Study shows California's autism increase not due to better counting, diagnosis

January 08, 2009

(SACRAMENTO, Calif.) - A study by researchers at the UC Davis M.I.N.D. Institute has found that the seven- to eight-fold increase in the number children born in California with autism since 1990 cannot be explained by either changes in how the condition is diagnosed or counted - and the trend shows no sign of abating.

Published in the January 2009 issue of the journal Epidemiology, results from the study also suggest that research should shift from genetics to the host of chemicals and infectious microbes in the environment that are likely at the root of changes in the neurodevelopment of California's children.

"It's time to start looking for the environmental culprits responsible for the remarkable increase in the rate of autism in California," said UC Davis M.I.N.D. Institute researcher Irva Hertz-Picciotto, a professor of environmental and occupational health and epidemiology and an internationally respected autism researcher.

Hertz-Picciotto said that many researchers, state officials and advocacy organizations have viewed the rise in autism's incidence in California with skepticism.

The incidence of autism by age six in California has increased from fewer than nine in 10,000 for children born in 1990 to more than 44 in 10,000 for children born in 2000. Some have argued that this change could have been due to migration into California of families with autistic children, inclusion of children with milder forms of autism in the counting and earlier ages of diagnosis as consequences of improved surveillance or greater awareness.

Hertz-Picciotto and her co-author, Lora Delwiche of the UC Davis Department of Public Health Sciences, initiated the study to address these beliefs, analyzing data collected by the state of California Department of Developmental Services (DDS) from 1990 to 2006, as well as the United States Census Bureau and state of California Department of Public Health Office of Vital Records, which compiles and maintains birth statistics.

Hertz-Picciotto and Delwiche correlated the number of cases of autism reported between 1990 and 2006 with birth records and excluded children not born in California. They used Census Bureau data to calculate the rate of incidence in the population over time and examined the age at diagnosis of all children ages two to 10 years old.

The methodology eliminated migration as a potential cause of the increase in the number of autism cases. It also revealed that no more than 56 percent of the estimated 600-to-700 percent increase, that is, less than one-tenth of the increased number of reported autism cases, could be attributed to the inclusion of milder cases of autism. Only 24 percent of the increase could be attributed to earlier age at diagnosis.

"These are fairly small percentages compared to the size of the increase that we've seen in the state," Hertz-Picciotto said.

Hertz-Picciotto said that the study is a clarion call to researchers and policy makers who have focused attention and money on understanding the genetic components of autism. She said that the rise in cases of autism in California cannot be attributed to the state's increasingly diverse population because the disorder affects ethnic groups at fairly similar rates.

"Right now, about 10 to 20 times more research dollars are spent on studies of the genetic causes of autism than on environmental ones. We need to even out the funding," Hertz-Picciotto said.

The study results are also a harbinger of things to come for public-health officials, who should prepare to offer services to the increasing number of children diagnosed with autism in the last decade who are now entering their late teen years, Hertz-Picciotto said.

"These children are now moving toward adulthood, and a sizeable percentage of them have not developed the life skills that would allow them to live independently," she said.

The question for the state of California, Hertz-Picciotto said, will become: 'What happens to them when their parents cannot take care of them?'

"These questions are not going to go away and they are only going to loom larger in the future. Until we know the causes and can eliminate them, we as a society need to provide those treatments and interventions that do seem to help these children adapt. We as scientists need to improve available therapies and create new ones," Hertz-Picciotto said.

Hertz-Picciotto and her colleagues at the M.I.N.D Institute are currently conducting two large studies aimed at discovering the causes of autism. Hertz-Picciotto is the principal investigator on the CHARGE (Childhood Autism Risk from Genetics and the Environment) and MARBLES (Markers of Autism Risk in Babies-Learning Early Signs) studies.

CHARGE is the largest epidemiologic study of reliably confirmed cases of autism to date, and the first major investigation of environmental factors and gene-environment interactions in the disorder. MARBLES is a prospective investigation that follows women who already have had one child with autism, beginning early in or even before a subsequent pregnancy, to search for early markers that predict autism in the younger sibling.

"We're looking at the possible effects of metals, pesticides and infectious agents on neurodevelopment," Hertz-Picciotto said. "If we're going to stop the rise in autism in California, we need to keep these studies going and expand them to the extent possible."

University of California - Davis - Health System

---

---

	Ten Things Every Child with Autism Wishes You Knew by Ellen Notbohm (Author) Winner of an iParenting Media Award and Honorable Mention in the 2005 ForeWord Book of the Year Awards! Every parent, teacher, social worker, therapist, and physician should have this succinct and informative book in their back pocket. Framed with both humor and compassion, the book defines the top ten characteristics that illuminate the minds and hearts of children with autism. Ellen's personal experiences as a parent, an autism columnist, and a contributor to numerous parenting magazines coalesce to create a guide for all who come in contact with a child on the autism spectrum. Don't buy just one of this book- buy one for everyone who interacts with your child! Give the gift of understanding. Helpful chapters include: My sensory perceptions are disordered Distinguish between...
	1001 Great Ideas for Teaching and Raising Children with Autism or Asperger's, Revised and Expanded 2nd Edition by Ellen Notbohm (Author), Veronica Zysk (Author), Temple Grandin (Foreword) Winner of Learning Magazine's Teachers Choice Award, the first edition of 1001 Great Ideas has been a treasured resource in the autism community since 2004. Now, in this expanded edition, Ellen Notbohm (best-selling author of the revolutionary book Ten Things Every Child with Autism Wishes You Knew) and Veronica Zysk (award-winning author and editor of Autism Asperger's Digest magazine) present parents and educators with over 1800 ideas try-it-now tips, eye-opening advice, and grassroots strategies. More than 600 fresh ideas join tried and true tactics from the original edition, while many ideas pick up where the first edition left off, offering modifications for older kids, honing in on Asperger's challenges, and enhancing already-effective ways to help your child or student achieve...
	Autism By Hand by Lorca Damon (Author) "I never wanted to write this book. I can’t write this book, it hurts too much. But I have to because this book wasn’t there when I needed it. It’s not a human-interest story or a self-help book or an instruction manual on how to raise an autistic child. It’s simply a well-thought out laundry list of everything I did to help my daughter be the best person she could become and I did it in the dark because this book wasn’t there for me." from the Introduction
	Autism Spectrum Disorders: The Complete Guide to Understanding Autism, Asperger's Syndrome, Pervasive Developmental Disorder, and Other ASDs by Chantal Sicile-Kira (Author), Temple Grandin (Foreword) Based on nearly two decades of Chantal Sicile-Kira's personal and professional experiences with individuals and families affected by this growing epidemic, Autism Spectrum Disorders explains all aspects of the condition, including: - The causes of autism spectrum disorders - How to properly diagnose ASDs - Treatments based on behavioral, psychological and biomedical interventions - Coping strategies for families - Educational needs and programs - Living and working conditions for adults with ASD - Community interaction - Teaching strategies and resources for educators and other professionals
	Thinking in Pictures, Expanded Edition: My Life with Autism (Vintage) by Temple Grandin (Author) Temple Grandin, Ph.D., is a gifted animal scientist who has designed one-third of all the livestock-handling facilities in the United States. She also lectures widely on autism--because Temple Grandin is autistic, a woman who thinks, feels, and experiences the world in ways that are incomprehensible to the rest of us. In this unprecedented book, Grandin delivers a report from the country of autism. Writing from the dual perspectivies of a scientist and an autistic person, she tells us how that country is experienced by its inhabitants and how she managed to breach its boundaries to function in the outside world. What emerges in Thinking in Pictures is the document of an extraordinary human being, one who, in gracefully and lucidly bridging the gulf between her condition and our...
	Early Intervention Games: Fun, Joyful Ways to Develop Social and Motor Skills in Children with Autism Spectrum or Sensory Processing Disorders by Barbara Sher (Author) A resource of fun games for parents or teachers to help young children learn social and motor skillsBarbara Sher, an expert occupational therapist and teacher, has written a handy resource filled with games to play with young children who have Autistic Spectrum Disorder (ASD) or other sensory processing disorders (SPD). The games are designed to help children feel comfortable in social situations and teach other basic lessons including beginning and end, spatial relationships, hand-eye coordination, and more. Games can also be used in regular classrooms to encourage inclusion.A collection of fun, simple games that can improve the lives of children with ASD or other SPDs.Games can be played by parents or teachers and with individual children or groups.Games are designed to make children...
	The Myth of Autism: How a Misunderstood Epidemic Is Destroying Our Children by Michael Goldberg (Author), Elyse Goldberg (Contributor) The explosive account of one doctor’s quest to convince the world that autism, as we understand it today, does not exist.Experts agree that America is in the midst of a disturbing epidemic of what has thus far been diagnosed as autism. In just thirty years autism diagnoses have risen from 1 in 5,000 children to 1 in 110, according to the Centers for Disease Control and Prevention. But in the history of our society there has never been an “epidemic” of any developmental or genetic disorder—it is scientifically impossible. So what is this mysterious affliction known as “autism,” and how can we stop it? Dr. Goldberg and his colleagues illustrate why autism cannot be genetic, but is a symptom of a treatable neurological disease that attacks the brain’s immune...
	Brains, Trains & Video Games: Living The Autism Life by Alicia Hart (Author), Brianne Bolin (Editor), Ewan Nees (Editor), Tera Swango (Editor) Brains, Trains & Video Games: Living The Autism Life details the emotional, humorous and often profoundly insightful journey of an everyday family raising a child with autism. This is a book about life with Ewan—the center of one family's universe and the gravity that holds them together. Far from being the stressor that causes this family to disintegrate, autism has made this family what it is today. A family that laughs more than it cries, and a family that eagerly awaits for the next Ewanism to spring forth from the lips of this solar system’s sun. Over the years we have built a bridge between his world and ours, his brain and ours, and his perspective and ours. Join us on the journey we’ve taken to help create a world of possibility for our son—a world filled with words,...
	Ten Things Your Student with Autism Wishes You Knew by Ellen Notbohm (Author), Veronica Zysk (Contributor) Winner of an iParenting Media Award and Finalist in the 2006 ForeWord Book of the Year Awards! Ellen Notbohm’s first book, Ten Things Every Child with Autism Wishes You Knew, was a shot heard throughout the worldwide autism community. Now, for the teacher in all of us comes Ten Things Your Student with Autism Wishes You Knew. The unique perspective of a child’s voice is back to help us understand the thinking patterns that guide their actions, shape an environment conducive to their learning style, and communicate with them in meaningful ways. This book affirms that autism imposes no inherent upper limits on achievement, that both teacher and child “can do it.” It’s the game plan every educator, parent, or family member needs to make the most of every “teaching moment” in...
	Toilet Training for Individuals with Autism or Other Developmental Issues, 2nd Edition by Maria Wheeler (Author), Carol Stock Kranowitz M.A. (Foreword) Individuals with autism are reportedly one of the most difficult populations to toilet train. This second edition offers effective strategies that take the child's physical and emotional sensitivities into account instead of trying to force traditional methods. Easy-to-read bulleted lists offer more than 200 do's and don'ts, along with over 50 real-life examples, to help make the process more of a lesson and less of a battle for all involved. The young trainee will learn to overcome fear of the bathroom, properly use toilet paper, flush once, wash hands, and more. The toilet trainer will learn how to overcome challenges caused by communication needs, sensory sensitivities, motor challenges, anxiety levels, etc.