While autism is defined as a separate childhood disease, its prevalence until the 1980s has been defined rarely, and it has been accepted as increasing frequency until today with many epidemiological studies. According to the researches, the rates observed by evaluating and screening children of different age groups by experts in their field were 1/160 in 2000, 1/68 in 2014, and this rate was reported as 1/59 for 2018.
Normally it is necessary to start this article with the definition of autism. However, we have a hard time doing this. Because it is not known exactly what autism is. It is included in many diagnoses. There is no definition of autism defined with precise and clear lines. In an article published in a journal, it is pointed out that there are serious incompatibilities in this regard, even in different versions of the DSM handbook, which provides cataloging mental illnesses.
Autism is not seen as a “categorical disorder” today. Rather, it is seen as a “spectrum disorder”. In other words, there is no such thing as “you have autism or you do not”. Depending on how you are in each of the categories specified, you may be at any point in the range between having autism and not. This makes it difficult to diagnose and assessment of autism, making the meaning of statistics in this field ambiguous.
This does not only affect diagnosis and statistics. It also has a direct impact on how autism research can be conducted. As the definition of autism becomes ambiguous and the number of populations identified as having autism increases, the smallest population required to conduct autism research is rapidly expanding. This not only results in shadowing the results of former researches but also results in new studies requiring more participants. Accordingly, how the researchers approach autism is radically changing. Naturally, this also directly affects you if you have someone with autism in your family.
If the definition of autism becomes very ordinary and has been dismissed as a problem, autism research may find it difficult to identify the aids that need to be given to those people. This may be one of the reasons why a remarkable breakthrough in autism research has not been achieved in the last 10 years.
In today’s world, even though it is hard to tell the exact reason for rising the prevalence rate of autism, researchers state a couple of main reasons. These reasons could be people are more aware right, diagnosis criteria are broader, and anything else. According to statistics published by The Centers for Disease Control and Prevention (CDC), among every 68 children, there is at least 1 child with an autism spectrum disorder. The prevalence rate is higher in boys than in girls. While it is 1 in 42 among boys, it is 1 in 189 among girls.
As we all know, the prevalence rate has been rising step by step. This rising is happening since the first investigation is done which is in 2000. According to the researchers, the main reasons behind this rising are awareness about autism and broaden the definition of autism. Now, there are many things that are included in the term. By this time, this rising has become more apparent.
The diagnosis of autism is done by experts’ observations and family stories. This diagnosis criteria also makes it rising more. There is no concrete and certain testing for autism even though researchers try to develop some testing, such as blood testing, brain scanning, and so on. Since they are not possible to understand whether a child has autism or not, diagnosis relies on observations of behaviors.
In order to obtain these numbers, researchers in The Centers for Disease Control and Prevention observe children who are 8 years old and live in the USA. The first investigation was done in 2000. It was supported by Autism and Developmental Disabilities Monitoring Network.
After the first investigation, this observation has been done every two years. The target population has been children who are 8 years old because of the fact that if there is a sign of autism, it reaches its peak around this age. It is easier to observe whether the child meets the diagnostic criteria or not. It is easier to make a health assessment.
- Approximately 1 in 54 children are getting diagnosed with autism.
- Among boys, the rate is 1 in 34.
- Among girls, the rate is 1 in 144.
- Boys are more likely to get a diagnosis of autism.
- Even though a child can get a diagnosis at age 2, most children don’t get a diagnosis until age 4. It is mostly the parents’ fault. They don’t want to believe their children have problems. They don’t want to accept their children’s needs.
- Most children with autism have an intellectual disability.
- 1/3 of individuals with autism are nonverbal.
- At least 2/3 of individuals with autism have been bullied during school years, mostly between 9 to 15 years old.
- Nearly 2/3 of individuals with autism are likely to engage in self-injurious and self-harming behaviors.
- Nearly 90% of deaths in the autism community are observed among the children who are 14 or younger.
- In the case of autism, there is no selectivity on ethnicity, race, and economical status.
- Education is very important in order to get diagnosed. If the parents are not enough educated and not aware of what autism is, their children are more likely to get diagnosed later.
- Early intervention and early diagnosis of autism are very important in order to get a proper treatment plan. With the proper treatment, people on the autism spectrum can live a better life and quality life. It will be beneficial in their whole life.
- There is no specific testing and assessments for autism. It is based on pediatricians’ observations.
- There is no certain treatment and medicine in order to cure autism spectrum disorder completely.
Prevalence Rate of Autism Spectrum Disorder in Some Countries
- Hong Kong: 372 in 10000 children
- South Korea: 263 in 10000 children
- United States: 222 in 10000 children
- Japan: 181 in 10000 children
- Ireland: 153 in 10000 children
- Switzerland: 145 in 10000 children
- Canada: 106 in 10000 children
- Denmark: 69 in 10000 children
- Singapore: 67 in 10000 children
- Belgium: 60 in 10000 children
- Estonia: 60 in 10000 children
- Finland: 54 in 10000 children
- Norway: 51 in 10000 children
- Netherlands: 48 in 10000 children
- Germany: 38 in 10000 children
- China: 23 in 10000 children
- Taiwan: 5 in 10000 children
- Poland: 3 in 10000 children
This estimation has been done in 2020. There are many reasons for these differences. These reasons could be population, education level, economical level, awareness of autism, and so on.
Reasons Behind Increasing Prevalence Rates of Autism
Why is the incidence of autism increasing so rapidly? There are two obvious reasons for this. One is the development and spread of diagnostic tools. It is now easier to diagnose. Second, environmental factors are thought to trigger the incidence of autism.
In studies examining the reasons for the increase of this frequency, the reason for this has been explained for different reasons. For example; the diagnosis becomes more known, it can be explained by the increase in the number of diagnostic units such as pediatric psychiatry centers or the awareness of the society.
In addition, since autism is a disorder known to occur in the first years of a person’s life, an investigation has been made on newborn children in diagnoses made to date. As a result of the studies on the subject, individuals who show the symptoms of this disorder at an advanced age are now included in the scope of the definition.
It was noticed that individuals exhibiting symptoms within the definition of autism did not have such ailments at a young age. As a result of some researches that caused the definition of autism to expand, there was a great increase in the number of people with autism around the world. In this way, the authorities emphasized that the awareness that should be gained in society many years ago has been created indirectly and underlines that autism is not a disease, but a need for support.
To explain, the point that draws attention rather than an increase in the incidence of autism is that the definition of the disease is expanded and more people are accepted as on the autism spectrum, and awareness increases and individuals with autism become more visible.
Numerous studies examining the relationship between vaccines and autism have not found a significant relationship between vaccination and the possibility of having autism. Vaccination is an application that significantly secures public health, especially in terms of childhood diseases. As the prevalence rate increases in vaccination, there is a decrease in childhood diseases in children or a decrease in the course of the disease even if the disease occurs in the child. In cases where vaccination is refused, it is stated that children are at a more serious risk than autism, at risk of death.
There are disorders that accompany autism spectrum disorder. Not all children can use medicines, but sometimes they can be accompanied by such a behavioral disorder. For example, the child is unable to control his impulses and begins to bite his arm; when he gets angry, he can hit his head against the wall very violently, or harm the other person. Impulse control disorder can be seen. In such cases, it is obligatory to get drug support. Just having any education is not enough. Because in order for the child to receive education, the child must be ready for education. Thank God, in today’s world, when you see a child of one and a half and two years old, it is highly possible to be said that “yes this child is on the autism spectrum”.
This point is one of the most difficult events in the world for parents. Imagine, you have children with great dreams, but after the birth, even before your child gets 18 months old age, you see that your child does not communicate with you, does not look at your face, when you clap your hands or when you show something, he or she does not care. This can cause incredible disappointment for parents. Especially after hearing the diagnosis, they may experience a period of depression and inadmissibility for days and weeks.
Has the Definition of Autism Spectrum Disorder Broadened Over the Years?
Obviously, the definition of autism spectrum disorder has changed over the years as it is supposed to be. However, this definition has been broadening since the first definition done by Leo Kanner. According to the first definition, only children who were socially isolated and withdrawn were included. Only they were seen as children with autism.
After the first description, the estimation prevalence rate was 1 in 2500 children. Most probably this estimation was based on severe autism. Because in those times only severe autism symptoms were being observed. If the child would have mild symptoms, they were not included in this estimation.
Before 1991, children with autism were accepted as children with intellectual disabilities. After this year, this trend has changed. This change gave families the courage to take their children to pediatricians to get an assessment of autism.
In 1994, the 4th edition of the DSM was published. The definition of autism has been broadened. They included Asperger’s syndrome in the 4th edition. Then, in 2013, the 5th edition of the DSM was released. According to the last definition, autism is a spectrum disorder. Now, autism, Asperger’s syndrome, pervasive developmental disorder-not otherwise specified and many others are collected under one diagnosis which is an autism spectrum disorder. It is a term that is even now used by pediatricians.
Nevertheless, the last estimation of the prevalence rate was done based on DSM-4. The next one will be based on DSM-5 and researchers believe that the prevalence rate will be lower.
How Does the Awareness of Autism Contribute to The Prevalence Rate of Autism?
Over the past decades, awareness of autism spectrum disorder has been increased. That increase is not mild. It is very obvious. And as a result, it has contributed to an increase in the prevalence rate of autism.
There are some main reasons in order to raise awareness and be aware of what autism is and its symptoms. These reasons could be living in urban and big cities, good medical care, and easy access to medical care, and educated parents. If people are more aware of the symptoms, they are more okay with having someone with autism around them. And, if people are more aware of the symptoms, those individuals with autism are more likely to get a diagnosis earlier.
Early diagnosis gives them an opportunity to get specialized services, special education, and a good treatment plan. This opportunity is beneficial for both parties, for both children themselves and their pediatricians. Pediatricians would be more helpful in this case. They can make a good treatment and therapy plan for them.
Moreover, according to DSM-5, the overlap is acceptable. Because of this reason, children get a more accurate diagnosis. This accurate diagnosis leads them to take a good treatment plan. For example, before children didn’t get ADHD and Autism diagnosis at the same time, however, in today’s world, it is highly acceptable. According to DSM-5, it is possible to get multiple diagnoses based on their developmental delay. After these diagnostic criteria, increasing in prevalence rate has been observed all over the world, not only in the US.
The awareness has arisen, criteria have been broadened, the population all over the world is more crowded, there are more educated people and biological changes are happening over the last decades. And, all of them contribute to the prevalence rate of autism spectrum disorder.
Does Technology Affect the Prevalence Rate of Autism?
The family whose child got the diagnosis should say, “My child was born like this, or yes, my child was diagnosed with autism, we should be strong and do something as soon as possible. If education is needed, education should be started immediately.”
As a parent, if you prolong the process of accepting the event, you will suffer a huge loss. Because of autism, the first period called 0-3 years is very critical. While the process becomes much more difficult after the ages of 5-6-7, the positive reaction of 22-23 months old children to education is much more and beautiful. Now we’re talking about a situation out of 56 in proportion. So it’s not incredible or distant to any of us. We will all become parents in the future, or we have become. This is a disorder that starts with a social communication problem, shifts towards autism or expands the population, such as being born with autism directly.
There are many children who are not born with autism and who show symptoms of autism. Unfortunately, three things called television, tablet and phone caused children to experience incredible social interaction problems. In the simplest way, for example, you come across a child, you ask what your name is and you don’t even get an answer. Or you say that I have an object in my hand, follow it, and he or she does not. When you say look at me, he or she doesn’t look at you. At this point, you realize that even if the child was not born with autism, he/she started to show symptoms like autism.
Do not think that autism will necessarily be born congenitally. If the family does not care about the child, the child will only watch cartoons or if he/she only has phone contact, then the symptoms of autism may begin to appear after 1-1.5 years. It may not be very severe autism, but the child has problems communicating socially. He cannot play games; when you give a toy to his hand, he cannot functionally play with it; and he cannot respond to your gestures and facial expressions.
If the child is already born with innate autistic features, there is no other way than accepting it and trying everything for the child’s education. The family needs to motivate themselves in some way, start treatment, and continue patiently.
But on the other hand, if you have a child who does not have autism, that is not born with autistic features, if he/she spends a lot of time in front of television, tablet, or computer and starts to show autism features after a while, you will be more regretful as a parent. Television, telephone, a computer should not be in the daily life of children between 0-3. The child must fully communicate with his family, friends, relatives. If this happens, there will be no problem.
There is also a situation in which people risk this incident by saying “this has not been the case with his child”. So his child may not have this situation, but that doesn’t mean that he won’t be in anyone else. According to experts, such situations began to appear very often.
Families coming to the doctor with complaints such as “When we say her name, he does not turn to us, does not look at us, does not communicate, does not speak.” When education is given for 6 months or 1 year, the child gets rid of these features that are autism-like. Why? Because the negativities that cause this situation are eliminated and education is started.
At the same time, experts think that the increasing ratio of nuclear families is also effective on this issue. In other words, children do not grow, play, or communicate with five or ten people as before. Only mother, father, and child are at home. In this case, too, the number of people the child communicates with is very small. Maybe science doesn’t focus on that right now. This event remains a bit more cultural, but after a while, this will become a matter of concern.
Some miraculous methods, such as food, diets, oxygen tents, animal therapies, music-drama, and theories have been made to suggest that autism can be controlled by eating. Mothers and fathers also believe them. Unfortunately, there are no miraculous therapies. There are different therapies and helps but it is impossible to cure autism at once.
Due to the nature of autism spectrum disorder, it is a complex, multifactorial, and high inherited disease group and its frequency is increasing all over the world due to the reasons explained above. Currently, there is no effective drug treatment for the main clinical picture of autism. Along with the early diagnosis, intensive education programs specific to individuals and specific to autism are the most effective treatment methods available. However, while raising awareness about the disease in society, it should be emphasized that this information should be at the level of scientific evidence.
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