Thursday, April 12, 2012
Dear Ms. O'Connor and Mr. Elmore,
We are writing in response to your online article, "Autism rate rises; disorder now affects 1 in 88 children" (March 30, 2012), and commend your coverage of what we see as a very important topic: the growing population of individuals diagnosed with autism. However, we have some concerns with the following quote about increase in prevalence rates reported in the recent Centers for Disease Control and Prevention (CDC) publication:
"It fails to take into consideration the expanded definition, and it's not the best strategy to make people afraid of this epidemic creeping around the corner," Scott said.
While we understand that you were summarizing the comments and opinions of others, the story unfortunately contains some misleading information. The March 29, 2012 CDC report tracked the prevalence rates among communities across three time points: 2002, 2006, and 2008. There were no changes in diagnostic criteria during that 6-year time period (yet there was a 78% increase in prevalence). Therefore, it would not make sense to "take into consideration" diagnostic changes when comparing prevalence rates across those time points.
Further, there have been a number of studies looking at the impact of changing diagnostic criteria and diagnostic substitution on the prevalence rates of autism. Those studies have shown that there is a relationship between diagnostic practice and prevalence rates; a large portion of the increase remains unexplained. In studies investigating this relationship, less than a third of the observed increase in prevalence of autism can be attributed to changes in diagnostic practice (Coo, et al., 2008; King & Bearman, 2009).
Regardless of the reasons behind the increasing rates, there are a large number of individuals and families who need services and support. At 1 in 88, there are currently over one million children directly affected by autism. Attention needs to be directed at programs to train and educate service providers in evidence-based procedures for supporting this growing population.
We encourage you to consider writing a follow-up article that would provide your readers with information regarding science-based interventions for individuals with autism. This is especially important as the number of individuals diagnosed with autism continues to climb.
Emily Callahan, Ph.D, BCBA-D
Media Review Committee, Association for Science in Autism Treatment
Mary E. McDonald, Ph.D, BCBA-D
Vice President, Association for Science in Autism Treatment
CDC. (2012). Prevalence of autism spectrum disorders—Autism and Developmental Disabilities Monitoring Network, 14 sites, United States, 2008. Morbidity and Mortality Weekly Report, 61, 1-19.
CDC. (2012). Prevalence of autism spectrum disorders'”Autism and Developmental Disabilities Monitoring Network, 14 sites, United States, 2008. Morbidity and Mortality Weekly Report, 61, 1-19.
Coo, H., Ouellette-Kuntz, H., Lloyd, J. E. V., Kasmara, L., Holden, J. J. A., & Lewis, M. E. S.
(2008). Trends in autism prevalence: Diagnostic substitution revisited. Journal of Autism and Developmental Disorders, 38, 1036“1046.
King, M., & Bearman, P. (2009). Diagnostic change and the increased prevalence of autism. International Journal of Epidemiology, 38, 1224“1234.