Home > Got Questions?, Science, Uncategorized > Autism Boom: An Epidemic of Disease or Discovery?

Autism Boom: An Epidemic of Disease or Discovery?

Today’s “Got Questions?” answer is from Autism Speaks Chief Science Officer Geri Dawson, Ph.D.

Earlier this week, the LA Times ran a provocative article under the questioning headline above. It suggested that autism’s twentyfold increase over the last generation may be “more of a surge in diagnosis than in disease.” In fact, scientific evidence suggests that autism’s dramatic increase is only partially explained by improved screening and diagnosis.

Some of the clearest evidence of this increase comes from research documenting a 600 percent jump in autism caseload in California between 1992 and 2006. In related studies (here and here), Peter Bearman estimated that around 42 percent of the increase can be explained by changes in diagnostic methods and awareness with another 11 percent possibly due to increases in parental age at the time of conception (a known risk factor).

Taking into account all the factors that have been studied, this leaves approximately half of the increase due to still-unidentified factors. Through research, we’re increasing our understanding of these influences. For example, we now know that prematurity and extreme low-birth weight increase autism risk in babies. Certainly survival rates for premature and very low birth weight infants have increased considerably over the last twenty years.

While no single factor is likely to explain the marked increase in autism’s prevalence, researchers agree that a number of influences likely work together to determine the risk that a child will develop an autism spectrum disorder (ASD).

Bottom line: It is undeniable that more children are being diagnosed with ASD than ever before. The need for increased funding for autism science and services has never been greater. Autism costs society is a staggering $35 billion per year. And with more cases, that figure is likely to increase. Fortunately, there is clear evidence that earlier identification and intervention and supports throughout the lifespan can improve outcomes and quality of life.

If you are concerned about your child’s development, please see the “Learn the Signs” page of our website. If you are an adult struggling with issues that might be related to autism, please follow the hyperlinks to our resource page for adults and our page on Asperger Syndrome.

Got more questions? Send them to GotQuestions@autismspeaks.org. And join our next live webchat with Dr. Dawson and her co-host, Autism Speaks assistant vice president and head of medical research Joe Horrigan, MD on January 5th. More information on their monthly webchats here.

  1. Katie Wright
    December 16, 2011 at 8:54 am

    The “LA Times” series was easily the worst, most irresponsible series of autism reporting written in modern memory. One would think gangs of autism families were running around robbing banks all over the state of California from the way Zarembo portrays these families- rather than merely trying to ensure their children get an education. Wow does Zarembo have chip on his shoulder. What did autistic kids ever do to him to spurn such vitriol?

  2. Joe
    December 16, 2011 at 9:21 am

    As a parent with a 12 year old autistic son, I’m constantly amazed at the defensive posture taken by this organization when it comes to addressing the facts concerning vaccines as a prime suspect in the case for “what causes autism”. And really …what is scientific evidence anymore. It appears to be selective driven by whose case you are trying to make. I would think Wakefields work (among others) would qualify but no…..too many feathers ruffled…too much money to be lost.
    Come on….

    • Matt
      December 16, 2011 at 10:09 am

      As a parent with a 5 year old Autistic son, I can’t believe there is still a debate about vaccines. There has never been any international independent studies confirming any vaccine risks. I live in Missouri, one of the least vaccinated States in the country. We also have one of the highest Autism diagnosis ratios. These should be incompatible findings. If there is less vaccination, there should be less autism. This is not the case. I normally don’t post on the internet, but it is time that we start looking for real solutions and quit looking at “facts” that offer us, as parents, an easy out. Vaccines are a scapegoat for bigger issues. Look at studies on vaccinated identical twins. They share 100% of the same genetic make up. There has to be something at the genetic level that is responsible for Autism or all vaccinated children should get Autism. Since this is not the case there is clearly a reaction to some environmental stimuli. If that stimuli is vaccines, then all identical twins that are vaccinated should show autistic traits since they share 100% of the same genes. But this is not the case. Recent studies are showing that the autistic brain has substantially more neurons than a neuro-typical brain. Neurons go through a massive development period between weeks 10-20 of pregnancy. There is a die off of neurons after this in neuro-typical brains that does not appear to happen in the autistic brain. Perhaps analyzing diets, hormones, vitamins and medication during pregnancy could shed more light on the topic of a cause than chasing ghosts that have been put to rest, scientifically, time and time again.

      • Katie Wright
        December 16, 2011 at 11:19 am

        Who is debating vaccines here? This series was about ABA!

      • Twins show it is environmental
        December 16, 2011 at 12:22 pm

        Matt – Pulling in identical twins (and fraternal) makes the environmental case (whatever “the environment” is at multiple times/multiple stressors). My kid doesn’t have one “hit”, my kid has multiple, multiple “hits.” Starting with his gestation and his daily “hit” of being downwind from a coal plant. What is the air pollution (water, pesticide, etc.) like in Missouri? What are the obesity/type 2 diabetes rates? What is the rate of cancer? Nothing is simple.

        A vaccination could certainly hit one identical twin differently on a given day. It is certainly possible that one had the sniffles sending her in a different direction.

        Remember this posts at this very blog?
        California Autism Twin Study Suggests Prenatal Risk Factors
        “It found that when one identical twin develops autism, the chance of the other twin developing the disorder is 70 percent. More surprisingly, it documented a whopping 35 percent overlap among fraternal twins. This is strong evidence that environmental influences are at play.”

        Discussing this study:
        Non-genetic factors play surprisingly large role in determining autism, says study by group
        “But the new study — the largest ever of twins in which at least one in each pair has autism — shows almost the opposite: It found that genes account for 38 percent of autism risk, with environmental factors explaining the remaining 62 percent.”

        Breaking it down further:
        New Study Implicates Environmental Factors in Autism
        “The study found that autism or autism spectrum disorders occurred in both children in 77 percent of the male identical twins and in 50 percent of the female identical twins. As expected, the rates among fraternal twins were lower: 31 percent of males and 36 percent of females.”

        Or the very cool post at this blog about environment?
        Gene-Environment Interactions: Context Matters

        Where the very cool video was shared with us (in the bottom of the post above)…
        The Epigenetics of Identical Twins

        “produced by Harmony Starr, Molly Malone and Brendan Nicholson of the Genetic Science Learning Center at the University of Utah and won an award in the 2009 International Engineering and Science Visualization Challenge, sponsored by the National Science Foundation (NSF) and the journal Science. The creators produced a nice illustration of what happens to our DNA over the course of a lifetime of different exposures. The video is not about autism, but gets across the main point – environmental context matters.”

        And yes, one of the many, many hits my child took was his vaccinations, one specifically was absolutely terrifying to say the least.

      • Dawn Havas
        December 16, 2011 at 11:45 pm

        Here is just one of the vaccine manufacturers literature. Page 11. There is more info and studies out there.

    • Katie Wright
      December 16, 2011 at 11:22 am

      Please read today’s article. It isn’t about vaccines. The writer infers autism families are bilking the system.

    • Diane
      December 16, 2011 at 11:40 am

      I’m a parent of an autistic child, and a social scientist. Wakefield’s work has been justifiably discredited because he used an unreasonably small sample to make generalizations, used unethical data collection procedures, and possible fabricated data. Scientific evidence, when produced with integrity, is the best way we have of differentiating correlation from causality. It’s important to understand both what it can and cannot determine, and especially “how much” and with how much certainty.

  3. December 16, 2011 at 9:51 am

    I just don’t understand why the medical insurance companies do not recognize this as a medical illness. Leaving the expense up to the schools, where most of them are struggling with funds for operation, why isn’t the considered a medical condition. I also think the schools need to require the teachers be educated in regard to ASD….so many know nothing. My daughter is about to graduate with a teaching degree in Art Education….she did a thesis on autism and she also has a nefew with autism. How do I contact my state legislators to address this issue and what key points should I bring up. Thank you for your informative article.

    • LPT
      January 6, 2012 at 12:06 pm

      Medical insurance companies do not recognize this as a disease because the
      AMA sees it and categorizes it as a neurological disorder. My son is on the spectrum, but he wasn’t born with this. He was developing normally until the age of 2 and then suddenly started to regress. The fact is (and there is a lot of scientific evidence on this, but the medical society refuses to acknowledge it and continues to have tunnel vision on this), is that most of the ASD cases now are derived from a neuro-immune dysfunction caused by a virus. I decided to not accept the traditional medical view point on this, which just treats the problem as a disorder, but instead I knew and know that my son was and is physically ill and he needs medications to help resolve this. Therapy and services from school alone will not resolve an illness/disease. He has been on medical treatment and a healthy diet now for 6 months and has had so many gains and improvements. There are many, many other parents that share my viewpoint and have their children in the same treatment and we are coming together to raise our voices this year to hopefully make a difference.

  4. December 16, 2011 at 9:54 am

    Expect more of the same, those at risk are the easiest targets of the heartless, the budget cutters, the scam artists and social darwinists. These are dangerous times we live in, as the worldwide depression descends upon us, the forces of economic manipulation are resorting to forced transfer of wealth from the many to the few. The media, as part of those forces of manipulation, merely reflect the direction of their owners.

  5. FangedFaerie
    December 16, 2011 at 10:04 am

    Wakefield, really? The guy who illegally took blood samples at a birthday party?

    • It's all in the eyes of the beholder
      December 16, 2011 at 10:54 am

      It’s all in the eyes of the beholder FangedFaeri…

      The ‘cuddle chemical’
      “I do – now time for a blood sample!”
      By Nicola Jones
      Globe and Mail Update
      Published Thursday, Feb. 25, 2010 7:04PM EST
      Last updated Thursday, Mar. 10, 2011 10:30AM EST

      I don’t understand why it would be “illegal” to take blood at a birthday party and pay the children accordingly, sign whatever accordingly just like we do anytime our kids give blood or whatever they do for whatever study. We had our baby in a study once and the nurse came to our house and had us sign something and gave us a small token of money (can’t remember how much). Our kids get money whenever they participate in any study, whether it is at home, at a hospital or for our older child – at an ABA centre.

      So, the upshot is, it’s okay to take blood at a wedding, because it’s not about the boogie man – autism – and god forbid, gut abnormalities – and even worse – the potential that these specific gut abnormalities may be the result of the MMR. But a wedding looking for oxytocin responses? Sure, no problem.

    • Janice Miller
      December 16, 2011 at 11:37 am

      Murdoch and Vaccines: Exposure of Crimes Reveals a Much Larger Story…
      “But what has not yet been covered is the media circus Murdoch’s London Times created internationally as it fabricated lies against a respected British doctor, with consequences that could impact the lives of billions of children in the world.
      Brian Deer is the reporter who savaged Dr Wakefield from the pages of the Sunday Times, a paper managed by Rupert Murdoch’s son James Murdoch who is on the board of GlaxoSmithKline which makes the MMR…”

  6. Janice Miller
    December 16, 2011 at 11:45 am

    Are parents really suppose to grasp the concept that 1-100 children challenged with autism have simply been overlooked, hidden, or called something else as the millions in psychiatric research continues to develop the best ways to cope with genetics. I wonder how much of the $35 million per year is spent on psychotropic assisted relief for children as young as two?
    So sad, but thankfully new research is finally targeting the pain that children are dealing with. When doctors become aware of bacteria and how it affects digestion, so many children will be relieved of the pain. With meaningful research, children will be able to be treated for with painful symptoms of gut bacteria imbalances and immune problems. Hopefully, the term Autism will be retired like so many other theories and will not apply to children who are challenged with painful medical issues .
    Time will tell whether scientists even continue to call this “pain” autism or be able to appropriately diagnose and treat children for gut bacteria dysfunction and immune issues. This report sheds new light on how to help children with the “pain”.
    A fresh perspective on autism research with the developing “Bacterial Theory” of autism. The fastest-growing developmental disorder in the industrialized world, autism has increased an astounding 600 per cent over the last 20 years. Science cannot say why. Some say it’s triggered by environmental factors and point to another intriguing statistic: 70 per cent of kids with autism also have severe gastrointestinal symptoms. Could autism actually begin in the gut? The “Autism Enigma” looks at the progress of an international group of scientists who are studying the gut’s amazingly diverse and powerful microbial ecosystem for clues to the baffling disorder.

  7. Diane
    December 16, 2011 at 11:46 am

    Taking blood samples in community settings can be valid research, depending on how it’s conducted and a whole range of other factors. However, taking blood samples at a child’s birthday party to use as the basis for a study of causality of a complex neurological condition violates the rules of ethics and science to such a degree that it makes the study not scientifically valid, or generalizeable to populations or to causality.

  8. December 16, 2011 at 7:22 pm

    The balance of data clearly favors the concept of rising tide of autism. That is also consistent with the findings that although genetics was underlying most autism a few decades ago, it is now the non-genetic factors that seems to play to play key role,

    This is also consistent with my hypothesis that gut may hold the main key to many cases of autism.

  9. Dawn Havas
    December 16, 2011 at 11:48 pm

    Here is one of the vaccine makers own literature. Page 11, SIDS and Autism

  10. December 19, 2011 at 1:31 am

    i do believe it is a gut problem along with environmental. not vaccinated related. i know this to be true myself. my daughter has always had stomach like issues and constipation. we have finally got it under control. i use active powder packs with fiber. it has done what no meds could do. i hope that more is looked into environmentally. water and food supply. look at africa’s autism rate. low because of no city water municipalities. i my self have so much to show anybody that wants to study autism. my daughter did not receive her vaccines until she was nine months. we noticed at birth there was an medical issue.

  11. Kristine
    December 19, 2011 at 9:02 pm

    I found the LA times series to be the most inaccurate news article about autism that I have ever read. It flies in the face of basically ALL research that has been done, with the exception of some extremely bizarre studies like the one by Cohen in England. My son has severe autism and I’m certain I never met anyone like him until the late 90s. Now there is one (with severe autism) on every street it seems. My own small n’hood has 3 kids with severe autism. It seems to me that people in their 30s and 40s could reflect back to when they were growing up and realize that what the LA times is feeding us is complete and total bull. I can definitely recall a few “odd ducks” and I recall the special ed classrooms with the kids with Down Syndrome or cerebral palsy. My own brother was in such a classroom- there were no kids with autism, or anything even remotely *close* to autism.
    The article was also completely offensive to those of us who have to daily fight for the leftover scraps in our education and medical systems. I eventually had to pull my kid out of public school (to homeschool) because it was damaging him. Meanwhile my two typical kids are getting a wonderful public education. The amount of money I have spent on private therapies, medical appointments, medicines is far more than we have ever got from the “system”. I feel this trend will continue as our population grows. How many autistic kids can we shove in one room? Just lock ’em in the closet, tie them to the chair. It’s the parents’ faults, why can’t they just discipline? I think this is only the tip of the iceberg. The backlash is coming, this article is the first.

  12. John Fryer
    December 21, 2011 at 12:24 pm

    For MATT

    Nobody is blaming vaccines for all autism cases. Pollution from mercury has been ocurring for hundreds of years. But there is evidence that high amounts of vaccines cause high amounts of autism.

    It cannot be genetics for more reasons than you can’t have a genetic epidemic.

    The idea of genetics for many illnesses was overthrown 75 years ago.

    We are ill because of pollution and we need to accept this.

    Already those that appreciate risks and live old enough face cancers and degeneration of their minds by such pollutants.

    We can eliminate wrong reasons when we get the right reasons.

    UNTIL then all is up for debate.

    Taking your case as an exception then look for heavy metal contamination for you and your state.

    Its not hard with crematoriums blowing out even more mercury than ever before, plus power stations, both normal and nuclear, incinerators not working properly etc etc.

  13. Matt
    December 21, 2011 at 1:24 pm

    For John. Most of the valid scientific literature is showing that Autism is caused by a genetic predisposition with an environmental trigger. Pollution is as good a place as any to start and i absolutely do not discount the role that polution to our air and water may play. But it is similar to cancer in that some people are not affected by known carcinogens because they are just not genetically predispossed to. It’s why someone can smoke a pack of cigarettes a day and never get cancer while others do. My issue with vaccines is that there have never been any studies that show casuality. High ammounts of vaccines may coincide with high ammounts of Autism diagnosis, but that does not make them the cause. I think our time is better spent on looking at other envirnomental factors, especially ones that affect neuron development and growth durring pregnancy. Why are they finding that the autistic brain has more neurons than neuro typical brains? Look at the MRI of Temple Grandin’s brain and look at a nero typical one. The way that it fires is different and the way that it is organized is different. This is at a bio mechincal level. I think that figuring out why the brain has developed in a specific way is critical in determining the true culprit in the cause for autism.

  14. December 21, 2011 at 7:41 pm

    i think the issue is clearer than most realize. if it was basically genetics it would be more prevalent everywhere. i wish they would study the food,vitamins, and locality at time of conception and during pregnancy a woman lived. i do believe in the fact that the “the squeaky wheel gets the first grease”. I’ve noticed in recent times they choose to not grease the squeaky wheel but to fix a broken problem later. what did you eat? did you live in the city or country? city water or well water? did you have issues in your pregnancy? i believe most of the issue is prenatal instead of post-natal. they are studying 7 parts of the brain that is enlarged. the same is going on in Parkinson’s disease. i believe the environment whether it is industry,food gene altering or our water supply is causing this. the sudan and the rural areas of africa maybe has less autism. not because of less knowledge but no industry and no city water or pollutants. what is the rate in other countries? lets look somewhere else instead of immunizations or genes. a lot started as our industry started. in my town they have a lot of industrial pollutants from brass to medications to fiberglass and painting companies. our water is full of flouride and chlorine and other pollutants that run in the water.

  15. HanaPipers
    February 7, 2012 at 9:44 pm


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