Almost one percent of American children had an autism spectrum disorder (ASD) in a large CDC surveillance study whose lead author called the condition a "significant public health issue."
Across 11 sites in the U.S., ASD prevalence in 2006 ranged from about one out of 80 children to one out of every 240 children, with an overall prevalence of one in 111 youngsters, according to a report by investigators from the CDC's Autism and Developmental Disorders Monitoring (ADDM) Network.
They reported their findings in the Dec. 18 Morbidity and Mortality Weekly Report.
"These new numbers are concerning and indicate that even more individuals, families, and communities are struggling to find answers," said lead author Catherine Rice, PhD, of the National Center on Birth Defects and Developmental Disabilities, during a conference call with reporters.
The overall estimate is slightly lower than that from a study using data from the 2007 National Survey of Children's Health -- one in every 91 children -- that was published in October. (See Wider Net Catches More Cases of Autism Disorders)
However, among 10 ADDM sites that reported data in both 2002 and 2006, there was an average 57% increase in ASD prevalence. No single factor could explain the rise, researchers said.
Overall ASD prevalence was 4.5 times higher in boys than in girls: about one in every 70 boys and one in every 315 girls.
From 2002 to 2006, prevalence increased 60% in boys and 48% in girls (P<0.001 for both).
"Some of the increases are due to better detection, particularly among children who may not have come to attention in the past, including girls, Hispanic children, and children without cognitive impairment," Rice said.
"However, a simple explanation is not apparent and a true increase in risk cannot be ruled out."
Janet Farmer, PhD, of the Thompson Center for Autism and Neuro-developmental Disorders at the University of Missouri in Columbia, said that, taken together, the current findings and those presented in October" add substantially to the body of evidence that the prevalence of autism is increasing."
The American Academy of Pediatrics has recommended that all children be screened for autism when they are 18 and 24 months old.
These findings should reinforce that guidance, according to Shlomo Shinnar, MD, PhD, of Albert Einstein College of Medicine in New York.
This is "especially important, as early recognition and treatment improves outcomes," he wrote in an e-mail.
In a statement on its Web site, the advocacy group Autism Speaks placed the burden of dealing with ASDs on the federal government, calling for enhanced efforts and increased funding.
"Now that the government has confirmed that one percent of American children have autism, the question becomes what it will take to get our elected leaders to wake up and take on this crisis in an appropriate way," said Bob Wright, co-founder of the organization.
"We need meaningful action now that acknowledges the scope of this problem and allocates the resources necessary to take the fight against autism to a new level," he said.
In a teleconference reporting the October findings, Tom Insel, MD, director of the National Institute of Mental Health, said President Barack Obama has proposed an increase in funding for autism research from $42 million this year to $48 million next year.
In 2006, the ADDM Network collected data from 11 areas of the U.S., including parts of Alabama, Arizona, Colorado, Florida, Georgia, Maryland, Missouri, North Carolina, Pennsylvania, South Carolina, and Wisconsin.
Health and education records were retrospectively reviewed to identify children with ASD, including autistic disorder, pervasive developmental disorder not otherwise specified, and Asperger disorder. Only 8-year-olds were analyzed because previous studies have shown most children have been diagnosed by this age.
In 2006, ASD prevalence ranged from 4.2 per 1,000 children in Florida to 12.1 per 1,000 children in Arizona and Missouri.
All sites but Florida contributed data to the 2002 assessment. Among these sites, all but Colorado reported a significant increase in ASD prevalence ranging from 34% to 95% (P<0.01).
ASD diagnosis was made at a slightly younger age in 2006 than in 2002, but it was still delayed to an average age of 53 months. That was so despite the fact that anywhere from 70% to 95% of children had developmental concerns noted in their records before age 3.
ASD was more prevalent among non-Hispanic whites (9.9 per 1,000) than among non-Hispanic blacks (7.2) and Hispanics (5.9) (P<0.001).
Susan Hyman, MD, an expert in developmental disabilities at the University of Rochester in New York, said these are "important data for public health officials examining etiologic associations, educational services planning to meet the needs of the students they serve, and social service organizations who need to plan for adolescents and adults who will ultimately transition out of the educational system."
Responding to the report, Lisa Ackerman, executive director of the advocacy group Talk About Curing Autism (TACA), said in a statement that the group "strongly believes that we have a national epidemic on our hands that is not being adequately addressed."
The rapidity of the increase, the organization said, points to an environmental cause for the disorders.
"Therefore," the statement read, "we need to explore and research the environmental triggers that are affecting our children at approximately the same time in their lives -- regardless of race and ethnicity."
Rice said, "The CDC considers ASDs to be a significant public health issue. Increased concern in communities, continued demand for services, and increasing estimates of ASD prevalence underscore the need for a coordinated and strong response to improve the lives of people with ASDs"
According to Dr. Robert O. Young, Director of Research at the pH Miracle Living Center, "ASD is the result of many different acidic contributors, including vaccinations, antibiotics and acidic foods and drinks. I have found great success in the prevention and reversal of ASD's with an alkaline lifestyle and diet. When children with ASD clear their bowels their brains clear as well. I have also found in all children with ASD low sodium levels and congestion and/or damage to the small and large intestine. The focal point of reversing ASD must be a holistic approach with a focus on healing the small bowel which in turn will calm the brain."
Primary source: Morbidity and Mortality Weekly Report
Rice C, et al "Prevalence of autism spectrum disorders -- autism and developmental disabilities monitoring network, United States, 2006" MMWR 2009; 58: 1-24.
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