The Whys of Increased Prevalence
We would like to share with parents that the latest Autism research and recent studies that indicate that there is a growing prevalence and an increase in Autism prevalence.
The latest numbers now indicate that incidences of Autism Spectrum Disorders have gone from 1 in 1500 to 1 in 150 and apparently now the figure that’s emerging is closer to 1 in 48*. Meaning, that even since 2000 there has been a very profound increase in the number of children being diagnosed with Autism spectrum disorders and Autism related disorders.
A lot of parents ask us if there is an increase in the number of children with the disorder or with the Autism Spectrum Disorder or does this largely reflect the change in the way the diagnosis is used or some sort of increase in ascertainment.
Changes in diagnostic processing and diagnostic criteria have made a difference, as has the number of parents coming forward and not looking at their children who have Autism with dismay and trying to cover up the issue.
However the changes in diagnostic criteria over the last 10-year period those operate on the border between Autism and Mental Retardation can be associated with about only a quarter of the increase prevalence. Over this period there has been a really fundamental change in the ascertainment, which we can view in lots of ways, but the most obvious way to see the changes in ascertainment, is to see that the social economic status gradient that used to be present for autism, the fact that children living and residing in wealthy communities are more likely to get a diagnosis, and that gradient largely disappears.
Given this assumption, it is not only better diagnostic criteria or parents coming forward, it is a real time increase in the prevalence of the Disorder also that is creating this increase.
If we were to decompose the increase in the incidents of Autism Spectrum Disorders being reported into its constituent elements we find that a very small proportion of the component of that is increased ascertainment, some component of that is diagnostic change in diagnostic criteria, some component of that arises from already known risk factors, such as increases in parental age which is positively associated with greater probability of genome mutations that could lead to copy errors that are associated with neurodevelopmental disorders.
In India it is also the Social Demographic changes that are affecting us and we in India need to understand how to decompose the increase in the incidents of Autism Spectrum Disorders into its constituent elements and to pay attention to two dimensions that are important. The first factor is temporal and how this fact of temporal change is affecting us. India is in a period of increased prevalence and along with this period of increased prevalence due to socio demographic movement and greater genetic mixing we are also observing an increase in the number of older parents.
The risk associated with older parents are quite serious and play a greater role today than they did a decade ago, and this may be dimension where we need to pay attention to temporal heterogenic which is quite important.
The other issue is for us and other mental health professionals to pay attention to the spacial heterogenic factors and the fact that it is now possible to observe distinct stable clusters of increased risks for Autism at very fine spacial resolution. There are pockets in India where clusters of human population have settled, and these are tier two towns and tier three urban and semi urban areas where the relative risk for Autism Spectrum Disorders is significantly higher over every year of observation.
This issue then invites us to ask that is there something in that local area that is driving an increased prevalence and that could this be a shared toxicological environment, it could be a virus that moves through and spreads from person to person and affects children in utero, or it could even be a piece of an ascertainment process which would be the diffusion of information from parent to parent as they learn how to recognize some symptoms for autism which have no biological markers.
In India we are observing a very sad phenomenon. Parents do not come forward to help their child because of the perception of social shame, and further the sadder part is that if they came forward we can pretty uniquely use the diagnostic criteria with the advances in diagnostic systems in identifying and helping children with Autism Spectrum Disorders. And this would include Autism and other Neurodevelopmental Disorders on the Spectrum like Aspergers, PPD - NOS etc.
The reason for early identification is important as almost 60%* of what we see at the Dyslexia Association of India™ is genetic. The increased parental age accounts for almost 11* percent of the increase over the last 10 years and the mechanism by which increased parental ages express itself is likely largely genetic. A great degree is also due to some toxicological environment that’s shared because of the spacial clustering. Because there’s a very strong process of amplification of the understanding of Autism Spectrum Disorders now that is leading to increased diagnosis – specially as educated parents learn how to recognize symptoms.
It is very difficult to advise and tell parents who ask about what is going on, specially when they may have a child who is on the Autism Spectrum Disorder. The reason is that a lot of parents are struggling enormously with the difficulty to manage a child on a day-to-day basis who is on the Autism Spectrum Disorder. The search for explanations is very frustrating and we think parents will need to come to terms with the fact that the search for a quick and dry explanation might not be present in pure science.
The Dyslexia Association of India™ would encourage parents who have been through a difficult pregnancy, or where someone in the family has a problem that has affected their day-to-day life and specially academics and social interaction – to come forward and speak to us. Even if there are far of relatives who have suffered depression or the parents specially the mother of the child who is showing behaviours and academic deficits and differences, has passed through very stressful stages of pre pregnancy and during and after the pregnancy or suffered and is suffering from depression should as a couple make an appointment and meet with us along with their child.
Our research on the Human Brain and specially the patented T.R.A.I.N™ or the Targeted Remedial using Advanced Intensive Neuroplasticity™ programme has proven that the earlier we start with the identification process of such Neurodevelopmental Disorders, the greater the possibility for us to bring about lasting cortical* changes in the childs brain.
Probably in India, parents begin to weigh the financial impact on them if they have their child assessed and diagnosed and how it will affect their lives. We would like to advise them that a cost for an assessment for a child can not exceed a few thousands of rupees and subsequently any supplement or a activity done at home is for a better prognosis for their own child.
So don’t let financial consideration hold any parent down. The loss of the childs future for the need to save a few thousand can be heartbreaking in the long run.
To make an appointment with the DAI™ please call us on +91 – 8826022886 or e mail us for an appointment on firstname.lastname@example.org as at the Dyslexia Association of India™ we have a strict policy to comprehensively check and diagnose only one child per day.
Any payment that is made for your appointment at the DAI™ qualifies for exemption from Income Tax (IT) and parents are provided a Section 80G receipt so that they can use it when filing their Income Tax Returns.
* Opinions and information expressed by the DAI™ are equivocal and specific to the organization.