Rate of autism diagnoses climbs, CDC study finds

— The likelihood of a child’s being given a diagnosis of autism, Asperger’s syndrome or a related disorder increased more than 20 percent from 2006 to 2008, according to a report released Thursday by the Centers for Disease Control and Prevention.

The new report estimates that in 2008 one child in 88 received one of these diagnoses, known as autism spectrum disorders, by age 8, compared with about 1 in 110 two years earlier. The estimated rate in 2002 was about 1 in 155.

The frequency of autism spectrum diagnoses has been increasing for decades, but researchers cannot agree on whether the trend is a result of heightened awareness, an expanding definition of the spectrum, an actual increase in incidence or some combination of those factors. Diagnosing the condition is not an exact science. Children “on the spectrum” vary widely in their abilities and symptoms, from mute and intellectually limited at one extreme to socially awkward at the other.

Children with such diagnoses often receive extensive state-financed support services, which some experts believe may have contributed to an increase in numbers.

Doctors working to update the Diagnostic and Statistical Manual of Mental Disorders have proposed significant changes to the definition of autism, due to take effect in 2013. If the changes are carried out, some experts say, they could reduce the number of children being given a diagnosis.

“One thing the data tells us with certainty: There are many children and families who need help,” Thomas Frieden, director of the CDC, said at a news conference Thursday.

CDC researchers did not meet any of the children they judged to have an autism spectrum disorder. The team made the decisions on the basis of evaluations of the children, drawn from 14 states. The estimated rates in those states varied widely, from 1 in 210 children in Alabama to 1 in 47 in Utah.

“This is a fourfold difference,” Eric Fombonne, a psychiatrist at McGill University and Montreal Children’s Hospital, said in an e-mail. “It means that ascertainment is unequal across states. Thus, in the next surveys, as ascertainment will most likely improve where it is currently low, average rates are bound to increase. Is there, in addition to this, a real increase in incidence? It’s possible, but cannot be determined from the study design.”

Overall, boys were almost five times as likely as girls to get such a diagnosis — at a rate of 1 in 54, compared with 1 in 252 for girls. The sharpest increases appeared among Hispanic and black children, who historically have been less likely to receive an autism spectrum diagnosis than white children.

Front Section, Pages 5 on 03/30/2012

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