| A shocking report from
California last week suggested that a large increase
in childhood autism in that state over the last
15 years is a true epidemic, not a statistical mirage
inflated by artificial factors. If that judgment
holds up after further analysis and research, it
raises disturbing questions about just why this
brain-distorting disease is on the rise and what
can be done about it.
Experts have known for some time that there seemed
to be a big upsurge in autism in California -
a tripling in little more than a decade of the
number of children with profound autism receiving
services from the state. The state's Department
of Developmental Services found that the number
of children with "full spectrum" autism
jumped from 2,778 in 1987 to 10,360 in 1998 and
continued to rise thereafter. That was bad news
indeed given that autism is a crippling brain
disorder that often leaves its victims unable
to speak, rocking compulsively, and unable to
form social relationships or behave normally in
everyday life.
Last week's report, commissioned by the California
Legislature and conducted by researchers at the
University of California at Davis, concluded that
the upsurge could not be explained away by demographics,
changes in the way autism is diagnosed or increased
migration of autistic children into California.
But whether the study looked hard enough for all
possible explanations will need to be addressed
when outside experts have a chance to review the
findings. One possible weakness is that the study
dealt only with autistic children receiving services
from the state's regional centers. It did not
examine whether parents and professionals are
referring more children with autism to the centers
today than in the past.
California's self-examination has underscored
the surprising lack of information about the prevalence
of this relatively rare brain disorder elsewhere
in the nation. Studies carried out by the federal
Centers for Disease Control and Prevention in
recent years found that the number of cases in
metropolitan Atlanta and in one New Jersey township
were significantly higher than previous estimates
of prevalence wouldsuggest. But nobody knows for
sure what the nationwide trends are. The C.D.C.
is financing studies in a dozen other states to
determine the prevalence there.
Virtually all experts agree that genetics play
an important role in autism, but genes don't propagate
fast enough to cause a sharp change in a decade.
Some experts believe that environmental factors
can trigger autism in people with susceptible
genes, with suspicion falling at various times
on vaccines, infections, heavy metals and other
environmental insults. The evidence, unfortunately,
is sparse. It could take years of study to unravel
the widening mystery of autism.
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