tolerate the office environment and has worked from home ever since. Our conversations also became much more interesting and indepth after the event. The way she describes her personality and internal subjective change is in terms of masking to please others/doing what she was told when young to be considered good, and not noticing her own feelings.

Based on these sorts of observations, my view is that we will see more and more diagnosis as the environment is reshaped by capitalistic, rather than human needs, and the social order in liberal democratic societies breaks down (and with it its invisible code). As the environment changes and Norms dissolve, there will be more and more people whose ability to compartmentalize, behave, repress and mask their authentic experience will be overwhelmed.

Personally I wish autistic people more often realized that all of society would benefit if it changed to better suit needs expressed by autistic people rather than seeking individual or class based accommodation. I understand, in the present one size fits all transaction based social system, the need for children to receive a diagnosis and special care in order to acquire language or other tools to develop their capacity to participate and contribute to society or to ensure care and support for adults requires a label + diagnosis. However, I wish high functioning adults recognized that the direction and development of current social order and the way our environment has and is being terraformed in a way that is incompatible with human needs, is a disabling force oppressing everyone, even neurotypicals who don't/cant consciously recognize the way it affects them.



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05 Nov 2021, 2:55 pm

Prospective screening finds the same prevalence of autism in adults as is usually found in children, and no correlation between age and autism prevalence:

https://jamanetwork.com/journals/jamaps ... act/211276

Pretty clear evidence that it's not an epidemic.

Also note that there used to be entire special schools full of children diagnosed with childhood psychosis, which is now considered quite rare. If you read case studies of childhood psychosis in the 50s, a lot of them sound suspiciously like autistic children.

Regression used to be exclusionary criteria for distinguishing autism vs childhood psychosis - autism was present right from the start, childhood psychosis involved regression. So, ironically, the people who claim that the MMR vaccine caused their child's autism generally have kids who wouldn't have met criteria for autism before.

And, of course, it used to be a lot more common to have mental retardation as a standalone diagnosis. In fact, mental retardation was also exclusionary criteria for autism - autism was seen as a psychological problem affecting a child of "normal potential". They were more likely to declare kids untestable, instead of giving a dubious MR diagnosis, but a child who seemed cooperative with testing but consistently delayed would not qualify for autism diagnosis.



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05 Nov 2021, 3:19 pm

When I was growing up autism was not recognized unless it was severe. Today it is recognized autism comes in different levels more readily. My take is that varying levels of autism has always been around. While the number has increased; the % has not.