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Study supports theory that rise in autism is related to changes in diagnosis
Date:4/8/2008

ional psychologists, paediatricians or speech therapists as having developmental language disorders and none had previously been diagnosed as autistic. However, when reassessed by Professor Bishop and colleagues using current criteria, around a quarter were identified as having autistic spectrum disorder.

In recent years, the criteria for diagnosing developmental language disorders and autism have changed. This has coincided with a marked rise in the rates of diagnosis of autism. According to the Special Needs and Autism Project(2), the figure until the 1990s was widely accepted as being about 5 people per 10,000; even using the narrowest definition of autism, this rose to almost 40 in 10,000 by 2006

There are two main hypotheses to explain this rise: the "autism epidemic" hypothesis and the "diagnostic substitution" hypothesis. Whilst the former says that the rise is genuine, the latter maintains that the true prevalence of the disorder is constant but that changes in diagnostic criteria mean that more children are being diagnosed as autistic. The latter theory is supported by a UK study(3) using the General Practice Research Database, which found that the rise in autism was mirrored by a decline in frequency of language disorders, and now by Professor Bishop's study.

"Our study shows pretty direct evidence to support the theory that changes in diagnosis may contribute towards the rise in autism," says Professor Bishop. "These were children that people were saying were not autistic in the 1980s, but when we talk to their parents now about what they were like as children, it's clear that they would be classified as autistic now.

"Criteria for diagnosing autism were much more stringent in the 1980s than nowadays and a child wouldn't be classed as autistic unless he or she was very severe. Now, children are being identified who have more subtle characteristics and who could in the past easily have been missed."

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Contact: Craig Brierley
c.brierley@wellcome.ac.uk
44-207-611-7329
Wellcome Trust
Source:Eurekalert

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