There is no autism epidemic

autismnotnew

One argument made by people opposed to vaccination is that autism is new, caused by vaccines, and is an epidemic. In the film Vaxxed, which I watched and reviewed here, the filmmakers quote Dr Stephanie Seneff, a computer scientist, as saying that by 2032, 80% of boys, 50% of all children, will be on the autism spectrum.  Respectful Insolence blog has done a nice job of debunking Seneff’s claims. Even though we know Dr Seneff is wrong, there are people who worry she could be correct.

I have already shown you how vaccines do not cause autism.  That argument involved looking at autism and immunization science. Some people don’t trust the science. If you discount the science because you do not trust it, there is another way of making this argument and it debunks the idea that autism is new and an epidemic. This way uses logic, which is reasoning conducted or assessed according to strict principles of validity. This is not about feelings. This is like how Mr Spock from Star Trek talks and reasons.

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Logic statements have rules or conditions. They are called conditional statements. for example,  “If all philosophers are thinkers and John is a philosopher, then John is a thinker,” is logical because if one is true and the other is true, then the third must be true.

 If the mental retardation and schizophrenia rates in USA used to be 3-5% and the current diagnosis of similar behavior is now called autism or intellectual disability and rates are currently 3-5%, then the autism rate is not increasing. 

Autism is not new. Mental retardation and schizophrenia rates have decreased as autism and intellectual disability rates have increased. This is because we have new terms for behaviors which have been in humanity for all eternity. A current diagnosis of autism includes behaviors we formerly diagnosed as mental retardation. Look at this meme from RtAVM. It makes the point visually.

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Source

First, a bit of history. Prior to the early 1900s, we did not have many good tools for diagnosing and treating people who had any differences from the “norm” with regards to their thinking and behavior. Gradually, the fields of psychiatry and psychology, as well as other social and behavioral sciences, have learned more and more about human behavior and the brain.  In his book, Neurotribes, Steve Silberman goes through the “earliest days of autism research” and he  chronicles “the brave and lonely journey of autistic people and their families through the decades.” I highly recommend this book as a starting place for anyone wanting to learn about the history of autism.

Prior to the 1970s, we did not have special education in the USA. Two legal cases from the early 1970s, Pennsylvania Assn. for Retarded Children v. Commonwealth of Pennsylvania (PARC) and Mills v. Board of Education of District of Columbia, paved the way for more laws that have led to what we know today as special education. In 1972, Congress decided to investigate how children with disabilities were living and found many problems, including lack of education. In 1975, they passed The Education for All Handicapped Children Act. Congress has since amended and added to it and renamed it IDEA, The Individuals with Disabilities Education Act.

Since 1975, more and more children are now educated in schools and, in order to do so, many changes have been made to medical and educational diagnoses for behavior and disabilities.  When I was a young child, in the early 1970s, we did not find any children with disabilities in the schools. My mother paid for private tutoring for my brother, who had a mild reading issue. There was no reading specialist in schools. Children with severe disabilities were institutionalized and children with mild disabilities struggled and often dropped out of school. Children with behavior issues fared poorly in school. Many school-related issues were blamed on the child or on parenting practices. All that has changed, thanks to IDEA, including the labels we give to children to enable them to get the services they need.

Before IDEA, a diagnosis of autism was rare. More likely, children with severe symptoms were labelled “mentally retarded” or “schizophrenic.” Yes, you read that correctly. Please continue to read as I explain.

In an analysis of the prevalence of mental retardation, Dutch epidemiologists Roeleveld and Zilhuis looked at rates for severe MR as well as mild from 1939 through 1986. They concluded, from looking at data from many countries, including USA, that the rate of mental retardation in children was 3%.

Now, look at the graph below. Yes, I know some of you don’t like Autism Speaks, but I am using this graph to make a point. The rate of autism appears to have risen dramatically since 1975. But, Autism Speaks published this graph and stated “approximately 53% percent of the increase in autism prevalence over time may be explained by changes in diagnosis (26%), greater awareness (16%), and an increase in parental age (11%).”  They acknowledge how the increase has many factors behind it.

prevalence-graph1

Today, in 2016, the Autism Science Foundation says the rate of Autism in USA is 1 in 68, which is 1.47%. Others think the rate of autism is 1:45, which is about 2%.  As of 2014, an estimated 5.4% of children between ages 5 and 17 qualify as disabled in some way. This includes hearing and vision disabilities as well as ambulatory disabilities and all other categories of disabilities. According to the National Center for Education Statistics, 14% of public school children qualify for special education services under IDEA. This includes children with speech and language impairments, learning disabilities, and many other categories. (Remember, none of these children would have had services at all prior to IDEA). Of those 14%, 8% are labelled autistic and 7% are labelled with an intellectual disability (ID). Thus, 1.12% and 0.98%, respectively, of public school children are autistic or have an ID. This comes to 2% of public school children. Doubtless, there are also children with ID or autism diagnosis not in public schools so, for the sake of the argument, let’s assume the autism plus ID rate is at least 2% in real life, in USA.

We no longer use the term “mentally retarded.”  So, what happened to it?  Are there no longer any children suffering symptoms we used to label “MR?”  Far from it. We changed the diagnosis from mental retardation to autism and intellectual disability. We know a lot more today than we used to about how intellectual quotient (IQ) tests are not the best way to define a person’s abilities.  In 1941, mental retardation was defined as social incompetence associated with deficits in mental ability. In 1959, it was “subaverage general intellectual functioning which originates during the developmental period and is associated win adaptive behavior.” In 1973, the definition changed again, to subaverage general intellectual functioning.

Meanwhile, according to Autism Speaks,  in the 1970s, autism was beginning to be understood as “a biological disorder of brain development.” In the 1980s, the diagnosis manual (DSM-III) first distinguishes autism from childhood schizophrenia and then the DSM-IIIR showed a checklist of criteria for diagnosing autism. By 2000, the DSM-IV and DSM-IV-TR had expanded the definition of autism to include Asperger’s syndrome. In 2015, a Danish study found the “vast majority of people diagnosed with autism spectrum disorders today would never have qualified under the 1980 classification, and no formal classification separate from schizophrenia existed before then.” Dr Jess P Shatkin writes that most of the early work on childhood “schizophrenia” was really about autism. We also know that in the 1940s, Leo Kanner and Hans Asperger delineated two forms of autism out of the pool of schizophrenia psychoses. Back then, anyone who would today have been labelled Aspergers would have just been called odd. Aspergers did not become an official diagnosis until 1994. Currently, we no longer commonly diagnose children as schizophrenic. Today, this is a very rare diagnosis.

Since the 1970s, thanks in part to IDEA and related research, the diagnosis of mental retardation has been used less and less. Gradually, the shift was made to using the term intellectual disabilities. In 2013, the term “mental retardation” was struck from federal registers by President Obama. It was replaced with the term “intellectual disability.”

So, here is what we know:

  • mental retardation and schizophrenia rates in USA used to be 3-5%
  • current (2016) autism rate is 1.47-2%
  • approximately 1% of public school children are identified as intellectually disabled
  • mental retardation diagnosis was replaced by intellectual disability or autism diagnosis
  • Aspergers was not commonly diagnosed until recently
  • 1+2=3
  • There is a small percentage of children diagnosed as autistic or intellectually disabled who are in private schools. They are not accounted for in the federal special education statistics. Let’s say they would be 1-2%.
  • 3+2=5

If we add all of that together, what I see is that the rate of severe autism has not changed much in the 100 years we have been tracking these kinds of diagnosis. We have just changed the name for it. Three percent (3%) of public school children fall in the autism or intellectual disability diagnoses. This is a similar rate to the mental retardation and schizophrenia rates of yesteryear.

 

Autism is not new.

 

 

Remember to think for yourself.

 

Kathy

 

 

 

 

 

 

 

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36 thoughts on “There is no autism epidemic

  1. Thanks you for clearing up this common misconception! Please consider withdrawing any form of support to Autism Speaks, who is widely regarded by autistic people as a harmful hate group that silences actual autistic voices.

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    • The reason I posted the info from Autism speaks is to make a mainstream point. A lot of people read that website and I wanted to refer to something people could understand. I hope you see that I also linked to great many other sources for information. Thank you for reading.

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      • I’m confused about AutismSpeaks. It does a positive service but creating awareness, does it not? Does it do some other not-so-great things?

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  2. I really want to understand this issue, and I’ve only done a shallow dive on the literature, but it looks like the reviews of the data show only a fraction of the increase in diagnoses is due to diagnostic substitution.

    Front Pediatr. 2015 Oct 12;3:85.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4600915/
    “The results of the present study revealed that subjects diagnosed by healthcare providers with a PDD in comparison to those diagnosed with MR or CP, within the VSD database were significantly different populations, and, as a result, these differences suggest that diagnostic substitution cannot fully explain the increase in diagnosed PDD during the 1990s within the US.”

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    • Okay, first of all, thank you for taking the time to read my post.

      Secondly, when we see the names Geier and Hooker, we have to remember who they are before reading. Geier and his son have been in trouble for years for shady practices. They advocate and practice chemically castrating autists with a treatment called Lupron. It is not approved for that purpose and dangerous. Because of this, Geier senior has had his medical license revoked in all 11 states where he held them. He is no longer able to practice medicine. Geier junior was never a doctor. Their ideas about metals in vaccines have been resoundly disproven by many.

      Hooker is a professor at a small university in California and recently lost his claim of vaccine injury (for his son) because he used Geier and Geier, among others, and their ideas were found fallacious. Also, his son’s own medical records were found to have many signs of early autism long before he was given the MMR. The claim was dismissed. It is interesting reading.

      Finally, the authors of this study are only looking at the years 1994 to 2003 which is not back far enough, in my opinion. I would also not trust their analysis. All of them are, in my opinion, shady characters with a long history of bad analyses. I would avoid anything with the name Geier on it. If you want more information as to why, go to the Left Brain Right Brain blog and read Dr Carey’s writings on the subject of G and G. https://leftbrainrightbrain.co.uk/

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      • I believe Frontiers in Pediatrics is also on the “possible predatory journal” list. In other words, it is an online journal in which the authors pay the publication costs and can also pay for favored author status. This came up in a recent story over ate Retraction Watch.

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  3. I thought I would put this paper in a separate post, for ease of reply. The papers I’ve come across suggest that some, but not all, of the increase in autism diagnoses is the result of diagnostic substitution.

    Int J Epidemiol. 2009 Oct; 38(5): 1224–1234.
    “Using the probability of change between 1992 and 2005 to generalize to the population with autism, it is estimated that 26.4% (95% CI 16.25–36.48) of the increased autism caseload in California is uniquely associated with diagnostic change through a single pathway—individuals previously diagnosed with MR.”
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2800781/

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    • The concluding paragraph of that paperwork makes the point.

      “We have estimated that one in four children who are diagnosed with autism today would not have been diagnosed with autism in 1993. This finding does not rule out the possible contributions of other etiological factors, including environmental toxins, genetics or their interaction to the increased prevalence of autism. In fact, it helps us to recognize that such factors surely play an important role in increasing prevalence. There is no reason to believe that any of these frameworks are wrong and many reasons to believe that the increase in autism prevalence is in fact the outcome of multiple self-reinforcing processes. However, this study demonstrates that subsequent explanations for the increased prevalence of autism must take into account the effect of diagnostic change.”

      A great deal of the increase in numbers has to do with the expansion of the definition of autism.

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      • It still seems that it’s a “some but not all” of the increase, at least in California. I want to admit to my biases: I suspect that part of the increase could result from changing parental demographics; older fathers and mothers producing offspring with more of the genetic risk factors for autism. I would predict a small increase in autism over time which would be an epidemic in the boring, pedantic, technical sense.

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  4. Has anyone looked at how the timelines for increase compare between Western developed countries? I would assume that the diagnostic instruments themselves, and the programs they support, wouldn’t be present in all Western countries at the same time. Do countries using older definitions show a lag in autism diagnosis increasing?

    One last paper here:
    Int J Epidemiol. 2009 Oct;38(5):1245-54.
    “The rise in incidence of all types of ASDs by year of diagnosis appears to be related to changes in diagnostic and service provision practices in Western Australia. In children aged <or=5 years, diagnosis of severe Intellectual Disability decreased, but mild-moderate Intellectual Disability increased during the study period. A true increase in ASD cannot be ruled out."
    http://ije.oxfordjournals.org/content/38/5/1245.long

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  5. My question is this…. in the research that was used for this (which I agree with your conclusion and explanation) the number of children with autism is based off of public school and IDEA. So is the numbers used then only children in public schools that are serviced by IEP’s for autism designation? If so then the numbers a very much skewed lower then what they actually are. Is is common in the autism community to have stories such as ours where the public schools will deny a child an “educational autism” designation even though the child has a medical autism diagnosis. This is done to refuse services to children and to save money on special education services by limiting the number of special education students they have.

    This has been the case with both of my children who are diagnosed with autism in the moderate range. The school refuses to give them a designation of “educational autism” and even completely revoked my daughters IEP saying she chooses to be alone and is just “quirky”.

    So I was just wondering how the numbers accounted for children such as mine and others with similar stories?

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  6. Mental retardation does still exist as a seperate diagnosis, it is just no longer the accepted medical terminology due to the slang misuse and negative connotations of the word “retard”. It is now called “intellectual disability” (ID) and not all people with ID have autism, just as not all people with autism have ID.

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  7. Pingback: Kako “Roditelji Autizam-ratnici” štete autističnoj djeci | Autizam - jednaki u različitosti

  8. Your blog is nothing but lies. Autism is caused from vaccination. William Thompson, a leading scientist at the CDC has admitted fraud in a major study of MMR vaccine causing autism. Every single blog post is filled with lies. Society can no longer deny the relationship between vaccination and autism/brain damage and auto-immune disease. Millions of parents stepping forward with vaccine injured children. These parents went in for vaccines with a normal, healthy child and then walked out with a child no longer able to walk or talk within 24 hours of vaccines. Anyone who would question this many people telling the same story is obviously lying, or being paid to lie.

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  9. Pingback: Vaccines Revealed 3 – a provaxer’s view | vaccinesworkblog

  10. Pingback: There is no autism epidemic | vaccinesworkblog – autisticagainstantivaxxers

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  12. Thank you. You have just re-stated everything I have been stating for a very long time. I’m not a mother (but I am an aunt and an honorary “auntie”) and so people tend to ignore my opinions. I firmly believe the anti-vaccine movement is dangerous and will only come crumbling down when a horrendous epidemic takes place.

    I also firmly believe that vaccines do NOT cause autism. I know a little girl, who has not been diagnosed with autism, but I believe she is borderline autistic. At the least, “developmentally delayed”. She has never been vaccinated. So how could a vaccine have caused her problems? Yeah, yeah I know the anti-vaccine line – “it was caused by a vaccine her mother received”. Whatever.

    Anyway, thank you so much for your time in researching this. Especially your work on “The Truth About Vaccines”. I tried to watch it, thinking it would be “un-biased” as advertised. Not hardly! It made me so mad, I had to quit watching. People I love and care about are soaking it up like a sponge, and I am terrified for their children.

    Liked by 1 person

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