Autism on the rise: Awareness to blame?

Even before Michelle Landrum enrolled her son Clark in preschool, she noticed something was amiss.

Being around other children was difficult, and the boy’s anxiety and sensitivity to light and sound concerned the Towson mother enough that she took him to the Baltimore-based Kennedy Krieger Institute for tests.

“He was having these huge meltdown tantrums, and it was really taking its toll on our family,” she said.

Doctors diagnosed Clark, now 10, with a disorder on the autism spectrum. Nearly six years later, Clark, a student at Rodgers Forge Elementary School, is functioning better with the help of therapists trained to treat children like him.

“I wouldn’t say he has true friends, but he’s doing very well in school,” said Landrum, a board member with the Autism Society of Baltimore-Chesapeake .  “He still sees a psychologist who helps him to identify his feelings and how to handle them.”

An estimated one in 68 children has a disorder on the autism spectrum—a number that’s skyrocketed since the U.S. Centers for Disease Control and Prevention began tracking the numbers in 2000.  

Autism spectrum disorder is a blanket term for a group of brain development disorders. Prior to last year’s publication of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, the disorders were recognized as individual subtypes, including Asperger’s syndrome, childhood disintegrative disorder and autism.

“It was really hard to tell these groups apart,” said Dr. Rebecca Landa, founder of Kennedy Krieger’s Center for Autism and Related Disorders .

Landrum said Clark has what would have previously been called Asperger’s syndrome, a disorder defined by difficulties with social interaction and awareness of others and an intense fixation on a particular topic.

“There’s a lot of gray area,” she said.

The CDC issued its latest report in March. Researchers studied 8-year-old children in 10 states, including Maryland, in 2010. About one in 68 children in those states were identified with an autism spectrum disorder.

It’s about a 30 percent increase over the 2008 estimates, which put the number of children with an autism spectrum disorder at one in 88. In 2006, it was one in 110; in 2002 and 2000, it was one in 150.

The CDC said about one in 42 boys and one in 189 girls were identified as having an autism spectrum disorder.

In Maryland, the rates were higher, with one in 60 children identified as having a disorder on the autism spectrum. For boys, the rate is one in 37; for girls, it’s one in 179.

The CDC tracked children in Anne Arundel, Baltimore, Carroll, Cecil, Harford and Howard counties.

“We don’t know why the numbers are increasing,” Landa said. “We do know it’s not just autism that is increasing—it’s also other disorders. But we don’t have an answer to the problem yet.”

Landa founded the Center for Autism and Related Disorders in 1995. In the early years, she worked with hundreds of families.

Now, it’s thousands of families, she said.

“I think there’s just a lot more hope on the part of families,” Landa said. “Still, there is no cure for autism. What we want to do is alleviate the suffering.”

Support groups such as the Autism Society have been helpful for families like the Landrums.

“It’s helpful to be with families who understand. No one needs to feel uncomfortable with a child who is flailing or toe walking,” she said.

Why the increase?

Researchers with the CDC, in their report, speculated the rise in cases could be due to an increased awareness of autism spectrum disorders and how to diagnose them.

Landa pointed to problems with motor skills as one example.

“Babies that go on to have autism often have one type of motor delay or another,” she said.

Twenty years ago, Landrum said, her son may have been viewed as an odd child, or perhaps a defiant child.

“I think a lot of it has been our continuing recognition and better understanding of what autism is and how it manifests in children,” Landrum said.

But Wendy Fournier, the president of the National Autism Association, is skeptical.

Fournier believes environmental factors are behind the jump in autism cases, and said the federal government and the medical community should devote more resources into figuring out whether that’s true.

“This is a national health crisis,” said Fournier, a Rhode Island mom whose 14-year-old daughter was diagnosed with autism when she was two and a half years old.

Fournier, president of the NAA since 2006, said her daughter was developing normally until she was about 15 months. Then she plateaued.

“I had no idea what autism was,” she said.

In the years since her daughter’s diagnosis, she’s learned to be her advocate, her teacher and her lawyer in addition to her parent.

If you’ve ever been around someone with severe autism, Fournier said, you recognize something is wrong.

So the argument that people are just more aware of the symptoms of autism doesn’t make sense, she said.

Landa said researchers continue to examine a link between potential environmental toxins and autism spectrum disorders, and said that hasn’t been ruled out.

“If it was straightforward, we would know it,” she said.  

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