Article: Evolving Definition Of Autism Prompts Questions About Prevalence

[Anonymous]

Ever since the DSM 5, I have been waiting to see how the changes would affect the numbers. Finally, here's a look at that.

https://www.disabilityscoop.com/2018/06/19/evolving-autism-prompts-questions/25205/


Now, for the first time, the Centers for Disease Control and Prevention is factoring the changing definition of autism into its regular tracking of autism prevalence.

Figures released in April show that 1 in 59 children have autism — an increase from reports two years ago that found 1 in 68 children were on the spectrum. However, the latest numbers, which rely on data collected on over 300,000 children who were 8 years old in 2014, are based on the older definition of autism.

In the same report, the CDC then evaluated the children under the newer DSM-5 criteria, finding that 18 percent fewer would qualify for an autism diagnosis. Using the updated definition and also including children who had previously received a diagnosis of autism, 4 percent fewer children were found to have autism.

[Anonymous]

Are there more children with autism or more children with a diagnosis these days? I don’t recall this many of either, growing up not that long ago. Is it the water? People becoming parents at an older age? Serious question.

[Anonymous]

Anonymous wrote:Ever since the DSM 5, I have been waiting to see how the changes would affect the numbers. Finally, here's a look at that.

https://www.disabilityscoop.com/2018/06/19/evolving-autism-prompts-questions/25205/


Now, for the first time, the Centers for Disease Control and Prevention is factoring the changing definition of autism into its regular tracking of autism prevalence.

Figures released in April show that 1 in 59 children have autism — an increase from reports two years ago that found 1 in 68 children were on the spectrum. However, the latest numbers, which rely on data collected on over 300,000 children who were 8 years old in 2014, are based on the older definition of autism.

In the same report, the CDC then evaluated the children under the newer DSM-5 criteria, finding that 18 percent fewer would qualify for an autism diagnosis. Using the updated definition and also including children who had previously received a diagnosis of autism, 4 percent fewer children were found to have autism.

Pretty sure this is not a surprise to anyone who was paying attention when the change in definition happened. The DSM V tightened the criteria and removed some of the umbrella terms (well, they combined them into one spectrum). You now need to meet several criteria to be on the spectrum, where before you could meet one criteria to be on one area of the spectrum.

That being said, the kids with those issues STILL EXIST. They did not disappear, and they still need help. I don’t really think it matters one way or another to parents if they are “ASD” or not as long as they can get services...but if they cannot, and are struggling because of it, that’s a problem.

[Anonymous]

Anonymous wrote:Are there more children with autism or more children with a diagnosis these days? I don’t recall this many of either, growing up not that long ago. Is it the water? People becoming parents at an older age? Serious question.

Diagnostic substitution. Everything is being coded as ASD these days, instead of cognitive impairment, language impairment, etc. Even children with genetic syndromes are diagnosed as ASD.

[Anonymous]

Anonymous wrote:Are there more children with autism or more children with a diagnosis these days? I don’t recall this many of either, growing up not that long ago. Is it the water? People becoming parents at an older age? Serious question.

Definitely more diagnosis. Autism was once thought to be a rare, always severe disorder. Children with little or no language, completely withdrawn and very bizarre behavior. This changed in the early 80's with the rediscovery of Hans Asperger's work on less affected children and the change was incorporated into DSM IV which came out in 1994.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Ever since the DSM 5, I have been waiting to see how the changes would affect the numbers. Finally, here's a look at that.

https://www.disabilityscoop.com/2018/06/19/evolving-autism-prompts-questions/25205/


Now, for the first time, the Centers for Disease Control and Prevention is factoring the changing definition of autism into its regular tracking of autism prevalence.

Figures released in April show that 1 in 59 children have autism — an increase from reports two years ago that found 1 in 68 children were on the spectrum. However, the latest numbers, which rely on data collected on over 300,000 children who were 8 years old in 2014, are based on the older definition of autism.

In the same report, the CDC then evaluated the children under the newer DSM-5 criteria, finding that 18 percent fewer would qualify for an autism diagnosis. Using the updated definition and also including children who had previously received a diagnosis of autism, 4 percent fewer children were found to have autism.

Pretty sure this is not a surprise to anyone who was paying attention when the change in definition happened. The DSM V tightened the criteria and removed some of the umbrella terms (well, they combined them into one spectrum). You now need to meet several criteria to be on the spectrum, where before you could meet one criteria to be on one area of the spectrum.

That being said, the kids with those issues STILL EXIST. They did not disappear, and they still need help. I don’t really think it matters one way or another to parents if they are “ASD” or not as long as they can get services...but if they cannot, and are struggling because of it, that’s a problem.

It matters a great deal if you want your child to get the right help.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Ever since the DSM 5, I have been waiting to see how the changes would affect the numbers. Finally, here's a look at that.

https://www.disabilityscoop.com/2018/06/19/evolving-autism-prompts-questions/25205/


Now, for the first time, the Centers for Disease Control and Prevention is factoring the changing definition of autism into its regular tracking of autism prevalence.

Figures released in April show that 1 in 59 children have autism — an increase from reports two years ago that found 1 in 68 children were on the spectrum. However, the latest numbers, which rely on data collected on over 300,000 children who were 8 years old in 2014, are based on the older definition of autism.

In the same report, the CDC then evaluated the children under the newer DSM-5 criteria, finding that 18 percent fewer would qualify for an autism diagnosis. Using the updated definition and also including children who had previously received a diagnosis of autism, 4 percent fewer children were found to have autism.

Pretty sure this is not a surprise to anyone who was paying attention when the change in definition happened. The DSM V tightened the criteria and removed some of the umbrella terms (well, they combined them into one spectrum). You now need to meet several criteria to be on the spectrum, where before you could meet one criteria to be on one area of the spectrum.

That being said, the kids with those issues STILL EXIST. They did not disappear, and they still need help. I don’t really think it matters one way or another to parents if they are “ASD” or not as long as they can get services...but if they cannot, and are struggling because of it, that’s a problem.

I suspect they are getting other diagnoses like ADHD, anxiety or communication disorders.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Ever since the DSM 5, I have been waiting to see how the changes would affect the numbers. Finally, here's a look at that.

https://www.disabilityscoop.com/2018/06/19/evolving-autism-prompts-questions/25205/


Now, for the first time, the Centers for Disease Control and Prevention is factoring the changing definition of autism into its regular tracking of autism prevalence.

Figures released in April show that 1 in 59 children have autism — an increase from reports two years ago that found 1 in 68 children were on the spectrum. However, the latest numbers, which rely on data collected on over 300,000 children who were 8 years old in 2014, are based on the older definition of autism.

In the same report, the CDC then evaluated the children under the newer DSM-5 criteria, finding that 18 percent fewer would qualify for an autism diagnosis. Using the updated definition and also including children who had previously received a diagnosis of autism, 4 percent fewer children were found to have autism.

Pretty sure this is not a surprise to anyone who was paying attention when the change in definition happened. The DSM V tightened the criteria and removed some of the umbrella terms (well, they combined them into one spectrum). You now need to meet several criteria to be on the spectrum, where before you could meet one criteria to be on one area of the spectrum.

That being said, the kids with those issues STILL EXIST. They did not disappear, and they still need help. I don’t really think it matters one way or another to parents if they are “ASD” or not as long as they can get services...but if they cannot, and are struggling because of it, that’s a problem.

Well said. Thanks.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Ever since the DSM 5, I have been waiting to see how the changes would affect the numbers. Finally, here's a look at that.

https://www.disabilityscoop.com/2018/06/19/evolving-autism-prompts-questions/25205/


Now, for the first time, the Centers for Disease Control and Prevention is factoring the changing definition of autism into its regular tracking of autism prevalence.

Figures released in April show that 1 in 59 children have autism — an increase from reports two years ago that found 1 in 68 children were on the spectrum. However, the latest numbers, which rely on data collected on over 300,000 children who were 8 years old in 2014, are based on the older definition of autism.

In the same report, the CDC then evaluated the children under the newer DSM-5 criteria, finding that 18 percent fewer would qualify for an autism diagnosis. Using the updated definition and also including children who had previously received a diagnosis of autism, 4 percent fewer children were found to have autism.

Pretty sure this is not a surprise to anyone who was paying attention when the change in definition happened. The DSM V tightened the criteria and removed some of the umbrella terms (well, they combined them into one spectrum). You now need to meet several criteria to be on the spectrum, where before you could meet one criteria to be on one area of the spectrum.

That being said, the kids with those issues STILL EXIST. They did not disappear, and they still need help. I don’t really think it matters one way or another to parents if they are “ASD” or not as long as they can get services...but if they cannot, and are struggling because of it, that’s a problem.

Well said. Thanks.

Actually, here's an article that spells out what's wrong with calling everything ASD.

https://blogs.scientificamerican.com/observations/we-need-to-stop-moving-the-goalposts-for-autism/

From my perspective as an observer of “autism” for over 60 years, I do believe there is an actual increase in the number of cases of autistic disorder, but it is not an epidemic. And it has not been an increase of 31 percent in two years here in Wisconsin, for example, or a more than 150 percent increase in the U.S. in the past decade. That is simply not believable. Instead much of that “epidemic” is a dilution of the rigor of the criteria for autism.



There are many reasons why the diagnosis of autism needs to be precise. Labeling some children as autistic when they have other learning disorders such as hyperlexia or language delay, for example, or “educational autism,” alarms families unnecessarily and can result in the wrong intervention or educational placement, which happens particularly with children who read early or speak late. Even “blindisms”—repetitive self-comforting behaviors such as rocking in children with visual impairments—can be mistaken for autism. As elsewhere in medicine, the first step in treatment is to make the correct diagnosis.

[Anonymous]

I've never fully understood how the CDC surveillance has integrity. I believe they identify autism based on educational records alone in some cases. My DS does not have autism, but he might "look" autistic from his IEP paperwork, since it includes social skills goals.

[Anonymous]

Anonymous wrote:I've never fully understood how the CDC surveillance has integrity. I believe they identify autism based on educational records alone in some cases. My DS does not have autism, but he might "look" autistic from his IEP paperwork, since it includes social skills goals.

Yes, they just look at records, not actual children. And the state's give an educational diagnosis based on their state's definition, not the DSM. It's a total sham as far as accuracy.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Are there more children with autism or more children with a diagnosis these days? I don’t recall this many of either, growing up not that long ago. Is it the water? People becoming parents at an older age? Serious question.

Definitely more diagnosis. Autism was once thought to be a rare, always severe disorder. Children with little or no language, completely withdrawn and very bizarre behavior. This changed in the early 80's with the rediscovery of Hans Asperger's work on less affected children and the change was incorporated into DSM IV which came out in 1994.

The people I know with Asperger's are very affected. Couldn't make it through college, hold on to a marriage, a job, drive, etc.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Are there more children with autism or more children with a diagnosis these days? I don’t recall this many of either, growing up not that long ago. Is it the water? People becoming parents at an older age? Serious question.

Definitely more diagnosis. Autism was once thought to be a rare, always severe disorder. Children with little or no language, completely withdrawn and very bizarre behavior. This changed in the early 80's with the rediscovery of Hans Asperger's work on less affected children and the change was incorporated into DSM IV which came out in 1994.

The people I know with Asperger's are very affected. Couldn't make it through college, hold on to a marriage, a job, drive, etc.

Not the point. If you compare DSM III vs. DSM 5 definitions of autism, they are completely different.
http://crackingtheenigma.blogspot.com/2014/01/the-evolution-of-autism-comparing-dsm.html

I know several kids with autism, none of them, including my own, would qualify under DSM III, but all qualified under DSM IV or 5.

[Anonymous]

Yes, good - I hope they save the funding for the actual disabled people now.

[Anonymous]

Anonymous wrote:Yes, good - I hope they save the funding for the actual disabled people now.

Changing the definition doesn't mean the excluded kids are NT or don't need services. It's likely they have some other disorder that shares features with autism, like ADHD or a language disorder.