Posted: October 9, 2009 05:06 PM
It amazes me to see that the Obama Administration and mainstream media have been rather nonchalant about the startling news that 1-in-100 American children – and perhaps around 1-in-60 boys – have an autism spectrum disorder.
On Friday, Health and Human Services Secretary Kathleen Sebelius told listeners on a conference call about an upcoming CDC study showing that the estimated rate of autism increased by about 50% among children living in study locations who were born in 1994, compared with those born in 1996.
Among children studied in select areas around the country, the CDC found an average ASD rate of 66-per-10,000 (1-in-150) in the 1994 cohort, but this jumped to somewhere “around one percent,” or 100-per-10,000 (1-in-100), in children born just two years later. (Keep in mind that the 1996 data pertain to 13-year-olds today; officials say they cannot tell us the rate among children younger than that).
Males are four times more likely to have an ASD. So extrapolating from the CDC data, among 15-year-old boys, the estiimated US rate is 102-per-10,000 (1-in-98), but among 13-year-old boys, it would appear to be somewhere around 167-per-10,000, or 1-in-60.
Sebelius said the government does not know if the actual rate has gone up, “and we are hoping to unlock these mysteries.”
Meanwhile, some experts seemingly want to brush this increase off as a mere artifact of better reporting, wider diagnostic criteria, greater awareness and early intervention programs among younger children. They don’t seem to feel that rising levels of environmental toxic exposures in genetically susceptible children might also be at play here. Some have called it “good news” that doctors are now so proficient at diagnosing the milder forms of ASD.
But these children were diagnosed, on average, in 1999 and 2001, respectively – which was quite a bit after the ASD classification was expanded (in the public schools and in the DSM-IV) to include Asperger syndrome and pervasive developmental disorder – not otherwise specified, or PDD-NOS.
Moreover, these boys were 8 years old when they were studied, so early intervention might not be a major reason for the increase. And while greater awareness and better reporting and record keeping have undoubtedly boosted the numbers, it is hard to see how this could explain the entire increase over the years.
We must wait until the final study is published, of course. Unfortunately, the CDC has not always tracked the exact same sites every study cycle. But among the six sites that were included in the 1992 and 1994 cohorts, the reported rate increased by 10 percent. It bears watching to see what happened in those same six sites among the 1996 cohort.
In order to accept that actual ASD rates have not gone up at all, one must also now acknowledge that the ASD rate among US males has always been at or around 167-per-10,000, and that all lower estimates were mistaken and all of those missing people went undiagnosed or misdiagnosed.
But how is it possible that tens of thousands of parents – not to mention relatives, teachers, schools, nurses, counselors, clinicians and pediatricians – could miss so many of the 15-year-old boys with ASD in their midst, but can detect ASD in more 13-year olds? It is hard to understand why more parents of the 1994 cohort would fail to get autism services for their children, compared with parents of children born just two years later.
In my opinion, to shrug and treat this story as if things have probably always been this way is, frankly, wishful thinking and unsettling.
Officials who say the numbers have not gone up are, in effect, telling pregnant women that if they are having a boy, there is a 1-in-60 chance he will have ASD – but not to worry, because it has probably always been this way, we just never noticed. Autism is very common; it is just part of the human condition.
Many will call me an alarmist, but I believe that 1-in-60 boys with an autism spectrum disorder is a national crisis – and not just a reassuring confirmation of how things have always been.
So, if you believe that autism rates are not increasing, then you must also believe that roughly 1-in-60 American males – of all ages — have an ASD.
Do you really believe that 1 in 60 American men are autistic?
That would mean some 2.55 million American males with autism, which is roughly the size of Nevada.
I have lived in many different cities, worked at nine different jobs, and met thousands of men and women throughout my years. I cannot recall people who showed the characteristics of high-functioning autism, though I must have met some along the way, at least in passing. But there were not 1-in-60 boys with ASD in my schools and there are not 1-in-60 men with ASD in my area. I think I would have noticed them by now.
I also spend time speaking with teachers and special education administrators who have been in the business for decades. One of them said she had surveyed every single long-term teacher she had worked with (those with 20, 30, or even 40 years on the job), “and every single one of them said that these kids just weren’t there in anywhere near these numbers when they started teaching – under any diagnosis.”
And Anne Dachel, a Wisconsin mother of an autistic son, a national advocate, and a teacher who works extensively with ASD students, said it was “an insult to thousands of teachers and counselors and doctors – who apparently ‘stupidly’ ignored these kids in the past. If they were always here, but we just called them something else, then what did we do with them? We would have had to provide services even if the kids weren’t called ‘autistic.’ So why are there waiting lists for services and more and more of a demand for special education teachers?”
Anne also frets that the new ASD numbers are “being presented as good news,” in some media, she said. “Autism hasn’t increased–we just never realized how common it really is. No official ever calls autism a crisis, no matter how bad the numbers get.”
Finally, if you can explain away an increase in autism, you can also ignore the mounting evidence and growing belief among some scientists that autism likely has an environmental component, and that certain environmental exposores have been on the increase in recent years. You can also ignore the growing clinical, animal and epidemiological evidence to suggest that mercury, other heavy metals and other environmental toxins might increase the risk of ASD in genetically susceptible subpopulations.
Consider mercury. Rising levels have been documented in rivers, lakes and waterways nationwide, and rising levels in humans is now a sad and terrifying fact as well. A new study has shown that inorganic mercury was detected in the blood of 30 percent of US women in the CDC’s most recent National Health and Nutrition Examination Survey (NHANES). That figure was 1,500 percent higher than what was reported in the 1999-2000 survey, when only 2% of women had inorganic mercury in their blood. And though these figures post-date the 1996 birth cohort, they do indicate steadily rising levels of background mercury over the years.
Other studies have shown an association between exposures to heavy metals and other toxins and autism risk. A paper published this year in Neurotoxocology showed a higher rate of ASD in schools located near Minnesota superfund sites, which typically contain high levels of “lead, mercury, cadmium, chromium and arsenic.”
Another CDC-funded study found that children born in the most polluted tracts of the San Francisco Bay Area were 50% more likely to have an ASD. “The individual compounds that contributed most to these associations included mercury, cadmium, nickel, trichloroethylene, and vinyl chloride,” the study concluded.
Mercury has been shown to cause immune disorders, oxidative stress, mitochondrial dysfunction, neuro-inflammation and other physical problems. These symptoms can also be found in at least some children with autism. And research on the brains of people with autism show markers that are associated with heavy metal exposure.
I personally believe that toxins like mercury can trigger ASD in children. These toxic exposures are on the rise, and so is the incidence of ASD.
An estimated 1-in-60 13-year-old boys has an ASD, but I don’t believe the same is true for 43-year-old men. It is time to stop pretending that the autism crisis is not happening.