CDC conference call: 1% autism prevalence.

The CDC conference call was today. This call was about the new MMWR (Morbidity and Mortality Weekly Reports) that is due out. (The report is here, with an appendix here).

Dr. Catherine Rice, lead author was there. She gave the intro.

Report is released today. “Significant public health issue”. We need a coordinated and strong response to improve the lives of people with ASD.

2006—identified prevalence to be about 1% of 8 year olds. Representing about 8% of 8 year olds. 4.2 to 12.1 per 1000, average of 9.0 per 1000 (1 in 80 to 1 in 240, average on in 110)

The ADDM network collects data from multiple sites. All showed increases in identified ASD prevalence. The increases ranged from 27% to 95%, with an average of 57%

Identified ASD prevalence increased across all categories. Increases 55% for White, 90% for Hispanic (missed African American)

The autism prevalence is 4-5 times higher for boys. Prevalence numbers are 1 in 70 boys, 1 in 315 girls (average). The increases were 60% for boys, 48% for girls.

There were between 13-35% of the children studied who had a report of regression or loss of skills by age 2.

For most children, concerns were noted in the records were noted before age 2, but average identification age is about 4.5 years of age.

No single factor explains increase. Better detection is a factor (girls, Hispanics, people without cognitive impairment were given as examples of improved detection). True increase can not be ruled out.

CDC has new studies (such as SEED) to look into causes of autism. CDC is also represented on the IACC.

Some of the increase is due to better record keeping. One question from WebMD was about a possible true increase. CDC responded about the various factors involved, but a true increase can not be ruled out.

Boston Globe: (1) why are there broad “incidence” rates across sites (2) what about this study in terms of vaccinations.

Rage is 4.2 to 12.1 per 1,000. 7 sites were much more closely grouped around 10 per 1,000 (1%). There is a variation in the types of records available. The CDC representative states the low numbers are likely a low estimate.

Since autism is a behaviorally diagnosed condition, there will be variation in prevalence by region.

This study is not designed to look at risk factors, including vaccine. The children in this study were born in 1998, so these children were vaccinated with thimerosal.

NY Times: Range of spectrum. How well does this study catch the more “mild” end of the spectrum like PDD-NOS and Aspergers.

This went by fast, but it sounded like the CDC said that autism and PDD-NOS were more represented than Asperger syndrome.

CDC: The researchers do not actually test the children, but work on a review of existing records.

Pediatric news: What is the take home message for pediatricians?

CDC: Since there was usually an indication of delay before the age of 2, but identification wasn’t made until (on average) 4.5, pediatricians should be proactive in referring children for further evaluation.

In response to one question on intellectual disability: there is an overlap between autism and intellectual disability. Old stats showed 75% of autistics had Intellectual disability. Now it is more like 41%. This points to the idea that either the nature of autism is changing or that identification methods are changing, catching more autistics without intellectual disability.

CNN question—how much did the average age of diagnosis change?

CDC: 5 months. Children were identified on average 5 months sooner in these data than in the previous study.

Note: I made significant updates to this post since it was first published.

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