1 in 68 children on autism spectrum, says US CDC | Hacker News Reader

1 in 68 children on autism spectrum, says US CDC

cdc.gov

67 pointssebleon70 comments

Prematurity is linked to developmental delay and is suspected to be correlated with more pronounced Autism spectrum attributes.

I wonder, in addition to the likely chemical sources, how many more children born early are saved than were in previous decades, and how they may be contributing to this rise.

I know that Surfactant has been around for decades now and I suspect but don't have data that it was the last truly game changing upgrade to NICUs.

The CDC has said with this data "this is up". I think the data is out there to also give a range of reasons and a likelihood for each.

On a personal note, if you suspect your child may be at risk for Autism, early therapy is available and effective. Get it, get it now, get as much of it for your child as you can. My contact info is in my profile and I am happy to point you to the data and assistance.

Multiple studies link parental age to autism. Teenage mothers, and to a much greater extent older parents (especially fathers) have a higher chance of autistic children.

http://www.npr.org/sections/health-shots/2015/06/10/41320592...

https://www.autismspeaks.org/science/science-news/study-ties...

https://www.autismspeaks.org/science/science-news/large-stud...

It doesn't seem to be enough to account for the whole difference, but given the increasing parental age at birth, it's an appealing theory. Lots of developmental disorders, e.g. Down's syndrom, have already been linked to older parents.

I know "45 is the new 25" is popular, but biology is harder to convince.

Perhaps autistic fathers are taking more time to find a mate, and they also pass on their genes.

Plausible.

Maybe autistic potential fathers find more acceptance in today's nerd culture, and have the opportunity to pass on autistic genes :)

Early studies showed autism as 90% generic, but more recent ones put it much lower.

That wouldn't explain why the rate is increasing, unless these autistic fathers are having higher than average children despite starting at a higher age.

The underlying biology of spermatogenesis is also involved. As males age, the germ cells (~stem cells) that produce sperm are continuously dividing. One of the daughter cells from the division becomes sperm, the other continues on as a germ cell [0]. Over time and with aging, the germ cells accumulate new mutations (primarily single nucleotide changes), which are then also passed on in the newly created sperm. While it is also possible that a mother's eggs carries a new mutation, these do not increase in frequency with aging because her eggs are created in utero and do not undergo the lifetime of regeneration that the father's sperm do.

These "de novo" mutations can sometimes affect or "break" genes important for normal development, thus resulting in autism. They can be studied by sequencing father/mother/child families and comparing the genetic sequence of each. The de novo mutations show up in the child only. We can differentiate if they arose in the father's sperm or the mother's eggs by examining the "haplotype" around each of these mutations (basically, looking for other nearby mutations that were inherited by the child from either mom or dad).

For more on this, see this paper: https://www.ncbi.nlm.nih.gov/pubmed/22495309

[0]: https://en.wikipedia.org/wiki/Spermatogenesis#/media/File:Sp...

I thought the rise of market economics would bring about better humans because its more efficient and just generally the best system for humans?

Since the recorded increase is large and for births within the last 25 years I suspect that changes in diagnosis play a bigger role in the increase than more gradually-changing birth ages and pre-term survival rates (much as I'd like to believe the latter was of huge importance and not just a potentially relevant factor since the relationship between preterm birth and inattention was the subject of my sister's PHd research...)

Except most kids with Down syndrome are born to young mothers... the risk is higher with older mothers but young women still make up the majority of new mothers.

Aspie here, my parents mid 20's when I was conceived and I was a week late being born.

Would in retrospect say my farther was also somewhat upon the spectrum, so genetics are a factor. If those genetics can be activated or induced by other factors, I can not say though like all DNA we have which is dormant in some and not in others, external factors can come into play by that stress, chemical (environmental or self induced exposure) and other factors we are still learning about. Heck recently identified an organ in the humanbody that we had overlooked for all this time ( http://www.independent.co.uk/news/science/new-organ-mesenter... )

So who knows. All we do know is once a trait becomes the predominant trait in humanity then that is classed the new normal.

One anecdote here: Both my daughter and son are on the spectrum (high-level autistic, or aspberger). Daughter was born when I was 29 and wife was 34, son three years later (so perhaps a little older than average). Neither was especially premature (both about 5-6 days early from memory) and very smooth pregnancies.

Son was diagnosed at age seven, daughter at age fifteen. Generally it can be harder to pick up with girls. They tend to be better mimics and it can present much more subtly. I really wish we had figured it out sooner with our daughter – she is had a lot of issues with anxiety and school refusal for the last few years, and I wonder if had had the necessary information earlier like we did with our son, how much of a difference it would have made. (Although both are autistic, they present so differently it was not obvious.)

So I reiterate johnnyg’s exhortation to seek a diagnosis and early treatment if you suspect there may be autism at play. There’s a steep learning curve to getting your head around it and figuring out how to best help yourself and/or your loved ones, but you read hacker news, so you’re up for the challenge. Find (or start) a local community support group – it’s a hell of a lot easier than trying to hack it alone.

"on spectrum" is a pretty loose definition though. I bet a decent chunk of the hn crowd could be made to fit onto the extra-mild side of the spectrum if one tries (myself included).

That's not meant to trivialise a real problem...point is the cut-off point is decidedly vague so stats like these are dicey at best.

Yeah isn't the whole point of a spectrum that everyone is on it?

I remember reading about how some scientists think everyone is technically on this spectrum (I mean, outside of the obvious "it's a spectrum so everyone is technically on it"). Ultimately it means the brain is far more complex than our attempts at bucketing disorders.

I'm very curious to see where this takes us. Does the spectrum just continue getting wider? Do we start finding more specific disorders and classifying those individually instead?

This is not true. There are specific indicators that are very well established.

Even indicators are a spectrum.

The definition of autism has changed significantly over time[1] and many studies[2] show this is correlated with the rate increased.

As it happens autism diagnosis is first possible around the same time as certain vaccines are given[3].

[1] http://www.unstrange.com/dsm1.html

[2] eg http://www.forbes.com/sites/tarahaelle/2015/01/05/majority-o...

[3] https://en.wikipedia.org/wiki/Apophenia

They've actually found that you can diagnose autism in even younger children e.g under a year. Way before vaccines are given. However such screening has not yet become widespread.

I think an AI program could help screen here.

Some vaccines are given at birth at many others by two months and still others at 4 months (in the US). I am not aware of any test that can work that early.

https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolesc...

This is a major public health crisis and there's not enough being done to help these kids. Where treatment is available there are long waitlists. Also ABA therapy is a huge growth industry. I encourage everyone to get involved. I worry greatly that the repeal of the ACA will doom many of these children in many states.

Autistic individuals don't need treatment, they need accommodation from society. (in my opinion, as an autist)

I think it unreasonable for you to claim to speak for everyone on the spectrum.

Is what you say true for some? Sure.

But there are many far more severely impaired who desperately need better support systems, as do their caregivers.

Especially considering there are some many that are unable to speak themselves.

(S)he has more right to speak for us than the majority of (neurotypical) decision makers.

Only for those on the lighter edge of the spectrum. I have a severely autistic sister who requires constant care and could never be functional in society. I feel I have more right to speak for her than the OP does. The neurotypical or neuroatypical decision makers argument doesn't really play when the individuals we're discussing lack the ability to make decisions in their own best interests.

But your sister, and her family, needs better accommodations from society.

She needs better treatment, so perhaps someday she could live something even resembling a normal life. She already gets plenty of accomodations from the government and society as a whole, living in a group home, etc. I don't know what other accomodations could really be made.

Yes, just as, as a man who's of below average height, I also can speak for little people.

No wait, I can't...

Agreed. Steve Silberman, author of Neurotribes, says, "If you've met one autistic person, then you've met one autistic person." For me that was definitely a caution against one-size-fits-all approaches.

I also think a fair bit here about how the default becomes invisible when we think about these topics. If you look at a lot of society's institutions, you could see them as "special accommodations" for the neurotypical. Some people will definitely need more support than others. But I'm often struck by how different people just need different support than others. It just looks like extra support because it's not what we're used to.

As a small example, introverts often have a whole host of tricks for dealing with an extroverted world. E.g., sneaking into a bathroom for a few minutes of blessed quiet. The relationship flips when you enter into some introvert-dominated space, like a library. I often wonder what the world would be like if being "on the spectrum" were the majority case, and our current neurotypicals were a clear minority.

I agree (I would never make that claim, other autists may feel differently) , and do think there should be better support systems.

Some individuals may need treatment because they have meltdowns / anti anxiety w/e but I don't think this should be framed as 'treating' or 'curing' autism. Autistic individuals may have all sorts of difficulties in their lives that need to be addressed, but the solution isn't to make those individuals not autistic.

When we talk about struggles that minorities and people of color face in American society today, you don't say let's 'treat' or 'cure' blackness -- I don't even need to explain why that's an affront.

I think what is needed is to understand what factors (e.g. environmental, genetic, etc) lead to autism so we as a society and parents can try to prevent it.

You can treat the symptoms. Amazing progress has been made.

so you are advocating for eugenics?

although you may have read in some headlines that autism is 'on the rise' and there are an increasing number of diagnoses, I think this is a misinterpretation.

statistics looks like it's on the rise because 50 years ago we didn't know what autism was, and instead we gave diagnosis like 'idiot' and 'imbecile'.

I don't think it's a stretch to say society has always had autists, maybe rather than trying to understand why autism happens energy would be better spent in trying to understand autistic individuals.

No but there is nothing wrong with understanding how now to pass a potentially disabilitating condition to your children.

Pre conception and post conception genetic screening is available and is practiced by a lot of people and in some case whole populations.

If both parents are carriers of certain genes there are solutions if only one it's easier and just selective fertilization is often used.

Autism is a disease, widespread access to screening and more information is not "eugenics"... you're equating disease prevention with forced government sterilization and selective breeding.

a disability isn't a disease. and I'm not equating anything with forced government this or that.

I agree that society should make accommodations for this but it should also be looked at to see if we can 'cure' it. In the US, there's plenty of accommodations for handicap people (usually people who can't walk) but I'm fairly certain we're still looking for ways to 'fix' that.

Surely as it is a spectrum they do not all need one thing, a range of treatments to go with the range of issues associated with it. I know you have only provided one sentence but it sounds very close to the institutions of the 1950s.

Accommodations means thing slike disability rights in the workplace, not housing.

The tough part in the US is that it just needs treatment. As an adult that means you are either employed and skilled enough to get health insurance through your employer, or go on disability and live in poverty (while probably getting poor treatment).

If you're posting here then you're probably high-functioning enough to be subclinical. But not all autists are. For many, some form of intervention is necessary to help them cope and live meaningful lives. This is the sad reality.

In my opinion as someone who works towards inclusion for those with intellectual and developmental disabilities...

Why not both?

oh, the hardcore pseudo-neurodiversity movement arrived. sorry for impoliteness but you guys need to stop looking only at yourselves as you're old-fashioned high-functioning intelligent people with certain emotional intelligence circuitry altered, perhaps, perhaps something else, doesn't really matter as long as you can talk and be understood.

now compare to this: https://www.youtube.com/watch?v=rvC5gzmwq_8 and please tell me with a straight face that this kid wouldn't greatly benefit from being able to communicate which treatment hopefully gives him or already has.

alternatively, some of you actually went through treatment and are in a i-am-fine-what's-the-problem state of thinking, which is obviously wrong in general.

No one is against occupational and speech therapy. What we're against is shocking children to make them obey, forced expose to adverse textures and other techniques frequently used to try to prevent harmless behaviors.

shocking children as in electric current? it's so awful i didn't even consider the possibility of it being done, i'm fully against such kind of torture.

I think this quote from Temple Gradin (noted autist) sums it up best:

“In an ideal world the scientist should find a method to prevent the most severe forms of autism but allow the milder forms to survive. After all, the really social people did not invent the first stone spear. It was probably invented by an Aspie who chipped away at rocks while the other people socialized around the campfire. Without autism traits we might still be living in caves.”

http://www.azquotes.com/quote/362838

Not just the repeal of the AVA. My friend with an autistic son is very worried about the lack of commitment to disability rights in public education shown by the incoming administration's nominee.

Yes I agree but one hope is the Supreme Court who is hearing a case on disability rights in schools. It's pretty clear that schools are not meeting the standard of equal education for students with disabilities and hopefully that finding will trump a hostile administrator.

I'm not optimistic about that given the open seat, advanced age of the notorious RBG, and the extremely ideological turn of US politics in recent years. Legal action and the appeal process could of course act as a brake, but I would expect to see a bias towards antifederalist legal theories from the solicitor-general's office in the coming years. Quite a few people are of the opinion that the federal government should divest itself of authority in various matters and return political power to the states (but probably not the people, who can't be trusted, oddly enough).

There is an inspiring TED talk, "A new way to diagnose autism" (2012) on early diagnosis using eye tracking by Ami Klin of the Marcus Autism Center: https://www.ted.com/speakers/ami_klin

Early diagnosis is critical for treatment and helping the affected child and their family. The linked CDC site says average age of diagnosis is 4 years of age, which is shown to be more expensive for society as a whole. We have reliable ways to diagnose by 2 years now (and eye tracking could lower this perhaps to 9 months or earlier). Early diagnosis should be standard of care.

Here is a simple appeal. By some definitions, I may fall somewhere on this spectrum.

I have always done very good work. But I need peace and quiet -- a distraction-free environment -- to think for myself. I'm also capable of interacting well with people and need some significant degree of it. But under my control.

The world, however, has continually insisted I conform (mightily, and exhaustingly, and stressfully) to its generalized, undifferentiated, trend-influenced, and -- observing those around me -- not terribly effective model of "randomly and noisily shoved together".

As I say, some amount of random, or at least different, and serendipity is very beneficial.

But -- whatever the cause -- please just acknowledge what works for me. Which I've figured out despite all the messaging, enculturation, and external pressure to the contrary. Just let me be. And let me work effectively. Give me a little quiet space in which to do so. It's not like society can't afford it (certainly not, here in the U.S.).

Causes, causes, causes... Stop for a second, and just deal with the reality at hand. Everyone will end up happier, and more productive.

It would really interested in seeing a heat map of the "counts of autism by zip code" overlaid with another heat map showing "counts of autism by zip code as a percentage of the population" - since it might show areas that are over and under reporting.

Technically aren't 68 out of 68 children on the spectrum? The point of a spectrum is that it includes all values.

Haha yes... I was also wondering what the article (or the headline) is actually stating. In that light it's also very questionable to assume that "people on that spectrum" create cost - even if you limit it to some range that makes intuitively sense.

And it’s observations like that that someone on the spectrum would make.

Perhaps we could agree that “on the spectrum” in this case is a messy neurotypical shorthand for being on the colourful end of the spectrum (autistic) rather than the grey boring end (non-autistic).

No, the spectrum is from severe autism through and including the old asperger's syndrome, however mild; it ends there definitionally, leaving the vast majority of humans outside the spectrum.

the increase in prevalence here [0] is due to more accurate identification ?

[0] https://www.cdc.gov/ncbddd/autism/images/addmnetworkprevalen...

And at what point does this become an overdiagnosis, versus an increase in prevalence?

I'm by no means suggesting that autism can be an extremely serious disorder. The question is if these numbers represent an increase in serious cases.

Also autism is not a binary diagnosis. It is a gradient of symptoms, and saying that kid is autistic doesn't say much about his condition.

Why not go and research that for yourself? I don't wish to be uncivil but I've heard this question so often for the last 20 years that I now regard it as little more than concern trolling. I get it, it's hard to make meaningful quantitative statements about a behavioral disease whose clinical parameters are hard to define.

But it's a naive point and this subject has been a topic of public debate for a long time now, so the skeptical signalling gets really tedious after a while. It's about as enjoyable as if I described your work as a computational scientist as 'pushing buttons all day' or made some crack about it being an excuse to play video games, as a way of signaling a lack of regard for nerdy pursuits.

Vaccines are life-saving and necessary. There is no evidence linking them to autism.

But, WHY do children in the US need nearly 4x as many doses by age two as compared with children in Germany and Finland? Since childhood diseases aren't problematic in those countries, you'd think we could get similar results with a streamlined schedule that looks more like Europe's.

Edit: thanks for the data. European schedules have changed since I knew them.

I don't know. Why do people make these sorts of fear-mongering claims with no supporting data?

https://en.wikipedia.org/wiki/Vaccination_policy#/media/File...

From what I can tell, this claim is simply false. The biggest difference in German vs US vaccination seems to be the lack of recommended flu vaccination in Germany. Plus rotavirus, which is perhaps less prevalent in Germany?

The US does vaccinate more than other countries, but it is not 4-fold higher. See this very interesting infographic:

http://www.bmj.com/content/351/bmj.h5966/infographic

By age 6, the standard vaccine schedule would result in 49 vaccinations in the US, 44 in Germany.

There was a recent post about lack of Vitamin D. Link to my comment - https://news.ycombinator.com/item?id=13210531

Yes, it could be that, or some environmental factor such as a material used in buildings now more than ever.

Epidemiologists will have some trouble sorting this out though.

And afterwards, interventional studies have to be ran.

Yeah! So lets pull from everyone basic, guaranteed health insurance, because every 1 in 68 persons should be able to generate a buck, somehow. And the other 27% of US population that has an existing condition too. Double good if a child, let's bill their parents for decades under a high risk pool until they too are broke and wards of the state. Let the downvotes rip, myopic people who can't understand a dollar is an imaginary thing, subject to whatever society says it is worth - not the other way around.

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