| Revision as of 21:41, 25 September 2007 view sourceCurse of Fenric (talk | contribs)Extended confirmed users1,209 editsNo edit summary← Previous edit | Revision as of 05:02, 26 September 2007 view source Cool Hand Luke (talk | contribs)14,522 edits Reverting country incidence. This makes more sense in the article on incidence. See Talk:Autism (incidence)#NPOV #2Next edit → | ||
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| An increased awareness of autistic spectrum disorders by parents and pediatricians may have also led to increased reporting of Autism due to 'case substitution', which occurs when children with other disorders are identified as autistic.<ref> Case substitution accounts for some of the increase in reported incidence</ref> This misdiagnosis may occur for several reasons including an increase in government funding for care of children diagnosed as autistic, but not for children with a similar degree of disability and need. If this is occurring, it means that children who in the past would probably have been diagnosed as having a different condition, or not diagnosed at all are recorded as new cases of autistic spectrum disorder. Possible alternate diagnoses include ], ] and childhood ].<ref></ref> High-functioning autistic children are sometimes misdiagnosed ].<ref></ref> Children who are not primarily autistic, e.g. those with ] (with characteristics that fit the criteria for autism) and even ] may have the diagnostic group with the best funding assigned.<ref> Dr Fred Volkmar, an autism researcher from Yale said "Autism is a kind of fashionable diagnosis".</ref> | An increased awareness of autistic spectrum disorders by parents and pediatricians may have also led to increased reporting of Autism due to 'case substitution', which occurs when children with other disorders are identified as autistic.<ref> Case substitution accounts for some of the increase in reported incidence</ref> This misdiagnosis may occur for several reasons including an increase in government funding for care of children diagnosed as autistic, but not for children with a similar degree of disability and need. If this is occurring, it means that children who in the past would probably have been diagnosed as having a different condition, or not diagnosed at all are recorded as new cases of autistic spectrum disorder. Possible alternate diagnoses include ], ] and childhood ].<ref></ref> High-functioning autistic children are sometimes misdiagnosed ].<ref></ref> Children who are not primarily autistic, e.g. those with ] (with characteristics that fit the criteria for autism) and even ] may have the diagnostic group with the best funding assigned.<ref> Dr Fred Volkmar, an autism researcher from Yale said "Autism is a kind of fashionable diagnosis".</ref> | ||
| == Geographical incidence== | |||
| === Japan === | |||
| The Yokohama study in ] (]) examined the incidence of autism before and after the 1993 withdrawal of ], reporting 48 and 86 cases per 10,000 children in two sequential years before withdrawal, doubling to 97 and 161 per 10,000 afterwards in the two years afterwards.<ref>{{cite journal|id=PMID 15877763 {{doi|10.1111/j.1469-7610.2005.01425.x}}|journal=Journal of Child Psychology and Psychiatry|volume=46|issue=6|pages=572|title=No effect of MMR withdrawal on the incidence of autism: a total population study|author=Hideo Honda, Yasuo Shimizu and Michael Rutter|year=2005}}</ref><ref>Bandolier: incidence around 1993 http://www.jr2.ox.ac.uk/bandolier/booth/Vaccines/noMMR.html</ref> | |||
| It studied over 30,000 children (278 cases) born in one district of ].<ref>Cited in ] and reviewed in with .</ref> | |||
| === United Kingdom === | |||
| The ] regarded the incidence and changes in incidence with time as unclear.<ref> http://www.autism.org.uk/nas/jsp/polopoly.jsp?d=459&a=5576 Position statement, official website of National Autistic Society (UK) viewed March 2007</ref> A ] review,<ref>http://www.mrc.ac.uk/OurResearch/ResearchFocus/Autism/ResearchStrategy/index.htm</ref> by the ], yielded an estimate of one in 166 in children under eight. | |||
| The reported autism incidence in the UK rose starting before the first introduction of the ] in ].<ref>{{cite journal | author=Kaye JA, del Mar Melero-Montes M, Jick H | title=Mumps, measles, and rubella vaccine and the incidence of autism recorded by general practitioners: a time trend analysis | journal=BMJ | year=2001 | pages=460-3 | volume=322 | issue=7284 | id=PMID 11222420}}</ref>. This places under question the views of ] and the controversy surround the ]. | |||
| ===United States=== | |||
| {| class="wikitable" align="right" | |||
| |+U.S. New Cases<ref></ref> | |||
| <!-- I doubt the source is primary - it would be better to seek out the primary source and reference that here --> | |||
| |- | |||
| !Year | |||
| |2001-02 || 02-03 || 03-04 || 04-05 | |||
| |- | |||
| !New cases | |||
| |1 451 || 1 981 || 3 707 || 3 178 | |||
| |} | |||
| After years of substantial annual increases, provisional data from the US Department of Education show a significant decrease in the number of new autism diagnoses recorded among children 3 to 5 years old. There were 1,451 new cases in 2001-2002; 1,981 in 2002-2003; 3,707 in 2003-2004; and 3,178 in 2004-2005, a drop of 529 new cases, or 14%.<ref></ref> | |||
| ====Olmsted County, Minnesota==== | |||
| "The incidence of research-identified autism increased in Olmsted County from 1976 to 1997, with the increase occurring among young children after the introduction of broader, more precise diagnostic criteria, increased availability of services, and increased awareness of autism." The authors ascribed this to "improved awareness, changes in diagnostic criteria, and availability of services, leading to identification of previously unrecognized young children with autism."<ref>http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15630056</ref> | |||
| {| class="wikitable" | |||
| |+Olmsted County: 8.2-fold increase, <br />confined to children younger than 10 years who were born after 1987. | |||
| <!-- I doubt the source is primary - it would be better to seek out the primary source and reference that here --> | |||
| |- | |||
| !Period | |||
| |1980–83 || 1995 to 1997 | |||
| |- | |||
| !Age-adjusted incidence of research-identified autism | |||
| | 5.5 (95% confidence interval, 1.4–9.5)|| 44.9 (95% confidence interval, 32.9–56.9) | |||
| |} | |||
| ===Denmark=== | |||
| In November 2002, a study reported a lower incidence of autism in Denmark than in the US and other countries. An incidence of 1 in 727 (738 out of 537,303) was reported, compared with up to 1 in 86 among primary school children in the ] and around 1 in 150 children in the USA. Danish authorities also reported a continued increase in the incidence of autism after 1992 after withdrawal of thiomersal-containing vaccines.<ref></ref> Data presented in 2003 shows a clear increase in incidence between 1990 and 1995 (before the criteria changed). Thus, the increased incidence of autism after the removal of thiomersal was not a measurement artefact.<ref name="madsen03">Anne-Marie Plesner, Peter H. Andersen and Preben B. Mortensen | |||
| Kreesten M. Madsen, Marlene B. Lauritsen, Carsten B. Pedersen, Poul Thorsen. Thimerosal and the Occurrence of Autism: Negative Ecological Evidence From Danish Population-Based Data. Pediatrics 2003;112;604-606. PMID 12949291</ref> | |||
| ==ADHD and autism== | ==ADHD and autism== | ||
Revision as of 05:02, 26 September 2007
Autism spectrum disorders (ASD), also called autism spectrum conditions (ASC) or the autism spectrum, with the word autistic sometimes replacing autism, are a spectrum of psychological conditions characterized by widespread abnormalities of social interactions and communication, as well as severely restricted interests and highly repetitive behavior.
Autism is one of the five autism spectrum disorders. Of the other four autism spectrum disorders, Asperger's syndrome is closest to autism in signs and likely causes; Rett syndrome and childhood disintegrative disorder share several signs with autism but may have unrelated causes; finally, pervasive developmental disorder not otherwise specified (PDD-NOS) is diagnosed when the criteria are not met for a more specific disorder. Unlike autism, Asperger's has no significant delay in language development.
The terminology of autism can be bewildering, with autism, Asperger's, and PDD-NOS sometimes called the autistic disorders, whereas autism itself is often called autistic disorder, childhood autism, or infantile autism. ASD in turn is a subset of the broader autism phenotype (BAP), which describes individuals who may not have ASD but do have some autistic-like traits, such as avoiding eye contact.
One review estimated a prevalence of at least 1.3 per 1,000 for autism and 6.0–6.5 per 1,000 for ASD; PDD-NOS was the vast majority of ASD, Asperger's was about 0.3 per 1,000 and the atypical forms childhood disintegrative disorder and Rett syndrome were much rarer.
Autistic traits
Behaviorally, certain characteristics identify the autism spectrum. The type, severity and/or number of autistic traits present determines the severity of autism in the individual. These autistic traits may be beneficial for some disciplines like science, mathematics, engineering and computer programming. Some autistic individuals might show a marked proficiency in rote memorization which may help learn the foundation of these subjects; however, the exceptionally good aptitude (in these subjects) of high functioning autistic spectrum persons may be due to their ability to readily identify patterns and apply them consistently to new situations outside of established knowledge or teaching. These savant skills, although popularly considered to be a major part of autistic disorders, are evident only in a small fraction of autistic individuals, with estimates of the fraction ranging from 0.5% to 10%.
Diagnostic criteria and techniques
When the rising prevalence of autism spectrum disorders sparked research in the late 1990s, medical opinion initially attributed the increase to improved diagnostic screening or changes in the definition of autism. In 1994, the fourth major revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) was published with updated criteria for the diagnosis of autism and autism spectrum disorders. Professional medical associations, including the American Academy of Pediatrics, say that this revision was an important factor in increasing the apparent prevalence of autism and a 2005 study by Mayo Clinic researchers found increases in autistic spectrum disorder diagnoses followed the revisions in DSM criteria and changes in funding for special education programs.
An increased awareness of autistic spectrum disorders by parents and pediatricians may have also led to increased reporting of Autism due to 'case substitution', which occurs when children with other disorders are identified as autistic. This misdiagnosis may occur for several reasons including an increase in government funding for care of children diagnosed as autistic, but not for children with a similar degree of disability and need. If this is occurring, it means that children who in the past would probably have been diagnosed as having a different condition, or not diagnosed at all are recorded as new cases of autistic spectrum disorder. Possible alternate diagnoses include mental retardation, learning disability and childhood schizophrenia. High-functioning autistic children are sometimes misdiagnosed ADHD. Children who are not primarily autistic, e.g. those with Fragile-X Syndrome (with characteristics that fit the criteria for autism) and even Down's Syndrome may have the diagnostic group with the best funding assigned.
ADHD and autism
Some research suggests a possible genetic and behavioral connection between ADHD and autism.
References
- World Health Organization (2006). "F84. Pervasive developmental disorders". International Statistical Classification of Diseases and Related Health Problems (10th ed. (ICD-10) ed.).
{{cite book}}:|access-date=requires|url=(help); External link in|chapterurl=|chapterurl=ignored (|chapter-url=suggested) (help) - Lord C, Cook EH, Leventhal BL, Amaral DG (2000). "Autism spectrum disorders" (PDF). Neuron. 28 (2): 355–63. doi:10.1016/S0896-6273(00)00115-X. PMID 11144346.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - American Psychiatric Association (2000). "Diagnostic criteria for 299.80 Asperger's Disorder (AD)". Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision (DSM-IV-TR) ed.). ISBN 0890420254.
{{cite book}}:|access-date=requires|url=(help); External link in|chapterurl=|chapterurl=ignored (|chapter-url=suggested) (help) - Freitag CM (2007). "The genetics of autistic disorders and its clinical relevance: a review of the literature". Mol Psychiatry. 12 (1): 2–22. doi:10.1038/sj.mp.4001896. PMID 17033636.
- Piven J, Palmer P, Jacobi D, Childress D, Arndt S (1997). "Broader autism phenotype: evidence from a family history study of multiple-incidence autism families" (PDF). Am J Psychiatry. 154 (2): 185–90. PMID 9016266.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - Fombonne E (2005). "Epidemiology of autistic disorder and other pervasive developmental disorders". J Clin Psychiatry. 66 (Suppl 10): 3–8. PMID 16401144.
- Treffert DA (2007). "Savant syndrome: an extraordinary condition—a synopsis: past, present, future". Wisconsin Medical Society. Retrieved 2007-09-19.
- Barbaresi WJ, Katusic SK, Colligan RC, Weaver AL, Jacobsen SJ (2005). "The incidence of autism in Olmsted County, Minnesota, 1976-1997: results from a population-based study". Archives of pediatrics & adolescent medicine. 159 (1): 37–44. doi:10.1001/archpedi.159.1.37. PMID 15630056.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - Am. Assoc. paed. Case substitution accounts for some of the increase in reported incidence
- CNN report Dr Fred Volkmar, an autism researcher from Yale said "Autism is a kind of fashionable diagnosis".
External links
- Template:Dmoz
- CDC's "Learn the Signs. Act Early.” campaign - Information for parents on early childhood development and developmental disabilities such as autism
- support forum with family members on the spectrum
- Autism Spectrum Disorders (Pervasive Developmental Disorders)
- Autism Spectrum Disorders from ScienceDaily - Latest research news on autism spectrum disorders. Includes searchable archives
- Autistic Spectrum Disorder fact sheets - Fact sheets on diagnosis, early intervention, behaviors, family issues & personal stories, for both parents of a child on the autistic spectrum, and adults on the spectrum.
- Attention deficit hyperactivity disorder and autism
