[Pharmwaste] Are Autism Cases on the Rise in U.S.?

DeBiasi,Deborah dldebiasi at deq.virginia.gov
Fri Feb 16 12:46:40 EST 2007


http://news.yahoo.com/s/hsn/20070216/hl_hsn/areautismcasesontheriseinus

Are Autism Cases on the Rise in U.S.? By E.J. Mundell
HealthDay Reporter
 40 minutes ago
 


FRIDAY, Feb. 16 (HealthDay News) -- The release last week of statistics
on the prevalence of autism spectrum disorders in American children --
one case in every 150 8-year-olds -- confirmed that the condition is
more common now than it was just a decade ago, when estimates ranged
anywhere from one in 500 youngsters to one in 166.


But the new statistics -- from a 14-state survey conducted by the U.S.
Centers for Disease Control and Prevention -- failed to clear up the
mystery of why autism might be striking more and more children with each
passing year.


Alison Singer, senior vice president of the nation's leading autism
advocacy group, Autism Speaks, said she didn't need the CDC statistics
to know that more families are now struggling with the behavioral
disorder.


A decade ago, "we didn't have more than year-long waiting lists for
places within schools for children with autism," said Singer, whose
9-year-old daughter is autistic. "In fact, we had far fewer schools then
for children with autism, because we had far less need. And if you go
into any elementary school in the country, you'll see more children with
special needs and with autism than you did when I was in elementary
school."


Autism spectrum disorders include autism as well as less disabling
conditions such as Asperger's syndrome and pervasive developmental
disorder (PDD). All of these conditions involve some level of difficulty
in communication and socialization, according to the CDC. Some children
may also engage in repetitive behaviors, have trouble dealing with
changes in routine, and be prone to emotional outbursts. As many as four
in 10 children with autism may not speak at all, the CDC says.


The exact causes of autism remain a mystery. "We know that genes are
important," said Dr. Bradley Peterson, professor of child psychiatry at
Columbia University Medical Center and the New York State Psychiatric
Institute in New York City.


On the other hand, he said, "we know that genes aren't the whole story.
Unfortunately, in terms of non-genetic or environmental factors, we just
don't have very good leads yet."


Theories as to possible environmental culprits are widespread and hotly
debated. They have included a variety of infections (including maternal
German measles during pregnancy); drugs such as thalidomide and a
labor-inducing agent, Pitocin; synthetic compounds such as PCBs and
plastics; and food additives.


Two agents -- the mercury-based vaccine preservative thimerosal, and the
measles-mumps-rubella (MMR) vaccine -- gained widespread public
attention after a 1998 study by British researcher Dr. Andrew Wakefield
linked vaccination to a spike in childhood autism cases.


Debate still rages on that front, although two more recent and much
larger studies -- one by the U.S. Institute of Medicine and another
British/Japanese effort involving more than 30,000 Japanese youngsters
-- have turned up no such link.


So, the question remains: Why are more and more parents discovering
their child has autism?


Peterson said the CDC statistics may not be as straightforward as they
seem.


"Actually, I think the numbers are comparable to what they were 20 years
ago," he said. "Twenty years ago, the estimate [of prevalence] was 5.5
to 6 per 1,000 children, and now it's estimated at 6.6 per 1,000."


While the gap between those numbers is substantial, "it is probably not
outside of the margin of error," Peterson said. So, it's still possible
that the supposed "rise" is merely a statistical artifact.


Singer discounted that notion, however. "It's not really reflective of
the reality of the situation," she said, pointing again to the long
waiting lines of parents desperate to get their child treatment or
proper schooling, problems Singer said didn't exist 10 years ago.


Peterson also pointed to possible changes in "diagnostic trends" to
account for rising numbers. For example, "clinically, in the past,
people actually thought it was less stigmatizing, and would bring a
child greater social services, if they were diagnosed with mental
retardation versus autism," he said. That situation has changed with
time, however, so more children may be diagnosed with autism now than
they were in the past.


Again, Singer challenged that view. "That's a very easy theory to test,"
she said. In California, she said, "data showed that there was no
drop-off in the number of children that were being diagnosed with mental
retardation" -- even as reported diagnoses for autism disorders were
climbing.


Then there's the theory that parents and physicians have simply gotten
better at spotting autistic spectrum disorders -- even in their milder
forms.

"Perhaps, for children that we used to call 'odd' or 'quirky', the radar
is now much more sensitive to detecting them and providing a syndromic
label, one that they might not otherwise have had in the past," Peterson
said.

But while it is true that the early detection of autism has improved in
recent years, Singer said no parent is in any rush to get their
youngster labeled autistic. "Look, no one would want to send their child
to a school for children with autism if they didn't have to," she said.
"The demand for those schools, the demand out there for therapists --
all of it points to a true increase."

And yet neither expert was ready to point the finger at any one cause
for the increase, environmental or otherwise.

Asked about the MMR/thimerosal debate, Singer said only that, "we
continue to focus on the need to cast a very wide net when it comes to
autism research. We are not ready say that it's 100 percent genetic or
environmental. We simply don't know enough to say what it is or is not."

She remains optimistic that dedicated research will bring real answers.

In December, groups like Autism Speaks helped push the Combating Autism
Act through to final approval in Congress. The act authorizes that $945
million be spent over the next five years to unravel the root causes of
the disorder.

"Now we need to get that money appropriated," Singer said.

She and Peterson agreed that research is the only way to understand
what's driving any rise in autism cases -- and how to turn that trend
around.

"We are only going to find real answers in the laboratory," Singer said.
"We have to fund scientists who are looking at the biology, looking at
what causes autism, who are looking at environmental exposures, looking
at the genetics. That's where we are going to find the answers."

More information

To learn more about autism, visit the U.S. National Institute of Mental
Health.



Deborah L. DeBiasi
Email:   dldebiasi at deq.virginia.gov
WEB site address:  www.deq.virginia.gov
Virginia Department of Environmental Quality
Office of Water Permit Programs
Industrial Pretreatment/Toxics Management Program
Mail:          P.O. Box 1105, Richmond, VA  23218 (NEW!)
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