When awareness of a disease or disorder hits critical mass, often its rate of diagnosis increases. That provokes the chicken-and-egg question of which came first, the incidence of disorder or the awareness of it?

In recent years, many people have looked at autism, and the spectrum of autism disorders, through that lens. A recent study boosts the notion that the prevalence of autism in children is increasing. The U.S. Centers for Disease Control and Prevention concluded that 1 in 88 8-year-olds has some form of autism. The previous estimate was 1 in 110.

Based on 2008 data, the updated figure is sure to fuel debate, according to the Los Angeles Times, over whether a growing environmental threat could be responsible. “But autism researchers around the country said the CDC data—including striking geographic and racial variations in the rates and how they have changed—suggest that rising awareness of the disorder, better detection and improved access to services can explain much of the surge, and perhaps all of it.”

Some experts questioned the validity of relying on records to reach the new estimate.
David Mandell, an autism expert at the University of Pennsylvania, told The Times that the CDC's numbers primarily reflect the degree to which the diagnosis and services have become established in different places and among different groups.

"As the diagnosis is associated with more and more services, this becomes a less and less rigorous way to determine the prevalence of autism," he said, referring to the CDC's methods.

Among the CDC’s results:

• Utah, which has widespread screening programs, had the highest rate—1 in 47 children.


• New Jersey, which also boasts generous autism services, is next at 1 in 49.


• Alabama, one of the poorest states in the country, ranked last. Its autism rate fell between 2006 and 2008 from 1 in 167 to 1 in 208.

The researchers’ goal was to focus attention on the need for more vigorous screening early in life. Early intervention has been shown to confer the best long-term prospects for autistic children. More than 1 in 5 children deemed autistic by the CDC had no such diagnosis in their records.

A recent series of studies in the journal Nature indicated that the genetic origin of autism is complicated and involves multiple genes. The cause of autism is unknown. There is no blood test or other biological marker—it’s diagnosed by symptoms, which are social and communication difficulties starting in early childhood, and repetitive behaviors or abnormally intense interests. The severity of symptoms can vary widely. Boys are more likely to have the disorder, and whites somewhat more likely than minorities. Ultimately, a diagnosis involves clinical judgment.

Some people, including representatives of Autism Speaks, an advocacy group, believe that the disorder is becoming epidemic in the United States. Others say raised awareness of the disorder enables health-care providers and school authorities to deem a child autistic.

To learn the symptoms of autism, link here. Autism Speaks’ Autism Response Team (ART) members are trained to connect families with information, resources and opportunities. Contact them at 888-288-4762.