<p>Sociologists King and Bearman have been looking into this (see <a href="http://ije.oxfordjournals.org/content/38/5/1224.full">King &amp; Bearman, 2009a</a>; <a href="http://ije.oxfordjournals.org/content/38/5/1243.full">King &amp; Bearman, 2009b</a>; <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3086778/">King &amp; Bearman, 2011</a>; <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2724463/">King et al., 2009</a>). They estimate that some of the increases in ASD identification are due to the following:</p>

<ol>
<li>25% attributed to diagnostic accretion - particularly children with mental retardation now being concurrently diagnosed with ASD.</li>
<li>15% attributed to improved awareness of ASD.</li>
<li>10% attributed to the increase in the age of mothers choosing to have children.</li>
<li>4% to geographic clustering - that is, families might move to an area where services are available, leading to increased diagnoses in specific areas.</li>
</ol>

<p>This leaves a significant proportion of the increase in ASD identification unexplained, and in need of further investigations. </p>

CC BY-SA 3.0
2013-10-02T04:05:04.457Z
2013-10-02T04:05:04.457Z
tenomushi
<p><a href="http://www.cdc.gov/ncbddd/autism/data.html" rel="noreferrer">Statistics offered by the CDC</a> indicate that the prevalance of autism spectrum disorder in the U.S. went from 1-in-150 children in 2002, up to 1-in-88 by 2008:</p>
<p><img src="https://i.sstatic.net/AuX7n.jpg" alt="CDC Statistics on Identified Prevalance of Autism Spectrum Disorders" /></p>
<p><a href="http://www.cdc.gov/nchs/data/nhsr/nhsr065.pdf" rel="noreferrer">A new report released in 2013</a> shows that this number has risen to 1-in-50.</p>
<p>The most recent study concludes that it is likely that the changes in prevalence are due to an improved awareness/survey techniques:</p>
<blockquote>
<p>While it is not
possible to definitively determine the
underlying reason for this trend, several
previous studies that also examined
changes over time in ASD prevalence
estimates within selected birth cohorts
suggest that increasing recognition of
children with ASD has had an important
impact. Evidence from
epidemiologic, genetic, and neuroscience
research points to the prenatal period as
the key exposure window for ASD risk
factors. If the causes of ASD are
related to factors that exist prior to or
occur just after birth, it is unlikely that
changes in ASD prevalence within the
cohorts of children aged 6–13 in
2011–2012 reflect ‘‘true’’ increases in
susceptibility to the condition at these
ages. Rather, changes in prevalence of
parent-reported ASD within these birth
cohorts (children born in 1998–2005)
likely reflect either changes in the
recognition of ASD by health
professionals or survey-based
measurement changes over time</p>
</blockquote>
<p>However, there also seems to be a significant support for the idea that <a href="http://www.cnn.com/2013/04/16/health/autism-facts" rel="noreferrer">ASD is rising to epidemic proportions</a>, and that anything from changes in how many older couples are having children to various environmental factors may be increasing the rate of ASD incidents.</p>
<blockquote>
<p>These rising rates inspired Bob Wright, co-founder of Autism Speaks, to say, &quot;We have an epidemic on our hands.... It is imperative that the U.S. government steps up its commitment to helping people living with autism today.&quot; Last November, the first congressional hearing on autism in 10 years was held to determine what the federal response should be. (It didn't exactly make front-page news: It aired on CSPAN-3.)</p>
</blockquote>
<p>...and...</p>
<blockquote>
<p>&quot;Now we know there's a host of genetic and environmental factors that are likely involved,&quot; says Dr. Susan Hyman, professor of pediatrics at the University of Rochester Medical Center and chair of the American Academy of Pediatrics subcommittee on autism.</p>
<p>One possible contributor to autism's rise is that people are having babies later. The chance for gene glitches increases as parents -- especially dads -- age, explains Irva Hertz-Picciotto, an environmental epidemiologist at the MIND Institute at the University of California, Davis.</p>
<p>But delayed childbearing explains only a very small fraction of the rise in autism rates. Environmental factors may turn many autism genes &quot;on&quot; or &quot;off,&quot; says Hyman.</p>
<p>&quot;The best studies we have now point to things that babies are exposed to in the womb, when the brain is forming,&quot; says Hertz-Picciotto. Living in areas with high levels of air pollution (such as near a freeway), having low levels of folic acid, being overweight or diabetic, and having a high fever during pregnancy all seem to up a woman's risk of having a child with autism.</p>
</blockquote>
<p>What studies or evidence support an actual increase in the rate of children with ASD?  Presumably there are stronger connections to environmental factors than the infamous Wakefield study, given the comments by Dr. Hyman?</p>
<p>Are there studies that show a strong correlation with increased rates with changes in the  diagnostic criteria, which would support the hypothesis that a significant portion of the increased prevalence is due to improvements in identifying individuals on the spectrum?</p>

CC BY-SA 3.0
2013-09-05T14:50:42.910Z
I will look it up when I find the time, but I remember a paper claiming that the father's age might be connected to the chance that the child will suffer from autism. It had to do with the overall amount of point mutations or something. So if people are having kids at a later age nowadays, there could (also) be a true increase in the incidence.
Ana
CC BY-SA 3.0
2013-09-05T15:23:36.933Z
From my understanding of genetics, a father's age does not generally factor into genetic abnormalities because the male gametes are constantly produced. The mother's age is a much more important factor as females are born with their gametes which means the longer they're alive, the more mutagens they're exposed to
GetSwifty
CC BY-SA 3.0
2013-09-05T15:31:57.393Z
@PEEJWEEJ that has been the conventional thinking but Ana is right, a recent study found that the currently accepted thinking might not be correct...
Josh
CC BY-SA 3.0
2013-09-05T15:55:30.427Z
@Ana If you find the article/paper talking about this I would be greatly interested in reading it.
GetSwifty
CC BY-SA 3.0
2013-09-05T20:13:45.930Z
@PEEJWEEJ, I haven't find the time to read these, but here are some links: an article in the [NY Times](http://www.nytimes.com/2012/08/23/health/fathers-age-is-linked-to-risk-of-autism-and-schizophrenia.html?_r=0), and one on [Nature News](http://www.nature.com/news/fathers-bequeath-more-mutations-as-they-age-1.11247).
Ana
CC BY-SA 3.0
2013-09-23T20:57:59.387Z
I don't think there is currently an answer to this question. It seems to be a controversial question with very smart people on either side. I think the real answer here is that more research is needed.
Four_0h_Three
CC BY-SA 4.0
2022-10-07T02:47:06.567Z
There is now a Wikipedia article on [diagnostic substitution](https://en.wikipedia.org/wiki/Diagnostic_substitution#Autism) with recent findings.
Arnon Weinberg
<autism>
Are the incidents of autism spectrum disorder on the rise, or is there an increase due to better definition of diagnostic criteria?
Beofett
# Are the incidents of autism spectrum disorder on the rise, or is there an increase due to better definition of diagnostic criteria?

(Asked by: username_0 on 2013-09-05)

[Statistics offered by the CDC](http://www.cdc.gov/ncbddd/autism/data.html) indicate that the prevalance of autism spectrum disorder in the U.S. went from 1-in-150 children in 2002, up to 1-in-88 by 2008:

![CDC Statistics on Identified Prevalance of Autism Spectrum Disorders](https://i.sstatic.net/AuX7n.jpg)

[A new report released in 2013](http://www.cdc.gov/nchs/data/nhsr/nhsr065.pdf) shows that this number has risen to 1-in-50.

The most recent study concludes that it is likely that the changes in prevalence are due to an improved awareness/survey techniques:

> While it is not
> possible to definitively determine the
> underlying reason for this trend, several
> previous studies that also examined
> changes over time in ASD prevalence
> estimates within selected birth cohorts
> suggest that increasing recognition of
> children with ASD has had an important
> impact. Evidence from
> epidemiologic, genetic, and neuroscience
> research points to the prenatal period as
> the key exposure window for ASD risk
> factors. If the causes of ASD are
> related to factors that exist prior to or
> occur just after birth, it is unlikely that
> changes in ASD prevalence within the
> cohorts of children aged 6–13 in
> 2011–2012 reflect ‘‘true’’ increases in
> susceptibility to the condition at these
> ages. Rather, changes in prevalence of
> parent-reported ASD within these birth
> cohorts (children born in 1998–2005)
> likely reflect either changes in the
> recognition of ASD by health
> professionals or survey-based
> measurement changes over time

However, there also seems to be a significant support for the idea that [ASD is rising to epidemic proportions](http://www.cnn.com/2013/04/16/health/autism-facts), and that anything from changes in how many older couples are having children to various environmental factors may be increasing the rate of ASD incidents.

> These rising rates inspired Bob Wright, co-founder of Autism Speaks, to say, "We have an epidemic on our hands.... It is imperative that the U.S. government steps up its commitment to helping people living with autism today." Last November, the first congressional hearing on autism in 10 years was held to determine what the federal response should be. (It didn't exactly make front-page news: It aired on CSPAN-3.)

...and...

> "Now we know there's a host of genetic and environmental factors that are likely involved," says Dr. Susan Hyman, professor of pediatrics at the University of Rochester Medical Center and chair of the American Academy of Pediatrics subcommittee on autism.
>
> One possible contributor to autism's rise is that people are having babies later. The chance for gene glitches increases as parents -- especially dads -- age, explains Irva Hertz-Picciotto, an environmental epidemiologist at the MIND Institute at the University of California, Davis.
>
> But delayed childbearing explains only a very small fraction of the rise in autism rates. Environmental factors may turn many autism genes "on" or "off," says Hyman.
>
> "The best studies we have now point to things that babies are exposed to in the womb, when the brain is forming," says Hertz-Picciotto. Living in areas with high levels of air pollution (such as near a freeway), having low levels of folic acid, being overweight or diabetic, and having a high fever during pregnancy all seem to up a woman's risk of having a child with autism.

What studies or evidence support an actual increase in the rate of children with ASD? Presumably there are stronger connections to environmental factors than the infamous Wakefield study, given the comments by Dr. Hyman?

Are there studies that show a strong correlation with increased rates with changes in the diagnostic criteria, which would support the hypothesis that a significant portion of the increased prevalence is due to improvements in identifying individuals on the spectrum?

**Tags:** autism

> **Comments:**
> **username_1**: I will look it up when I find the time, but I remember a paper claiming that the father's age might be connected to the chance that the child will suffer from autism. It had to do with the overall amount of point mutations or something. So if people are having kids at a later age nowadays, there could (also) be a true increase in the incidence.  
> **username_2**: From my understanding of genetics, a father's age does not generally factor into genetic abnormalities because the male gametes are constantly produced. The mother's age is a much more important factor as females are born with their gametes which means the longer they're alive, the more mutagens they're exposed to  
> **username_3**: @PEEJWEEJ that has been the conventional thinking but username_1 is right, a recent study found that the currently accepted thinking might not be correct...  
> **username_2**: @username_1 If you find the article/paper talking about this I would be greatly interested in reading it.  
> **username_1**: @PEEJWEEJ, I haven't find the time to read these, but here are some links: an article in the [NY Times](http://www.nytimes.com/2012/08/23/health/fathers-age-is-linked-to-risk-of-autism-and-schizophrenia.html?_r=0), and one on [Nature News](http://www.nature.com/news/fathers-bequeath-more-mutations-as-they-age-1.11247).  
> **username_4**: I don't think there is currently an answer to this question. It seems to be a controversial question with very smart people on either side. I think the real answer here is that more research is needed.  
> **username_5**: There is now a Wikipedia article on [diagnostic substitution](https://en.wikipedia.org/wiki/Diagnostic_substitution#Autism) with recent findings.  

---

## 1 answers

### Answer by username_6 on 2013-10-02. Score: 13 | Accepted answer

Sociologists King and Bearman have been looking into this (see [King & Bearman, 2009a](http://ije.oxfordjournals.org/content/38/5/1224.full); [King & Bearman, 2009b](http://ije.oxfordjournals.org/content/38/5/1243.full); [King & Bearman, 2011](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3086778/); [King et al., 2009](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2724463/)). They estimate that some of the increases in ASD identification are due to the following:

1. 25% attributed to diagnostic accretion - particularly children with mental retardation now being concurrently diagnosed with ASD.
2. 15% attributed to improved awareness of ASD.
3. 10% attributed to the increase in the age of mothers choosing to have children.
4. 4% to geographic clustering - that is, families might move to an area where services are available, leading to increased diagnoses in specific areas.

This leaves a significant proportion of the increase in ASD identification unexplained, and in need of further investigations.


---

