President Trump said that Robert F. Kennedy Jr., his nominee to run HHS, will investigate the rise in diagnoses of autism spectrum disorder (ASD).
Since at least 2014, Trump has I put forward a theory Vaccines are behind the rise, but there is no evidence to suggest this is true.
“There have been extensive studies looking at possible links to routine childhood diagnoses and autism diagnoses, and the results have shown that there is no such link,” said Eric Burnett, MD, of Columbia University Irving Medical Center in New York City.
Burnett told… Medpage today. “Correlation does not imply causation; just because two trends occur together, one does not mean the other.”
Do more people have autism?
In the past two decades, ASD diagnoses among children in the United States have jumped fourfold, according to CDC data. The agency’s Autism and Autism Surveillance Network, which tracks the number and characteristics of children with ASD in 11 communities, showed that the prevalence from 2000 to 2020 rose from 6.7 to 27.6 cases per 1,000.
This means Estimated 2.8% Among 8-year-olds with autism in 2020, the CDC said. A recent analysis of medical records suggested that ASD diagnoses also It rose significantly in young adults From 2011 to 2022.
Alison Singer, president of the Autism Science Foundation, a nonprofit group that funds autism research, said there is no single cause of autism, but there are many factors that may be fueling the increasing prevalence numbers.
“The first is that the definition of autism changed in 2013 when we moved DSM-IV to DSM-V.The singer said: “The five subtypes of autism in DSM-IVwhich included classic autism and Asperger syndrome, was collapsed into the very broad category of autism spectrum disorder.
She said better awareness and ensuring that part of the increase in spread. Societal changes are coming into play as well.
“Parents are having children later in life and we know that higher maternal and paternal age leads to higher rates of autism,” Singer noted. Babies born prematurely are more likely to survive now, and these babies are More likely to be diagnosed With ASD and developmental delay.
Why do we screen more?
Susan Hyman, MD, of the University of Rochester Center in New York, who co-authored the latest study, said: American Academy of Pediatrics (AAP) report On the identification and management of ASD.
The necessity of screen for ASD was recognized by parents and groups such as the AAP when research showed that early intervention can improve functional skills in many developmental areas. “If improved functional outcomes are possible, identifying children who may benefit has become an important movement,” Hyman said Medpage today.
Screening is now done during well-baby visits in most primary care pediatric practices when children are between 18 months and 24 months old.for Hyman noted. She noted that there is also a “catch-up in diagnoses” among medically underserved populations.
“While there is still inequity in services provided, gains have been made in recognition of the diagnosis,” she said. “Increasing diagnosis rates among females, older youth, adults, and underserved populations has contributed to increased prevalence of diagnosis.”
Why were vaccines blamed?
In 1998, Andrew Wakefield, MBBS, formerly of the Royal Free Hospital and Medical School in London, published a paper which has now been repackaged in Lancet He mentioned that 12 children suffered from intestinal abnormalities After receiving the vaccination, vaccination, and MMR. In eight of the 12 children, parents associated the vaccine with the appearance of behavioral symptoms.
Wakefield and co-authors hypothesized that inflammation of the intestine after the MMR vaccine released gut proteins eventually into the brain, causing damage reflected in autism symptoms.
“The Wakefield study was flawed because nothing was studied,” said Paul Offit, MD, of Children’s Hospital of Philadelphia.
“It was just a report of eight children who developed signs and symptoms of autism within a month of receiving the MMR vaccine. There was no control group,” he emphasized. “Therefore, there was no way to know whether autism was occurring at a greater level than would be expected by chance alone.”
An investigative reporter later demonstrated that “Wakefield had been incensed by the clinical and biological data, causing the journal to retract the paper.” Medpage today.
According to London timesit was Wakefield Accused of altering clinical outcomes For eight of the 12 children in the study. Five of the eight children reportedly had psychosocial problems before they received the vaccine, although the paper described them as developmentally normal. Hospital pathology reports showed no findings of pediatric enteritis. Only one child allegedly had new behavioral symptoms days after receiving the vaccine.
In January 2010, Ruling by the General Medical Council of the United Kingdom Wakefield acted dishonestly and irresponsibly. After several days, Lancet to retreat His paper.
What have other studies shown?
In 1999, another group of researchers in London reported on Lancet There was There is no epidemiological evidence There is a causal link between autism and the MMR vaccine. This conclusion was played out repeatedly in studies published in subsequent years.
It was one of the largest retrospective analyzes of more than 537,000 children in Denmark published in New England Journal of MedicineThat showed The risk of an autism diagnosis was similar Whether or not the child has had the MMR vaccine. In the United States, a study published in mosque No harmful association between the MMR vaccine and autism has been shown, even in… Children at high risk for ASD. “These were well-conducted studies, with appropriate controls,” Offit said.
Other hypotheses link autism and vaccines Which has been exposed Centering around thimerosal, a preservative containing low levels of methylmercury used in some multiple vials of vaccines, are arguments that giving multiple vaccines at once may weaken the immune system. (All vaccines routinely recommended in the United States for children ages 6 years or younger Does not contain thimerosal.)
However, what causes autism is still unknown. There has been rapid progress in translational research integrating genetics, neuroscience and clinical presentation, which should continue.
“that it maybe “Environmental factors — other than vaccines for which there is extensive data to suggest they are not responsible — may interact with genetic predisposition to increase an individual’s risk of developing autism,” she said.
