Autism Numbers Rise Dramatically
There have been vast improvements in diagnostic testing and a significant change in the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) from DSM-IV, contributing to the change. These changes include a significant shift in diagnosis criteria, such as reclassifying Asperger’s to a broader autism diagnosis. With broader definitions and diagnoses, new numbers reflect higher numbers while the number of reported cases per capita may remain stable.
Those who are autistic and older will likely not be counted as the metrics have never been structured correctly. The first count did not include an accurate number of Americans and began by counting school children because at the time, autism was presumed to be a pediatric condition, and schools provided the easiest place in which counting could be performed. There are many flaws with this metric.
Among these flaws – children who are home schooled are not counted. In areas of the country with few diagnosticians, and few school resources for testing or evaluation, children were totally bypassed. One example, Thomas, living in the rural area of his state was autistic, but not intellectually disabled. His autism was high functioning, so the school never included him with developmentally disabled children. Training available to teachers in some areas is extremely limited, so none of his teachers noticed his condition. Even Thomas’ doctors never noticed it – neither his pediatrician nor his primary care doctor as an adult.
Parents, often blinded by love and disbelief, learn of the child’s condition from grandparents, aunts, uncles, cousins, neighbors and others who notice the lack of eye contact, and unusual behaviors like hand flapping, stacking toys or other objects, and single-subject fascinations. Thomas, now 27, still says repetitive things in a continuous string of statements. Thomas was diagnosed at age 26, but had to travel a long distance to find a qualified specialist to conduct the diagnosis.
Michael, another young man, now 36, was not high functioning, was nonverbal all his life, but his doctors presumed he had some kind of problem with his larynx and never looked at the young boy’s eye contact, habits, or behavior. Michael was diagnosed finally, at age 22, and has had serious difficulty living as an adult. When his parents died, he was left penniless, and alone, without support.
The care of autistic adults is very important because every single autistic child becomes an adult in fairly quick time. Autistic adults who had little or no support as children have a very difficult adulthood, as financial resources for their long-term care are often unavailable. Parents who do not deal with their child’s autism early usually neglect to set up special needs trusts to provide life-long care.
So, when the CDC reports 1 in 45, we have to seriously believe that one day, very soon, that will be 1 in 30.