Since my son was diagnosed with Autistic Disorder in 1998 the rates of diagnosed autism have risen dramatically from 1 in 500 to the current estimated rate of 1 in 88.  There is common acknowledgement that a substantial increase resulted from the DSM-IV changes which pushed acceptance of Aspergers as part of an autism spectrum.  Social factors such as increased awareness and availability of services under an autism label have also been cited.  Some purported autism experts  though have concluded that the dramatic autism increases are entirely attributable to diagnostic changes, increased awareness and the desirability for service reasons of an autism diagnosis. One such  autism expert is Behavior Analyst Steve Taylor who proclaims  in the Modesto Bee that "Autism isn't spreading, but the diagnosis is". 

The dramatic increases have also taken place during years when genetic autism research received an overwhelming share of the autism research dollar. Calls for increased funding for environmental autism research by respected researchers like Hertz-Picciotto, Pessah, Landrigan, Birnbaum and others have not  tilted the balance dramatically away from the "its gotta be genetic mindset".  No study proving that the overwhelming increase in autism disorders is caused entirely by diagnostic change and increased social awareness has been produced.  No study producing a genetic explanation for all or even a significant number of autism disorders has been produced.  Very few environmental autism studies have been funded compared to genetic studies and yet the Steve Taylors of the expert autism community claim that there is no real increase at all.  

As they did with the refrigerator mothers theory of autism a few decades ago many of the world's autism "experts" embrace as an article of faith that autism isn't increasing.  Once again too the finger is pointed, at least in part, at parents ..... this time it is parents seeking services for their children as stated by Taylor in the  Modesto Bee:

"I'm still working with the same kind of kids, but everyone today seems to have autism. I met an area family for the first time recently and the 3-year-old I was there to help looked me in the eye and told me, "Go home." He's got autism, now.

From last years increase of autism prevalence rates from 1 in 110 to 1 in 88 a new report, based on parental reporting now indicates a rate of 1 in 50. Time once again to call out Inspector Renault (looking much like Insel, Grinker and other autism can not really be rising true believers) to round up the usual suspects of increased awareness, ascertainment and any other non environmental excuse they can manufacture to rationalize the failure to conduct the necessary environmental research into autism causation. Following is last years comment on the tired and pathetic posturing of the autism epidemic apologists:

The LA Times has written an  ill informed, one sided, article on autism increases which misleads the public into believing that the evidence has clearly established that the entire increase in autism diagnoses over the past two decades is attributable to the 1994 DSM diagnostic manual changes, diagnostic substitution, and the hunt for government funded autism services. The article, Discovering Autism Unraveling an epidemic, can be summarized in the following paragraph from the article:


"Two decades into the boom, however, the balance of evidence suggests that it is more a surge in diagnosis than in disease."

The truth is the LA Times article publishes no reference to studies that confirm that conclusion about the alleged balance of evidence.  The LAT does refer dismissively to Dr. Irva Hertz-Piccioto who has conducted research on possible environmental causes of autism disorders.  It also offers selective quotes from a variety of other autism sources, in addition to Roy Richard Grinker, the anthropologist and father of a high functioning child with Aspergers, who has sought out all the allegedly autistic Korean children who function very well in Korean society.

What the article does not mention is the emerging consensus that autism arises not just from genetic factors, which would support the biased perspective the LAT offers, but from the interaction of genetic and environmental factors.  Nor, in dismissing Dr. Hertz-Picciotto's work, does it mention that genetic autism research has been overwhelmingly funded at the expense of environmental autism research.  Better to present positively the opinions of a biased anthropologist with an agenda then an actual autism researcher.

Dr. Bearman, a sociologist, is also quoted but not in any meaningful way. He was interviewed more fully, or quoted more fully, in an article on the National Institute of Mental Health website reporting a discussion Dr. Bearman had with Dr. Tom Insel of the IACC:

Dr. Insel: From what you know now when you add all of those together how much of the increase can you explain?


Dr. Bearman: Well that’s a complicated question, but I think we can pretty uniquely associate about a quarter of the increase from the birth cohorts from 1992 to 2001 which is a lot, to diagnostic change on the border between diagnosis and mental retardation in autism. I think we can associate about 16 percent of the increase on the other border between autism and other neurodevelopmental disorders on the spectrum: Asperger’s, PPDNOS etc. And those are largely non over-lapping components of increase, so that’s about 40 percent. I think the spacial clustering itself adds another few percent. I would say I am confident that 40 percent of the increase I think I know what caused that. That leaves a lot of increase left, 50 percent is a lot to look for still.


Dr. Insel: Any ideas about what’s driving that other 50 percent?


Dr. Bearman: Well, some is genetic. I think that the increased parental age accounts were 11 percent of the increase over this period and that’s a lot and the mechanism by which increased parental ages expressing itself I think likely largely genetic. I think the tricky part is going to recognize that it would be harder now to find that 50 percent. It would look like it should be some toxicological environment that’s shared because of the spacial clustering. Because there’s a very strong process of amplification of the understanding of autism that leads to increased diagnosis as parents learn how to recognize symptoms a very, very, small event that would transform the environment five years ago, ten years ago, even you could imagine, 40 years or 50 years ago, when the moms of children with autism now were in utero as eggs- a very small event could cascade into a larger epidemic now."

The LA Times could have checked out the web site of the IACC, the Interagency Autism Coordinating Committee which states:

"As with many complex disorders, [autism] causation is generally thought to involve some forms of genetic risk interacting with some forms of non-genetic environmental exposure. ... In addition, a number of other environmental factors are being explored through research because they are known or suspected to influence early development of the brain and nervous system. Recent studies suggest factors such as parental age, exposure to infections, toxins, and other biological agents may confer environmental risk. ... Progress in identifying environmental factors which increase autism risk has been made recently (Eskenazi et al., 2007; Palmer et al., 2006; Palmer, Blanchard,; Wood, 2009; Rauh et al., 2006; Roberts et al., 2007; Windham et al., 2006), although this area of research has received less scientific attention and far fewer research dollars than genetic risk factors" [Underlining added - HLD]


- United States IACC (Interagency Autism Coordinating Committee)

No one disputes the obvious fact that the 1994 DSM changes increased the number of autism diagnoses.  The LAT implies though that the "science" indicates that the increase in autism diagnoses is simply a matter of diagnostic change and substitution and that environment plays no significant role in causing autism disorders. That position amounts to a confession of ignorance and/or bias by the LAT ... and a lack of concern over whether the number of autism diagnoses could be decreased if the research dollars were distributed more evenly towards research of environmental causes and triggers of autism disorders. 

The article began by reporting another large contribution to Autism Speaks by Summer Redstone and outlined briefly some of his other generous contributions to medicine and health care. It included  a no nonsense realistic description by Dr. Dawson of autism disorders and the challenges they present to those who suffer from them.  Not a whiff of  feel good "autism is beautiful" stuff. It indicated  point blank that autism is increasing without any of the usual attempts to obscure the increase that often accompany reports of new increases in autism rates. What I found most interesting though was the concise and clear description of the focus of Autism Speaks research:

"We are actually very hopeful at this point that we will be able to conduct clinical trials with people with autism in the upcoming few years," says Dr. Dawson. "That's never been done. We've never really been as hopeful as we are now."


I hope that Autism Speaks does not abandon any of its contributions to researching the causes of autism, particularly to the woefully underfunded environmental causes of autism, but I am very pleased with the efforts to find new treatments.  The goals of exploring the biological basis of autism disorders, the common pathways in the brain implicated in autism disorders, and Dr. Dawson's expression of optimism that medicines aimed at restoring the functions of those pathways will be developed in the upcoming years is clear, sensible and ... focused.  It is that focus which is so important and which I had begun to think was missing in Autism Speaks' activities.

Many parents hope for the development of treatments, of medicines, which will help their autistic loved ones but many of us grow skeptical, if not outright cynical, after seeing so many false starts and so much spin and hoopla over very little.  Dr. Dawson has stated that she and Autism Speaks are actually very hopeful for development of new medicines that will actually help the general population of persons with autism disorders and explained why they feel that way.  I believe she is speaking honestly and is in a position to know what she is talking about.

I am, once again, optimistic about Autism Speaks and the future of autism research.

"Based on the above mentioned research, 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%). While this research is beginning to help us understand the increase in autism prevalence, half of the increase is still unexplained and not due to better diagnosis, greater awareness, and social factors alone. Environmental factors, and their interactions with genetic susceptibilities, are likely contributors to increase in prevalence and are the subject of numerous research projects currently supported by Autism Speaks.

The increase in autism prevalence is real and the public health crisis is growing. More families are affected by autism today then ever before."

Autism Speaks Official Blog, October 22, 2010

The above statement by Autism Speaks was based on several published sources and CDC information. including articles by authors Bearman and King, who have indicated that approximately 50% (47%) of autism prevalence increases are based on factors other than social factors. Now Autism Speaks and the Centers for Disease Control and Prevention (CDC) are co-sponsoring a workshop  on February 1, 2011 to investigate the changes in autism prevalence over time in the United State:

"The purpose of this workshop is to identify promising directions, priorities, and needs for better understanding ASD prevalence trends. The workshop will include presentations on what has been done to understand reasons for ASD prevalence changes, examples of understanding prevalence change from other conditions, and panel breakout sessions to allow for further discussions.


This meeting is open to the public with pre-registration required by January 24, 2011 for US citizens and January 13 for non-US citizens."

Autism Speaks Official Blog, January 5, 2011

While Autism Speaks has been puzzling at times in its efforts to "speak" about autism disorders, promoting the careers of purported autism spokespersons who question the very existence of autism as a  medical  disorder,  the importance of the above initiative can not be overstated.  For far too long the "it's gotta be genetic" mindset has held sway and prevented substantial scientific exploration of possible environmental causes or triggers of autism. Hopefully the recent US Senate hearings, official statements by the IACC acknowledging the emergence of a gene environment interaction paradigm, the CHARGE study, work by Dr. Irva Hertz-Picciotto and UN Davis M.I.N.D. researchers,  and efforts like the Autism Speaks/CDC prevalence workshop will lead to further environmental autism research; research which should have been commenced  years ago.

Obviously if the increases in autism diagnoses did not reflect real increases in autism there would be no merit to the CDC position that increased autism rates confirm that thimerosal does not cause autism.   The increases in autism diagnoses are real, autism IS rising, the CDC says so.