By Robert Bazell
Chief science and medical correspondent
NBC News
During the briefing for reporters Thursday on the CDC’s latest findings that one in 88 children in the U.S. (one in 54 boys) has a diagnosis of some brain disorder that falls on the “autism spectrum,” there was a polite but revealing dust up. Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention, conceded –in response to a question– that the increase in cases could be the result in changes in the way such disorders are diagnosed. Then Mark Roithmayr, president of Autism Speaks, the biggest activist organization concerned with the disorder, said he begged to differ. Maybe half the cases, Roithmayr insisted, must be due to some as yet identified environmental factors.
Click here to read what every parent should know about autism.
Last January Dr. Fred Volkmar, director of the Yale Child Study Center, created a far bigger controversy when the New York Times reported he had said new definitions of autism about to come from The American Psychiatric Association could effectively end the autism surge. ''We would nip it in the bud,'' the Times quoted Dr. Volkmar.
Related story: Better diagnosis, screening behind rise in autism
Volkmar was not available today, but I interviewed his colleague Dr. James McPartland, who did not back down from that view.
“People who might have been diagnosed with something else in the past are now being diagnosed with an autism spectrum disorder," McPartland said. By “something else,” McPartland means problems that used to be labeled as ranging from “mental retardation” to “learning disabilities.”
“The way we diagnose autism spectrum disorder has changed,” McPartland continued. “We're more inclusive. We include people with more cognitive ability and less severe problems then we have in the past.”
Anyone who spends time around children diagnosed on the “autistic spectrum” knows that it is indeed wide. Many have the severe withdrawal and lack of ability to engage in social interactions that characterize classical autism. But others seem high functioning and verbal.
Scientists have spent a lot of time looking for genetic changes that might account for disorders labeled as autism. More than 500 genes have so far been implicated indicating that no clear genetic cause will be implicated.
As for environmental factors, there are strong suggestions that older parents, especially fathers can increase the risk as can multiple births. But none of that could account for more than a fraction of the enormous increase (78 per cent since 2002 when the CDC started tracing autism.) The alleged association with childhood vaccinations has been widely discredited by scientists although a few hard core activists still cling to it.
So that takes us back to diagnosis. Whatever it is called, there can be no doubt that a lot of kids need special attention – and the sooner they get it, the better off they are. What a problem is called matters less than how society copes with it.
