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Our 1 in 54 need more

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On Thursday the 26th, the Centers for Disease Control released new prevalence numbers: the prevalence of ASD has jumped from 1 in 59 to 1 in 54 kids who are 8. They also revealed prevalence numbers in 4 year olds. On this week’s podcast. CDC epidemiologist Dr. Matthew Maenner (and ASF class of 2010 predoctoral fellow) explains the numbers, where they came from, what they mean and where the trend in prevalence numbers is going. Shockingly, even though the numbers keep going up, some people are not getting an autism diagnosis when they should.

https://www.cdc.gov/mmwr/volumes/69/ss/ss6904a1.htm
https://www.cdc.gov/ncbddd/autism/addm-community-report/index.html
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CBT and ADDM – two acronyms in the autism news

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Two studies missed last year (sorry) but are of importance to the autism community include a modified version of Cognitive Behavioral Therapy to treat anxiety, which was adapted and updated for people with ASD.  It also works better than traditional CBT, which is good news for  the 80% of people with ASD that also suffer from anxiety.  Also, in recognition of MLK day today, the CDC released information last year that shows that 1/4 of those that they counted in their prevalence numbers were missed by schools or other health care providers.  Unfortunately, those who were black or hispanic were more likely to be those that were missed but still met criteria.  This just shows that educators have to do better in helping those with ASD from all racial and ethnic backgrounds.

https://www.ncbi.nlm.nih.gov/pubmed/31868321

https://www.ncbi.nlm.nih.gov/pubmed/31755906

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This study is s**t

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You may have heard on the internet that a new “radical” treatment leads to a “50% reduction” in autism symptoms.  This radical treatment is fecal transplants, which is taking the bacteria from the feces from one person and putting them in another person.  This is a still experimental treatment, and while the microbiome should be researched more in regards to its relationship to autism, there might be a less invasive way to alter the microbiome which could stand up to the rigor of a well designed trial.  Also this week, new prevalence data on 4 year olds across multiple years.  Did it change across time, and is it different from 8 year olds, and why is this difference important?

https://www.ncbi.nlm.nih.gov/pubmed/30967657

https://www.ncbi.nlm.nih.gov/pubmed/30973853

 

 

 

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In partial praise of the DSM5

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While much work needs to be done to include individual abilities and disabilities into the DSM5, after the CDC prevalence numbers were published last month, it became clear the old DSMIV was not working.  In a replication of a previous finding, it showed that the DSMIV categories of Aspergers, PDDNOS and autistic disorder were just not being use consistently across states, and left the interpretation of those diagnoses somewhat meaningless.  While DSM5 is a step in the right direction, more work needs to be done to ensure everyone is receiving the most specific diagnosis possible, and getting the services they need.

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What is the real prevalence of ASD?

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Unfortunately this podcast does not really provide an answer, but does highlight data published over the holidays which shows in another dataset, that the prevalence of autism seems to be leveling out, rather than continue to increase as it has done for the past several decades.  It isn’t the final word and clearly there may be exceptions, but now two national datasets have shown no further increase in autism prevalence in the last few years of looking.  Is it 1:68 as reported in one study or 1:39 in another?  Is it somewhere in between?  Still to early to say, but white boys seem to be the most likely to get a diagnosis no matter where you look.  Also, folic acid proves to show an effect on the probability of not just an autism diagnosis, but autism symptoms.  This is especially important for women taking anti epileptic medications for seizures and bipolar depression.  Welcome to 2018!

Here are links to the articles.  Some of them are open access!

https://www.ncbi.nlm.nih.gov/pubmed/29297068

https://www.cdc.gov/nchs/data/databriefs/db291.pdf

https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2667432

https://www.ncbi.nlm.nih.gov/pubmed/29279889