Originally posted by: Genx87
I have heard the higher incidences of diagnosis has more to do with understanding from the medical community than anything. Kids who were high level autistics may have been diagnosed as ADD where they are properly diagnosed as Austistic.
I have a nephew who is a high level autistic and this area is interesting to read.
No competent physician has EVER confused ADD with autism.
There are multiple factors that 'likely' contribute to the reported increased prevalence:
1) better diagnostic techniques: prior to 1989 the primary means of diagnosis was based on the criteria in the DSM (Diagnostic and Statistical Manual of Mental Disorders). In the late 80s, Cathy Lord and others developed and published two truly revolutionary tools: ADI (autism diagostic interview) and ADOS (autism diagnostic observation schedule). Curiously, autism rates have increased significantly since the early 90s.
2) more trained clinicians: sadly child psychiatrists and child neurologists have not increased in number (or quality since most residency programs provided little if any training in autism). But the number of trained professionals in developmental disorders has increased significantly; PhD, Masters-level, etc. In fact, there's far more of these people with training in the use of the ADI and ADOS than there are MDs . . . like me.
3) public education confounder: Most school systems have categorizations for special needs kids. "Autistic" often provides an augmented level of services compared to a child that's just MR (mentally retarded), for instance. Accordingly, some parents (and teachers) actively seek out the diagnosis . . . even on the fringe. Further, many school systems have autism 'teams' actively evaluating kids.
4) diagnostic "fuzziness": As a corollary to #3, there's been a bit of 'expansion' in what is called autism. The conventional wisdom is to put strictly defined autism, Asperger disorder, and pervasive developmental disorder-not otherwise specified (PDD-NOS) under the single term of autism spectrum disorders (ASD). The National Institute of Mental Health (NIMH) is even considering another one; Multidimensionally Impaired Disorder . . . which basically covers kids exhibiting characteristics of autism, OCD, and even psychosis but without clearly meeting criteria for a specific neuropsychiatric disorder. The problem is that 10 years ago autism was a type of PDD. Now PDD-NOS is considered part of the autism spectrum.
5) Less likely but certainly intriguing hypotheses:
a) increased breeding between 'spectrumy' people . . . Internet effect . . . connecting odd people all over the world
b) true environmental factor (ie pollution) +/- immune-mediated response to environmental factors
The vaccine (mercury) issue has long been debunked. Best evidence of course being that rates of autism began increasing most dramatically AFTER most childhood vaccine manufacturers STOPPED using thimersol as a preservative. In EU countries with real systems of healthcare for children, the data is unequivocal.
As for the OP, I'm always wary about 'economist' analyzing public health data. Their work is NOT peer-reviewed or published. It's a paper they are presenting at conference on Friday.
Science Daily
The results of their study suggest higher prevalence of autism among kids that lived in areas that get high amounts of precipitation and in areas that have good cable TV access/subscription rates.
I won't bother with every idiotic element of their analysis. Suffice it to say the average age of definitive diagnosis is probably around 4 years-old these days. BUT most parents can give a retrospective account of problems starting between 6-9mo (ADI). General visual acuity for an infant isn't so good (for TV viewing at appropriate distance) until 6mo or so; not to mention the fact they spend nearly all day either sleeping (16hrs+), looking at the ceiling, or attached to a boob or bottle.
Even by 12mo most kids are still sleeping 14hrs+. They are on the move, most can walk. And naturally, most damning the typical toddler has an attention span shorter than Mark Foley's list of close personal friends in the GOP leadership.
In essence, the likelihood that TV-viewing (by the kid) plays a causative role (or excerabates) autism is about as likely as watching a videotape and having a scrawny Goth girl call you up for a play date.
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