On the second day of 2018, the news proclaimed that autism
rates in the United States had reached a plateau. Of course, this report should
be cause for great celebration, but before we get too excited, the details need
some scrutiny first. On Tuesday, January 2, 2018, the Los Angeles Times
published an article written by Karen Kaplan entitled “Autism spectrum
disorders appear to have stabilized among U.S. kids and teens” based upon
research published that same day in The Journal of the American Medical
Association. [To read this article, please click here.] Other media outlets
also reported this information that seems to indicate that the rate of autism
is not currently increasing. However, a closer look at this research may lead
to other conclusions.
The research conducted by the National Health Interview Survey (NHIS) includes polls of American households across the county about various health conditions. When families are polled, one child is chosen at random to be included in this survey. Parents are asked the following question: “Has a doctor or health professional ever told you that (the randomly selected child) has autism, Asperger’s disorder, pervasive developmental disorder, or autism spectrum disorder?”
In 2014, 2015, and 2016, 711 parents out of the 30,502 polled answered yes to that question; their children had some form of autism. That data was given to researchers at the University of Iowa, who considered the likelihood of a household being chosen that had a child with autism and how likely a parent would be to answer that question. Using their statistical methods, they determined the rate of autism for U.S. children and teens to be 2.41% in the years 2014-2016.
Although the rate of autism increased, according to this study, from 2.24% in 2014, 2.41% in 2015, and 2.58% in 2016, the researchers concluded that the increase was not statistically significant and could be due to chance. Hence, they decided that the rates have stabilized. (If the rates could be due to chance, what was the point of the University of Iowa researchers calculating based upon likelihoods?) Over those three years, the rate of autism for boys was higher at 3.54% than the rate for girls at 1.22%. Rates of autism around the United States varied somewhat with the South at 2.21%, the West at 2.24%, the Midwest at 2.47%, and the Northeast at 3.05%.
In comparing data with another research study, the NHIS reported higher numbers of autism than the Autism and Developmental Disabilities Monitoring Network (ADDM). However, the ADDM research only focuses on a few communities (about twelve), while the NHIS surveys the entire country. In addition, the methodology is different. The NHIS relies upon family members to report whether their children have autism, whereas the ADDM has doctors review medical and educational records of the children. Nonetheless, both research groups imply that autism rates have stabilized.
The University of Iowa researchers affiliated with the NHIS study indicate that more research needs to be done to ascertain what factors, such as environmental causes, diagnostic criteria, autism awareness, or others, may be the reason for this “apparent end to a decade-long increase” in the rates of autism in the United States.
Ironically, last month that same study by the NHIS was used to show that the U.S. autism rate in 2016 reached a record high: 1 in 36 children and 1 in 28 boys. This was an increase from the previous rate of 1 in 43 children with autism in 2015 and 1 in 45 children in 2014. Nonetheless, the U.S. Centers for Disease Control minimized the significance of this increase, stating, “there was not a statistically significant change in the prevalence of children ever diagnosed with autism spectrum disorder from 2014 to 2016.” Of course, the CDC also assures people that vaccines are perfectly safe for everyone and enthusiastically recommended flu shots that have proven to be essentially useless this year.
Some factors that may skew the data would be the willingness of parents to share that their children have autism for a survey; some parents would consider that information confidential. Also, the methodology of the survey that chooses a random child might miss another child in the family who has autism. In addition, this survey includes children ages 3-7, but some children do not receive a diagnosis of autism until they are in school, which may cause the data to reflect autism numbers less than the actual statistics. Moreover, the wording of the survey question regarding autism may be problematic. Specifically, the question asks if a doctor or health professional has diagnosed the child’s autism.
However, many children, including mine, were diagnosed with autism through the educational system. In fact, my son’s pediatrician disagreed with me when I told him I thought Alex had autism, telling me that Alex was "too smart" to be autistic. Had we not pursued further testing through the school system, a diagnosis would have been delayed. That was more than twenty years ago; I would truly hope more doctors would recognize signs of autism in toddlers and trust their parents’ intuition regarding developmental delays in their children.
While I have great hope that autism rates in the United States and around the world will eventually stabilize and even decrease, I do not believe that is happening now, despite what the media reports. The methodology behind this research, like most surveys, seems to have flaws that could lead researchers to inaccurate conclusions. While the subjects of this particular research may appear only as numbers and percentages, we must remember that these are real children with autism and their families who need help. To minimize the impact of the increase of autism in this country may lead to less support for their unique needs and to less research to find the cause and cure for this lifelong disability. Our children cannot be reduced to a statistic that may or may not be true. Until a cure for autism is found, we parents must speak up for our precious children whose voices have been hindered or silenced by autism. They certainly deserve no less.
“I love the Lord because He hears my voice and my prayer for mercy.” Psalm 116:1
The research conducted by the National Health Interview Survey (NHIS) includes polls of American households across the county about various health conditions. When families are polled, one child is chosen at random to be included in this survey. Parents are asked the following question: “Has a doctor or health professional ever told you that (the randomly selected child) has autism, Asperger’s disorder, pervasive developmental disorder, or autism spectrum disorder?”
In 2014, 2015, and 2016, 711 parents out of the 30,502 polled answered yes to that question; their children had some form of autism. That data was given to researchers at the University of Iowa, who considered the likelihood of a household being chosen that had a child with autism and how likely a parent would be to answer that question. Using their statistical methods, they determined the rate of autism for U.S. children and teens to be 2.41% in the years 2014-2016.
Although the rate of autism increased, according to this study, from 2.24% in 2014, 2.41% in 2015, and 2.58% in 2016, the researchers concluded that the increase was not statistically significant and could be due to chance. Hence, they decided that the rates have stabilized. (If the rates could be due to chance, what was the point of the University of Iowa researchers calculating based upon likelihoods?) Over those three years, the rate of autism for boys was higher at 3.54% than the rate for girls at 1.22%. Rates of autism around the United States varied somewhat with the South at 2.21%, the West at 2.24%, the Midwest at 2.47%, and the Northeast at 3.05%.
In comparing data with another research study, the NHIS reported higher numbers of autism than the Autism and Developmental Disabilities Monitoring Network (ADDM). However, the ADDM research only focuses on a few communities (about twelve), while the NHIS surveys the entire country. In addition, the methodology is different. The NHIS relies upon family members to report whether their children have autism, whereas the ADDM has doctors review medical and educational records of the children. Nonetheless, both research groups imply that autism rates have stabilized.
The University of Iowa researchers affiliated with the NHIS study indicate that more research needs to be done to ascertain what factors, such as environmental causes, diagnostic criteria, autism awareness, or others, may be the reason for this “apparent end to a decade-long increase” in the rates of autism in the United States.
Ironically, last month that same study by the NHIS was used to show that the U.S. autism rate in 2016 reached a record high: 1 in 36 children and 1 in 28 boys. This was an increase from the previous rate of 1 in 43 children with autism in 2015 and 1 in 45 children in 2014. Nonetheless, the U.S. Centers for Disease Control minimized the significance of this increase, stating, “there was not a statistically significant change in the prevalence of children ever diagnosed with autism spectrum disorder from 2014 to 2016.” Of course, the CDC also assures people that vaccines are perfectly safe for everyone and enthusiastically recommended flu shots that have proven to be essentially useless this year.
Some factors that may skew the data would be the willingness of parents to share that their children have autism for a survey; some parents would consider that information confidential. Also, the methodology of the survey that chooses a random child might miss another child in the family who has autism. In addition, this survey includes children ages 3-7, but some children do not receive a diagnosis of autism until they are in school, which may cause the data to reflect autism numbers less than the actual statistics. Moreover, the wording of the survey question regarding autism may be problematic. Specifically, the question asks if a doctor or health professional has diagnosed the child’s autism.
However, many children, including mine, were diagnosed with autism through the educational system. In fact, my son’s pediatrician disagreed with me when I told him I thought Alex had autism, telling me that Alex was "too smart" to be autistic. Had we not pursued further testing through the school system, a diagnosis would have been delayed. That was more than twenty years ago; I would truly hope more doctors would recognize signs of autism in toddlers and trust their parents’ intuition regarding developmental delays in their children.
While I have great hope that autism rates in the United States and around the world will eventually stabilize and even decrease, I do not believe that is happening now, despite what the media reports. The methodology behind this research, like most surveys, seems to have flaws that could lead researchers to inaccurate conclusions. While the subjects of this particular research may appear only as numbers and percentages, we must remember that these are real children with autism and their families who need help. To minimize the impact of the increase of autism in this country may lead to less support for their unique needs and to less research to find the cause and cure for this lifelong disability. Our children cannot be reduced to a statistic that may or may not be true. Until a cure for autism is found, we parents must speak up for our precious children whose voices have been hindered or silenced by autism. They certainly deserve no less.
“I love the Lord because He hears my voice and my prayer for mercy.” Psalm 116:1
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