Children born to fathers of advancing age are at significantly higher risk of developing autism compared with children born to younger fathers, according a comprehensive study published yesterday that offers surprising new insight into one of the most feared disorders of the brain.

The finding comes at a time of great controversy over autism in the United States, as a recent surge in diagnoses has fueled speculations about various possible causes of the disorder. For scientists, both the origins of and potential treatments for the disorder remain a mystery.
With every decade of advancing age starting with men in their teens and twenties, the new study found, older fathers pose a growing risk to their children when it comes to autism — unhappy evidence that the medical risks associated with late parenthood are not just the province of older mothers, as much previous research has suggested.

Of special concern is the finding that the risk for autism not only increases with paternal age but also appears to accelerate.

When fathers are in their thirties, children have about 1 1/2 times the risk of developing autism of children of fathers in their teens and twenties. Compared with the offspring of the youngest fathers, children of fathers in their forties have more than five times the risk of developing autism, and children of fathers in their fifties have more than nine times the risk.

Autism is a developmental disorder that is often characterized by social and verbal problems. It becomes manifest early in childhood and is associated with learning deficits and other problems. Many cases are diagnosed shortly after children enter school, where differences among kids become too obvious to ignore.

A wide variety of interventions are increasingly available for autistic children, and early behavioral interventions have been said to help with outcomes and functioning. There is, however, no cure for the disorder, and scientists are not sure about its biological roots.

The new study presents an intriguing new avenue for research, because it suggests that genetic traits passed along by fathers, as opposed to mothers, may play some significant role in creating susceptibility to autism. Several other studies have suggested that older parents of both sexes are at greater risk of having children with developmental disorders. Three earlier studies looking at the relationship between paternal age and autism have produced mixed results; the new study is the most rigorous analysis conducted to date.

The study was based on an enormous sample of 17-year-olds — nearly all the male and three-quarters of the female subjects of that age found over a six-year period in Israel, as they came of draft age. In all, data from 378,891 people were analyzed.

Since all Israeli citizens have a unique identification number, and the draft process routinely calls for listing the identification numbers of parents, researchers were able to develop a large-scale map that allowed them to determine the age of both parents for 132,271 draft candidates. They then compared that information against medical evaluations conducted by the draft board for autism and other disorders for those same candidates.

Abraham Reichenberg at the Mount Sinai School of Medicine in New York, along with several others at research institutions in the United States and Israel, found a significant relationship between paternal age and autism, even after accounting for other factors, such as mothers’ age and socioeconomic status.

Children of fathers who were 15 to 29 years of age had a risk of about six in 10,000 of developing autism. Children of fathers in their thirties had a risk of nine in 10,000. Children of fathers in their forties had a risk of 32 in 10,000, and children of fathers who were older than 50 had a risk of 52 in 10,000.

In a paper published yesterday in the Archives of General Psychiatry, the researchers said that the number of cases of autism among families with the oldest dads was too small to lead to definitive conclusions about that group, but that there was little doubt about the overall trend. The only question, they said, is whether the risk accumulates at an accelerating rate with advancing paternal age, as the numbers in this study suggest.

Scientists in the United States are increasingly thinking about autism in terms of a spectrum of problems, which is why they have coined the term “autism spectrum disorders.” The federal government estimates that the risk for autism spectrum disorders in the United States is around 3.4 for every 1,000 children between the ages of 3 and 10.

Whether that number is on the rise has been hotly contested; better outreach and diagnostic efforts may be finding children who would previously have gone undetected. Enduring disparities in access to health care complicate the picture. While the medical complexities of autism are present in Israel, concern over disparities is mitigated to some extent because Israel has universal health insurance, which guarantees equal access to care.

The Israeli military draft board’s medical diagnostic system does not differentiate among conditions on the autism spectrum, which includes autism, Asperger’s syndrome, Rett syndrome and what are known as pervasive developmental disorders.

Autistic people can be unresponsive in social situations, or focused intently on a single task or object for long periods. While some parents recognize that their babies seem different from a very young age, U.S. government researchers also say that sometimes engaging and babbling babies can suddenly turn “silent, withdrawn, self-abusive, or indifferent to social overtures.”

In recent years, concern and controversy have grown — despite a lack of conclusive evidence — that mercury in children’s vaccines produces toxicity that leads to autism.

While the link between older fathers and autistic children is likely to be genetic, the researchers who conducted the new study also acknowledged the possibility that unknown other factors could simultaneously be causing men to delay parenthood while independently increasing autism rates.

© 2006 The Washington Post Company, used on Wrong Planet under the doctrine of fair use

By Shankar Vedantam
Washington Post Staff Writer
Tuesday, September 5, 2006; Page A01

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The post Three Reasons Not To Believe In An Autism Epidemic appeared first on Wrong Planet.

In 1990, about one in 10,000 children was diagnosed with autism. Today, that number is about one in 166.

The reason for the increase has been the subject of debate, but one thing remains – autism is still a mystery.

“I had a normal son and we lost him,” said Mandy Commons, Bryce’s mother.

Mandy Commons said her son quit eating, quit drinking and lost hair when he was about 18 months old, just one week after receiving the vaccine for measles, mumps and rubella – the MMR vaccine.

Some people believe the MMR vaccine is a trigger of autism, although others disagree.

“He lost nine pounds in 13 days,” she said. “He acted like he had the flu.”

She said she took Bryce to Hospital District No. 1 of Crawford County in Girard and they thought he had a bowl obstruction.

“Then we went to Children’s Mercy Hospital in Kansas City,” she said. “By then he quit talking. He looked right through you.”

Mandy Commons said many tests were done to find out what was wrong with Bryce. At one point, they thought he might be deaf.

“We had his hearing tested,” she said. “That is when the word ‘autism’ came into our vocabulary. That is when I started doing research and had him diagnosed.”

Sanchez said scientists still don’t know what causes autism, but she believes greater awareness of the disorder among health care providers and educators has contributed to the greater number of diagnoses.

She said studies of the brain have done little to help find a cause.

“Some studies show that the brains of children with autism are larger than normal children, but the cerebellum is smaller,” she said. “There are other areas of the brain that control emotion Š that are smaller in children with autism. But there is no coherent pattern.”

With no pattern for understanding what causes the disease, not much can be done to treat it, which Sanchez said is “very frustrating.”

“We have advanced so much in medicine, but autism, we don’t have a specific treatment for that,” she said.

Sanchez said some of the symptoms can be treated with medications like anti-psychotics, anti-depressants, and even drugs for attention-deficit disorders.

“The most important intervention is the early and intensive education that addresses the behavior and communication,” she said. “It is in the repetition in teaching social skills and all forms of appropriate communication.”

Sanchez said most autism programs recommend 20 to 40 hours per week of intensive intervention, which is something she said most children don’t get from schools.

“It is very frustrating. Parents have to fight to get those kind of services,” she said. “Sometimes they might get 30 minutes of treatment every day or three times per week, or something like that.”

But there is hope.

Temple Grandin is autistic. She has a Ph.D., teaches animal science at Colorado State University, and has written books.

“The way she overcame autism was because she had good teachers and good parents,” Sanchez said. “It is very interesting to read about her.”

Sanchez said that with early intervention, starting at about 18 months of age, at least 50 percent of children with autism will be able to go to a mainstream school.

“This is what most of the studies say about outcome, but we have to start early,” she said. “That is why it is important for health care providers to listen to parents’ concerns. This is one of the most important things.”

Staff Writer Joe Noga can be reached at joe.noga@morningsun.net or 231-2600, Ext. 132.

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The childrens’ names had been collected by the Colorado State Department of Health and Environment which classifies autism as a “reportable disease.” This classification triggers reporting requirments.

The complete article may be found at
http://www.rockymountainnews.com/drmn/local/article/0,1299,DRMN_15_3806716,00.html

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This is the first article of a two article series.

The post Unusually low rate of Autism in the Amish community appeared first on Wrong Planet.

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.”

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 kseligman@sfchronicle.com.

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