Autism on the Rise: Many Speculation with No Definitive Answers - Coursework Example

Autism on the Rise: Much Speculation with No Definitive Answers HERE HERE The diagnosis of autism among children, or more accurately Autism Spectrum Disorder, is on the rise in children throughout the world. Researchers, despite much speculation on the various causes behind the rise, have yet to find one definitive answer. Various factors have been analyzed, such as better diagnostic criteria for analyzing behaviors in children, wider screening procedures to find children that may be suffering from autism. In some cases, the finger has been pointed towards the environment and what exactly it contains that could be making children autistic. Other studies have undertaken the responsibility of finding out what part genetics plays in the current rising trend of autism. Though one or all of these factors may one day emerge as the definitive cause behind autism and the various disorders associated with it, the fact remains that there is no one definitive cause, and as such, all must be examined and researched further with careful thought and study. Introduction The medical condition of autism, more commonly known today as Autism Spectrum Disorder (ASD), actually comprises three or four specific medical disorders, each of which is unique and yet characterized by a common set of criteria. All types of autistic disorders are classified as neurodevelopment disorders, meaning that they affect the growth and development of the brain and/or the central nervous system (National Institute of Neurological Disorders and Stroke, 2012). The most severe cases of Autism Spectrum Disorder are commonly called simply “autism” or “classical ASD”, while others along the spectrum are generally more mild, including the diagnoses of Asperger Syndrome, childhood disintegrative disorder, and pervasive development disorder not otherwise specified, usually abbreviated PDD-NOS (National Institute of Neurological Disorders and Stroke, 2012). Of the milder forms, Asperger Syndrome is seen the most often, while children that exhibit some symptoms are often diagnosed with PDD-NOS, and childhood disintegrative disorder, whereby a child progresses normally until approximately their third or fourth year and then suddenly shows regression, is the rarest form seen (National Institute of Neurological Disorders and Stroke, 2012). In all disorders, the hallmark of the spectrum itself is delayed or nonexistent communications between the child and others (National Institute of Neurological Disorders and Stroke, 2012). Generally, it has been found that symptoms of autism appear as early as two or three years of age, though they can appear both sooner and later in childhood development, at which time any type of disorder along the autism spectrum can be diagnosed by behavioral tests and other methods administered by a licensed physician (National Institute of Neurological Disorders and Stroke, 2012). While criteria for diagnosing any disorder along the autism spectrum exist, there is no one “test” that can be administered (National Institute of Neurological Disorders and Stroke, 2012). Due to this, physicians and parents alike must rely on signs, symptoms, and testing to determine what may be occurring with the child in question. The exact cause of autism, or if one even exists, is unknown at this time. Most researchers can agree that it is unlikely that a “smoking gun” will ever be found, and there will never be simply one reason that one child is affected by autism and another is not (Cone, 2009). Despite any lack of agreement on this issue, however, it cannot be denied that autism and the associated disorders with it are becoming more and more prevalent in children throughout the United States, and even throughout the world (Novella, 2008). In 2008, 1 in 88 children were found to have some type of disorder related to autism, as opposed to 1 in 150 even as recently as the year 2000 (“Prevalence of autism,” 2012). Moreover, it has been found that autism is five times as likely to occur in males versus females, with 1 in every 54 young males having some form of autistic disorder versus 1 in 252 females (“Prevalence of autism,” 2012). When relatively short time spans are compared, the results become even worse; cases of autism rose 23% from 2006 to 2008, and 78% between the years of 2002 to 2008 (“Prevalence of autism,” 2012). Though speculation has been formed as to risk factors and characteristics behind autism, the only concrete evidence that has been gathered is that it knows no discrimination between ethnic groups or socioeconomic boundaries (“Prevalence of autism,” 2012). In short, every child could be at risk, and no research has, as yet, been able to find out exactly why. Just as there is no definitive cause for the disorder itself, there is also no definitive cause for the rise in autism prevalence that currently plagues the world. The best reasoning that can be speculated is that earlier diagnoses and better diagnostic criteria for determining if a child is affected with an autistic disorder could be behind the increase. Some, on the other hand, attribute the rise in to environmental factors, especially if there are a high percentage of autism cases in one geographic area. Others are quick to blame childhood vaccinations, while more research studies are attempting to determine if genetics plays any part in autism spectrum disorders, particularly given the prevalence in young males. Whether one factor or all factors listed above are the cause behind the rising numbers of the disorder has yet to be determined. There can be no doubt, however, that each deserves closer examination and review. The Various Causal Factors behind the Rise in Autism Cases Cause Number One: Better Diagnostic Screening and Broadening Criteria One of the biggest speculations about the rising prevalence of autistic disorders, in fact possibly the biggest of all, is that there are simply better methods for detecting the disorders in children. Researchers have gone so far as to go back to children diagnosed with developmental disorders such as “non-specified language disorders” in 1980, and use with them the criteria that are used today to make a diagnosis of an autistic disorder (Novella, 2008). It was found in doing so that 25% of those that had been diagnosed as simply “learning disabled” or with a more general disorder would have today been labeled as autistic in varying degrees (Novella, 2008). Studies have also confirmed that this could be the case. Even United States federal health officials have confirmed that diagnostic procedures by physicians have had an effect on the number of cases of autistic disorders that are reported every year (Stobbe, 2012). Reviews of literature and other cases have had the same effect; given the criteria of today, the new definitions of what exactly comprises an autistic disorder, and increased training to diagnostic procedures, there are indeed more cases of autistic disorders seen that in the past would have been given another diagnosis (Novella, 2008). Given the range of the studies that have been completed, enough hard data is available to reach the conclusion that better measures of detection certainly has something to do with the rising number of cases of autistic disorders. Hand in hand with better diagnostic procedures are better means of finding children that may suffer from autistic disorders. No longer is it up to the parent to bring their child to a physician; in fact, entire communities are sometimes scoured for those that may be suffering from an autistic disorder (Novella, 2008). Alongside this, parents are now more accepting of the label of “autism”, and not hesitant to accept that their child may indeed suffer from some form of the disorder (Novella, 2008). No longer does the diagnosis of autism strike up the image of a drooling adolescent in diapers, unable to feed themselves. While this may certainly describe someone with “classical autism”, adults are now seeing that children diagnosed with autism are able to live relatively normal and happy lives with varying degrees of help and support from the educational system (Novella, 2008). It should be noted, however, that this is by far not the only reason for the rising prevalence being seen. The same health officials stating that better diagnostic procedures and wider screening abilities are the reason behind the rising prevalence of autism are just as quick to point out that it should not be considered to be the only cause (Stobbe, 2012). They are also quick to point out that they are not entirely sure what the reason is behind the rise in autistic disorders, and that even though better diagnostic criteria and wider screening procedures are, again, certainly a factor, they are not the only reason (Stobbe, 2012). Other avenues of research are still being explored, and at this present time, no one cause has been singled out as the culprit behind why, exactly, so many children are showing up with autistic disorders. Cause Number Two: Environmental Factors There are times when, even though an increase in methods and detection is certainly supported, it just does not offer a complete explanation of the rising prevalence, particularly when the numbers of autism cases are presented against a specific geographic area over time. The state of California is one such example. Since 1990, they have seen a dramatic increase in numbers of children with autistic disorders, to the extent that children now are seven to eight times more likely to have autism (Cone, 2009). In 2006, more than 3,000 new cases of autism were reported, compared to the 205 that were reported in 1990 (Cone, 2009). The trend was once thought to be artificial, due to other factors such as migratory patterns or the aforementioned “better diagnosis” theories (Cone, 2009). Researchers in California now believe that not to be true, at least not completely, and are now looking towards anther culprit for explanation. Though it is acknowledged that diagnostic criteria and better screening procedures do have their place among the rising trend of autism, researchers in California now propose that the environment is the main factor behind autistic disorder cases in that state. Scientists at the University of California-Davis Department of Public Health Sciences, in analyzing over seventeen years of data compiled by the state that tracked autism and other childhood disorders, found that there was no substance to the theory of migratory patterns being the cause (Cone, 2009). Furthermore, they found that better diagnostic care and screening procedures actually accounted for less than 50% of the increase in recorded cases (Cone, 2009). While it was also agreed that autism was being diagnosed at a younger age by physicians, it was found that this only accounted for a 24% increase, while the inclusion of more mild disorders only accounted for a 56% increase (Cone, 2009). Overall, that left much unexplained about the 600-700% increase in autism disorder diagnoses that were seen throughout the state between 1990 and 2006 (Cone, 2009). An even more disturbing factor was that the rising numbers showed absolutely no sign of stopping, or even slowing down (Cone, 2009). Clearly, something else was to blame other that simple diagnostic procedures and more widely available screening. The focus is now shifting to environmental factors, at least in research studies in the state of California. Though progress is being made, it is doubtful when actual results will be published, both due to the length of studies and the amount of environmental factors to consider (Cone, 2009). The factors could include anything from pesticides and chemicals in household products to naturally-occurring bacteria and viruses (Cone, 2009). Theories are also being posited that pertain to exposure of pregnant women to chemicals such as pet flea shampoos, cosmetics, and even antibacterial soaps, which may contain chemicals potentially able to cause autism (Cone, 2009). While the chemicals themselves do not directly cause autism, they can affect brain development and growth, which is the main reason behind the research studies (Cone, 2009). Again, however, given the size of the environment, the number of chemicals and other factors to take into account, and the length of time over which studies must be conducted, scientists do not believe that they are close or even in some cases beginning to find the root cause, if it does exist, in the environment. For now, all that can be done is to continue to watch and analyze data, and conduct trials and studies in an attempt to ferret out the cause of rising autism prevalence, at least in the state of California. Cause Number Three: Childhood Vaccinations Of all of the causal factors evaluated for the rising trend in autism disorders, this is perhaps the one with the most definitive proof behind it. However, those (namely parents of autistic children) that have been looking towards childhood vaccinations as a cause for autism have been sorely disappointed by the results. Parents were not completely wrong in their worries, for there were studies undertaken that showed a link between the measles-mumps-rubella (MMR) vaccine and rising autism figures (Roberts & Harford, 2002). It was thought that there was a link between the thimerosal found in vaccinations and the rising cases of autism being reported (Roberts & Harford, 2002). What the studies failed to take into account, however, were several essential factors. First, autism cases rose steadily despite MMR uptake being the same (Roberts & Harford, 2002). Second, thimerosal was never included in MMR vaccines, and was not found to be present in any vaccine since the year 1992 (Roberts & Harford, 2002). Therefore, studies linking autism and thimerosal, or any other childhood vaccine, were refuted in theory. The theory was proven in a critical review of the data used in original testing (Parker, Schwartz, Todd & Pickering, 2004). It is now the proven opinion of the medical community that there is not now, nor has there ever been, any link between childhood vaccinations and autism (Parker, Schwartz, Todd & Pickering, 2004). Despite controversy surrounding the needed immunizations, and parental fears, there is nothing at this time to suggest that any vaccine will cause autism. Cause Number Four: Genetics Another possible cause that is now being researched and studied for the prevalence of autism disorders is genetics. Validated data is now available to prove that autism disorders are far more likely to occur in boys as opposed to girls, in fact at a 5 to 1 ratio (“Prevalence of Autism,” 2012). While researchers are still stymied as to the cause of this, they have made strides in identifying what has become known as an “autism-risk gene” (Park, 2009). It has also been shown that this risk gene, labeled CACNA1G, is more common in boys than girls (Park, 2009). The supposition is therefore becoming clear: Since this risk gene is more common in boys, autism will also be more common in boys. Though this has not definitively been proven, and in no way can the conjecture be made that this “risk gene” is the cause behind autism, at least a door has been cracked open to what may prove a valuable piece in decoding the autism puzzle. Again, this gene in and of itself has in no way proven that it is the root cause of the disorder. It has only been hypothesized, based on available findings that this may have something to do with risk towards autism disorders. CACNA1G sits on chromosome 17, and is responsible for regulating calcium into and out of the cells of the brain (Park, 2009). Brain cells rely on calcium for stimulation and deactivation; therefore, should the gene be acting in a faulty manner, things such as overstimulation and desensitization can result (Park, 2009). Even though this is only a hypothesis, if enough studies are undertaken over time to study the genetics behind autism disorders, should there prove to be any, this may one day emerge as a root cause for prevalence of autistic disorders. At the present time, it can only be looked upon as another possibility, alongside things such as environmental factors and better diagnostic criteria. Conclusion It is in the nature of humans to be curious, and as such, to try and determine the exact causal factors behind any trends that are shown to occur. This proves particularly true with a disorder such as autism, where it not only affects children but appears to affect larger and larger portions of them as time moves forward. Unfortunately, at this time, autism and its related diagnoses, despite better criteria and earlier detection, have no known cause, and no definitive reason behind the rise in children being diagnosed and afflicted with any disorder related to autism, however disturbing it may be. Though it has clinically been disproven that vaccinations play a part in autism, and the leap forward in discovering the “autism gene” certainly did not hurt, the sad reality is that there is, at this time, no one known cause for either the disorder itself or the rising numbers of children affected by it. The most that can be hoped for is that research into this as-yet mainly mysterious disorder can continue and expand, so that one day the questions and speculations that have arisen can finally be put to rest. The numbers of those diagnosed with autism or related disorders that today travel in an upward direction, with further research may someday fall, and it is no doubt the hope of many that the trend may soon be stopped or reversed altogether by finding and isolating the definitive cause behind it. . References: Cone, M. (2009). Autism increase not caused only by shifts in diagnoses; environmental factors likely, new California study says. Environmental Health Sciences, Retrieved from http://www.environmentalhealthnews.org/ehs/news/autism-and-environment National Institute of Neurological Disorders and Stroke. (2012, May 04). Autism fact sheet. Retrieved from http://www.ninds.nih.gov/disorders/autism/detail_autism.htm Novella, S. (2008, April 16). The increase in autism diagnoses: Two hypotheses. Retrieved from http://www.sciencebasedmedicine.org/index.php/the-increase-in-autism-diagnoses-two-hypotheses/ Park, A. (2009, May 19). A genetic clue as to why autism affects boys more. Time Magazine, Retrieved from http://www.time.com/time/health/article/0,8599,1899756,00.html Parker, S. K., Schwartz, B., Todd, J., & Pickering, L. K. (2004). Thimerasol-containing vaccines and autistic spectrum disorder: A critical review of published original data. Pediatrics, 114(3), 793-804. doi: 10.1542/peds.2004-0434 Roberts, W., & Harford, M. (2002). Immunization and children at risk for autism. Journal of Pediatric Child Health, 7(9), 623-632. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2796520 Stobbe, M. (2012, March 29). Better diagnosis, screening behind rise in autism. Retrieved from http://www.msnbc.msn.com/id/46892046/ns/health-childrens_health/t/better-diagnosis-screening-behind-rise-autism/ U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. (2012). Prevalence of autism spectrum disorders — autism and developmental disabilities monitoring network, 14 sites, united states, 2008 (Surveillance Summaries / Vol. 61 / No. 3). Retrieved from Office of Surveillance, Epidemiology, and Laboratory Services website: http://www.cdc.gov/mmwr/pdf/ss/ss6103.pdf Read More