|By Lindsey Tanner for Associated Press.]
Mention autism to parents, doctors and scientists these days, and among an earful of different theories will emerge a common nod of agreement: The perplexing condition is not nearly as rare as once was thought. As recently as a decade ago it was estimated that only about 4 in 10,000 children were affected. Research now suggests the rate may be at least 10 times higher.The numbers have fueled debates over whether there has been a true
surge of cases and whether environment or genetics could be the cause.
Some parents and research advocates blame vaccines despite evidence to the
But many mainstream scientists point to two much less worrisome
explanations: The definition for autism has changed and schools now offer
more educational services to autistic kids.
In 1991, the U.S. Department of Education made autism a new,
separate category for special education services offered at public schools. Those
services tend to be broader and more intensive than for other disorders,
including mental retardation. There’s evidence that the 1991 change
prompted “diagnostic substitution,” said Dr. Fred Volkmar, a Yale University
“Everybody’s interested in getting better services,” he said.
Statistics seem to back up the theory. Department of Education
figures show that the number of children getting services for mental retardation
fell from 553,262 in 1991-92 to 532,362 in 1992-93. During those years,
the number of children getting services for autism swelled from 5,415 to
The change in school services and the definition, along with research showing that early intervention could help, raised awareness of the condition.
Autism used to be thought of as “the kid who sits in a corner
watching the record player go around and around. Everybody said that’s what
autistic is and anything else is not,” said pediatrician Joel Schwab.
Like many doctors, Schwab said, he may have inadvertently diagnosed
autistic youngsters a decade ago as being mentally retarded, or with
nondescript behavior problems.
Now, autism increasingly is recognized as “being more than just the
classic picture,” he said.
Molecular biologist Andy Shih, director of research and programs for
the National Alliance for Autism Research, says that whether there has
been a surge in cases, “what is clear is that autism is a serious public health
“With potentially 1 million Americans afflicted with this disorder,”
Shih said, “it is no longer something that is rare or seldom seen.”
The impact has reached far outside the medical realm.
Many schools are struggling to provide enough services to affected
children, funding for research into causes has grown, and lawsuits blaming
vaccines are proliferating.
“There’s just so many kids who have been affected, it’s hard to find
somebody who doesn’t know somebody who has a kid with autism,” said Liz
Birt of Wilmette, Ill., whose 9-year-old son, Matthew, is autistic.
Matthew developed normally until he was 15 months old. He developed
autism symptoms gradually after receiving two childhood vaccinations on
the same day, Birt said. He stopped talking, acted as if he was deaf, spun in
circles, stared at lights and shunned his family.
Within seven blocks of their suburban Chicago home, five other
children also are afflicted. “It’s just rampant,” Birt said.
Autism even ended up in a debate over a last-minute provision
attached to Homeland Security legislation enacted last fall. The provision, aimed
at protecting drug makers from lawsuits over vaccine-related injuries,
prompted protests in Washington in January by parents who think childhood vaccines cause autism.
Much has been learned about autism in the past half century. The
once prevailing “refrigerator mother” theory suggesting cold, aloof mothers
caused autism was long ago thrown out as scientific advances favored a
But many key questions remain. Researchers don’t know if a single
gene or many are involved, or possibly different ones in different cases.
Some think environmental factors might trigger the disease in
genetically susceptible people. Potentially plausible but unproven
triggers range from illness during pregnancy to soil toxins, electromagnetic waves
and even vaccines, though strong evidence so far suggests the shots are
“There’s so many things that it could be,” said Dr. Robert Byrd of
the University of California at Davis. A recent study suggested autism cases
in California surged nearly 300 percent over 10 years, and Davis researchers
are trying to pinpoint why.
Autism has raised deep questions ever since psychiatrist Leo Kanner
first described it as a distinct developmental