The CDC made headlines last month when they announced that Autism rates have risen by 30 percent, now one in 68 children can expect an autism spectrum disorder (ASD) diagnosis. Headlines blared, parents expressed grave concern, and calls for “solutions” echoed around the internet.
But let’s all take a breath. The first 2007 CDC report estimated autism at one in 150 children. These revised numbers look at data through 2010, but a lot has happened since then.
Diagnosis Creep
Our Sermo physicians have discussed the phenomena of diagnosis creep. As the medical community learns more about ASD there is a spike in diagnoses. Essentially cases that previously would have been dismissed, now receive a diagnosis. Other suggested reasons for the increase in diagnosis:
- Children receive ASD diagnoses from providers who are not properly trained
- An increase in older parents may contribute to the problem
- An increase in maternal stress during pregnancy
It’s a whole new DSM-5
The fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) released nearly a year ago changed several aspects of autism. The criteria for diagnosis simplified and raised the bar for those who fit the newly named autism spectrum disorder. The Task Force Chairs discussed the reasons for their changes here. One reason for the changes was to tighten and clarify the diagnosis of what is and isn’t autism.
The DSM-5 also recommends that those who received an autism spectrum diagnoses under DSM-IV-TR guidelines be grandfathered and continue with treatment and support options already in place. The current guidelines should apply only to new diagnoses.
Columbia researchers completed a systematic literature review and meta-analysis to see the impact of the new guidelines. The study found 31 percent fewer ASD diagnoses using the DSM-5 compared with its predecessor, the DSM-IV-TR.
Is This Even a Responsible Study?
The CDC’s data is four years old and doesn’t reflect the recent DSM-5 changes. Early indications are that the diagnoses will decrease significantly under the new guidelines. Did the CDC act responsibly when they released this study, knowing the parameters are outdated?
As a physician what do you think about the changes in criteria? Have you found the new guidelines more helpful or did you prefer the DSM-IV-TR? We will be discussing this inside Sermo, if you’re an M.D. or D.O. please join us.
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