Enough Already Autism Needs to Be Declared a National Health Crisis
by Edward Morgan
The CDC is due to release its latest ADDM surveillance numbers.
Will our federal health agencies continue to downplay the numbers� significance, as
they have done each time the data show a rise in ASD prevalence?
Or will they finally sound an alarm and make it a top priority to find out what is causing
this epidemic in our children?
It is both astonishing and insulting that, nearly three decades in, federal agencies
and public health experts persist in denying and refusing to tackle our nation�s staggering
autism epidemic.
With typical dismissiveness (and a straight face), one group of pediatric researchers
recently had the temerity to put the word �epidemic� in quotes while endorsing the
charade that the rising prevalence of autism is attributable to broader diagnostic criteria,
increased awareness and �the inclusion of milder neurodevelopmental differences bordering
on normality.�
Over the first decade of surveillance, the CDC reported that Autism Spectrum Disorder
prevalence rose by 123%.
The government�s own surveys�as well as parents, school systems and municipal budgets�tell
an entirely different story, however.
Autism spectrum disorders (ASDs) began skyrocketing in the late 1980s, concurrent with a massive
expansion of the childhood vaccine schedule and a corresponding increase in children�s
exposure to neurotoxic vaccine ingredients such as mercury and aluminum.
Using data from the U.S. Office of Special Education Programs, a 2005 study published
in Pediatrics reported that autism prevalence went from roughly 1 in 2,850 ten-year-olds
born in 1982 (0.035%) to about 1 in 550 ten-year-olds born in 1990 (0.183%).In the early 2000s,
the Centers for Disease Control and Prevention (CDC) began monitoring ASD prevalence (and
changes in prevalence over time) through its Autism and Developmental Disabilities Monitoring
(ADDM) Network, an active surveillance system that gathers data from roughly a dozen sites
around the U.S. to ascertain ASD prevalence in 8-year-olds.
Over the first decade of surveillance, the CDC reported that ASD prevalence rose by 123%.
As the above table illustrates, the ADDM program has one major shortcoming, which is the lag
time between data collection, analysis and publication of prevalence data.
For example, the data published in 2014 took four years to analyze and captured ASD prevalence
for the cohort born 12 years earlier (i.e., children born in 2002 who were eight years
old in 2010).
CDC did not report the prevalence estimates for children born in 1992 until 2007.
The ADDM program has other acknowledged limitations as well, including:
Constant changes in the number and location of surveillance sites
A reliance on educational records that are not consistently available at all surveillance
sites (which would tend to underestimate true prevalence)
Failure to differentiate between ASD subgroups as an indicator of severity (but with differentiation
by IQ, with 70 as the cutoff) For these reasons, some observers believe
that data routinely published by the National Center for Health Statistics more accurately
represent the true autism picture.
The Center�s prevalence data are based on parental reports from the National Health
Interview Survey (NHIS).
As of 2014, NHIS data indicated that 1 in 45 children aged 3-17 years had been diagnosed
with ASD (2.24%), and by 2016 this number was 1 in 36 (2.76%)�a 23% increase over
the two-year period�and a far cry from the 1 in 550 reported from other data sources
in 1990.
A study that compared individuals with autism to the general population found elevated death
rates in the ASD group�
A health care and education burden At a societal level, ASD imposes a substantial
economic burden, especially on the health care and education sectors.
A study by Harvard researchers found that ASD was associated with over $17,000 more
in health care and non-health-care costs annually per child.
School systems (and thus taxpayers) carry a large portion of this additional financial
burden to cover the special education services used by 76% of ASD children versus 7% of children
without ASD.
Over the decade from 2005-2015, the number of students with ASD (ages 6-21) rose by 165%
nationally.
At the family level, the average lifetime cost of caring for a child with autism (including
the cost of lost wages) ranges from an estimated $1.4 to $2.4 million (depending on the level
of intellectual disability), representing �a huge hit on families.�
Individuals with ASD also face vastly increased risks of medical comorbidities, including
atopic disorders such as allergies and asthma, seizures, gastrointestinal problems, cancer
and decreased life expectancy.
A study that compared individuals with autism to the general population found elevated death
rates in the ASD group for causes of death such as seizures and accidental drowning or
suffocation and noted overall reduced life expectancy �even for persons who are fully
ambulatory� and have only �mild� intellectual disability.
An urgent situation Over the years, many of the CDC�s bulletins
about ASD prevalence have placidly reported that �ASDs are more common than was believed
previously.� However, the continued dramatic rise in ASD prevalence and autism�s heavy
burden on individuals, families, schools and wider society call for a far greater sense
of urgency.
Autism must be recognized as a national crisis.
As of this writing (April 2018), the CDC is due to release its latest ADDM surveillance
numbers.
Will our federal health agencies continue to downplay the numbers� significance, as
they have done each time the data show a rise in ASD prevalence?
Or will they finally sound an alarm and make it a top priority to find out what is causing
this epidemic in our children?
No one�and not least the agencies that are supposed to be looking out for children�s
best interests�can afford to be complacent any longer about this unjustifiably neglected
public health emergency.
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