62 million people worldwide now diagnosed as autistic
The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) calls itself the “single largest and most detailed scientific effort ever conducted to quantify levels and trends in health.” Over 12,000 researchers have gathered and analyzed data from over 160 countries; its latest update covers the year 2021.
One of the reports generated by GBD is on autism, titled: “The global epidemiology and health burden of the autism spectrum.” It has concluded that, across the world, one in every 127 people (adults and children) is on the autism spectrum, which translates to almost 62 million people.
The data suggest that an increasing number of people are having trouble adapting to the requirements of daily life in the modern world. For them, their personality traits and neurological variations may well be experienced as a burden, and yet, aside from calling for more “programs” to address autism, the report is light on what can be done to ease this burden of ASD, autism spectrum disorder. Another notable omission is any reason why so many people struggle as, apparently, never before.
A brief history of autism
Autism as a definition has been around for just over a century. The term was first used to describe a certain constellation of systems shared by people with schizophrenia, all related to a tendency to withdraw into one’s own world. Later, in the 1940s, scientists noted how autistic people had difficulty in forming emotional connections to others, but it was only in the 1980s that autism made it into the “Bible” of psychiatry, the third edition of the Diagnostic and Statistical Manual (DSM), as a subcategory among Pervasive Developmental Disorders and later as a separate disorder.
Diagnostic criteria included a pervasive lack of responsiveness to others, peculiar speech patterns, and bizarre responses to outside stimuli. When the fifth edition of the DSM was published, autism became “Autism Spectrum Disorder” – allegedly based on research suggesting that autism, Asperger’s disorder, and other collections of symptoms are all different manifestations of the same underlying condition.
Defining just what that underlying condition is and testing for it has proven more difficult than many expected, despite advances in neurology and genetics. Presently, the diagnostic criteria fit into two main areas: persistent deficits in social communication and interaction across a variety of settings; and restricted and repetitive interests and patterns of behavior.
Lots of people grow out of it, data suggest
If one in every 127 people is autistic, that statistic is concerning enough. Among children, the incidence is (according to the CDC) much higher and currently stands at one in every 36 children, up from one in 54 children in 2016.
The CDC also states that boys are four times more likely to be diagnosed with ASD than girls. The GBD study, meanwhile, does show a huge disparity between the sexes but not the 4:1 ratio the CDC describes. According to GBD research, 11 out of every 1,000 males and 5 out of every 1,000 females are autistic, suggesting that as people age, they may learn new ways of adapting to the outside world that enable them to outgrow autism.
Scientists in general suggest various reasons why males may be more likely to be diagnosed as autistic, such as genetic mutations, neurological differences, and females being more adept at covering up autistic traits.
The GBD study, however, suggests that the disparity in female-male results could merely be the result of bias:
This meta-analysis illustrated a potential sex bias for receiving diagnoses of autism spectrum disorder and, together with our findings, highlights the need for more consideration into how screening procedures and services can be altered to ensure that both autistic female and male individuals receive support.
Autism diagnosis and suicide
Another striking finding of the GBD research was that people diagnosed with autism are significantly more likely to both attempt and commit suicide.
In a separate analysis, we explored the fatal burden attributable to the elevated risk of suicide among autistic people. We estimated 13400 excess suicide deaths among autistic people globally in 2021, equivalent to 1·8% of all suicide deaths.
The GBD study that focused exclusively on suicide and autism found that autistic people are almost three times more likely to die by suicide, or attempt suicide, than people without an ASD diagnosis. The researchers then distinguished between people with an ASD diagnosis with intellectual disability (ID) and those without ID. They found that people with an ASD diagnosis and no intellectual disability were more than five times more likely to commit suicide than the average person in the general population. People with an ASD diagnosis and also ID, by contrast, were no more likely than anyone else to commit suicide (although they were three times more likely than the average person to try to kill themselves).
'Single largest study' doesn't ask why
Concluding from their findings that action should be taken to help all these tens of millions of people mainstream medicine defines as disordered, the report’s authors suggested “programs” to address their particular struggles:
School-age autistic children and adolescents could benefit from programs addressing social communication difficulties, social skills training, or technology-based augmentative communication systems.
Given the health burden of autistic spectrum disorder estimated during adulthood, autistic adults could benefit from programs enhancing independence, such as life skills and employment training, but more research is required to identify the full range of effective services during adulthood.
Not only did they fail to comment on why the numbers seem to have exploded, they neglected to suggest any preventative measures. However, numerous scientific studies have linked a variety of factors to autism.
Vaccines
The autism numbers first started shooting up around 1989, and while it is generally accepted that a large proportion of those with an ASD diagnosis today would simply have gone undiagnosed in the past, it is also generally accepted that certain drugs, interventions, and circumstances can make it more likely for a person to be autistic.
Childhood vaccines are what come to many people’s minds as the primary cause, as the beginnng of the spike in ASD diagnoses roughly coincides with Congress’ decision to remove all liability from vaccine manufacturers (in 1986) and the increase in the numbers of vaccinations given to children.
Lithium in the water
Most mainstream scientists, however, deny vaccines-autism causation. However, there is acknowledgement that exposure to certain drugs can predispose to autism. A recent population-wide study conducted in Denmark, for instance, showed an association between expectant mothers ingesting lithium naturally occurring in drinking water and ASD.
After adjustment for demographics, neighborhood socioeconomic factors, and ambient air pollutants, maternal prenatal exposure based on the estimated lithium level in the local drinking water was associated with a 23% increase in the odds for ASD in offspring...
The highest quartile, exposed to lithium levels over 16.8 μg/L, had 46% higher odds of ASD in offspring
The amount of lithium the researchers found to be especially dangerous, 16.8 μg/L or 16.8 micrograms in a liter of water, was miniscule. To put it in perspective, a single drop of water weighs around 50,000 micrograms.
Prenatal ultrasound
Another prenatal factor influencing the likelihood of an ASD diagnosis is ultrasound (US) exposure. A study published in 2018 found that prenatal US increased the risk of children developing autism if they had a pre-existing genetic vulnerability:
We found that male children with ASD and copy number variations (CNVs), which is a type of genetic vulnerability, and exposure to first trimester ultrasound had decreased non-verbal IQ and increased repetitive behaviors compared to male children with ASD and CNVs but no ultrasound.
Studies conducted in earlier decades have found associations between US and a higher risk of dyslexia, developmental defects (including neurological), being left-handed, and delayed speech.
One study from 1993, for instance, found that US exposure was associated with a 32-percent increase in not being right-handed. Another study from the same year found that children with delayed speech “of unknown cause” were almost three times as likely to have been exposed to US before birth.
Other studies have found that US caused baby monkeys to sit or lie around at the bottom of their cages instead of engaging in typical behaviors such as climbing.
Epidurals and preemies
Moving forward to birth, several studies have suggested links between epidural anesthesia and a subsequent ASD diagnosis, although some suggest that the increased risk is insignificant when other factors such as general pregnancy complications, smoking during pregnancy, and maternal BMI (i.e., overweight) are taken into account. That is to say, these factors apparently are also considered to be associated with autism.
Children born pre-term are also thought to be more likely to be diagnosed with ASD. One study, conducted in Sweden, illustrated a relationship between the degree of prematurity and the likelihood of a diagnosis:
- 22-27 weeks: 6.1%
- 28-33 weeks: 2.6%
- 34-36 weeks: 1.9%
Screens
Moving to Japan, another study examined the effect of “screen time” on infants and a subsequent ASD diagnosis.
Compared with one-year-old boys who spent no time looking at screens, those who spent one or more hours looking at screens were two to three times more likely to be diagnosed with ASD at age three, the researchers reported:
- 1 to 2 hours: OR 2.16 (that is, 2.16 times more likely to get a diagnosis)
- 2 to 4 hours: OR 3.48
- Over 4 hours: OR 3.02
Solutions?
Can anything be done? One study, published in 2021, followed 103 Australian infants “showing early behavioral signs of ASD.” They were divided into two groups. The parents in one group were given ten video sessions of “feedback intervention” to help them adapt to their infants’ communication style. The other parents were left to muddle through as best they could.
In this randomized clinical trial of 103 infants showing early behavioral signs of ASD, preemptive intervention led to a statistically significant reduction in the severity of ASD behaviors across early childhood. Infants who received the preemptive intervention had lower odds of meeting diagnostic criteria for ASD (7%) than those who received usual care (21%) at age 3 years...
That is, helping parents to interact with their children resulted in those children being 67 percent less likely to be diagnosed with ASD.
The information contained in this article is for educational and information purposes only and is not intended as health, medical, financial or legal advice. Always consult a physician, lawyer or other qualified professional regarding any questions you may have about a medical condition, health objectives or legal or financial issues.
