Discussing Autism

In 1988 Dustin Hoffman and Tom Cruise brought us Rainman and brought Autism to the Big Screen. Since the 1980’s the autism rate has increased dramatically, partly because of changes in diagnostic practice and partly because of prevalence. Today the autism rate is said to be 1 in 50, averaging a 4.3.1 male to female ratio.

The increase in autism is, as some researchers state, partly due to the change in diagnostics; while the autism cases increased the number of children labeled as retarded or learning disabled decreased. “Diagnostic Substitution” means labeling someone today as autistic who would have been labeled as “retarded” 30 years ago.

Additionally, in past decades, many children were often labeled as having behavior difficulties or speech delays but are often labeled on the spectrum now as highly functioning autistic children. The “New Face of Autism” is considered mild to moderate by doctors and mainly includes communication delays, behavior issues, and social skills but they do not struggle with the major sensory processing issues, repetitive behaviors such as hand flapping, or have issues with noise making.

Dorothy Bishop, D.Phil of the University of Oxford, and colleagues stated online in the Developmental Medicine and Child Neurology that data illustrates how changes in diagnostic and clinical awareness have led doctors to diagnose autism in children instead of language disorders.

“Both of these schemes, especially DSM-III, adopted more stringent criteria [for a diagnosis of autism] than are currently used,” the researchers said, “and milder forms of autism, currently referred to as [autism spectrum disorders], were not well recognized.”

The earlier DSM editions described autistic children as completely closed off with little interest in interacting with other people, a description, the researchers said, that the participants in this study did not fit as children.

It is possible that children with language disorders could actually have just a language disorder or they could have both but doctors need to be careful to look at all the autism criteria, not just the communication aspect when diagnosing. According to the study conducted by Bishop, many children who were diagnosed in the 1980’s and 1990’s with severe language disorders would, in fact, be diagnosed with autism today.

Interestingly, the rate of severe autism has apparently stayed pretty steady with one to two children in every 1,000.