Presently, the Centers for Disease Control and Prevention (CDC) calculates that 1 in 68 children are diagnosed with autism. This number has been skyrocketing over the years, but is it real? The United Nations also says that autism affects one percent (1%) of mankind, but is that figure real? If these numbers are not real, then what’s the truth?
Taking this from an economist’s perspective, we have to look at the metrics and discover any flaws in the methodology. The first thing that springs to mind is age. The age of those being calculated isn’t necessarily the right metric.
The figures presume that autism is a childhood condition or discovered in childhood. This isn’t true. Today, people are diagnosed with autism at all ages. However, we’ve discovered that it’s extremely difficult for adults with autism to actually find a diagnostician to conduct a proper evaluation and testing.
If a person is diagnosed after a certain age (8 years old), they are not counted in this calculation. While the figure does factor into account the aging of this population, it’s multiplying the 8 year olds, not considering any of the following factors:
- The population of autistic citizens already existing prior to the start of the calculation who were never diagnosed.
- Adults diagnosed outside the statistical age group, specifically adults, but also older teens and senior citizens.
- Adults, children and teens who’ve received a mis-diagnosis which ignored autism in favor of a different disability.
- Adults children and teens who’ve never been diagnosed in any manner.
With regard to autistic citizens uncounted, let us remember that autism is a relatively new diagnosis, and prior to the end of World War II, wasn’t known by this name, or counted. In the days prior to 1943, those with some degrees of autism were classified by doctors as suffering mental retardation, but not all people with autism were counted even among that classification. Some were kept at home, raised by parents and others died at early ages due to their risk-taking and wandering. As a result of such things, no initial count of autism could have been accurate when counting first started. This likely explains the reason the CDC counts children only. It was the only group from which accurate counts could be obtained via schools and doctors.
Even after school age children were counted, adults with autism who were never diagnosed remained an uncounted population. well into the early 1980’s. The reason for this is that again, many adults with autism, particularly high-functioning or extremely serious autism were never among the counted populations. One might presume that someone with severe autism would have been diagnosed as they’d need medical care.
Unfortunately, this isn’t true. Doctors treated any one of a number of serious medical conditions that accompany severe autism, and prioritized their diagnosis on those without examining the possibility of autism. If the patient was unusual in behavior, it was considered a form of retardation, likely caused by oxygen deprivation at birth, or by alcohol or drug use by the mother during pregnancy.
Mis-diagnosis is still a common occurrence with autism. If a doctor, particularly a family physician, isn’t trained in this condition, he or she will not necessarily observe the tell-tale signs, or order testing. One of our own corporate officers has seen doctors all his life, but none considered his condition to be Asperger’s. Syndrome. He didn’t have a clue about his condition until someone said “Hey, you’re just like that guy in ‘The Big Bang Theory'”.
The problem for doctors isn’t just the lack of training, but also geo-demographics. A doctor who practices in a remote area, is less likely to make any effort to learn about the condition believing there’s little need to do so. Additionally, some doctors specialize based on the demographics of an area. In New Jersey and Florida, you will likely find more geriatric specialists than neuro-psychiatric or clinical psychologists because of large aging populations in some areas.
Due to the complexities of autism, many who have conditions such as Epilepsy, and even today, doctors focus on this, ignoring the person’s autism for the conditions they understand. Further compounding this is a doctor’s constant fear of malpractice, resulting in their opinion that by not diagnosing a condition the person has lived with, and will continue to live with, leave it to a specialist to diagnose and just remain silent until that diagnosis comes back to him or her.
We must also consider economic conditions in diagnosis as well. Those who don’t have sufficient medical resources due to economic conditions or, who live under strict controls on medical coverage due to government policies are less likely to see doctors capable of diagnosing the condition. Still further, health insurers usually require referrals, and in some regions or under some policies, referrals may be impossible to obtain, leaving numbers of people undiagnosed.
If the medical community in the United States isn’t properly diagnosing autism across all age groups and economic levels, what happens in third world countries where medical care is sparse or under-trained? The answer is that people with autism are simply not diagnosed at all, and in large numbers. Still worse, people with autism are often deemed a problem in some countries and ‘disposed of’ by killing early in life, if detected.
When taking into consideration all the populations excluded from the CDC’s and UN’s calculations, it is reasonable to conclude they probably are quite shy of reality. Though we’re not capable of better calculation, we’re able to say the inadequacies of the present methodologies result in exceedingly low figures on a United States national level, and on a global level. The prevalence of autism is far greater than previously estimated or calculated.