Skyrocketing autism

(Note: Between the 1992-1993 and 2000-2001 school years, 23 states had an increase of 1000% or more of children between 6 and 21 with autism, some many times more. Another 15 states had increases of between 500% and 999%.- SM)

The segment of children with "regressive autism," the form where children develop normally for a period of time then lose skills and sink into autism most commonly at 18-24 months of age, is increasing at a phenomenal rate. I am seeing multiple children in the same family affected, including in the last week four cases of "autistic regression" developing in four-year-old children after their MMR and DPT vaccination. In the past, this was unheard of.

I think we are staring a disaster in the face that has affected thousands of Americans.

Some supposed experts will tell you that the increase reflects only greater awareness. That is nonsense. Any pediatrician, teacher or school official with 20 or more years experience will confirm what the studies tell us: there is a real increase in autism and the numbers are huge and growing. The epidemic is serious and world-wide.

The number of children diagnosed with autism in America is continuing to increase at a rate of more than 20% a year, according to the latest figures published by the US Department of Health.

The figures show that in the year 1999/2000 the number of schoolchildren in America with autism was 65,396 compared with 53,576 the previous year.

Figures have risen steeply since the reporting of autism became mandatory in American schools in 1991. At first the increase was attributed to better reporting of the condition but after nine years some experts argue that the consistent rise must demonstrate an actual rise in autism rates.

Observers are calling it a national emergency as the rate of autism among children in the US and around the world is rising by as much as 800 percent.

In the 1970s the rate of autism was about one case in 2500 children. Today it is one in 250 children. In California in the 1970s only 100-200 new cases of autism were reported annually. In 1998, new cases reported to the public-school system were 1425! In 1999 that figure jumped to 1944! In New Jersey the reported cases of autism jumped from 241 in 1991 to 1634 in 1997 (an 800% increase)! There were 4.4 cases of autism per 10,000 live births reported in California in 1980 and 20.8 cases per 10,000 live births in 1994, a 373 percent relative increase. [Journal American Medical Association 285: 1183-85, 2001]

The British Medical Journal reports that autism jumped by 700% from 1988 to 1999! [British Medical Journal 322: 460-63, 2001] In studies prior to 1988, the estimated prevalence of autism was between 4-6 cases per 10,000 children. Among 15,500 British children between the ages of 2 and 6 years of age the autism rate has risen to 17 cases per 10,000 children. When the entire spectrum of autism disorders is considered (which includes Asperger syndrome and other rare childhood degenerative disorders), the rate rises to 63 per 10,000 children. [News.telegraph.co.uk July 8, 2001] In Japan the rate of autism was 5-16 per 10,000 in the 1980s but rose to 21.1 per 10,000 in 1996, a 31-400% increase. [Japanese Journal Infectious Diseases 54: 78-79, 2001]

When asked about the increased rates in autism, many will immediately discount that there even is an increase. Even though the latest statistics from the Department of Education show increased rates in every state. Others will say the increase is due to better diagnostic skills. Others will say it is because the diagnostic category was expanded.

California has reported a 273% increase in children with autism since 1988. As for this increase, twenty-one percent of all autistic children in California live in the 29th district.

Florida has reported a 571% increase in autism. Maryland has reported a 513% increase between 1993 and 1998. You can't attribute all of that to better diagnostic skills.

In 1999, there are 2,462 children ages 3 to 21 in Indiana diagnosed with autism. That is one-fourth of one percent of all the school children in Indiana or 1 in 400. Twenty-three percent of these children live in the 6th district. This increase is not just better counting.

CAMPAIGNERS say a new study revealing that the number of children diagnosed as autistic is 15 times more common than previously believed is further proof of a link between the condition and the combined measles, mumps and rubella (MMR) vaccine.

A scientific study carried out by the Autism Research Centre at Cambridge University shows that 57 in every 10,000 children aged between five and 11 have been diagnosed with the condition. Campaigners have long argued that the rise in autism can be linked to the introduction of the combined vaccine in 1988.

Dr Fiona Scott, one of the researchers, said: "Most people, including the health authorities, argue that the the prevalence of autism is four or five in 10,000, and most research up until now has stated that the largest possible number would be 18 in every 10,000. This is the first scientific study to show that it is significantly greater."

When I read statistics from the Department of Education that said autism in school-age children had increased 556 percent in five years, skyrocketing past any other disability, I was shocked and horrified.

California maintains what is probably the world’s best and most systematic database on autism and other developmental disabilities, which includes children who are formally diagnosed by strict criteria for acceptance into a comprehensive entitlement program. California reports an increase in the prevalence of autism of over 1,000% (in autism, not mental retardation, epilepsy nor cerebral palsy) over a 20-year period. Similar enormous increases have been reported in New Jersey, and in several places in the U.K., in the Middle East, and in Asia. The increase is certainly not the result of greater awareness nor better diagnosis.

California Autism Epidemic Explodes

According to figures recently released by DDS, California has experienced an all time record number of new cases for a second quarter reporting period in professionally diagnosed cases of level one autism, which again does not include any of the other autism spectrum disorders. The addition of the 664 new children added to the system from April 3 to July 8, 2001 represents the largest number of new cases of autism added to the system during a second quarter reporting period in the 32 year history of California’s developmental services system. The increase represents a 27% increase in the number of new children added to the system over the previous (April to July, 2000) second quarter reporting period. The most recent numbers continue the onslaught of children diagnosed with “full blown” autism and qualified for services in California at the incredible rate of seven (7) new children a day....seven day’s a week.

Even more horrifying is the fact that through the first SIX MONTHS of 2001, California added more children with level one autism to it’s system then in any other FULL YEAR from 1969 through 1998 !! If this trend continues for the remainder of 2001, California will add over 2,700 new children with autism to it’s system in 2001 alone.....A number that would equal 13.5 years worth of new cases of autism, pre-1979-80, or more new cases of autism then entered the system for all of 1994,1995, and 1996 combined !!

According to figures just released from the California Department of 2 developmental Services (DDS), during the third quarter of this year (July 7through October 6), 457 new children with fully diagnosed DSM IV autism were added to the roles of California's Developmental Services System. 457 new children have qualified for services at a cost to taxpayers, according to DDS, of at least $ 2 million each ($914 million worth of new kids in just three months from just one state!). Keep in mind as well, that these 457 new children DO NOT include any children with PDD, Asperger's, NOS, or any other of the autism spectrum disorders, except full-blown, DSM IV autism.

This most recent third quarter report represents the second highest number of new cases reported for a third quarter in seven years. An astonishing 35% of all the new intakes to the system during this three-month period were new cases of autism; this, compared to the pre-autism epidemic traditional intake rate of 3%. During the first nine months of 2000, the California Developmental Services System experienced a 5% increase in total caseload growth, which includes all new cases of mental retardation, conditions similar to mental retardation, epilepsy, cerebral palsy, and autism. During this same nine-month period, there was a 14% increase in caseload growth in autism. California continues to add an average of 5 new children a day, with full-blown DSM IV autism, seven day's a week to its system.

What would the response be from the public health community if five new children a day from one state were showing up on their doorsteps with a horrible disease that leaves its victims brain damaged and terribly disabled? Besides trying to develop a vaccine for it, I would guess that an immediate public health crisis would be declared, and a major effort by CDC and NIH would be undertaken to find the cause, and develop treatments and a cure. We are experiencing such a public health crisis today...it's called the autism epidemic.

California Autism Growth Still Breaking Records

Based on the most current data report obtained from the California Department of Developmental Services (DDS), California has just experienced the largest quarterly increase in the number of new cases of level one autism in it’s history.

According to DDS, between July 6, 2001, and October 4, 2001, a record number 705 new cases of DSM IV autism entered California’s developmental services system, bringing the nine month total for 2001 to 2,069....more new cases in the first nine months of 2001 then reported in any other FULL YEAR on record. As with all of DDS’s autism case growth reporting, the 705 new cases do not include other autism spectrum disorders such as PDD, NOS, Asperger’s, etc.

The 2001 Third Quarter report represents: (1) the largest quarterly increase EVER reported by DDS, (2) constitutes a 54% increase over the year 2000 Third Quarter report, (3) shows that autism, for the first time, has now increased from, on average, 7 new children a day entering the system to 8 new children a day, (4) that 708 ADDITIONAL children with autism entered California’s system during the first nine months of 2001 then did during the first nine months of 2000, (5) that in October 2000 level one autism accounted for 28% of the total number of all new intakes (autism, cerebral palsy, mental retardation, epilepsy, and conditions similar to mental retardation) now in October 2001 level one autism accounted for 36% of all new intakes, and (6) that for the third straight quarter, autism has become the number one disability entering California’s developmental services system.

The cruel reality is that the last published incidence of autism in the UK of 1 in 324 (Journal of the American Academy of Child and Adolescent Psychiatry, volume 39, p 694), was just amended this week to 1 in 166, according to a Medical Research Council (MRC) report commissioned by the Department of Health. A National Autistic Society survey had found that 1 in 110 children under 11 has autism.

Similar increases in the incidence of autism have been reported on the European Continent. A Swedish study in 1993 by Ehlers and Gillberg found a rate of 71 per 10,000 (1 in 141) in children with IQs of 70 or above. A Finnish study looking at the incidence of autism in the northern provinces, revealed a fourfold increase between 1979 and 1994 with a present incidence rate of 1 in 483 among 5 to 7-year-olds (European Child and Adolescent Psychiatry, volume 9, p 162). Also, in this study, a clear increase in the number of children with IQ of 70+ was reported. (This finding has often been reported with regressive or late-onset autism.) Interestingly, this particular Finnish study went almost unnoticed, while other Finnish studies (of dubious epidemiological relevance) were highly publicized because they supported the MMR vaccine’s “safety”.

In the United States, the atrocities of September 11, the Anthrax letters and the present war in Afghanistan have certainly touched every one. But life goes on. For the parents of children with autism, each day’s battle is overwhelming and their lives have changed forever. There is no final victory they can look forward to and no end to their war in sight. Each morning brings new problems, new challenges and more concerns about funding cuts and decreased services. Every night, the same awful dream recurs “What will happen to my child when I am gone?”

According to the Department of Education annual reports to the US Congress, autism cases in children aged 6-21 in US schools increase yearly by approximately 25%

Since September 12, it is more than likely that between 600 and 700 new cases of autism were diagnosed and accepted into the system in California alone. This projection is based on the last published 3-month rate of between 7 and 8 new cases a day. If the average incidence of new cases of autism in the remaining 49 states averages only 1/8^th of the California rate—a very conservative estimate, indeed—we should expect that approximately 4000 new cases of autism have been diagnosed nationwide in the last 3 months. In the United States, the cost per child over a lifetime is soon to surpass 2 million dollars.

With no changes in the diagnostic criteria for many years, and in a system that has been ascertaining autism since 1970, the California Department of Developmental Services (DDS) recently released the following data on the number of new cases of fully diagnosed DSM IV (Level One) AUTISM (NOT including other autism spectrum disorder such as PDD, NOS, or Asperger's, or other rare "autism like" genetic diseases):

1. An all time one year (1970-2001) record number of cases (2,725) were added to California's system in 2001. This number represents a 20% increase in one year over the previous record year of 2000. The just completed 4th Quarter of 2001 (Oct. 4, 2001 to Jan. 3, 2002) also set an all time record for numbers of new cases for any 4th Quarter in the history of the system. During 2001, each of the four quarters posted all time record setting increases. THERE WERE MORE CASES OF LEVEL ONE AUTISM ADDED IN 2001 THEN IN ALL OF 1994, 1995, AND 1996 COMBINED.

2. In 2001, for the first time ever in California's history, level one autism became the number one disability entering California's system...accounting for an astonishing 35% of all new intakes in 2001. A percentage that has exploded from historic levels of 3%. AUTISM HAS SURPASSED MENTAL RETARDATION, CEREBRAL PALSY, EPILEPSY, AND ALL OTHER CONDITIONS SIMILAR TO MENTAL RETARDATION AS THE NUMBER ONE DISABILITY ENTERING CALIFORNIA'S DEVELOPMENTAL SERVICES SYSTEM.

3. California now has 16, 802 persons with level one autism in it's system. IT TOOK 25 YEARS (1970-1995) TO ADD 6,527 CASES. UNBELIEVABLY, IT HAS TAKEN ONLY 3 YEARS (1999-2001) TO ADD AN ADDITIONAL 6,596 NEW CASES. SIMPLY PUT, WHAT USE TO TAKE 25 YEARS NOW TAKES THREE.

4. According to DDS, of the 16,802 persons with level one autism in it's system: 82% are male, 56% have NO mental retardation, and 80% were born after 1980... the beginning of the autism epidemic. AMAZINGLY, OF THE TOTAL NUMBER OF PERSONS IN THE SYSTEM (16,802).... 11,104 OR TWO OUT OF EVERY THREE PERSONS (66%) ARE CHILDREN BETWEEN THE AGE 0 TO 13 YEARS OLD.

Autism Epidemic

Responding to the concern of a Dad, whose healthy son became autistic following a series of DPT, Hib and MMR vaccinations, in 1998 the California Legislature decided to analyze the history of autism in the state. Rick Rollens, father of two, former Secretary of the California Senate, and co-founder of FEAT (Families for Early Autism Treatment - (http://www.feat.org) and the University of California-Davis M.I.N.D. Institute, persuaded the legislature to fund an investigation by the California Department of Developmental Services (DDS) into state autism statistics after he concluded his son, Russell, now 9, was not the victim of a rare disorder but one that had become quite common in children.

California Autism Rates Soar

Sure enough, in an April 1999 report (http://www.dds.ca.gov) DDS found a 273 percent increase between 1987 and 1998 in the numbers of new children entering the California developmental services system with a professional diagnosis of autism. The report concluded that “the number of persons with autism grew markedly faster than the number of persons with other developmental disabilities (cerebral palsy, epilepsy and mental retardation)” and “compared to characteristics of 11 years ago, the present population of persons with autism are younger (and) have a greater chance of exhibiting no or milder forms of mental retardation. . . .”.

Although autism has been cited by public health officials and autism researchers to occur in 2 to 10 in 10,000 children nationwide, the Centers for Disease Control in a report released in April 2000 found the incidence of autism in Brick Township, New Jersey in 1998 was 1 in 150 children (the incidence in the Granite Bay, California public elementary school district is 1 in 132 children), which may be more reflective of the true rate of autism in the U.S. today. The Autism Society of America estimates that “more than one-half million people in the U.S. today have autism or some form of pervasive developmental disorder,” making autism one of the most common developmental disabilities. (http://www/autism-society.org).

After the California report documented the dramatic increases in autism in the past decade, the California legislature voted to appropriate one million dollars to the UC-Davis M.I.N.D. Institute to look for environmental and biological factors, including vaccine use, that could have contributed to this autism increase. At the same time, parents began to check autism statistics in other states.

Other States Report Similar Increases

The story is the same in other states. The 1998 Maryland Special Education Census Data revealed that the state experienced a 513 percent increase in autism between 1993 and 1998, while the general Maryland population from 1990 to 1998 increased just seven percent. A comparative analysis of the 16^th and 20^th Annual Reports to Congress on the implementation of the Individuals with Disabilities Education Act (IDEA) conducted by Ray Gallup, President of Autism Autoimmunity Project (http://www.gti.net/truegrit) and father of Eric, who has vaccine-associated autism, showed increases of more than 300 percent in autistic children served under IDEA between 1992 and 1997 in the states of Alabama, Alaska, Arkansas, Colorado, Delaware, Illinois, Indiana, Iowa, Kentucky, Maine, Maryland, Michigan, Montana, Nebraska, Nevada, New Mexico, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Vermont, and Wisconsin.

There are those who will argue that we are better at diagnosing autism today than in the past and that these children were once considered mentally retarded. However, according to a recent study, the mentally retarded have followed normal population increases and remained a steady constant while the autistic population has exploded. Is autism just the diagnosis du jour? Hardly. I would truly like to know where the parents of these autistic children were that did not recognize that their children were not talking, were spinning constantly in circles, doing odd things, abusing themselves, not making eye contact, having serious gastrointestinal disturbances, eating and sleeping problems, experiencing a failure to thrive due to malabsorption and suffering from excessive allergies. You cannot miss these children.

Fact: It is not known how many children in the United States currently have autism spectrum disorders. Studies done in Europe and Asia since 1985 indicate that there may be as many as 2 to 6 per 1000 children who have one of the autism spectrum disorders. (This works out to be from 1out of 500 to around 1 out of 160.)

Autism spectrum disorders (ASD) are a group of life-long developmental disabilities caused by an abnormality of the brain. ASD are characterized by problems with social interaction and communication skills, and by the need for sameness or repetition in behavior. ASD includes autistic disorder, pervasive developmental disorder - not otherwise specified (including atypical autism), and Asperger’s disorder.

Children with ASD require long-term intervention and support services. Special education costs for a child with ASD are over $8,000 per year, with some specially structured programs costing about $30,000 per year, and care in a residential school costs $80,000 - $100,000 per year.

Little is known about what causes ASD, although genetic and environmental factors have been suggested. There is no cure for ASD, however, early and intensive education can help children develop skills. Also, although available medicines cannot cure ASD, some may relieve symptoms associated with the disorders.

How many people have autistic spectrum disorders?

The specific pattern of abnormal behaviour first described by Leo Kanner is also known as ‘early infantile autism’. Kanner made no estimate of the possible numbers of people with this condition but he thought that it was rare (Kanner 1943).

Over twenty years later, Victor Lotter published the first results of an epidemiological study of children with the behaviour pattern described by Kanner in the former county of Middlesex, which gave an overall prevalence rate of 4.5 per 10,000 children (Lotter 1966). (This works out to be about 1 out of 2,000 in 1966.)

Dr. Eric Fombonne says, "prevalence of autism is 68 per 10,000 or 1-147. "

At the recent IMFAR (International Meeting For Autism Research) Conference, noted autism epidemiologist Dr. Eric Fombonne stated in his presentation that based on 50 previously published epi studies of autism, the prevalence rate of autism had been established, by his work and others, at between 2 to 10 per 10,000...which is to say as low as 1-5000 or as high as 1-1000 (Fombonne's own past studies reported the lower end of the prevalence spectrum). In a monumental statement at IMFAR, Fombonne now claims, as a result of his most recent work, that the prevalence of autism is 68 per 10,000 or 1-147.

Fombonne's latest work shows that the prevalence of autism has increased between 600% and 3400% (1-1000 down to 1-147 = 600% increase) and (1-5000 down to 1-147 = 3400% increase). Using the middle ground of 5 per 10,000 or otherwise stated as 1-2000, the most recent epi study by this most conservative autism epidemiologist would now suggest a 1300% increase in the prevalence of autism over a 25 year period, or on average, a doubling of the prevalence of autism every two years between 1976 and 2001.

Any changes in prevalence of autism must be determined

Fombonne has argued that despitereported increases in the prevalence of autism in many countries,the true incidence has remained constant. The impression of anincrease, he argues, arises only because of increased rates ofdetection.

There is no hard evidence to support this hypothesis. The only studies that have explored the question have failed to finda "hidden horde" of autistic children. Burd et al conducted aprevalence study of autism in North Dakota.³ They found a prevalenceof 3.26 per 10 000 among a cohort of children born between 1967and 1983. A 12 year follow up survey of the same cohort showedthat the original prevalence study had found 98% of the autisticchildren in the area; only one child had been overlooked.⁴

Many scientists and health professionals are uncomfortable about the data regarding recent increases in rates of autism. Afew have developed extravagant theories as an expression of theirdiscomfort. Nevertheless, the simplest interpretation of the recordsupports the conclusion that the incidence of autism hasincreased.

Letter from Wakefield

Can the dramatic increase in autism be ascribed to change in diagnostic practice? Data from the recent California report from the Office of Developmental Services belie this contention. The figure juxtaposes the data from California with those from north-west London. Identical temporal trends are shown, with the rise in autism from a steady baseline value, coinciding with the introduction of MMR vaccine as the single strategy in both countries that use the same diagnostic criteria for autism.

Autism and mercury: coincidence or cause and effect?

Once considered a rare disorder with an incidence of only 1-3 per 10,000 births, autism is now reaching epidemic proportions with an incidence of 20-40 per 10,000 births and “clusters” of 1 per 150 have been reported in New Jersey and California. Autism now ranks third among childhood developmental disorders, making it more common than Down’s syndrome, Multiple Sclerosis and Cystic Fibrosis.

(a) First, autism was first discovered in the early 1940s among children born in the 1930s; and thimerosal was first introduced into vaccines in the 1930s.

(b) Second, prior to 1970, autism was estimated at 1 in 2000 children, while studies after 1970 showed a higher prevalence of 1 in 1000; this was a period of increased immunization of American children.

(c) Then in 1996, the NIH estimated the rate of autism to be 1 in 500, and just recently the CDC has found 1 in 250 children affected with classic autism; this dramatic increase in the past decade coincided with the introduction and spread of two thimerosal-containing vaccines - the HIB and Hepatitis B.

MERCURY in vaccines for babies and infants could be the cause of a steep rise in cases of autism in children around the world, according to a growing number of scientists.

Estimates of the prevalence of the syndrome in Britain range from 10 cases per 10,000 of the population with “classic” autism, to 9.1 cases per 1,000 showing some signs of autistic behaviour.

The National Autistic Society estimates that there are about 500,000 people with autism in Britain, 120,000 of them children. According to one recent study, there has been a tenfold increase among children between 1984 and 1994.

There is an epidemic of autism in the US and the UK. We are losing children daily to this life-long disability and the sad part is that we can prevent this as well as develop research to look into immuno-therapeutic treatments that will help those already damaged.

First, the conclusion that autism has reached epidemic proportions is based on numbers and not rates. It does not take into account increasing populations, Fombonne notes.

Further, researchers made no attempt to account for changing diagnostic criteria used over the years. Nor does the data reflect the fact that children are now diagnosed at a much earlier age than 30 years ago, he writes.

“Prevalence data nevertheless point to the magnitude of the problem, which had clearly been underestimated in the past. But there is no need to raise false alarms on putative epidemics nor to practice poor science to draw the attention to the unmet needs of large numbers of seriously impaired children and adults,” Fombonne states.

While there have been conflicting reports on whether autism rates are on the rise, a new UK study indicates that pervasive developmental disorders (PDDs) like autism and Asperger syndrome are more common than previously believed.

“PDD is not as rare as once thought. Thirty years ago, we had a narrow view of autism, and we estimated the rate to be four or five children out of every 10,000 children,” lead researcher Dr. Eric Frombonne of King’s College in London told Reuters Health.

Most data indicate increased recognition and reporting as primary factors, but the epidemiologic data are insufficient to determine if there has been a true increase in the incidence of ASD (autistic spectrum disorder).

For reasons not at all clear, the rate of reported cases of autism is rising. Between the years 1987 and 1998, the latest figures available, the California Department of Developmental Ser-vices -- a statewide agency providing services and support to children and adults with developmental disabilities -- reported a 273 percent increase in diagnosed cases of autism, one of several diseases in a related spectrum that also includes Asperger's syndrome and Pervasive Development Disorder.

California isn't unique. Studies in Illinois, Florida, England, Iceland and Japan have all recorded incidence rates of autism much higher than previously assumed, some worse than here. A decade ago, it was estimated that one child in 10,000 would become autistic; now the number has dropped to 1 in 500, and less. Autism activists have a word for what's happening: epidemic.

But is it? Like almost everything else about autism, indisputable facts about the disease are scarce. At least some of the increase is likely due to improved techniques for diagnosing the disease and a greater social willingness to do so.