EPTAbout a year or so ago, however, I began to notice news stories in the newspapers every now and then about how "common" autism might be. I read a good deal of reports about how autism might be "on the rise", or that the diagnosis itself is readdressed to establish a new definition for the disorder. On top of that, I have kept in touch with the special education teacher that presided at my old middle school, and she reports that more and more kids with a diagnosis of autism have been enrolled in her class every passing year.
To me, it seems that autism in general, and Asperger's in particular, is in a sense, "in vogue". It seems like a convenient catch-all diagnosis that medical personnel are tossing around toward anyone who exhibits even mild symptoms or attributes associated with the disorder. I'm not too comfortable with that; I don't feel that it's good practice to have this sort of "safety net" disorder to adequately label oddball kids. Of course, some people do possess autism, but recent times portray it as more and more common.
From a medical writer with the Associated Press:
A study in South Korea suggests about 1 in 38 children have traits of autism, higher than a previous U.S. estimate of 1 in 100.
By casting a wider net and looking closely at mainstream children, the researchers expected to find a higher rate of autism characteristics. But they were surprised at how high the rate was. They don't think South Korea has more children with autism than the United States, but instead that autism often goes undiagnosed in many nations. U.S. estimates are based on education and medical records, not the more time-consuming survey conducted in South Korea.
Two-thirds of the children with autism traits in the study were in the mainstream school population, hadn't been diagnosed before and weren't getting any special services. Many of those undiagnosed children likely have mild social impairments, rather than more severe autism.
"It doesn't mean all of a sudden there are more new children with (autism spectrum disorders)," said co-author Dr. Young-Shin Kim of the Yale Child Study Center. "They have been there all along, but were not counted in previous prevalence studies."
It's not clear whether the children need special services or not, other experts said.
"I'm sure some of these children probably could benefit from intervention, but I don't think we could make a statement that all would benefit from intervention," said Dr. Marshalyn Yeargin-Allsopp, chief of the Centers for Disease Control and Prevention's developmental disabilities branch.
The CDC wasn't involved in the new study, although another federal agency, the National Institute of Mental Health, provided some funding. The group, Autism Speaks, which advocates for more aggressive autism screening, also helped pay for the study. Autism Speaks had no role in the study's design.
The research, published Monday in the American Journal of Psychiatry, attempted to screen all 55,000 schoolchildren, ages 7 to 12, in a district of Goyang City, near Seoul.
However, only about two-thirds of mainstream children participated. About 63 percent of their parents filled out a survey. The researchers acknowledged that parents of affected children might be more likely to fill out the survey.
The questionnaire used is a recognized screening tool for high-functioning autism such as Asperger's syndrome. It asks such questions as whether the child "stands out as different" in a number of ways, including lacking empathy, lacking best friends and being bullied by other children.
From there, some of the children who screened positive were tested further. Very few of the children actually completed the entire diagnosis process. But the researchers say they still were able to use the findings to estimate that about 2.6 percent of the population had some autism traits — compared to the U.S. estimate of 1 percent.
The ambitious study took five years to complete. The U.S. government's approach is quicker and allows more ongoing results, Yeargin-Allsopp said.
"Community providers, researchers and others are interested in prevalence of autism on a frequent basis," Yeargin-Allsopp said. "This is not possible if you're doing a screening of an entire population" as was attempted by the South Korean researchers.
Other funders of the study were Children's Brain Research Foundation and the George Washington University Institute for Ethnographic Research.
By casting a wider net and looking closely at mainstream children, the researchers expected to find a higher rate of autism characteristics. But they were surprised at how high the rate was. They don't think South Korea has more children with autism than the United States, but instead that autism often goes undiagnosed in many nations. U.S. estimates are based on education and medical records, not the more time-consuming survey conducted in South Korea.
Two-thirds of the children with autism traits in the study were in the mainstream school population, hadn't been diagnosed before and weren't getting any special services. Many of those undiagnosed children likely have mild social impairments, rather than more severe autism.
"It doesn't mean all of a sudden there are more new children with (autism spectrum disorders)," said co-author Dr. Young-Shin Kim of the Yale Child Study Center. "They have been there all along, but were not counted in previous prevalence studies."
It's not clear whether the children need special services or not, other experts said.
"I'm sure some of these children probably could benefit from intervention, but I don't think we could make a statement that all would benefit from intervention," said Dr. Marshalyn Yeargin-Allsopp, chief of the Centers for Disease Control and Prevention's developmental disabilities branch.
The CDC wasn't involved in the new study, although another federal agency, the National Institute of Mental Health, provided some funding. The group, Autism Speaks, which advocates for more aggressive autism screening, also helped pay for the study. Autism Speaks had no role in the study's design.
The research, published Monday in the American Journal of Psychiatry, attempted to screen all 55,000 schoolchildren, ages 7 to 12, in a district of Goyang City, near Seoul.
However, only about two-thirds of mainstream children participated. About 63 percent of their parents filled out a survey. The researchers acknowledged that parents of affected children might be more likely to fill out the survey.
The questionnaire used is a recognized screening tool for high-functioning autism such as Asperger's syndrome. It asks such questions as whether the child "stands out as different" in a number of ways, including lacking empathy, lacking best friends and being bullied by other children.
From there, some of the children who screened positive were tested further. Very few of the children actually completed the entire diagnosis process. But the researchers say they still were able to use the findings to estimate that about 2.6 percent of the population had some autism traits — compared to the U.S. estimate of 1 percent.
The ambitious study took five years to complete. The U.S. government's approach is quicker and allows more ongoing results, Yeargin-Allsopp said.
"Community providers, researchers and others are interested in prevalence of autism on a frequent basis," Yeargin-Allsopp said. "This is not possible if you're doing a screening of an entire population" as was attempted by the South Korean researchers.
Other funders of the study were Children's Brain Research Foundation and the George Washington University Institute for Ethnographic Research.
http://news.yahoo.com/s/ap/20110509/ap_on_he_me/us_med_autism_study
This article surprised me, but also left me skeptical. 1 autistic out of 100 people as an estimate in the U.S. is already fairly difficult to believe, but 1 out of 38? To me, this statistic feels inflated, as if the definition for autism is too broad and is being applied to too many individuals.
In particular reference to Asperger's Syndrome, the World Health Organization (WHO) seems to have unusually loose requirements for diagnosis, which is odd to me. To qualify for a diagnosis of AS, the following must be met:
A. A lack of any clinically significant general delay in spoken or receptive language or cognitive development. Diagnosis requires that single words should have developed by two years of age or earlier and that
communicative phrases be used by three years of age or earlier. Self-help skills, adaptive behaviour and curiosity about the environment during the first three years should be at a level consistent with normal intellectual development. However, motor milestones may be somewhat delayed and motor clumsiness is usual (although not a necessary diagnostic feature). Isolated special skills, often related to abnormal preoccupations, are common, but are not required for diagnosis.
B. Qualitative abnormalities in reciprocal social interaction (criteria as for autism).
C. An unusually intense circumscribed interest or restricted, repetitive, and stereotyped patterns of behaviour, interests and activities (criteria as for autism; however it would be less usual for these to include either motor mannerisms or preoccupations with part- objects or non-functional elements of play materials).
communicative phrases be used by three years of age or earlier. Self-help skills, adaptive behaviour and curiosity about the environment during the first three years should be at a level consistent with normal intellectual development. However, motor milestones may be somewhat delayed and motor clumsiness is usual (although not a necessary diagnostic feature). Isolated special skills, often related to abnormal preoccupations, are common, but are not required for diagnosis.
B. Qualitative abnormalities in reciprocal social interaction (criteria as for autism).
C. An unusually intense circumscribed interest or restricted, repetitive, and stereotyped patterns of behaviour, interests and activities (criteria as for autism; however it would be less usual for these to include either motor mannerisms or preoccupations with part- objects or non-functional elements of play materials).
This set of criteria is quite vague and abstract. I am aware that mental conditions are often subject to nuance (being, as they are, entirely internal and not superficial), but with this set of conditions, I could probably diagnose about 50 of my friends. That's ridiculous. One of my friends is very interested in cars, and is a bit shy, so apparently that makes him eligible for AS. Where does one draw the line, anyway?
It's all very confusing.
So, TeamLiquid, what it comes down to is this: Do you feel that Asperger's Syndrome, along with other mental disorders such as ADD, are being "overdiagosed" to try and excessively label individuals that may not even have them? Is this rash of diagnosis for these conditions due to medical criteria that are simply too wide? Is this some widespread pharmaceutical scam to sell more prescription pills? *puts on tinfoil cap*
I made this thread partly because I'm genuinely interested in finding an answer to this, but I also want to know what you guys think. I could just go Google my way to victory, but I feel that input from you guys is far more varied and valuable.
EDIT: Thanks for the responses so far, guys. It's good to see varying perspectives on this. By all means, if you think I'm full of shit, let me know. I'm reading every post, and while I can't respond to all of them, I am definitely thinking about each one.
Also, Paperplane gives a more thorough set of criteria for diagnosis of autism; I suggest you read it.
On May 10 2011 22:34 Paperplane wrote:
Here's the DSM criteria for diagnosis. It's a little bit more than just shy and very interested in cars.
+ Show Spoiler +
Here's the DSM criteria for diagnosis. It's a little bit more than just shy and very interested in cars.
+ Show Spoiler +
Diagnostic Criteria for Autistic Disorder
A. A total of six (or more) items from (1), (2), and (3), with at least two from (1), and one each from (2) and (3)
(1) qualitative impairment in social interaction, as manifested by at least two of the following:
(a) marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction
(b) failure to develop peer relationships appropriate to developmental level
(c) a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest)
(d) lack of social or emotional reciprocity
(2) qualitative impairments in communication as manifested by at least one of the following:
(a) delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
(b) in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
(c) stereotyped and repetitive use of language or idiosyncratic language
(d) lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level
(3) restricted repetitive and stereotyped patterns of behavior, interests and activities, as manifested by at least one of the following:
(a) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
(b) apparently inflexible adherence to specific, nonfunctional routines or rituals
(c) stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)
(d) persistent preoccupation with parts of objects
B. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years: (1) social interaction, (2) language as used in social communication, or (3) symbolic or imaginative play
C. The disturbance is not better accounted for by Rett's Disorder or Childhood Disintegrative Disorder.
A. A total of six (or more) items from (1), (2), and (3), with at least two from (1), and one each from (2) and (3)
(1) qualitative impairment in social interaction, as manifested by at least two of the following:
(a) marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction
(b) failure to develop peer relationships appropriate to developmental level
(c) a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest)
(d) lack of social or emotional reciprocity
(2) qualitative impairments in communication as manifested by at least one of the following:
(a) delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
(b) in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
(c) stereotyped and repetitive use of language or idiosyncratic language
(d) lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level
(3) restricted repetitive and stereotyped patterns of behavior, interests and activities, as manifested by at least one of the following:
(a) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
(b) apparently inflexible adherence to specific, nonfunctional routines or rituals
(c) stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)
(d) persistent preoccupation with parts of objects
B. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years: (1) social interaction, (2) language as used in social communication, or (3) symbolic or imaginative play
C. The disturbance is not better accounted for by Rett's Disorder or Childhood Disintegrative Disorder.
