A Boston TV Report on the Vaccine Controversy

WFXT in Boston reports on a new chapter in the vaccine controversy:

Group claims link between Autism and vaccines: MyFoxBOSTON.com

Educational Placement in New Jersey

Inclusion is a major issue in the education of ASD students. The Press of Atlantic City reports:

The number of students in New Jersey public schools diagnosed with autism has almost doubled in the past five years, to more than 13,000 in 2010. More of these children are now being educated in their hometown schools.

But as their number has grown, so has the debate about how and where to best educate children with autism.

A review of special education placement data by The Press of Atlantic City shows the percentage of autistic students ages 6 to 21 sent to specialized schools dropped from 40 percent in 2005 to 28 percent in 2010.

While advocates and experts support keeping the children in their hometown districts, they say many schools are still not equipped to offer the specialized programs autistic children need to learn to interact with others.

“A high number of students are still going to out-of-district placements,” said Diana Autin, co-director of the Statewide Parent Advocacy Network, or SPAN. “And even if they are kept in district, they are often placed in programs that are still very segregated.”

About one in four autistic students spends most of the school day in a regular class, Department of Education data show, an improvement from 2005 when the ratio was less than one in five. But almost half are spending at least half of their day in a separate special education class.

A 2010 report in the International Journal of Special Education indicates that autistic students placed in regular classrooms performed better academically than those placed in special programs. But research on the issue is new and limited, and advocates warn there is no one-size-fits-all placement.

From: Jennifer A. Kurth and Ann M. Mastergeorge, " Academic And Cognitive Profiles Of Students With Autism: Implications For Classroom Practice And Placement," International Journal of Special Education 25 (Number 2, 2010):

In all academic areas, students with autism who had received all of their math and language arts instruction in general education outperformed those students who had received their instruction in special education settings in skill areas that are traditionally difficult for students with autism (abstract skills). These findings suggest that inclusion is academically beneficial to students with autism in this sample. The small sample size and geographically limited nature of the present study preclude broad generalizations; more research is thus warranted with larger sample sizes in more diverse areas.

Korea: One in 38

Previous posts have dealt with the question of prevalence: just how much autism is there? The New York Times reports:

An ambitious six-year effort to gauge the rate of childhood autism in a middle-class South Korean city has yielded a figure that stunned experts and is likely to influence the way the disorder’s prevalence is measured around the world, scientists reported on Monday.

But experts said the findings did not mean that the actual numbers of children with autism were rising, simply that the study was more comprehensive than previous ones.

“This is a very impressive study,” said Lisa Croen, director of the autism research program at Kaiser-Permanente Northern California, who was not connected with the new report. “They did a careful job and in a part of the world where autism has not been well documented in the past.”

For the study, which is being published in The American Journal of Psychiatry, researchers from the Yale Child Study Center, George Washington University and other leading institutions sought to screen every child aged 7 to 12 in Ilsan, a community of 488,590, about the size of Staten Island.

...

“From the get-go we had the feeling that we would find a higher prevalence than other studies because we were looking at an understudied population: children in regular schools,” said the lead researcher, Dr. Young-Shin Kim, a child psychiatrist and epidemiologist at the Yale Child Study Center.

South Korea was chosen not only because autism prevalence had not been measured there, but also because its national health care system, universal education and homogeneous population made it a promising region for a planned series of studies that will also look at genetic and environmental factors in autism.

The study, which was largely financed by the research and advocacy group Autism Speaks, raises the question of whether a similarly high prevalence would be found in the United States if all children were screened.

From the AP report:

A study in South Korea suggests about 1 in 38 children have traits of autism, higher than a previous U.S. estimate of 1 in 100. By casting a wider net and looking closely at mainstream children, the researchers expected to find a higher rate of autism characteristics. But they were surprised at how high the rate was. They don't think South Korea has more children with autism than the United States, but instead that autism often goes undiagnosed in many nations. U.S. estimates are based on education and medical records, not the more time-consuming survey conducted in South Korea.

Two-thirds of the children with autism traits in the study were in the mainstream school population, hadn't been diagnosed before and weren't getting any special services. Many of those undiagnosed children likely have mild social impairments, rather than more severe autism.

VA Governor Signs Mandate

Previous posts dealt with the Virginia mandate legislation. Olympia Meola writes at The Richmond Times-Dispatch:

To the delight of the autism community, Gov. Bob McDonnell has signed the state's autism-insurance bills.

Virginia is the 26th state to enact autism-insurance reform legislation.

McDonnell had concerns with the bills, which require health insurers to cover some treatments for autistic children ages 2 to 6, and he tried to amend it in ways that advocates said watered it down.

He eventually came to an agreement with legislators to let some of his amendments pass. In exchange, he pledged not to veto the bill.

That didn't mean he had to sign it, though. It would have become law without his signature. Advocates, aware of McDonnell's objections, have been anxiously waiting to see if he would sign the measure.

"Denying autism claims was a senseless, arbitrary practice by the insurance industry in Virginia, and this law will put an end to it," said John Maloney who worked with other parents for years to pass the bill.

A release from Autism Speaks:

Autism Speaks joins the Virginia Autism Project and Virginia families in applauding Governor Bob McDonnell for signing House Bill 2467 and Senate Bill 1062 into law today.This legislation requires state-regulated health plans to provide coverage of autism diagnosis and treatment for children between the ages of two to six. Stakeholders and Virginia legislators have been working to pass autism insurance reform legislation in the Commonwealth for more than a decade.

HB 2467 was sponsored in the House by Delegates Tag Greason (District 32) and Tim Hugo (District 40). SB 1062 was sponsored in the Senate by State Senator Janet Howell (District 32).

"HB 2467 and SB 1062 are the culmination of over 11 years of legislative work, and countless hours of effort put forth by the parents and advocates in support of Autism, “ said Delegate Tag Greason. “This legislation delicately balances the needs of our families with the struggles that employers throughout the Commonwealth are faced with. It is the right thing to do and I am proud to be a small part of the process."
...

In addition to Virginia, twenty-five states – Arizona, Arkansas, Colorado, Connecticut, Florida, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, Pennsylvania, South Carolina, Texas, Vermont, West Virginia and Wisconsin – have enacted autism insurance reform legislation. Several other state legislatures are considering similar legislation during the 2011 session.

Prevalence Doubles in Utah

Judith Pinborough-Zimmerman, et al, Changes in the Administrative Prevalence of Autism Spectrum Disorders: Contribution of Special Education and Health from 2002–2008," Journal of Autism and Developmental Disorders, 3 May 2011.

This study examined changes in the administrative prevalence of autism spectrum disorders (ASD) in Utah children from 2002 to 2008 by record source (school and health), age (four, six, and eight), and special education classification. Prevalence increased 100% with 1 in 77 children aged eight identified with ASD by 2008. Across study years and age groups rates were higher when health and school data were combined with a greater proportion of cases ascertained from health. The proportion of children with both a health ASD diagnosis and a special education autism classification did not significantly change. Most children with an ASD health diagnosis did not have an autism special education classification. Findings highlight the growing health and educational impact of ASD.

From the University of Utah's news release:

Pinborough-Zimmerman and colleagues looked at de-identified medical and education records in Utah’s three most populous counties – Davis, Salt Lake, and Utah counties. They looked for specific diagnostic codes in medical records that indicated a child had been referred to a health care provider for ASD. In education records, they looked at whether a child had been classified with autism by a team of educational specialists.

The researchers discovered that ASD prevalence steadily increased throughout the study period, but varied with the age group studied. Prevalence was lower in younger children, suggesting that continued efforts to improve earlier diagnosis and treatment are needed. Prevalence rates also varied depending on the record used. Prevalence rates based on health records alone were significantly higher than those based on education records alone. The highest prevalence rate was found when health and education sources were used together.

The Salt Lake Tribune reports:

"After all this work we still don’t know what the true prevalence of autism is in Utah," said Judith Pinborough-Zimmerman, the study’s lead author and research assistant professor in the University of Utah’s Department of Psychiatry. "We are only capturing kids that have a previous diagnosis. There may be many children and adults who have autism and still haven’t been diagnosed."

Utah’s rate appears to be higher than the national average: The latest national figures are from 2006 and show the rate among 8-year-olds was 1 in 111. The national figures are expected to be updated by the summer.

It’s unclear why Utah’s numbers have doubled: A change in the diagnostic criteria, increased awareness and better diagnostic tools may have contributed to the rise.

But that doesn’t fully explain the increase, said Jocelyn Taylor, one of the study authors and an autism education specialist at the Utah State Office of Education.

"As I interview teachers, I have veterans, teachers who have been teaching 20 or 30 years who say they’ve never seen anything quite like this," Taylor said. "While there may be better recognition of autism, there seems to be more autism."

Geier, Blogging, & Neurodiversity

Jean Marbella writes at The Baltimore Sun:

If, like me, you don't know much about autism, let me explain where the cosmic justice comes in: One form of the wide-ranging developmental disorder, on the high-functioning, high-verbal end of it, is Asperger's syndrome, which among other things is characterized by a tendency to obsess on a single subject.

Geier happened to become that subject for Kathleen Seidel.

"I'm the kind of person once my brain kicks in, I just go hog wild," says Seidel, a blogger who lives in New Hampshire. "For me, it's like putting together a big puzzle."

Seidel has a college-aged child who was diagnosed with Asperger's, and considers herself on the spectrum as well. With a master's in library science, she tends to meticulously research her obsessions and, after seeing references to Geier's work on some autism-related websites, started to investigate him about five years ago.

...

Seidel's investigation resulted in a 16-part takedown of the Geiers on her blog, neurodiversity.com, that was widely circulated and drew renewed attention this week when the news hit that Maryland suspended his medical license.

...

For Seidel, the suspension of Geier's license — he has the right to an appeals process, starting with a hearing before the board on Wednesday — offers some vindication. She's tangled, at least through the media, with Geier and others who have dismissed her work, saying she's not a doctor.

No, she's simply part of the "Aspie" community. And indeed, even by phone, you see why interacting with them can be both engaging and somewhat tiring. Seidel speaks in whole paragraphs — footnotes even, if you can imagine that in an entirely verbal exchange — and calls back a couple of times to make what were already good points better.

"I'm grateful," she says of the Maryland board's action. "It's not just me out there saying this is awful. It's not just me, a blogger. The professionals have paid attention, a whole table-full of doctors putting their intellect to work."

See also the discussion at Left Brain/Right Brain.

The Geier Case

The Baltimore Sun reports:

A doctor nationally known for treating autism with a drug sometimes used to chemically castrate sex offenders has been suspended from practicing medicine in his home state of Maryland after state officials determined that he is putting children at risk.

Dr. Mark Geier allegedly misrepresented his credentials, misdiagnosed children and urged parents to approve risky treatments without fully informing them of the potential dangers, according to the Maryland Board of Physicians.

The board's order states that Geier "endangers autistic children and exploits their parents by administering to the children a treatment protocol that has a known substantial risk of serious harm and which is neither consistent with evidence-based medicine nor generally accepted in the relevant scientific community."

Geier told the Chicago Tribune in 2009 that he had treated hundreds of children with a testosterone suppressant called Lupron, which he called a "miracle drug." But a Tribune investigation exposed the treatment as a potentially dangerous therapy based on junk science and promoted by a physician not board-certified in any specialty relevant to autism or the use of hormone-disrupting drugs.

According to the Maryland Board of Physicians, Geier has licenses in 10 states. In Maryland, he's the president of Genetic Center of America, which has offices in Rockville and Owings Mills. In Maryland, the offices are called Genetic Consultants of Maryland, which he told the board offers genetic counseling to high-risk obstetric patients, evaluation of adults at risk for cancer and "genetic workups" of children with neuro-developmental disorders.

He also practices under the name ASD Centers LLC, and in 2006, the board said, he founded the Institute of Chronic Illness with his son, which offers the disputed autism treatment.

Geier is prominent in the world of alternative treatments for autism. His ASD Centers advertise "new hope for autism," and he has offices around the country.

The Maryland board found that in six of nine cases it reviewed, Geier incorrectly diagnosed children with autism with "precocious puberty" — the extraordinarily early onset of puberty — and prescribed Lupron, which is sometimes covered by insurance to treat that rare condition.

The same paper follows up:

A day after Dr. Mark Geier's medical license was suspended in Maryland over allegations of putting children with autism at risk, state officials were seeking to remove his son from a state commission that advises the governor on the disorder.

The officials were also struggling to explain why David Geier, who has an undergraduate degree in biology and does not have a medical license, was identified by the Commission on Autism as its "diagnostician." The commission's website had listed him as a doctor until Wednesday, which officials said was a clerical error. The commission's listing also includes the Geiers' company, ASD Centers LLC, whose website lists a corporate center in Silver Spring but is not registered in Maryland.

"Under the circumstances, we do not believe it's appropriate for David Geier to serve on the autism commission," said David Paulson, a spokesman for the state Department of Health and Mental Hygiene, which submitted 19 names to the governor, including David Geier's, for approval to the panel. "Unfortunately, he declined to resign his commission. ... As a result, we are considering the appropriate next steps."

Paulson said the state was aware of "the controversial nature of David Geier's views" when he was recommended for the position on the commission, which was formed by the legislature in 2009. But officials were looking for a "diverse" panel.

He also said that there was no legal definition of diagnostician.

The Geiers' views, spelled out in papers and by the state Board of Physicians that suspended the senior Geier, have been discredited by the Institute of Medicine and mainstream medical science in general. They connect autism to the mercury in vaccines. Among the treatments the Geiers say they've developed is one that uses Lupron — a drug that a host of autism experts have called dangerous for children.

See a 2010 post on Lupron.

DSM-V Update

CNN reports:

Reflecting a new understanding of many mental illnesses, the proposed organization for the newest edition of the "bible" of psychiatry is now open for public comment at dsm5.org.

The American Psychiatric Association this week released its vision for the next Diagnostic and Statistical Manual of Mental Disorders (DSM V). The updates incorporate insights from research since 1994, the last time the manual was issued with substantial changes, the organization said. Publication of the DSM V is scheduled for 2013.

An earlier version of proposed information for the DSM V was released in February 2010. Tuesday, the American Psychiatric Association put out a more specific framework for how the new manual would be organized, showing connections between disorders that were previously unlinked. The goals are to call attention to commonalities and underlying vulnerabilities in certain groups of conditions, and to spur further research in those areas, said Dr. Darrel Regier, director of the Division of Research at the American Psychiatric Association.

"This organizational framework is trying to emphasize that we don’t have strict divisions between disorders," Regier said.

For instance, Asperger's syndrome, a high-functioning form of autism, instead of being its own diagnosis, would now fall under the broader “austism spectrum disorders.” This move has some parents unhappy because "autism" sounds scarier than Asperger's, which has taken on its own identity in that community, and because children with Asperger's have specific educational needs that are different from kids with more severe autism.

But the association has heard from other parents frustrated that their children with Asperger's are denied special education benefits reserved for autism, Regier said. And biologically speaking, Asperger's is a form of autism, doctors say.

Here is the proposed definition of ASD:

Autism Spectrum Disorder

Must meet criteria A, B, C, and D:

A. Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following:

1. Deficits in social-emotional reciprocity; ranging from abnormal social approach and failure of normal back and forth conversation through reduced sharing of interests, emotions, and affect and response to total lack of initiation of social interaction,

2. Deficits in nonverbal communicative behaviors used for social interaction; ranging from poorly integrated- verbal and nonverbal communication, through abnormalities in eye contact and body-language, or deficits in understanding and use of nonverbal communication, to total lack of facial expression or gestures.

3. Deficits in developing and maintaining relationships, appropriate to developmental level (beyond those with caregivers); ranging from difficulties adjusting behavior to suit different social contexts through difficulties in sharing imaginative play and in making friends to an apparent absence of interest in people

B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of the following:

1. Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases).

2. Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change; (such as motoric rituals, insistence on same route or food, repetitive questioning or extreme distress at small changes).

3. Highly restricted, fixated interests that are abnormal in intensity or focus; (such as strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).

4. Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment; (such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects).

C. Symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities)

D. Symptoms together limit and impair everyday functioning.

Congressionally Directed Medical Research Program

A previous post dealt with the military's autism research program.

Shelley Hendrix, the Director of State Based Advocacy at Autism Speaks, writes at the group's blog:

The military has a weapon in the war on autism that few people know about even in our own community – a Congressionally Directed Medical Research Program specifically focused on research of previously overlooked medical issues, including autism spectrum disorder.

As a taxpayer, you contribute your two cents to this program – literally – every year.

The Department of Defense Autism Research Program (ARP) was established in 2007 after parents lobbied Congress for years. Lucky enough to be selected as a stakeholder, I participated in shaping the vision and mission of the program in March 2007.The program has a two-tiered review process with proposal evaluation by both a Scientific Review Panel (SRP), which reviews scientific method and validity,and Integration Panel (IP), which primarily focuses on programmatic impact to the community and issues final recommendations for funding projects. My service on the IP has allowed me to be intrinsically involved in funding scientific proposals for projects ranging from those designed to gather preliminary data that may lead to new breakthroughs one day up to complex clinical trials for new treatments or therapy modalities.

Since its inception, ASDRP has funded 66 projects investing $31.9 million in autism research.

...

ARP Funding Timeline – Fiscal Year 2010

Fall of 2009 – $7.1 Million allocated to the ARP by United States Congress.

December, 2009 – IP meets to review vision and mission of program, research area focus and funding mechanisms.

February, 2010 – Program announcements and requests for proposals posted.

Late April, 2010 – Pre-proposals received from investigators seeking funding.

Late May, 2010 – Pre-proposals screened by IP determining invitees for full proposal submission.

June, 2010 – Invitations for full grant submission mailed.

July, 2010 – Full grant proposals received, prepared by program staff for review by SRP.

September, 2010 – SRP meets to review grant applications.

Late October, 2010 – Program staff organizes and prepares SRP reviews for IP

November 30, 2010 – IP approves $7.1 Million in funding on accepted grant proposals.

January, 2011 – Grant recipients are notified of award and must advise program staff if they accept funding or another source was found. If recipients turn down grants, alternates are contacted in rank order for funding opportunities so every dollar is effectively spent.

February, 2011 – All money is invested. Grant recipients must then demonstrate that approval at their institutional levels to work with human subjects or on human tissues.

September, 2011 – Grantees are anticipated to receive their first funding – funding that was first allocated in 2009.

September 20** - **Wait two, three or four years for the research projects to conclude and another couple for researchers to publish their findings in a paper and it’s easy to see why the process begun on that cold wintery day in Annapolis in December, 2009 might not finish until December 2015, or beyond.

...

Congress appropriated another $6.4 Million to the ARP in April 2011. As a community, we could grow that figure for this innovative program if we just act. Learn more about the ARP and register at Autism Votes so you can be first to contact your Congressman and Senator to let them know we want their support to increase funding next year.

IDEA Fairness Restoration Act -- Autism Society Alert

A message from the Autism Society

IMPORTANT ACTION ALERT: CALL/EMAIL CONGRESS TO COSPONSOR IDEA FAIRNESS RESTORATION ACT
WEDNESDAY, MAY 4, 2011

On Wednesday, May 4, 2011, please contact your senators and representatives and ask them to cosponsor the IDEA Fairness Restoration Act (S.613 AND H.R. 1208). This bill will allow parents to recover expert witness fees when they prevail in due process hearings and court actions under the IDEA.

IDEA gives parents the right to an impartial due process hearing, but parents must be able to afford expert witnesses to testify at those hearings. Expert witnesses can include psychologists; physicians; speech, occupational, physical, and other therapists; educational experts; positive behavioral support experts, and others. Without expert witnesses, most parents cannot prevail. Sometimes, school districts sue parents and parents must have expert witnesses to adequately defend themselves.

The IDEA Fairness Restoration Act will restore the right to recover expert witness fees for parents and students with disabilities. Congress intended that parents have this right when it amended the IDEA in 1986. But in 2006, the Supreme Court acted contrary to this intent and held that parents could not recover expert witness fees in Arlington Central School District v. Murphy. Plaintiffs in other civil rights cases, like ADA cases, recover fees. This bill would simply give parents the same right.

ON WEDNESDAY, MAY 4, 2011, PLEASE CONTACT YOUR SENATOR AND REPRESENTATIVE AND ASK THEM TO COSPONSOR S.613 and H.R. 1208. It is crucial that Congress hear from parents of children with disabilities, advocates, attorneys, family, friends, and colleagues that this legislation is very important. If you cannot do this on May 4, please do it the week of May 2-6, 2011.

Please share this email with others.

HOW TO CONTACT CONGRESS: It is best to call your Representative and Senators. Calls are more personal and receive more attention. Even a 2 minute call is very helpful. But if you need to email because of work schedule, disability, or other reason, please do so.

CALL CONGRESS: Call your Representative and Senators and ask them to Cosponsor S.613 and H.R. 1208, the IDEA Fairness Restoration Act. You can call 202-224-3121 (TTY 202-225-1904). If you do not know who your representatives are, you can look them up at www.house.gov or www.senate.gov. Ask for the staff member who handles education or disability. Share with them the information below:

SEND AN EMAIL MESSAGE TO CONGRESS: You can email your representatives through their special forms on the House of Representatives website, http://www.house.gov/writerep, and write your Senators through their Web form on the Senate website, http://1.usa.gov/Senat

SAMPLE EMAIL / INFORMATION TO SHARE IN YOUR CALL: Here is information you can share with Congress. You can use it for your phone call, or you can cut and paste it into an email form. If you email, it helps to personalize it with even a few sentences about your child or your legal/advocacy practice. You might add something like “We are the parents of a child with autism and it is important to us that you support this bill, so we can afford due process if we are ever forced to go.” Or write something longer and more personalized.

Dear Congressman/Senator,

Please cosponsor the IDEA Fairness Restoration Act H.R. 1208 and S.613. It will restore Congress' original intent in enacting the Handicapped Children's Protection Act of 1986 that parents who prevail in administrative hearings and court actions be allowed to recover expert witness fees. The bill would overturn the Supreme Court decision in Arlington Central School District v. Murphy (2006).

When school districts provide an education so poor that they fail their legal obligations, parents can seek an impartial due process hearing to protect their child. In those hearings parents must provide testimony from such expert witnesses as psychologists, doctors, therapists, and educational experts. This testimony is needed to prove that a free appropriate public education was not provided to their children. Few parents can afford expert witnesses. Nearly 36% of children with disabilities live in families earning less than $25,000 a year; over two-thirds in families earn less than $50,000 a year. Without the ability to afford expert witnesses, the right to a due process hearing is not meaningful for most parents.

The bill simply gives parents the same right as prevailing plaintiffs under the Americans with Disabilities Act and other similar laws to recover expert fees. When Congress passed the Handicapped Children's Protection Act of 1986, it intended that parents would recover expert witness fees in IDEA cases, as clearly stated in the Conference Report. But the Murphy case overrode that intent. We ask Congress to restore its original intent and provide parents with the right to recover expert witness fees if they win their case.

Sincerely yours,
Your name here

---

More Resources:

The Senate bill, (S.613) is here: http://hdl.loc.gov/loc.uscongress/legislation.112s613
The House bill (H.R. 1208) is here: http://hdl.loc.gov/loc.uscongress/legislation.112hr1208
For more information about this alert, please contact Jeff Sell at jsell@autism-society.org

Sincerely,

Jeff Sell
Vice President, Public Policy & General Counsel
Autism Society

"A Big Question Mark Over the Autism Epidemic"

A new study boosts the notion that diagnostic substitution and greater awareness may be largely responsible for the apparent increase in autism prevalence. (Other studies, however, leave open the possibility of a true increase.) John Gever writes at MedPage Today:

The prevalence of autism spectrum disorders among British adults in a population-based survey was about 1%, researchers said -- closely matching rates seen recently among British and U.S. children, but contradicting suggestions that the incidence has risen dramatically over time.

Based on in-person clinical assessments performed on 618 adults of all ages, researchers from several U.K. universities calculated a community-wide prevalence of 9.8 cases of autism spectrum disorder per 1,000 population, according to a paper in the May issue of Archives of General Psychiatry.

Two recent prevalence studies in U.S. children also came up with figures near 10 per 1,000.

However, rates in the new British study did not differ markedly by age, "suggesting that the causes of autism are temporally constant," wrote Traolach S. Brugha, MD, of the University of Leicester in England, and colleagues.

The study is the first to attempt a population-based prospective assessment of autism-related disorders in adults, the researchers indicated.

Other studies, especially in the U.S., have suggested rising rates of autism among children over time, which ought to translate to substantially lower rates among older adults.

Although Brugha and colleagues did find a small decrease in prevalence with age -- about 1% per year -- the 95% confidence interval was a 4% increase to a 6% decrease per year of age.

"Based on [previous published studies], we would expect substantially lower rates in earlier birth cohorts (older respondents) if rates of autism spectrum disorders have been rising considerably during recent decades, and we would also expect lower rates in younger adults than in recent childhood surveys using the ADOS-4 [Autism Diagnostic Observation Schedule Module 4]. We did not find this," the researchers wrote.

"Overall, our findings suggest that prevalence is neither rising nor falling significantly," they added. "This favors the interpretation that methods of ascertainment have changed in more recent surveys of children compared with the earliest surveys in which the rates reported were considerably lower."

On the other hand, Brugha and colleagues did find several factors significantly associated with adult autism and related disorders in multivariate analyses. These included male sex, low educational attainment, and living in public housing

Frederik Joelving writes at Reuters Health:

"It was surprising to all of us," said Dr. Traolach Brugha, a psychiatrist at the University of Leicester, who worked on the study. "If this study is correct, it does put a big question mark over the autism epidemic."

...

In fact, more and more research hints that some if not all of the increase in autism may be due to changes in how, and how often, the disorder is diagnosed. Kids who used to be classified as mentally retarded or just plain eccentric, for instance, might now get an autism-spectrum label instead.

"That simply means more people are coming forth and being recognized," Brugha told Reuters Health.

...

Brugha said he was confident in the results, but that they should still be confirmed in other studies given the small number of people with autism found in this study.

Ha added that he had been disappointed to discover that none of those who got the diagnosis based on the study's clinical assessment were aware of their condition.

"None of them had been diagnosed (previously) with autism," he said. "I think for me the issue is that people have been ignoring autism in adulthood and only focusing on children."

See the abstract in Archives of General Psychiatry.

Asperger Truancy Charges

WPLG in Miami reports (h/t Disability Scoop):

The parents of a South Florida boy suffering from Asperger's syndrome said Broward School District administrators are threatening them with criminal truancy charges while they strive to find a proper class for their son.

The boy, 7-year-old Blake Buell, suffers from the developmental disorder, which is similar to autism, but different enough that his parents weren't happy when administrators at Floranada Elementary School placed their son in a class full of autistic children last fall.

"Their IQs were lower and they were not at grade level," said Blake’s mother, Nannette Buell. "Blake is at grade level, but his behavioral difficulties were causing him not to be able to access his education."

The Buells pulled Blake out of school and put him in an expensive, private program. Because the district didn't offer a more suitable program for Blake, his parents said the district is required, by law, to use federal money to pay for the program in which they enrolled Blake.

They asked the district for a due process hearing on the matter, but instead, the district threatened to have the Buells charged with truancy, a second-degree misdemeanor, because Blake isn't attending the class in which he was placed.

"And I feel the reason they did that is mainly because they didn't want to have to pay for the treatment," said Rick Buell, Blake’s father.

Video here

This dispute comes just as the American Psychiatric Association is considering a proposal to subsume Asperger's into Autism Disorder.

Minocycline

The Los Angeles Times highlights a medical intervention, building the story around Chase Brown, a young man who has made recent progress in his struggle with Fragile X:

Minocycline, the medication Chase has been taking for almost eight months, is one of several drugs that might correct — even reverse — many of the brain perturbations of fragile X and several other developmental disorders, including autism.

The medications are still far from proven: Large-scale trials may take several years to complete. But if they live up to their promise without dangerous side effects, they could accomplish what no medication has been able to: cure a genetically based intellectual disability.

Great caution is necessary. A pilot study of the use of minocycline for treating regressive autism found negligible clinical improvements.

The article also touches on neurodiversity:

Not all parents hailed this "ray of hope." Reacting to the news on a blog called Contrarian, Jenn Power, a Canadian mother of twin boys with Down syndrome, echoed the views of many who have been active in promoting the rights of those with intellectual disabilities.

"They do not need a needle in their brain to make them more functional, to help them find their car keys," she wrote. "What they need is a society that values what they have to offer."