300,000 Children in U.S. Found to Have Autism

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300,000 Children in U.S. Found to Have Autism*

By Shankar Vedantam

<http://projects.washingtonpost.com/staff/email/shankar+vedantam/>

Washington Post Staff Writer

Friday, May 5, 2006; A09

http://www.washingtonpost.com/wp-dyn/content/article/2006/05/04/AR2006050401724.\

html

About 300,000 American children have been diagnosed as having autism,

according to the first comprehensive national surveys of the

developmental disorder.

Boys were four times more likely than girls to have the disorder, which

is characterized by verbal, social and emotional problems. White

families with higher incomes were also more likely to report having

children with the disorder, a fact that federal experts said probably

reflected unequal access to medical services.

The new data came in two surveys released yesterday by researchers at

the Centers for Disease Control and Prevention, who said the numbers

matched the range found by earlier studies that looked at smaller groups

of people.

Autism has been dogged by controversy for more than a decade after what

appeared to be a sharp increase in diagnoses in the 1990s. Many experts

believe the increase reflects changes in diagnostic criteria adopted in

1994, increased public awareness of the problem, and the difficulties in

telling apart a number of overlapping conditions that fall under an

umbrella known as autism spectrum disorders. Some advocates have blamed

a mercury-based preservative in children's vaccines, even though

repeated analyses have failed to confirm a link.

The new surveys show that Hispanics have a much lower autism rate than

whites, but experts said that this probably reflected differences in

access to care.

" This does provide important results on the need to consider autism may

be under-diagnosed in certain populations, " said Schieve, an

epidemiologist at the National Center on Birth Defects and Developmental

Disabilities, at a teleconference organized by the CDC.

Schieve and José Cordero, director of the birth defects center, said

both surveys showed some differences in autism prevalence by age group

-- with children ages 6 to 11 more likely to be diagnosed than those

ages 4 to 5. However, they said the differences were not statistically

meaningful and could not address whether the decision to phase out the

mercury-based preservative from children's vaccines in 1999 had led to a

leveling off or fall in autism diagnoses.

Cordero said it was far more likely that the age-group differences in

prevalence reflected the fact that many children are not diagnosed until

they enter school and teachers recognize the problem. That means the

number of diagnoses among the 4-to-5-year-olds in the surveys could rise

as they enter school.

" Let's do it again next year and the year after, " said Goldstein,

president and CEO of the Kennedy Krieger Institute at s Hopkins

University, which has a large autism research program. " My prediction is

you are going to see a rise in the younger ones. If it was going away,

which I would love, you would see a falling number. "

Goldstein said the racial and class differences in diagnoses reflected

the fact that getting a diagnosis often requires that parents be

effective advocates, at least in the years before children arrive in school.

" It's not like leukemia or a broken bone where a diagnosis will be made

no matter what your social class is, " said Goldstein, who is also a

board member at Autism Speaks, an advocacy group focused on research and

awareness. " You have to be an advocate. "

Bell, chief executive of the Cure Autism Now Foundation, an

advocacy group, said the fact that some children do not get diagnosed

before they reach school is troubling. Early diagnoses, he said, allow

for early interventions, which are more effective.

Two local researchers who have long claimed there is a link between the

mercury additive thimerosal and autism said the CDC numbers suggest

there is a connection. Mark and Geier, a father-son team, said at

the very least the CDC data showed a leveling off in autism diagnoses.

" In early 2003, we looked at a number of databases and how much mercury

children were getting from their shots, and we said there is a causal

relationship between thimerosal and autism, " Geier said.

" Thimerosal started to be removed in July 1999. We predicted the rates

of autism would begin to decrease. What we are seeing is decreasing

trends. It coincides with children getting less mercury in their shots. "

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