Autism at epidemic levels

Friday, January 1, 1904

Parents, health care professionals and educators have known for some time that the number of U.S. children with autism and related disorders is on the rise. But it's likely that even they are stunned by a Thursday report from the Centers for Disease Control and Prevention that estimates that 1 out of every 88 American children -- about 1 million -- is now affected by some form of autism. That's an increase of 78 percent compared to a decade ago. Given those alarming numbers, it is obvious that autism has reached epidemic status in the United States.

What's particularly scary for parents of autistic children is that scientists and physicians are unable to provide definitive answers to questions about its cause. Moreover, they're unable to pinpoint the reasons for the increase, though they believe that enhanced screening programs and better diagnosis play a role. What they do know is that early detection is vital to treat the neurodevelopment disorder.

Early detection, experts say, leads to early intervention and treatment. "The earlier kids are detected," says Dr. Thomas Frieden, CDC director, "the earlier they could get services, and the less impairment they'll have on their learning and in their lives ..."

Currently, the CDC reports, most children are diagnosed with autism between ages 4 and 5, when a child's brain is already more developed and harder to change. The CDC recommendation: Kids should be screened between the ages of 18 and 24 months. Doing so could positively affect tens of thousands of children and their parents.

Early treatment can't cure autism, but programs to moderate behavior associated with it can reduce in many instances the impaired language, poor communication and underdeveloped social skills that are hallmarks of the disorder. In the battle against autism, that counts as an important victory.

Even as screening, diagnosis and treatment improve, the effort to identify autism's cause continues. Scientists do know that genetics can play a role, but to what extent remains a mystery. Other possible factors include medications taken by women during pregnancy, medications taken by children when they are young, and some problems in the immune system. In each instance, though, there's not enough evidence to establish a causal relationship. Researchers continue to pursue those and other possibilities.

Research does refute a popular theory about a cause. For years, many parents and even some scientists were convinced that vaccines or thimerosal, a chemical used in some childhood vaccines, or both, could be connected to autism. Exhaustive studies have failed to establish that connection.

What is certain, though, is that the number of children with autism is higher than ever. And despite progress in treatment, it remains a diagnosis that carries with it years of physical, emotional and fiscal upheaval for families, schools and communities. Expanded investment in research and treatment of autism remains the best antidote.