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By Francis Koster, Ed.D.
 
We have a medical condition spreading in our society that, in the space of 30 years, has gone from hurting one in 3,000 kids to hurting one in 88.   This is astounding on two counts - the sheer speed and reach of the condition, and the silence surrounding it. 
  
Before the 1980's the rate of autism in the United States was somewhere around one in 310,000[1].  By  the 1990's, the reported to be about one in 34 kids per 294 [2] - more than10,000 [3] - 10 times more.  This growth was alarming to educators and scientists as reports of more damaged kids emerged. This concern led to a more comprehensive reporting system being put in place in 2000 which found that of the rate had risen to one in 150 kids.[4]
 
Public attention was called to the possibility that mercury in vaccinations might be the cause.   By 2002, mercury had been removed from vaccinations, yet the rate of autism continued to rise.  Back to the tear-stained drawing board.
 
By 2006, the national monitoring system reported one in every 100 kids was being diagnosed with autism. [5]   And in March of 2012, solid research found one in 88 kids were diagnosed as autistic[6] and that among boys the rate is now one in 54 [7].  On our watch.
 
As a futurist, this issue is actually easier to see forward on than others I write about.  The future is grim unless we do something.
 
These numbers are not without controversy. Some folks believe that if you fund treatment of something, you are going to get more people claiming to have the disease. Some feel that increased public awareness leads to more reporting. Some feel the reporting methods years ago were bad, and that the rate of increase is not as high as it has been reported. It is likely there is some truth in all of these perspectives - but even if all were true, that does not explain away the figure of one in 88 and rising.
 
Americans are very fond of a "single cause" mindset. We like to think that if some bad thing happens, it has a specific, identifiable cause.  
 
Life is more complicated than that - you can have an auto accident because you did not sleep well, failed to eat breakfast, put in a hard day, got a cell phone call, and were trying to quiet the kids in the back seat - all at once. You just get overwhelmed. Crash. 
 
Our "single cause" mindset is, in part, fed by our legal system, which has developed theories around the notion that unless an industry can be proven to have been the "cause" of a problem, they are excused from responsibility. Left unanswered is the question of who is responsible to fix problems which have several contributing factors - as appears to be the case in many public health problem areas.
 
And, like car wrecks, the brain breakdowns of autism are not all the same - some are fender-benders, some are rear-enders. And some are devastating. That is why healthcare professionals diagnose a child as falling somewhere on the "Autistic Spectrum," calling autism a "spectrum of disease."
 
Surprisingly, many autistics have bigger brains than the rest of us. And, as with car accidents, autism appears to have many contributing factors, including genetics, issues during pregnancy, poor nutrition uptake (both mother and child), overactive immune systems, and various cumulative forms of pollution.   
 
This means that the research into "cause" must take into account many possible combinations, at a time when research money is being cut.
 
In spite of less funded research than the size of the problem might suggest would be a good idea, some progress is being made.[8]  Many studies have found that autistics commonly have low levels of vitamins and minerals in their system. (This does not necessarily mean that they are not eating right - it may have to do with how their body absorbs the food).  One interesting finding is that woman who participate in the Woman, Infants and Children program had lower autism rates[9]. Other studies are finding that the way the body fights threats gets broken - it may produce more defenders than is needed, hurting the brain in the process[10]
 
So, we have a mess on our hands.   Until we can be clearer on how to prevent this problem, we can take comfort from over 500 studies that show that that early intervention is very helpful to these children, and pays a cost/benefit of between $6 and $21 saved for each dollar of treatment given. [11]
 
One program that shows us a path forward is the Early Start Denver Model[12], where researchers found that spending 20 hours a week with 18- to 30-month-old diagnosed autistics resulted in an IQ gain of 18 points. 
 
We need to support these tortured parents and overwhelmed school systems.  Early intervention costs are not trivial - but they are a lot less than the cost of caring for these wounded children for the rest of their lives.
 
 

References:

[1] http://ezinearticles.com/?Autism-Statistics-in-the-United-States&id=1863885
[2] http://jama.ama-assn.org/content/289/1/87.extract
[3] http://jama.ama-assn.org/content/289/1/87.extract
[4] http://www.webmd.com/brain/autism/news/20120329/autism-rates-cdc-2012?page=2
[5] http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6103a1.htm 
[7] http://i2.cdn.turner.com/cnn/2012/images/03/29/ss6103.ebook.pdf
[8] Journal of Developmental & Behavioral Pediatrics: January 2011 - Volume 32 - Issue 1 - pp 56-68 
[9] http://www.jacn.org/content/30/5/348.abstract
[10] http://www.autismfile.com/newly-diagnosed-with-autism/diagnosis-of-autism-10-quick-tips
[11] http://www.hta.hca.wa.gov/documents/supplemental_information submitted cited evidence_articles_draft_findings_decision_091611.pdf page 1
[12] http://www.sciencedaily.com/releases/2009/11/091130084720.htm
 
 
Copyright 2012. All rights reserved.
 
 
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