Talk:Frequency of autism

See also: Wikipedia:Notice board for autism-related topics

/Archive1

Level One Autism

There is no mention of "level one" autism as the diagnostic category least susceptible to ambiguous diagnosis and hence increases in diagnoses of that category are most likely to reflect a real increase rather than merely increased tendency to diagnose.

Graph is very unclear

I think the first graph is very unclear. Why not just provide an graph with the percentage of the population diagnosed with autism, that would be the best way to demonstrate what is going on, and also would be clear for the averege reader. --KimvdLinde 20:13, 25 February 2006 (UTC)

Drive-by speedy delete tag

Yeh, right, the autism epidemic is 'theoretical'. Try telling that to the millions of families around the globe who are dealing with the consequences of the skyrocketing autism rates right in their households. Try telling that to the Iowa state epidemiologist, who just this week has declared that 17 cases of mumps constitutes an epidemic. The tag is entirely without merit. Ombudsman 21:31, 1 April 2006 (UTC)

My own son has Aspergers, so I know what it's like, thank you. There is still no good evidence that autism is an "epidemic." Mumps and autism have no relation to each other. Nice try. -- Fyslee 21:43, 1 April 2006 (UTC)

Ombudsman's point is that if an outbreak of one disease with 17 cases gets labeled an "epidemic," then it wouldn't be unreasonable to label a much higher reported increase in incidents of another disorder also an "epidemic." I'll agree with you that the term is hyperbolic, but then we have to see that it is used hyperbolically in many other contexts as well.

Epidemic is a specific term, and misused in many cases. Anything nowadays is an epidemic. However, that requires equal detection capability and such, and for a syndrome that was only described in the 40ties (?) and the change of diagnostic criteria makes it pretty much impossible to determine whether there is an epidemic going on. KimvdLinde 19:52, 5 April 2006 (UTC)

This page has been created by the same person who created 'autistic enterocolitis' and a number of biographical pages, for the transparent purpose of attempting to place into the public domain concepts that are not accepted by anybody, in America or the world, of any stature in the relevant specialties, and to create a sense of spurious significance for purported 'experts', such as Krigsman, Wakefield and Bradstreet, who have no legitimate call on the public's attention. In my view, this is driven by the autism omnibus action before the court of special masters in DC, where attorneys are attempting to fabricate a case against vaccines. -- 86.129.123.118 08:05, 2 April 2006

Well, new evidence does claim it's 'theoretical'... [1] Michael Ralston 02:43, 4 April 2006 (UTC)

Suggestion to you, Michael: read the articles you cite in support of your position. Shattuck simply says that according to his research - in one state - the rise in reported cases is more due to changes in reporting that changes in incidence. He doesn't rule out an increase in incidence and he in fact remains open to the idea that autism has environmental triggers. He certainly doesn't say anything is "theoretical." --Leifern 19:44, 5 April 2006 (UTC)

Suggestion to you, Leifern: If you have evidence that contradicts a citation, try citing it yourself, rather than, apparently, making things up. There is nothing in that article that mentions a single state in any way, and it very clearly states that the rise in autism is a "labelling issue". Yes, Shattuck hasn't ruled out environmental factors. So? It could be caused by some environmental factor that hasn't changed in centuries, and examining prevalence wouldn't show anything whatsoever about that. Michael Ralston 06:44, 6 April 2006 (UTC)

The 'autism epidemic' has not occurred. This is clear from a number of observations, such as changes in the characteristics of the autistic population over time, diagnostic substitution, and geographic isolation. The apparent prevalence numbers just don't cut it anymore. At this point even the title of this article makes no sense as more facts come out. Neurodivergent 20:21, 4 April 2006 (UTC)

The tag is definitely worthwhile and should be replaced by different editors at regular intervals. The whole idea of this article is without merit and violates Wikipedia's policy against No original research. -- Fyslee 18:40, 5 April 2006 (UTC)

While the term "epidemic" may be debatable, there is no question that the number of reported cases has increased dramatically. Without a doubt, people will argue endlessly whether it's because of greater awareness, blah, blah, blah, until the CDC finally concedes that a whole generation of children has had their health wrecked. There is a significant number of people here who seem to believe that "not definitely proven" = "definitely refuted," much like Bush says there is no reason to worry about global warming. I am open to a move with a less biased title, but the issue is definitely worth an article. The charge that it is original research is, well, stupid. The article discusses at length the basis for the assertion that it is an epidemic (or not), citing lots of sources. --Leifern 19:37, 5 April 2006 (UTC)

I agree, that the increase in cases is worthwhile to have an article, but the current versions is heavily biased. I just removed the section about natural selection, which is just bullshit. Selectiontakes MANY generations, so that can not explain the epidemics (only reference was a popular article), and if there is a genetic disposition, it is a issue that it has not been detedcted before, because it should have been around already. everything than points as a environmental (different living style) cause, not to genetics. KimvdLinde 19:49, 5 April 2006 (UTC)

Regardless of whether or not Kim happens to believe that natural selection is or is not involved with the prevalence of autism, it is a theory that has gained notability. Beyond mere notability, which necessitates its inclusion in the article, the fact is that subsets of the population are clearly unable to excrete heavy metal toxins and autoimmune disorders. That is a result, undoubtedly, of thousands or millions of years of natural selection. The two issues are not mutually exclusive, but rather leverage one another, which is exactly why (after throwing in assortative mating and a few other variables) there is an autism epidemic. There is absolutely no good reason to keep removing the passage, other than to stymie attempts at accurately portraying the leading theories about the skyrocketing incidence rate. Ombudsman 21:08, 5 April 2006 (UTC)

That is an interesting hypothesis (original research?), but seems to be an argument that Homo Sapiens has for a long time been speciating! If a population that had low excretion was geographically or otherwise isolated from a population that had high excretion, and there was no selective pressure on the low excretors - I they lived somewhere with less Mercury than the others, then the two populations would behave differently. But there are not two populations...or no argument as to what separated and keeps them separate, never mind the nature of the speciating influence. I say speciating because that is the order of separation and effect that seems to be suggested here. It isn't credible, and it isn't referenced. Midgley 22:28, 5 April 2006 (UTC)

A subset of the population being unable to excrete heavy metals is not a "fact". It's a disputed hypothesis at best. And if you think about it, if it were true, a good subset of the population would die a few years after getting dental amalgams. Environmental mercury would kill you over time. I'd be dead already. Neurodivergent 19:16, 6 April 2006 (UTC)

second sentence

A mess. At present it looks as though someone either used voice recognitiion software, or themeselvs had misheard incidence as instance. THere is more wrong with it, but that makes nonsense of it. Copyediting may be more useful to this article than trying to show humanity is speciating over mercury excretion. Even written perfectly it may not be a useful article. But give it a chance. Start with a title that doesn't label it with a conclusion "Autism, Changes in Incidence" would do well. Midgley 22:34, 5 April 2006 (UTC)

Leaky Gut Syndrome and related

bad heading. Midgley 22:38, 5 April 2006 (UTC)

Caused by Microsoft?

"Microsoft became the first major US corporation to offer employees insurance coverage for the cost of behavioral training for their autistic children in 2001, due to the high prevalence among the children of its employees." Hmm. Not genetic or environmental then?

The heading under which that item appears is another remarkably bad headline. Is there any likelihood that a structure for the article could be agreed in discussion? Midgley 22:41, 5 April 2006 (UTC)

Incidence and prevalence

not the same.

Denmark: "The incidence of autism reported in the study appeared lower than the prevalence reported in the US and other countries."

What does the enumeration of the countries add to Wikipedia? Midgley 00:27, 6 April 2006 (UTC)

Major revision

I am willing to do a major revision, that is, kick out everything that is crummy, not supported and make a basic version. After that, I need someone to do english editing. Furthermore, this will raise some objections of some people, so I am not going to do that unless there is a substantial number of editors that can agree with doing this, and who will watch this page after that to prevent the reinsertion of blatant crap. I have already removed the complete nonesense regarding NatSel causing this. IS there support for his? KimvdLinde 01:27, 6 April 2006 (UTC)

Would you look at Autism (Incidence) as a starter please? It needs several editing cycles of taking stuff out and a very little bit of the embedded comments bringing out into text, some citing for things I simply took on faith but cannot persist if not verifiable and so on, but the English is reasonable. Good morning to all you cheerful cooperative readers. Midgley 09:35, 6 April 2006 (UTC)

Name corrected. Midgley 19:24, 6 April 2006 (UTC)

Citations - Generalizations and Stereotypes

This is a broad generalization, isn't it? Who wrote this, and what verification is there for this? A citation? "The majority of mainstream scientists view the concept of an autism "epidemic" with skepticism, noting that autism is predominantly believed to be of genetic, not bacterial, viral or man-made causes." Also... The generalization about engineers being social misfits is stereotypical to the point of being absurd. It is as ludicrous as the old wives tale that geniuses are anti-social. That stereotype has long been debunked in studies that show geniuses are often gifted in a variety of disciplines and are often more socially adept than average. I note that there is no citation for this bald statement about 'geeks' and 'nerds' being anti-social. Jgwlaw

Repeat proposal: Change article title

Given disagreements on the title POV, and the fact that the article is still on a notable topic, I propose, as has been in the past, that the article title be renamed to 'Autism Prevalence'. Neurodivergent 19:11, 6 April 2006 (UTC)

You could see this as a nitpick, but one of the big arguments ver autism seems to be more related to _incidence_ than _prevalence_ in teh epidemiological senses. Incidence and Prevalence are the key numbers in Epidemiology, so one could reasonably write about both or eitehr of them in an article Autism (Epidemiology). On the collaborative medical reference project at http://ganfyd.org/ we have not as yet found it necessary to split the epidemiology of any disease out of its article, AFAIK, although we have no objection to doing so. Similarly, before running an article on epidemiology of x one must show that the article on x is already too large and unwieldy to tolerate empidemiology of x as a section. Midgley 19:22, 6 April 2006 (UTC)

You're right. The distinction is important. There are those who claim incidence is dropping in California, for example, while prevalence is clearly still rising. (I don't believe it's correct incidence is dropping, but this will become clear soon enough). Neurodivergent 19:26, 6 April 2006 (UTC)

Sources

This article (if it survives or is renamed) could really do with using the new citation/footnote stuff rather than all these inline links, many of which are broken. Some effort is required to find the primary source for the references rather than link to newsletters, etc. Sources that don't meet Wikipedia's "reputable" guidelines should be removed. This article would also be improved if it clarified that statistics for "autistic spectrum disorder" do not necessarily correspond to those for "autism". It also uses the words "incidence", "incident" and "prevalence" interchangably.

Great care should be made not to generalise and expand or reinterpret what the sources say. Taking two sections as examples:

Australia

The article says:

Australia is apparently experiencing a surge in autism spectrum disorders, where a ten-fold rise in diagnoses have been made in the past decade.[2] The Australian Education Department reported a 276 percent jump in students with autism spectrum disorder between 2000 and 2005. As of 2005, a total of 23,083 Victorian students were placed in school disability and language disorder programs, rising 74 per cent from 13,257 students in 2000. An expert from the Royal Children's Hospital in Sydney, Australia said the figures were "a significant underestimate."[3]

The first reference is to a newsletter hosted by TMCnet "The Authority on VoIP..." What a bizzare source! Anyway, I think I've tracked down the actual research paper:

• Icasiano F, Hewson P, Machet P, Cooper C, Marshall A (2004). "Childhood autism spectrum disorder in the Barwon region: a community based study". J Paediatr Child Health. 40 (12): 696–701. PMID 15569287.{{cite journal}}: CS1 maint: multiple names: authors list (link)

This does indeed state "The prevalence increased 10 fold over a 16-year period". The study involved 177 children in Barwon region - so it is relatively small. The abstract doesn't indicate how they established this 10 fold increase - the full paper is not free. Their conclusions are "The relatively rapid increase in prevalence is consistent with overseas studies and suggests significant changes in diagnostic criteria, increasing community awareness and the need for support at all levels of intellectual functioning. Increased occurrence in siblings and relatives gives further evidence for a genetic cause.".

The second reference is to a page that contains a summary of a number of articles. The actual source article is

• Chee Chee Leung (2005-04-26). "Number of disabled students soars". The Age. Retrieved 2006-04-07.

This article confirms the 276 percent jump in state-school students with ASD between 2000 and 2005. However, it would still be best to get at the primary source of this information.

The rest of the above-quoted paragraph, whilst correct in iteself, is irrelevant to this article on autism. The special needs being discussed will include all sorts of conditions including learning difficulties, ADHD and dyslexia, for example. The news article goes on to speculate some reasons for the rise in disabled students in state schools:

• Improvements in recognising disabilities
• Parents were finding it hard to get disabled children into independent schools (anecdotal)
• There was greater funding for disabled children in the state rather than the private sector
• Funding policy encouraged schools to claim financial help for more children and also to exaggerate the severity of their condition.

The "significant underestimate" quote is also irrelvant to autism incidence. The professor claims "most academics believed at least 10 per cent of school children had extra learning needs" - in other words, his feeling is that far more children require help than are getting it (through the school disability and language disorder programs). He is not arguing that cases of autism are being under-reported -- which is the impression a casual reader might come away with.

A revised paragraph could be:

A study in 2004 involving 177 children in the Barwon region of Western Australia, found a 10 fold increase in the prevelance of ASD over a 16 year period. The Australian Education Department reported a 276 percent jump in students with ASD between 2000 and 2005.

China

The article says:

In a July, 2005, interview Robert F. Kennedy, Jr. stated that, "six years ago, autism was unknown in China. We started giving them our vaccines in 1999. Today there's 1.8 million cases of autism in China."[4] Shanghai alone has over 10,000 known autistic children.[5] However, this seems to conflict with a 1997 study, in China, about teaching Chinese to autistic children, [6] as well as a 1991 study of a Chinese "calendar savant". [7]

The reference for Robert F. Kennedy, Jr's quote is broken. An alternative could be the article

• Robert F. Kennedy Jr. (2005-06-16). "Deadly immunity". Salon.com. Retrieved 2006-04-07.

Whilst it would be acceptable to use this article when discussing Kennedy's personal views on the causes of autism, it isn't an acceptable source for an encyclopedic entry on the prevalence of autism in China. Kennedy's statement/article has a clear non-neutral agenda (thimerosal), he does not cite his sources, and is obviously not personally the source of this "information". A quick Google shows that he has got his facts wrong. Two examples:

The Chinese Stars and Rain Institute for Autism. was founded in 1993 ([8]). Their web site has the interesting statement "There are an estimated 2 million people in China with autism, yet only 20 doctors are qualified to diagnose the disorder; an increase from the three physicians qualified a decade ago.".[9] If this is true, then any estimates regarding the prevelance of ASD in China now or in the past must be given a huge margin of error.

The following facinating paper mentions enrolling 250 children with autism into a study in 1999.

• Virginia Wong (October 2003). "Can Acupuncture of the tongue help Autism?". Institute for Complementary Medicine Journal.{{cite journal}}: CS1 maint: year (link)

It should be noted that this is Hong Kong, which may vary from PRC. It is interesting that autism is known as the "Self-Shut-Off Syndrome" in Hong Kong and Taiwan, and the "Lonely Syndrome" in the PRC. Also that in Traditional Chinese Medicine, "no such disease called autism exists".

Therefore, the quote from Kennedy must go as he isn't a "reputable source" on the prevelance of autism in China. I suspect it will be virtually impossible to get accurate figures for any increase in autism in China. There are just too many variables and there is a lack of historical stats.

Colin Harkness°^Talk 17:34, 7 April 2006 (UTC)

Reference 17 odd or broken

http://www.nas.org.uk/nas/jsp/polopoly.jsp?d=299&a=3527 is where I got to, but the secondary source that is pointed at in th reference gives a reference to an original report, whcih does not end in a document at present. The NAS site seems prefereable to a reporting site which the author may argue is WP:RS but may not convince everyone of. Either way, the figures given by the NAS don't seem to match those quoted in teh WP article or the vacciantion news item. THe reference should be pointed correctly, and directly, I think. Midgley

Medscape article

Medscape article, free subscription required. Autism "Epidemic?" Sandy 21:42, 8 April 2006 (UTC)

Why there's no epidemic

For the record, these are the reasons why it is fair to conclude that an actual epidemic of autism (not just an increase in administrative prevalence) has not happened:

• The characteristics of the autistic population have changed with time. The proportion of mental retardation and epilepsy drops as prevalence increases. This can be observed in the California DDS data.

• The 'epidemic' is largely confined to certain urban areas. In California, there's really not much of an 'epidemic' outside Los Angeles. Comparison of characteristics between regions suggest that these differences in prevalence are administrative as well.

• There is evidence of diagnostic substitution. This applies to learning disability and mental retardation. It may also apply to childhood schizophrenia, ADHD, etc.

• There is no evidence that co-morbidities of autism are on the rise, and we know for a fact some of them are not on the rise.

• There is no evidence of an incidence drop following removal of at least one possible environmental trigger, thimerosal.

• There are no conclusive indications of an actual prevalence increase from epidemiological studies, when we compare apples to apples.

Neurodivergent 20:27, 10 April 2006 (UTC)

new title is as POV as old one

I think the new title is still POV, there is no epidemological data presented at all, just some random incidence data and a suggestive graph that is misleading. KimvdLinde 22:57, 14 April 2006 (UTC)

Some of the "incidence" stuff is prevalence. Disentangling that is critical in an epidemiology article. The Incidence article is fairly clean now, and would give a sizeable section for "Incidence". It may also populate a section on confounding factors, or why it is difficult to measure prevalance and incidence of this group of conditions in the societies where most debate occurs. I suspect that in welfare states the figures will be less convincing than in the US, due to different perverse effects, and a more even spread of resources according to need rather than diagnosis may have occurred. Midgley 23:34, 14 April 2006 (UTC)

Why has the increasingly common use of common sense terminology 'autism epidemic' caused anyone to try and twist the English language into politically correct mumbo jumbo? The renewed attempts at renaming this article simply shows the lengths to which some editors will go in order to deny the reality behind the skyrocketing number of autism diagnoses. Since medical doctors are utilizing the diagnosis at an ever escalating rate and in epidemic proportions, then the facts that have led to the obvious conclusion that there is an epidemic of diagnoses must be addressed honestly. Sugar coating this iatrogenic nightmare with doublespeak terminology is not going to absolve big pharma from culpability, it will only make the Wiki look ridiculous for taking an Orwellian turn for the worse. Only the industry's vast lobbying and propaganda warchest may, just may, absolve big pharma from the eleven or twelve digit financial liability. Big pharma has basically acknowledged its culpability for triggering the autism epidemic by means of its enormous expenditures on massive lobbying and propaganda campaigns aimed at shielding itself financially from the millions upon millions of potential vaccine injury claims that are multiplying rapidly around the globe. Ombudsman 00:59, 15 April 2006 (UTC)

Moved the thing to "alleged autism epidemic" which more aptly catches the nature of this dispute. - Nunh-huh 01:02, 15 April 2006 (UTC)

Sounds better. However, there is also a Autism (incidence) page, which is much less infected with POV speak. And Ombudsman, We know your strong POV on this. KimvdLinde 01:08, 15 April 2006 (UTC)

Soapbox. Midgley 12:02, 15 April 2006 (UTC)

When the title is sorted out,

the opening is still a mess. Someone using voice-recognition, perhaps? Midgley 12:03, 15 April 2006 (UTC)

Oh all right, I've done it. Instance = one case, incidence = how many cases.

This article actually has a paragraph about how it is presenting a point of view not a concensus... THe aim of the article seems to be to keep the title in place. Midgley 12:16, 15 April 2006 (UTC)

Prevalence might be a good title... as distinct from incidence Midgley 10:13, 16 April 2006 (UTC)

Vaccine Theories Removed?

Even though I think the vaccine theory of autism is nonsense, and after looking at data on administrative prevalence I'm quite sure there is no "epidemic" at all, completely removing the sections on the vaccine theory seems quite POV. They should at least be mentioned. It just seems dishonest to exclude them. Under what principle are they not elegible for inclusion? Neurodivergent 16:10, 20 April 2006 (UTC)

Why should they be included here? Vaccine theory is described in Causes of autism. I only let information relavant to the increase of autism be in this article. The rest was moved to the relevant articles and removed. You could insert a reference for vaccine theory, but I don't think this is necesary. There are many other reasons for changes in prevalence, so we would have to bring over the entire Causes of autism article here.--Rdos 04:44, 21 April 2006 (UTC)

I agree there's some redundancy in Causes of autism, Controversies in autism and Heritability of autism. But it's probably necessary redundancy here. The article lists theories and hypothesis that attempt to explain the rise in number of diagnoses, not the causes of autism. Other hypothesis listed are about as speculative as the vaccine theory. (Incidentally, the real verifiable causes are not well explained in the article). Neurodivergent 15:54, 21 April 2006 (UTC)

OK, if somebody wants to add some kind of *summary* of vaccines and the increase in autism, I won't complain. However, the long sections I removed is hardly motivated for this. A few lines of text should be enough. --Rdos 17:33, 21 April 2006 (UTC)

proponents

If ... "the remainder of this article is built on a proposition challenged by large portions of the autistic community and the scientific and medical community." ... would it not be as well to be more specific about whom it is proposing this? And characterising them in some fashion, perhaps? Midgley 03:30, 23 June 2006 (UTC)

It is really only curebie subgroups of the autism community that propose this; specifically, groups that have a pet theory, such as the thimerosal theory or the MMR theory. And that does seem notable enough to be spelled out. Neurodivergent 02:27, 24 June 2006 (UTC)

Should we list the Autism Fries theory too? :) Neurodivergent 02:30, 24 June 2006 (UTC)

Are any of them notable and identifiable enough to be used as citations? If so they ought to be so used. The section on caveats is an odd one - some of it makes sense in relation to _frequency_ (incidence, prevalance, lifetime risk or whatever else "frequency" is serving as a shorthand for), but a chunk of it is an apologia for the word epidemic... which has its own article. Pruning that section drastically, and removing the diagnositic criteria - which must be in the autism article surely already , would make it shorter and more clear, which are no worse aims for a good article than a bad one. Midgley 18:00, 8 July 2006 (UTC)

RE: Sources of Information

Sorry but i think that the sources in this article should be reviewed, they clearly have not gone under academic scrutiny and have fallen to the media hypes and exagerations. The statistics are un-reliable and mis-represented. Please can i suggest that someone attempts to scrap the whole article until an expert on the subject can be consulted; and i say that as an academic researching in the field!

Page move to Autism epidemic

While it is all well and good that a small number of medical professionals intend to pretend that an autism epidemic does not exist, their numbers pale in comparison to the millions of parents, families and children affected adversely by the exponential increases of autistic spectrum conditions in recent years. Unvaccinated populations (e.g., the Amish and Homefirst Health Services patients) only have a handful of children with such symptoms, not surprisingly those that have been identified were attributable to severe pollution in a few cases, and vaccines administered to children while outside their communities. Indeed, it is very clear that Leo Kanner and Hans Asperger had every reason to treat the symptoms as unique, since nothing similar to the distinct symptoms of autism had ever been seen by them before, nor were such symptoms ever reported by others before. Really, there wouldn't even be any skepticism about whether or not an epidemic now exists, given the zero to millions exponential growth, except for the issue of immense financial liability, an issue that has largely been dodged by means of vast expenditures on legal fees, lobbying and political contributions.

In fact, the epidemic is so staggering now that even the corporation-dominated US Senate passed the watered down Combating Autism Act this year. Autism was virtually non-existant in 1943, as would be expected for populations which had not been subjected to the corpulent vaccination schedules that have become so bloated in recent years. In the late 1990s, vaccines further contributed to the epidemic due to bolus concentrations of ethylmercury (but worry not, finding the article on the thimerosal scandal now only takes navigation through a redirect, to an obscure name for the neurotoxin, and then a secong 'soft' redirect to a page that has deliberately been made difficult to goofle).

Regardless of the minority opinion of the vastly outnumbered medical professionals who insist on pretending the epidemic doesn't exist, the article title should be accurate. The Wiki should aim at providing the most useful answers about the epidemic from the millions of parents who are now raising children with autistic conditions. Accuracy begins with proper article titles.Ombudsman 04:13, 13 September 2006 (UTC)

Asperger et al described the syndromes. This is not equivalent to them having not existed before that decade, and suddenly arisen. Frequency of autism is indeed a poor title, since frequency conflates incidence and prevalence, but autism epidemic is worse. This isn't a good article. ombudsman's continued attention falls at least close to the arbcom's strictures upon him. WP is not a soapbox. Midgley 09:50, 13 September 2006 (UTC)

I don't even know where to begin to address Ombudsman's comment. I believe every single sentence is questionable. For example, according to this survey nearly all pediatricians attribute the increase in diagnoses of ASD to changes in diagnostic criteria and treatment. Certainly on the web it's not at all clear that there's a concensus. But that's not really relevant. How do you explain, for example, that in 1992 about 70% of all California DDS autistics were classified as mentally retarded and today only about 30% are? Unless you do some really convoluted mental gymnastics, it is clear autism today is not the same as autism in 1992. It's not true that autism had never been seen before. Many descriptions can be found on the literature and people born before the 1930s have been retrospectively diagnosed based on clinical notes. Kanner himself indicated that the autistics he identified had previously been deemed feebleminded or schizophrenic. There is no zero to millions exponential growth -- that's just ridiculous. The earliest epidemiological study found a prevalence of 4 in 10,000 based on Kanner's criteria in the 1960s. Current DSM-IV autistic disorder prevalence is estimated at 20 in 10,000. It's still comparing apples and oranges. There's really no compelling reason to believe in the autism epidemic, and plenty of reasons to believe otherwise. Neurodivergent 17:30, 13 September 2006 (UTC)

It should not be difficult at all to fathom the vast differences in autism rates during the 1940s, the 1980s, and today. The rise in autism is real and is now beyond any possible doubt. In 1943, the constellation of symptoms described by Kanner was entirely unique and unheard of, even among experts. In contrast, hard scientific evidence now exists that autism spectrum disorders have skyrocketed 1200% since the 1980s. This has once again been reconfirmed by the recently released 'paternal age' study, which used current diagnostic criteria (ICD10) to compare data from 1980s birth cohorts directly with data from recent birth cohorts. (The researchers, unsurprisingly, did not use records from before 1980, due to the obvious constraint that there are exceedingly few adults 25 years old and over with the constellation of symptoms first identified as "unique" by Kanner in 1943.) Furthermore, today's identified unvaccinated groups have not been shown to have any instances of autism, with the minor exception of a vanishingly small number of children who meet the ICD10 criteria, but who were also exposed to significant amounts of mercury pollution. Doesn't that link to mercury sound familiar?

No evidence of any sort has been offered indicating that there are millions of adults over age 25 with autistic symptoms. There are relatively few teenagers and young adults with autism, a fact that has been reinforced by the data from the 'paternal age' study, because the rate of diagnosis has increased by more than tenfold. And most of the millions of children with the symptoms described by the ICD10 (and in line with Kanner's description) were born between the 1990s and now. Thus, until credible evidence is provided showing that there are millions of people who were born before 1980 and who meet current ICD10 criteria for autism, then the page ought to be returned to where it belongs. 132.241.246.57 06:36, 14 September 2006 (UTC)

Why exactly is the rise real? There has to be a scientific reason to conclude that, not "because it kind of looks real". The only paper to offer data in support of the notion that the rise is real has a well-known naive error in reasoning. There have not been any screenings of unvaccinated populations to be able to claim there's no autism in them. BTW, the Amish do have autism. The Inuit, who do vaccinate and are exposed to a lot of mercury in their diet, may or may not have autism -- still waiting for a screening there too.

Finally, there is some evidence of a high prevalence of ASD in adults, even though, again, no whole-population screenings have been done. There are several relevant papers, but let me just offer this one which documents that 30% of adult ADHD patients had comorbid ASD. The prevalence of ADHD in adults in the US is about 4%. Do the math. Neurodivergent 23:41, 14 September 2006 (UTC)

The "evidence" of high incidence of ASD in adults is not. There is no mention of whether the 241 ASD adults were over or under 25 and the paper says nothing of the prevalence of ASD in adults.

Like I said, no whole-population screenings of adults have been done. This study is nevertheless interesting, because they took adults with ADHD and found that 30% have comorbid ASD. They were adults. What's this 25-y/o goalpost shift? (I can help you with the confounds there, e.g. they might have been ADHD adults more "severe" in average than those in the US). Neurodivergent 15:34, 15 September 2006 (UTC)

Aside from the increasingly daft diagnoses and conditions invented annually in psychiatry for the DSM IV psychistrists' "Billing Bible", far more interesting is that one of the authors of this "evidence", Christopher Gillberg, was accused of research fraud. When he was away for a weekend, his staff shredded 40 years of research when ordered by a Swedish court to disclose the data for peer reviewed scrutiny. The shredding was dubiously alleged to protect patient confidentiality (despite none of the subjects being patients). There were criminal proceedings with convictions which included the then Vice-Chancellor of the University, Goteborg in Sweden.

I'm aware of the scientific conduct issues sorrounding Gillberg. I guess we should scrap most of what is known about Asperger's syndrome on that account. I also suppose this Nylander & Gillberg study is no good, particularly since it found that 89.5% of adults with "definite autism" at an outpatient psychiatric hospital had previously been missed. But there's more. For example, as early as 1982, Shah, Homles and Wing screened patients at a mentally handicapped hospital for autistic characteristics, and found that 38% of the patients met them. I'll leave it as an excercise to research the prevalence of MR, and current prevalence of ASD with MR. Note that at the time, Kanner's criteria was used, but Lorna Wing was ahead of her time and understood the notion of a spectrum. In addition to that, we have this study by Baron-Cohen et al. which found that 2% of a control sample of adults scored higher than 32 in the AQ test, which appears to be a sensitive screening instrument for ASD in adults. This was closely replicated in Japan, where 3% was the proportion found (but the Japanese sample included a random control sample and University students). In summary, when autism is screened thoroughly, much autism that wasn't seen before is often found -- and there are many other studies I can cite to support his assertion. Neurodivergent 15:33, 15 September 2006 (UTC)

If you look closely you will see that all the authors of the paper are from the Department of Child and Adolescent Psychiatry, Goteborg University, Sweden.

Professor Sir Michael Rutter of the Institute of Psychiatry in London (Kings College) considers Gillberg's "DAMP" condition that the shredded research concerned to be BS but dresses that conclusion up in what is described as "The concept of DAMP is even more muddled and it similarly lacks both internal coherence and external discriminative validity. Moreover, it has no demonstrated treatment or prognostic implications. It is past time that it too was abandoned."

See here from the British Medical Journal "Destruction of data prompts calls for Swedish agency to investigate research misconduct" http://bmj.bmjjournals.com/cgi/content/full/329/7457/72

80.4.39.202 05:54, 15 September 2006 (UTC)

And I'd like to emphasize that the 1200% increase is still biased and flawed, even though not as ridiculous as the oft cited 6000% increase. You could claim a rise of a factor of 5 for "classic autism" (let's call it 500% if you prefer to make it sound like more than what it is). But this still compares Kanner autism with DSM-IV autistic disorder, which have completely different criteria. An extreme analogy for this apples to oranges comparison would be comparing the prevalence of autism with that of ADHD. Neurodivergent 23:58, 14 September 2006 (UTC)

Why is "the 1200% increase is still biased and flawed". You give no reasons. How can it be? The Israeli Army want to ensure their soldiers are 100% fit for service. So if they diagnose something, they do it with good reason (unlike some researchers). So what is wrong with the data from the Israeli draft board medicals? 80.4.39.202 05:54, 15 September 2006 (UTC)

Because, obviously, a factor of 12 is the increase from 5 in 10,000 to 60 in 10,000. The former is the prevalence of Kanner autism in the 1960s. The latter is the prevalence of ASD today, which includes autistic disorder, PDD-NOS and Asperger's syndrome. Is there any doubt why this comparison is invalid? Neurodivergent 15:07, 15 September 2006 (UTC)

Did the Israelis do a whole-population screening for ASD in adults? Didn't think so. Neurodivergent 15:33, 15 September 2006 (UTC)

You have not read the paper. 132,000 Israeli draft board recruits were given comprehensive screenings aged 17 and were born in a straight six year period ending no later than 1988. The screenings were carried out in the past 6 years using the same diagnostic approach as is used today and not in the 1980's. "Do the math" is the phrase? As you say "The former is the prevalence of Kanner autism in the 1960s". Seems to indicate a new kind of autism - late onset? MMR was introduced into Israel in December 1988. 80.4.39.202 15:56, 15 September 2006 (UTC)

I don't have the full text. Without knowing which instrument they used, it's not clear what the screening (of 132,000 persons) involved. It could be the screening relied on prior diagnoses of something, which is fairly typical and misses a lot. Might warrant contacting the authors to clarify. And yes, there is a "new kind" of autism, because the definition has evolved; there are no indications something biological has changed. Neurodivergent 16:22, 15 September 2006 (UTC)

It seems to me that a neutral term might be Epidemiology of autism, in which all the issues that are being argued about here might be framed in an appropriately encyclopedic way. I for one think that incidence vs prevalence vs changing diagnostic criteria vs increased awareness vs more likely reporting be examined carefully. We are not going to reach agreement on these issues on talk pages or in the article spaces, nor are we supposed to; but we are supposed to explain what the disagreements and/or conflicting evidence is about. --Leifern 16:04, 15 September 2006 (UTC)

I think that's a good title. Neurodivergent 16:06, 15 September 2006 (UTC)