Tag Archives: Asperger syndrome

Autism Q & A: Is autism really increasing?

By Daniel B. Kessler, M.D.

The rates at which children are being diagnosed with autistic spectrum disorders (Autistic Disorder, Asperger Syndrome and PDD-NOS) continue to rise. The latest numbers are that one in 88 children are diagnosed with autism nationally and the figure is higher in Arizona. But those numbers don’t necessarily mean more kids are becoming autistic. There is in fact disagreement about what these numbers mean.

It is very likely that a large part of the increase is due to the expanded definition and broader use of the autism spectrum concept, as well as wider awareness of the disorder(s). The fact that there is better understanding of the kinds of educational, speech and behavioral interventions that are available to support children with autism and their families and the likelihood that kids will do better with these supports is an incentive for families to get the correct diagnosis earlier and earlier. There has also been a large effort underway to increase the availability of clinicians experienced in making the diagnosis and better diagnostic tools. But is there something else also going on? Some advocates for children believe that only about half of the increase in identification can be explained by “better and broader diagnoses.” What else is going on here?

As has been true in the past is true in the latest numbers. They vary from location to location across the 14 sites where these latest numbers originate. And while they seem to be increasing one year to the next there is no certainty that they can’t go back down as well. While they appear to exist in every ethnic, racial and socioeconomic group they differ from group to group (though they appear to be increasing in each). Is this an issue of access to services? Is this an issue of different cultural interpretations of disability? As is often the case it is usually “all the above.”

What is true, and this is probably a good thing, is that having a child with autism is no longer a rare event. What can possibly be “good” about this? Families of children with autism are not alone. People are seeing individuals with autism in multiple settings and with varying abilities. I have the good fortune to know a number of very remarkable high-functioning adults on the spectrum and they, like the rest of us, have different strengths and different challenges. Just like the rest of us.

Next: Is autism really increasing? 

Daniel B. Kessler, M.D., is a developmental and behavioral pediatrician and medical director of the Children’s Developmental Center at Easter Seals Southwest Human Development. His private practice, where he provides evaluation and treatment for children and adolescents, is located at Southwest Human Development.

The views he expresses in this series are based on his training, his reading of the literature and his more than 30 years of experience taking care of hundreds of kids on the autism spectrum. The series begins here.

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Autism Q & A: What is the autism spectrum?

By Daniel B. Kessler

No two children with autism are alike. The various challenges that make up the diagnosis of autism come in a wide range, even when they recur in the same family.

If you look at an autistic individual’s intellectual abilities, skills in social interaction, ability to communicate, challenging behaviors (hyperactivity or physical aggression) or repetitive behaviors (hand flapping), sensory sensitivities to loud noises or rough textures or even motor difficulties, you will find they vary from one person to the next. If you have met one child with autism you have met one child with autism. Each individual is uniquely different. That’s true for each of us, really.

However, there is another aspect to the term “autistic spectrum disorders.” Three of five disorders that appear in the Diagnostic and Statistical Manual of Mental Disorders (the DSM, now in its slightly revised 4th Edition) under the heading, Pervasive Developmental Disorders, are commonly referred to as “autistic spectrum disorders.” They are “autistic disorder,” “Asperger disorder” and “pervasive developmental disorder – not otherwise specified.” Two other disorders under this same heading (PDDs) are Rett’s Syndrome and Childhood Disintegrative Disorder but they differ significantly from the other three and may not be included under the term “autistic spectrum disorders” when the next edition of the DSM (the DSM-5) is due (2014). To make things even more complicated, scientists are beginning to talk about “the autisms” with the understanding that there may be several overlapping conditions that have similar underlying causes or express themselves in similar ways.

Next: What causes autism?

Daniel B. Kessler, M.D.

Daniel B. Kessler, M.D., is a developmental and behavioral pediatrician and medical director of the Children’s Developmental Center at Easter Seals Southwest Human Development. His private practice, where he provides evaluation and treatment for children and adolescents, is located at Southwest Human Development.

The views he expresses in this series are based on his training, his reading of the literature and his more than 30 years of experience taking care of hundreds of kids on the autism spectrum. The series begins here.