美国自闭症患病率大幅提高

忠于我心

Breaking news from Autism Socity
1 in 57 boys  between the ages of 3 and 17
从2007年底的统计数据150个小孩中间就有一个上升为91个小孩中就有一个，其中57个男孩中就有一个

http://www.autism-society.org/site/News2?page=NewsArticle&id=15065&news_iv_ctrl=1882
Monday, October 5, 2009
By: Carin Yavorcik

Autism Society Calls for Answers to Crisis Now

A national report released today in the journal Pediatrics reveals that 1 percent of U.S. children ages 3-17 have an autism spectrum disorder, an estimated prevalence of one in every 91 children. This is a dramatic increase from the one in 150 prevalence rates currently reported.

“This national study charts a dramatic rise in the prevalence of autism in the United States and we applaud this administration’s recognition that autism is an urgent public health priority,” said Autism Society President and CEO Lee Grossman. “But families today are asking: how high must these prevalence rates rise before the nation responds? Significant resources must be directed toward screening and diagnosis, affordable interventions that treat the whole person and comprehensive education plans to foster lifelong skill development so that people with autism will have the ability to work and live independently.”

The report, entitled “Prevalence of Parent-Reported Diagnosis of Autism Spectrum Disorder Among Children in the US,” published in today’s issue of Pediatrics, was conducted by the Department of Health and Human Services National Survey of Children’s Health, using data from the Centers for Disease Control and Prevention. The report was conducted via a telephone survey of over 78,000 parents, and determined a point prevalence of 110 per 10,000 respondents, roughly 1 percent of the population of children in the United States.

On a constituent call to discuss the report, the CDC reported that its initial analysis of the Autism and Developmental Delay Monitoring project data, due out later this fall, confirm the 1 percent figure. This report will also contain more data on age of diagnosis, groups affected, and access to interventions.

The increasing numbers have long-term economic costs to the country, as autism is a chronic medical condition affecting people across the lifespan. “Lifespan services, particularly for adults, are typically inadequate and inappropriate,” Grossman stated. “This new data should be a call to action to the government to improve and increase services and supports first.”

The Autism Society has been working with Congress on several key bills, which have stalled. “The information in this new report highlights the pressing need for additional services, support and treatments for families affected by autism spectrum disorders,” said Senator Dick Durbin (D-IL). “My bill, the Autism Treatment Acceleration Act, will help children and adults with autism gain better access to coordinated services, improve training for professionals treating these disorders, and will relieve the financial burden on the millions of families struggling with this disability.”

This bill, if funded, would provide funding for applied research into effective interventions, the first ever demonstration grants on adult services, create an adult prevalence study, and fund family support and information networks.

“Autism affects millions of American families, and the cost of diagnosis, early intervention, and treatment imposes a heavy burden on most of them,” said Congressman Mike Doyle (D-PA), co-chair of the Congressional Autism Caucus. “This legislation, the Autism Treatment Acceleration Act of 2009, would improve the dissemination of information between autism researchers and service providers, improve training for professionals treating autism spectrum disorders, and mandate that health insurers cover the diagnosis and treatment of autism spectrum disorders. Enactment of this legislation would do a lot to help millions of American families.”

“The increase in the reported prevalence of autism across the nation testifies to the urgency of executing a comprehensive strategy in response to this public health emergency,” said Congressman Chris Smith (R-NJ), co-chair of the Congressional Autism Caucus. “For its part, Congress must ensure robust funding to support aggressive programs of research, education, and services. Furthermore, Congress needs to enact additional legislation, such as the Autism Treatment Acceleration Act of 2009, that will establish the infrastructure and mechanisms for delivering appropriate services across the lifespan to individuals with autism and their families. We must look to maximize the reach and impact of our investments and activities by closely coordinating government efforts with those of national advocacy organizations, such as the Autism Society.”

忠于我心

Monday, Oct. 05, 2009

New Studies See a Higher Rate of Autism: Is the Jump Real?

By Claudia Wallis

<<TIME>>

One in a hundred American children has an autism spectrum disorder (ASD). That stunning new statistic was released on Monday by the Federal Government, officially revising the 2007 federal estimate of 1 in 150 children. The new number puts U.S. prevalence on par with reported rates in England, Japan, Sweden and Canada. It is based on two separate and very different government-funded research studies: a telephone survey of 78,037 parents by the Health Resources and Services Administration (HRSA), and a rigorous national surveillance study conducted by the Centers for Disease Control and Prevention (CDC). In an unusual show of attention and concern, top officials from the Department of Health and Human Services, the National Institutes of Health and the CDC held a press conference on Oct. 2 in which they attempted to explain the new numbers, allay concerns and assure the public that substantial government resources are being devoted to understanding autism. (See pictures of the world of autism.)

"We are extremely concerned about the apparent increase in estimated prevalence of autism spectrum disorders," said Ileana Arias of the CDC. "However, we urge extreme caution in interpreting this change. An increase in diagnosis does not necessarily mean that more children actually have ASD. Unfortunately, the information that we currently have doesn't allow us to give a true account of whether the apparent increase is an actual increase or the result of changes in the way we describe and diagnose ASDs."

Indeed, there is considerable uncertainty in the scientific and public-health communities about the meaning of the dramatic rise in autism numbers. Several factors other than a true increase in autism incidence have contributed to the ballooning numbers. These include greater awareness on the part of parents, pediatricians and educators; much broader definitions of autism than in decades past, when only the most severe form of the disorder was recognized (today, ASD includes the milder forms known as Asperger's syndrome and pervasive developmental disorder, not otherwise specified); earlier diagnosis of ASD, which can now be recognized by age 2 in many cases; and the growing availability of special services and interventions for children identified with ASD.

It is not clear, however, that these factors can entirely account for the dramatic rise in autism numbers. "I don't think we can explain away all of the increase with these artifacts," said Dr. Thomas Insel, director of the National Institute of Mental Health, in discussing the new studies at Friday's press conference. "Buried in these numbers there may be a true increase."

The flurry of federal attention was occasioned by the publication of the HRSA survey in the journal Pediatrics. The survey — part of the 2007 National Survey of Children's Health — contained a number of intriguing data points. Most notable was the surprisingly high prevalence rate: one in 91 children ages 3 to 17 (1.1%) were described by parents as having an ASD diagnosis. Among boys, who are four times as likely to have autism as girls, the rate was 1 in 58. Even more mysterious, an additional group of children — 0.6% of the sample — were described by parents as having had an ASD diagnosis in the past, but suffered from it no longer.

HRSA researcher Michael Kogan, the lead author of the study, admitted that it was hard to explain these vanishing cases of autism — which is by definition a lifelong condition. Yet nearly 40% of children who were diagnosed with autism, according to parents, no longer had the condition. It may be that such children received the autism label "to facilitate services for other conditions such as developmental delays," Kogan said. Or it could be that children were only tentatively classified as having ASD when they were very young and then the disorder was ruled out.

The parent survey indicated that autism is more commonly diagnosed among white non-Hispanics than other groups. African-American children were 57% less likely to be diagnosed with an ASD than whites; they were also more likely to be in the group that "lost" the diagnosis. Mild autism was the most common type reported by parents. Half of parents said their child had a mild form of ASD, one-third described the child's condition as "moderate" and the remaining 17% said their child was severely affected. Parents also indicated that nearly 9 out of 10 (87%) children with ASD also had other mental-health issues such as attention deficit disorder and anxiety.

Experts not involved in the study caution that parent surveys are not the gold standard for measuring the prevalence of a medical condition. "The fact that 40% of the parents reporting that their child had received an ASD diagnosis now say the child no longer met criteria does suggest that there may be over-reporting in this survey," says Craig Newschaffer, a leading autism epidemiologist at Drexel University School of Public Health. "Nonetheless, the survey reinforces what we have come to understand over the past decade — that autism is much more common than previously thought." (See six tips for traveling with an autistic child.)

What's significant is that the study lines up well with other, more rigorous studies finding a 1% rate of autism. "It provides what scientists call convergent validity: no matter how you shake the bushes, you come up with this 1%," says Richard Roy Grinker, an autism researcher at George Washington University who has worked to determine ASD prevalence in South Korea.

The CDC's 1% figure is based on a more substantive study design than parent interviews. The CDC uses a network of up to 11 sites around the country known as the Autism and Developmental Disability Monitoring network (ADDM) to gather medical and special education records on 8-year-olds. Researchers and clinicians actually go through the records in an attempt to confirm diagnoses and identify children who may have been missed. Details of the CDC study are not expected to be released until December.

Autism advocacy groups responded to the new federal numbers by pressing for a greater federal commitment to autism research — particularly on possible environmental causes — and to treatment. "It is imperative that more resources be given to autism research so we can understand the causes and biology of autism and develop more effective treatments," said Geraldine Dawson, chief scientific officer for Autism Speaks, the largest ASD advocacy group in the U.S.

Anticipating this concern, federal officials took pains to emphasize that federal dollars devoted to autism have been rising in recent years. According to Peter Van Dyke, who oversees HRSA's Maternal and Child Health Bureau, President Obama has proposed an increase from $42 million this year to $48 million in 2010 for HRSA's autism-related programs. Insel, who heads the federal Interagency Autism Coordinating Committee, noted that autism is the only disorder specifically targeted for federal stimulus funds, to the tune of $85 million over the next two years.

忠于我心

San Diego, CA
October 6th, 2009

Yesterday the Maternal & Child Health Bureau of Health Resources and Services Administration (HRSA), US Department of Health and Human Services released a study evaluating the number of children in the U.S. who currently have an Autism Spectrum Disorder (ASD) diagnosis, The Prevalence of Parent-Reported Diagnosis of Autism Spectrum Disorder among Children in the United States, 2007, published in Pediatrics.

The study evaluated data from a National Survey of Children's Health (NCHS) in which 78,000 U.S. households were surveyed to estimate the prevalence of autism spectrum disorders.  The households were queried if their child (ages 3-17) "currently has autism, Asperger's Disorder, pervasive development disorder, or other autism spectrum disorder." Read the new report online  

Findings:

The NCHS survey estimated the prevalence rate of ASD to currently be 110 per 10,000 which equates to 1 in 91 children ( 1 in 57 boys)  between the ages of 3 and 17.

Previous prevalence data from the Center for Disease Control and Prevention's Autism and Developmental Disabilities Monitoring (ADDM) Network reported the average rate of autism among eight-year-olds was 67-per-10,000 in 2000 (the 1992 birth cohort), and 66-per-10,000 in 2002 (the 1994 birth cohort). Data from the NCHS was from the birth cohort born from 1990 to 2004.

For the first time the health survey also asked if the child who was diagnosed with ASD currently has the disorder, and nearly 40% ( 38.2%) responded NO.  This finding supports recent research that children diagnosed with autism can recover from the disorder with appropriate interventions, both medical and behavioral.

Investigators also found that non-Hispanic black and non-Hispanic multiracial children had 57% and 42% LOWER odds of having ASD than non-Hispanic white children, and that children whose parents had less than 12 years of education had twice the odds of NOT having an ASD dx child than those with higher education.  Another interesting finding is that those who lived in the Midwest and Northeast had higher odds of having ASD than children in the West. Such demographic and geographic disparities deserve further scrutiny for etiologic risk factors.

When investigators broke the data down a little more by age, the odds of having a child with ASD were 54% greater for ages 6-8 years (birth years 99-01) and 83% greater for 9 to 11 years (birth years 96-98).  Note that the older birth cohort was exposed to larger amounts of ethyl mercury than the younger birth cohort.