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Rise in autism increases calls for awareness

There has been an explosion in autism-related treatment and services for children.

A new report issued by the Centers for Disease Control (CDC) in early April during Autism Awareness Month indicates that one child out of 88 is believed to have autism or a related disorder, prompting autism education advocates to call for better autism services.

Advocacy groups seized on the new number as further evidence that autism research and services should get more attention, especially when tight school budgets often lead to the downsizing or elimination of much-needed special education programs. The increase in the rate is attributed largely to wider screening.

“Autism is now officially becoming an epidemic in the United States,” said Mark Roithmayr, president of Autism Speaks.

The previous estimate was 1 in 110. The new figure is from the latest in a series of studies that have steadily raised the government’s autism estimate. This new number means autism is nearly twice as common as officials said it was only five years ago, and likely affects roughly 1 million U.S. children and teens.

Experts have said that a number of key steps are important in a school-based autism program in order to effectively support students with autism, including individualized assessment, functional curriculum, research-based teaching, low staffing ratios, family involvement, data tracking, and training and supervision.

There has been an explosion in autism-related treatment and services for children. In 1990, Congress added autism as a separate disability category to a federal law that guarantees special education services. School districts have been building up autism-addressing programs since.

Companies have heard educators’ call for help in the form of software and other intervention products that can help them reach more students with autism:

The most recent figures

The CDC study is considered the most comprehensive U.S. investigation of autism prevalence to date. Researchers gathered data from areas in 14 states – Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Maryland, Missouri, New Jersey, North Carolina, Pennsylvania, South Carolina, Utah, and Wisconsin.

They looked specifically at 8-year-old children, because most autism is diagnosed by that age. They checked health and school records to see which children met the criteria for autism, even if they hadn’t been formally diagnosed. Then, the researchers calculated how common autism was in each place and overall.

An earlier report based on 2002 findings estimated that about 1 in 150 children that age had autism or a related disorder. After seeing 2006 data, the figure was revised to about 1 in 110. The estimate of 1 in 88, based on 2008 data, is about 1.1 percent of kids that age.

The study also found that autism disorders were almost five times more common in boys, while a growing number of black and Hispanic children were also reported to have them. And an increasingly large proportion of children with autism have IQs of 85 or higher, it said—a finding that contradicts a past assumption that most autistic kids had IQs of 70 or lower.

What causes autism?

The CDC is also studying the cause of autism, which has remained a mystery. Scientists say genetics play a role.

For years, the best-known environmental theory involved childhood vaccines, prompted by a flawed 1998 British study that has been thoroughly discredited. Dozens of later studies have found no link between vaccines and autism.

In the past week, a spate of studies released during National Autism Awareness Month has offered tantalizing new information about potential causes. Research published in the journal Nature widened the understanding of the genetic roots of some cases and confirmed the elevated risks for children with older fathers. Another study, released online in Pediatrics, suggested maternal obesity may play a role.

“I do think over the next three to five years we’ll be able to paint a much clearer picture of how genes and environmental factors combine” to cause autism, said Geraldine Dawson, a psychologist who is chief science officer for the advocacy group Autism Speaks.

To be sure, finding the causes of autism—an umbrella term for a variety of disorders that delay children socially or intellectually—remains daunting. The causes are believed to be complicated, and not necessarily the same for each child. Some liken autism to cancer: a small word for a wide range of illnesses. In many cases, autism can be blamed on both genetic problems that load the gun and other factors that pull the trigger.

The lion’s share of money for finding a cause has been spent on genetics, which so far experts believe can account for roughly 20 percent of cases. The earliest success was in the early 1990s and involved the discovery of the genetic underpinnings of Fragile X syndrome, a rare condition that accounts for just 2 to 4 percent of autism cases but is the most common form of inherited intellectual disability in boys.

The focus on genetics has been bolstered by dramatic improvements in gene mapping, as well as the bioengineering of mice with autism symptoms. Dozens of risk genes have been identified, and a half-dozen drug companies are said to be working on developing new treatments.

But even genetics enthusiasts acknowledge that genes are only part of the answer. Studies of identical twins have shown that autism can occur in one and not the other, meaning something outside a child’s DNA is triggering the disorder in many cases. Some cases may be entirely owing to other causes, Dawson said.

That broad “other” category means “environmental” influences—not necessarily chemicals, but a grab bag of outside factors that include things like the age of the father at conception and illnesses and medications the mother had while pregnant.

Studies on the horizon

There also are “association” studies—they don’t prove cause and effect, but merely find connections between certain factors and autism. And sometimes these conclusions can be skewed by other things researchers failed to account for.

Some study results expected within a year:

• Hertz-Picciotto’s study of 1,600 children in Northern California is comparing autistic children, youngsters with other developmental disabilities, and those who have no such diagnoses. Some results have been released already, including the recent finding that suggests a link between autism and a mother’s obesity. An earlier part of the study found that children born to mothers living less than two blocks from a freeway were twice as likely to have autism—presumably because of auto exhaust and air pollution, the researchers speculated.

• A Centers for Disease Control and Prevention study involves 2,700 families nationwide. The researchers are interviewing parents and poring over medical records to look for common threads among autistic families, as well as doing genetics tests and checking hair samples for mercury. Much of the focus is on illnesses, medications, nutritional deficiencies, or other problems during pregnancy.

• A study by Pennsylvania researchers involves 1,700 families in various regions of the country. Scientists are doing brain-imaging to look for changes over time in the brains of infants who have an older autistic sibling.

• A large Scandinavian study is examining patient registries in six countries for prenatal risk factors.

See also:

States struggle over how to evaluate special-ed teachers [8]

iPad and iPod apps open up world for special-needs students [9]

3D technology helps autistic kids learn to read [10]