Autism ‘epidemic’ may be all in the label

Changing perception
Perception of the size of the problem changed, too.

Fourteen years ago, only 1 in 10,000 children were diagnosed with it. Prevalence estimates gradually rose to the current government estimate of one in 150.

That increase has been mirrored in school districts. Gwinnett County Public Schools — Georgia's largest school system — had eight classrooms for teaching autistic youngsters 13 years ago; today there are 180.

Some researchers suggest that as autism spectrum diagnoses have gone up, diagnoses of mild mental retardation have fallen.

U.S. Department of Education data show that the number of students with autism rose steadily, from about 42,500 in 1997 to nearly 225,000 in 2006. Meanwhile, the number of students counted as mentally retarded declined from about 603,000 to about 523,000.

CDC scientists believe education numbers are misleading, because they reflect only how kids are categorized for services. They say there's no clear evidence doctors are substituting one diagnosis for the other.

Environmental causes?
Some parents believe environmental factors — ranging from a preservative in vaccines to contaminants in food or water — may be important contributors. (The last doses of early childhood vaccines containing the preservative thimerosal expired in 2002, although some children's flu shots still contain it.)

Dr. Gary Goldstein, scientific adviser to the national advocacy group Autism Speaks, said the explanation for the rising autism prevalence is probably complex. Labeling and diagnosing probably play a role, as do genetics, but he believes the increase surpasses those two explanations.

Online autism resources Centers for Disease Control and Prevention autism information American Academy of Pediatrics autism reports

"I'm seeing more children with autism than I ever would have expected to see," said Goldstein, who is chief executive of the Kennedy Krieger Institute, a treatment center for pediatric developmental disabilities in Baltimore.

Autism Speaks budgets more than $4 million each year to research the causes of autism, and about 90 percent of that has gone to genetics research. But organization officials recently have been talking about changing that mix, and spending as much as 50 percent of that money on potential environmental triggers, Goldstein said.

Three brothers with autism
Whether it's because of genes or the environment (or both), autism has hit the Massey family hard. Chuck and Julia Massey, of Dacula, Ga., have three sons with Asperger's.

The youngest, Ryan, was first diagnosed after he was slow to develop speaking ability. His brothers — Trevor, 14, and Morgan, 16 — had learning and behavior problems and were later diagnosed with Asperger's, too.

All got special education services and were treated with medications. Morgan has improved, or matured, or both, and is now a social kid in mainstream classes at a Gwinnett County high school. Trevor seems to be making the same transition, his mother said.

Ryan is the most extreme. He still has uncontrollable tantrums and must attend an Asperger's-only sixth-grade classroom that teaches social skills along with traditional subjects.

In a recent interview at the family's home, Ryan acknowledged he still has anger control issues. One of the three other students in his class is particularly irritating. Ryan said the way he reacts is by "grabbing his throat."

But on this night, Ryan was calm. He described himself as happy, and paced the room telling jokes, like a nervous stand-up comedian. ("Why didn't the skeleton go to the party? He didn't have the guts," he said, eyes fixed on his audience.)

Having three Asperger's boys under one roof has at times been very intense, Massey said, noting a replaced dining room window.

Ryan acknowledged it's been educational living in a house full of Asperger's kids. Asked to name something he's learned from his brothers, he replied, "Swears."

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