When 1 in 150 is really 1 in 67

When 1 in 150 is really 1 in 67

By Raymond W. Gallup & F. Edward Yazbak, MD, FAAP

On February 8, 2007 the CDC released “New Data on Autism Spectrum Disorders (ASDs) from Multiple Communities in the United States.” (1)

Since then, most people and the press have been under the impression that in the United States, the “new” CDC- reported ASD prevalence rate of 1 in 150 was a recent discovery that was current for 2007 when indeed it was not at all. The study did not document a prevalence of 1 in 150 among children born now or five years ago. The study revealed that among U.S. children born in 1994, thirteen years ago, 1 in 150 on average had a spectral disorder.

According to the official press release:

“The Centers for Disease Control and Prevention (CDC) reported findings today from the first and largest summary of prevalence data from multiple U.S. communities participating in an autism spectrum disorder (ASD) surveillance project. The results showed an average of 6.7 children out of 1,000 had an ASD in the six communities assessed in 2000, and an average of 6.6 children out of 1,000 having an ASD in the 14 communities included in the 2002 study. All children in the studies were eight years old because previous research has shown that most children with an ASD have been identified by this age for services.”

The U.S. Department of Education has recently released the official figures for autism/ASD by age and state for school year 2006-2007, in accordance with the Individuals with Disabilities Education Act’s requirement that comprehensive annual reports be published and presented to the United States Congress.

Children born in 1994 and who according to the 2002 CDC study had an ASD prevalence of around 1 in 150, probably started first grade in the fall of 2000.

In Table I, we compared by state, the number of 6 year-old children with Autism/ASD in U.S. schools in 2000-2001 with those similarly diagnosed children of the same age who attended school in 2006-2007. The percent increase in that particular group since the CDC’s acclaimed 1 in 150 prevalence figures is listed by state in the right column.

All states, except Alaska and Oklahoma had increased first grade enrollment of children with spectral disorders. Thirty five (35) states more than doubled their load and consequently their financial needs and in New Mexico, the number of ASD students quadrupled between 2000 and 2006. The District of Columbia did not report.
STATE 2000-2001 2006-2007 % increase
Alabama 47 146 211
Alaska 30 28 -6
Arizona 151 454 201
Arkansas 95 106 12
California 1,539 3,465 125
Colorado 55 156 184
Connecticut 146 343 135
Delaware 22 56 155
District of Columbia 11 x 0
Florida 481 1,080 125
Georgia 273 551 102
Hawaii 42 76 81
Idaho 28 62 121
Illinois 499 945 89
Indiana 254 576 127
Iowa 33 56 70
Kansas 84 141 68
Kentucky 96 217 126
Louisiana 102 173 70
Maine 57 145 154
Maryland 232 414 78
Massachusetts 29 604 108
Michigan 415 735 77
Minnesota 240 695 190
Mississippi 31 64 106
Missouri 198 410 107
Montana 24 35 46
Nebraska 32 87 172
Nevada 59 214 263
New Hampshire 28 70 150
New Jersey 470 1,002 113
New Mexico 14 63 350
New York 664 1,306 97
North Carolina 273 450 65
North Dakota 12 20 67
Ohio 306 798 161
Oklahoma 67 43 -36
Oregon 213 452 112
Pennsylvania 427 1,065 149
Puerto Rico 68 167 146
Rhode Island 34 89 162
South Carolina 88 216 145
South Dakota 23 47 104
Tennessee 83 251 202
Texas 738 1,629 121
Utah 79 167 111
Vermont 12 21 75
Virginia 198 484 144
Washington 122 323 165
West Virginia 49 90 84
Wisconsin 201 461 129
Wyoming 9 27 200
Total 9,483 21,275 124

Table I
Children aged 6 with autism served by IDEA
Source: U.S. Department of Education

In February 2007, Marshalyn Yeargin-Allsopp, MD, MPH chief of the CDC's autism program was quoted as saying (1):
• “It is extremely difficult to accurately estimate the number of children who have an ASD”
• “Medical records often do not provide such information, and identification is often made by schools or education specialists”
• “We don't know the causes of ASDs, but we do know that if we can identify autism and other developmental problems in children early, they can begin receiving appropriate interventions sooner”
Parents of children with autism would probably agree with Dr. Yeargin-Allsopp’s first two points and most of them would gladly share their thoughts and ideas about the causes of autism, if she cared to listen.

In the same press release (1) CDC Director Gerberding was quoted as saying: “Our estimates are becoming better and more consistent, though we can't yet tell if there is a true increase in ASDs or if the changes are the result of our better studies.”

No one asked Dr. Gerberding why, when many at the CDC knew that their own 2002 study yielded a prevalence of 1 in 150 among eight-year old children, the CDC approved, distributed and advertised an “Autism A.L.A.R.M” (2) in January 2004 that proclaimed that “1 in 166 children are diagnosed with an autism spectrum disorder.”

Dr. Gerberding did not volunteer and it appears that no one thought of asking her why the CDC kept the results of the 2000 and 2002 studies secret for so long or if a third CDC study had been done in 2004 that was still “Top Secret” for undisclosed reasons.

In any case, if according to the CDC, the ASD prevalence rate was 1 in 150 on average among children born in 1994 and if the number of 6 year-old children with ASD known to the U.S. Department of Education indeed increased by 124% nationwide over the last six school years, then it is likely that among children born in 2000 who are now registered in U.S. schools, the prevalence rate of autistic spectral disorders is around 1 in 67, on average. Now that would be a catastrophe of unprecedented proportions.

Since the CDC 2002 study results were released in early 2007, no one in authority has bothered to correct the false impression that the “new” prevalence was current. Every day tens of newspaper articles and news items discuss the alarming increase in autism “that has now reached 1 in 150” and promptly reassure people that it is not related to vaccines and a mercury preservative. It will be interesting to see when the head of the CDC’s autism program will reveal to the Nation that the prevalence of autism and other spectral disorders is really more than double that estimate.

In Table II, we have compared the number of 6-21 year-old students with ASD who attended U.S. schools in the different states, the District of Columbia (DC) and Puerto Rico in school years 1992-1993 and 2006-2007.
STATE 1992-1993 2006-2007 % increase
Alabama 68 2,178 3,103
Alaska 8 454 5,575
Arizona 199 4,001 1,911
Arkansas 30 1,581 5,170
California 1,605 31,077 1,836
Colorado 14 1,642 11,629
Connecticut 164 3,361 1,949
Delaware 15 576 3,740
District of Columbia 0 219 0
Florida 582 9,101 1,464
Georgia 262 6,815 2,501
Hawaii 52 859 1,552
Idaho 39 993 2,446
Illinois 5 9,398 187,860
Indiana 273 7,391 2,607
Iowa 67 1,102 1,545
Kansas 74 1,510 1,941
Kentucky 38 2,068 5,342
Louisiana 409 1,964 380
Maine 37 1,384 3,641
Maryland 28 5,130 18,221
Massachusetts 493 5,966 1,110
Michigan 288 9,723 3,276
Minnesota 296 8,613 2,810
Mississippi 0 880 0
Missouri 336 4,381 1,204
Montana 20 314 1,470
Nebraska 4 1,023 25,475
Nevada 5 1,638 32,660
New Hampshire 0 922 0
New Jersey 446 7,706 1,628
New Mexico 16 612 3,725
New York 1,648 13,951 747
North Carolina 786 6,462 722
North Dakota 9 335 3,622
Ohio 22 9,059 41,077
Oklahoma 31 1,598 5,055
Oregon 37 5,459 14,654
Pennsylvania 346 9,865 2,751
Puerto Rico 266 1,070 302
Rhode Island 19 1,018 5,258
South Carolina 141 1,977 1,302
South Dakota 36 477 1,225
Tennessee 304 2,881 848
Texas 1,444 16,801 1,064
Utah 105 1,959 1,766
Vermont 6 328 5,367
Virginia 539 5,813 978
Washington 476 4,677 883
West Virginia 101 782 674
Wisconsin 18 5,042 27,911
Wyoming 15 279 1,760
Total 12,222 224,415 1,736

Table II
Children aged 6-21 with autism served by IDEA
Source: U.S. Department of Education

There were 193,481 students with ASD, age 6 -21, registered in school year 2005-2006. The 224,415 students in the same category in school year 2006-2007 reflect a 16% increase over 1 year.

The U.S. Department of Education started providing enrollment statistics on pre-school children age 3-5 in 2000. In Table III we compare those original statistics with the recent figures for school year 2006-2007.
STATE 2000-2001 2006-2007 % increase
Alabama 84 195 132
Alaska 27 x 0
Arizona 94 364 287
Arkansas 95 195 105
California 3,422 8,521 149
Colorado 53 249 370
Connecticut 152 453 198
Delaware 62 138 123
District of Columbia 16 60 275
Florida 847 1,799 112
Georgia 272 635 133
Hawaii 88 159 81
Idaho 28 78 179
Illinois 670 1,221 82
Indiana 456 798 75
Iowa 128 90 -30
Kansas 87 169 94
Kentucky 168 299 78
Louisiana 121 318 163
Maine 150 376 151
Maryland 371 606 63
Massachusetts 231 1,579 584
Michigan 631 1,272 102
Minnesota 345 1,241 260
Mississippi 34 96 182
Missouri 134 298 122
Montana 40 58 45
Nebraska 37 161 335
Nevada 89 497 458
New Hampshire 55 138 151
New Jersey 397 831 109
New Mexico 6 116 1,833
New York 2,244 1,520 -32
North Carolina 261 903 246
North Dakota 17 40 135
Ohio 326 410 26
Oklahoma 9 65 622
Oregon 429 848 98
Pennsylvania 594 2,458 314
Puerto Rico 147 188 28
Rhode Island 48 130 171
South Carolina 121 392 224
South Dakota 35 89 154
Tennessee 153 481 214
Texas 1,108 2,443 120
Utah 58 247 326
Vermont 14 58 314
Virginia 222 581 162
Washington 64 514 703
West Virginia 14 38 171
Wisconsin 410 593 45
Wyoming 21 35 67
Total 15,685 35,043 123

Table III
Children aged 3-5 with autism served by IDEA
Source: U.S. Department of Education

Here again, the number of children with Autism/ASD more than doubled in six years. Alaska did not report and the number of affected children decreased in Iowa and New York by 30 and 32% respectively. In all other states and in DC, the number of 3 to 5 year-old children with ASD increased significantly over the last six years with thirty seven states reporting increases of over 100%. New Mexico, Washington State and Massachusetts had the highest increases: 1833%, 703% and 584% respectively.

The Diagnostic and Statistical Manual of Mental Disorders clearly outlines the required criteria for the diagnosis of autism and autistic disorders. The manual’s 4th and last revision was introduced in 1994. Since then, the diagnostic criteria of DSM-IV have not changed in any way. There have been incessant claims that the increasing prevalence of ASD is only due to the less stringent “newer” diagnostic criteria. We disagree and we have shown that indeed DSM-IV criteria are more numerous and specific. (3)

In any case, it is hard to believe that anyone would even think that in this day and age, school districts would be willing to pay thousands of dollars to provide specialized remedial services to children and adolescents who do not have a spectral disorder and distinct special needs. More ludicrous is the idea that these services would be perpetuated without a convincing reason year after year.

Table IV lists the number of students aged 6 to 21 who were registered in U.S. schools since DSM-IV and the yearly increases since then.
School Year Students Increase
1994-95 22,780
1995-96 28,813 6,033
1996-97 34,082 5,269
1997-98 42,487 8,405
1998-99 53,561 11,074
1999-00 65,391 11,830
2000-01 78,717 13,326
2001-02 97,847 19,130
2002-03 118,603 20,756
2003-04 140,920 22,317
2004-05 166,302 25,382
2005-06 193,481 27,179
2006-07 224,415 30,934

Table IV
Yearly increase: Children 6-21 with autism
Source: U.S. Department of Education

In 1994, the population of the United States was estimated at 260,204,000. It increased by 14.7% to 298,444,215 in 2006. During the same period, the number of students aged 6-21 with autistic spectral disorders known to the U.S. Department of Education increased by 885% from 22,780 to 224,415.

Table V lists the yearly increases in the number of children who are 3 to 5 years old and who carry the diagnosis of autism or ASD.
School Year Students Increase
2000-01 15,581
2001-02 17,032 1,451
2002-03 19,017 1,985
2003-04 22,724 3,707
2004-05 25,902 3,178
2005-06 30,276 4,374
2006-07 35,043 4,767

Table V
Yearly increase: Children 3-5 with autism
Source: U.S. Department of Education

This 125% increase in children 3 to 5 years old in 6 years is 20 times greater than the percent increase in the US population since the 2000 census when it was 281,421,906.

The following graph illustrates the increase in the number of children with autism and ASD during the last 15 years, in fact since autism was listed as a separate category by the U.S. Department of Education.

Increase over the last 15 years
Children with Autism / ASD age 6-21 in U.S. Schools
Source: U.S. Department of Education

We are fully aware that many do not believe the statistics that are collected yearly by the U.S. Department of Education on which we have based our reviews (and concerns) since 1999. We respect their right to do so.

We believe that the alarming trend that we have described must be halted and reversed before another generation of children is lost and thousands more families are destroyed.

Shame on them who have chosen to close their eyes, their ears and their minds to this tragic and serious problem!

References

1. http://www.cdc.gov/od/oc/media/pressrel/2007/r070208.htm
2.
3. http://www.medicalhomeinfo.org/health/Autism%20downloads/AutismAlarm.pdf
4.
5. Yazbak FE. Autism in the United States: A Perspective. J. Am Phys Surg 2003; 8(4) 103-108 http://www.jpands.org/vol8no4/yazbak.pdf
6.

ends

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