Mark Henderson
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When Leo Kanner first described autism in 1943 it was thought to be extremely rare, affecting no more than one to three children in 10,000. Yet it is now so common, with a prevalence of between one in 300 and one in 100, that most people know an individual or family touched by it.
These statistics have given currency to the idea that there is an autism epidemic - and to fears that an aspect of modern life has made children more susceptible. This has fed unfounded scares about the role of vaccines.
Although autism is certainly diagnosed more often than it once was, that does not mean that more children are developing it. As a remarkable book being published next week explains, the condition is probably no more prevalent than it has always been. What has changed is that it is being recognised properly for the first time.
Roy Richard Grinker is the father of Isabel, an autistic girl, now 14. His book Unstrange Minds is a powerful memoir of his family's experience;of the struggle to obtain a diagnosis for Isabel and to have her needs catered for by the education system. It also describes her difficult but warm and rewarding personality and her family's joy as she learns to make sense of a confusing and often frightening world.
It is impossible not to be moved, not least by Isabel's transforming fascination with Monet's water lilies, and the moment when an argument with her non-autistic sister shows that she is starting to understand other people's emotions.
Grinker is also an anthropologist, who has used his skills to examine how cultural attitudes to autism affect our experience of the condition. His compelling argument is that there is no autism epidemic. The apparently rising incidence is the result of broader, earlier and more accurate diagnosis and greater awareness among doctors and patients.
Autism did not feature in the standard psychiatry textbook, the Diagnostic and Statistical Manual of Mental Disorders, until 1980. Later revisions broadened the criteria, placing more children in the autistic spectrum. One even contained an error that inadvertently widened the definition.
These changes, Grinker shows, matched the curve of the supposed epidemic. Children who would once have been considered mentally retarded or schizophrenic are today classed, more correctly, as autistic. So, too, are some higher-functioning children with autism-spectrum disorders, who previously escaped psychiatric attention altogether. These people were always there but have now been given an appropriate label.
Altered parental perceptions have made a difference, too. As autism has been diagnosed more often, it has become less frightening and more socially acceptable. Indeed, much less stigma is attached to this disorder than to mental retardation: many parents of atypical children now want them to be labelled autistic. Grinker's assessment of autism in non-Western cultures adds to his case that complex cultural factors cause the same symptoms to be interpreted differently.
The availability of social, educational and medical services can also matter. Grinker's home state of Maryland, for example, waives many medical fees for autistic children but not for the mentally retarded, creating an incentive for parents and their doctors to lean one way and not the other.
If Grinker is right, the so-called autism epidemic is not to be feared but to be celebrated. It means that children and adults who for centuries have been given the wrong diagnosis, or been missed altogether, are finally being assessed appropriately. That can only be good for research into the condition's origins and treatment. Most importantly, it will help the rest of us to understand and meet autistic people's needs.
Mark Henderson is Science Editor of The Times
Unstrange Minds (Icon Books, £14.99)
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Great article! I am an Aspie and I was misdiagnosed as a child. Unfortunately there is a lot of woo that circulates on the internet about autism and 'cures'
Autistic people simply want acceptance from others. Unfortunately ,as evidenced by some of the comments here, it's going to be a long road.
Jacque, USA,
There is no Autism epidemic - only better diagnosis. There are more Autistic people born because more Autistic adults survive (as opposed to being shunned or killed like they were in the past), get great education, have good jobs, marry and have Autistic children. I'm GLAD my children are like ME!
Rozagy, Birmingham, UK
Alfred Prunesquallor is a fictional character from a novel. There are no studies that can account for the genuine rise in autism. Just ask the doctors, the teachers, the speech therapists and those that are charged with allocating funds and placements for those with autism. This is fact, not fiction
Richard, Jersey,
The "better diagnosis" hypothesis is utter nonsense, as any pediatrician practicing more than thirty years will know. What is new is the epidemic of "regressive" autism, affecting normally developing children. Fears of vaccines are not unfounded. Rates are low in unvaccinated populations.
Fred, Portland, USA
In the scientific community there is no "standard denial of any increase" in autism . The hypothesis that the increase is mostly due to broadening of diagnostic criteria and younger age at diagnosis has been tested and confirmed in numerous peer-reviewed studies. You can check this on PubMed.
Alfred Prunesquallor, Niagara Falls, New York, USA
Could the "autisim epidemic" be something to celebrate? Not really, unless you can spell autism correctly in the sub headline of the article! In any case, it is time that the standard denial of any increase is tested, without prejudice to those whom were born autistic and also those whom were not.
Richard, Jersey,
Autism is just a term from the psychiatric DSM-IV manual. It's nothing but a smokescreen. It provides an alibi for all the perpetrators responsible for this mass brain poisoning . There are now 11 published papers which identify the underlying medical condition of autism as neuroinflammatory disease
Joe, Madison, usa
Unstrange Minds is a very good book, well researched by a Professor of Anthropology and father to an autistic child, as am I.
Unlike most of the commenters in this thread, he presents a cogent well reasoned arguement. I very much doubt that the commenters to this thread have read the book.
Kev, Staffordshire, UK
Autism is not a brand but like mental retardation or schizophrenia it is a blunt dumb label to describe something amiss. A brain is a complex organ in function and structure. If a computer goes awry there is the potential for a hundred thousand things to describe, neuroscience requires the same.
kevin, Lincoln, UK
Your language is appalling:
Children who would once have been considered to have mental retardation or schizophrenia are today addresed correctly as having autism.
Harold A. Maio, Ft Myers FL, USA
Les repeats again the chestnut about aging fathers. I made a calculation that even if the data was reliable (it isn't), and the average age of fathers went up by one year every decade, and the trend was maintained, it would take 90 years to double the autism rate. Not a significant contributer.
John Stone, London, UK
Massive rises in autism cannot be attributed to better diagnosis.Doctors are more aware of this condition because they are encountering more cases. Epidemiological studies, so far, have been mainly designed to refute any connection with vaccines. The result; no valid answer and flat earth reporting.
Richard, Jersey,
the fact is that in the very small percentages of children that have some mental retardation or autism they may need help, because our educational system is the way it is the only way to get all children the actual help they may need is to label them with a false disease called autism
Janie, Somerset, United States
Unbelievable, show me 1 in 86 adults rocking, flapping, stimming, self-harming, chanting & walking on tip-toes and tell me why Adult Services are so ill-prepared with this number already in the system, only then will this man-made (vaccine) induced living nightmare not be the epidemic it is.
Elayne, Kent, UK
Perhaps Mr. Henderson knows something that Dr. Bernadine Healy, former head of the National Institute of Health, doesn't know. She has stated that the autism vaccine question is unanswered and requires more research, but if the science editor says that fears are "unfounded", well, they must be!
Anita, Temple Herdewyke, UK
I think I would remember if all my siblings could not talk or speak in an understandable manner. My children are recovered now. Its a bacteria. The toxins and electrosmog make it worse, as do the vaccines, and gmo foods. Use Samento, Cat's Claw or other anti-bacterial herbs. Save your kids!
Heidi N, Texas, USA
Excellent review, Mr. Henderson. Although Roy Richard Grinker is an anthropologist, many psychiatric epidemiologists have also concluded that "there is no autism epidemic." See, for example, http://epiwonk.com/?p=38.
Alfred Prunesquallor, Niagara Falls, New York, USA
Latest research shows that autism cost the UK almost 28 billion pounds per year. The lifetime cost for an individual with autism is 4.7 million pounds. The human cost caused to many families of children with autism is immeasurable. What is there to celebrate ????
Jane Hogan, Ormskirk, Lancs
It seems to me, that if there were any other disease, the media would be declaring war. However, being that Big Pharma & the government created this mess, in order to create at treatment, they would have to reveal the cause. 'Celebrate'? Heck NO! We're Fighting!! AUTISM IS TREATABLE. NOT a gift!
Jenna Myrick, Newton, USA
I was saddened to read Mark's article.
Our children now young adults are being ignored by the government, medical establishment, the media and worst of all the pharmaceutical companies who are making billions every year. It is wrong for this man Grinker to say that there is no autism epidemic.
Joan Campbell, Glasgow, Scotland
Most people on the spectrum have autism that is genetic in origin, some of whom have low IQ's. The percentage of those who are diagnosed as Low Functioning Autistics are about 20% of the ASD spectrum, and half of those LFA's are not genetic autists in origin but NT kids brain damaged by vaccines.
Alectrum, Malaga, Spain
My friend, as a "science editor", you of all people should know the raging debate on what "caused" the autism epidemic is not between "parents and science". It is between "science and common sense"....and....your column once again demonstrates that science is losing that debate.
Bob Moffitt, Sloatsburg, United States
We now have thousands of young ASD adults emerging on to the scene for which there is no precedent and no help: pretending that it is all somehow magical - and a normal situation - will not do. Whatever we pretend about the causes, the situation is desperate.
John Stone, London, UK
This is all very interesting, but it doesn't go one millimetre towards explaining why my son was a perfectly normal healthy child before receiving his measles and DPT vaccines, then regressed over the following two months into an aimless silent state, then degenerated into profound autism after MMR
David Thrower, Warrington, Cheshire, UK
"autism epidemic is not to be feared but to be celebrated" This kind of mindless review will sicken most parents of autistic children who have had to watch their children suffer with ill health and to struggle in an ill-prepared educational system. Today one in five children have an impairment.
Ann, Gourock,
The number in the UK is 1 in 86.
How low does it have to get before people accept this is a serious epidemic..?
If there were 1in 86 blind or deaf people would be panic stricken.
Autism epidemic is REAL...
These days everyone knows someone with autism we didnt 20 years ago !
Joanne, Manchester, uk
Grinker is not autistic and his take on the rise in autism is ridiculous and cold-hearted. One of the major causes the RISE in the rate of autism/childhood schizophrenia is ever older dads at the baby's conception. http://how-old-is-too-old.blogspot.com/ Average paternal age is very high.
Les, Berkeley, USA
Check the statistics of autism in Urequey.
The doctors there are trained like ours.
Autism is almost unheard of. Do you think their doctors have not heard of autism? Or they can't diagnose it? OR MAYBE IT IS NOT THERE BECAUSE THEY DO NOT VACCINATE AS MUCH AS WE DO!!!!!!!
Do your home work!
Fil Navarra, Montreal, Canada