Study Watch : Epidemiology of pervasive developmental disorders.

From the "la-la-la I can't hear you" department comes the latest work from Dr Eric Fombonne

Epidemiology of pervasive developmental disorders.

There is evidence that the broadening of the concept, the expansion of diagnostic criteria, the development of services, and improved awareness of the condition have played a major role in explaining this increase, although it cannot be ruled out that other factors might have also contributed to that trend.

If we are to believe the work of Dr Fombonne the reason that is seems like autism is increasing is:

1. The expansion of diagnostic criteria
   
2. The development of services
   
3. Improved awareness
   

Otherwise known as the holy trinity of denial.  

So which came first - the expansion of the criteria, development of services or improved awareness?  Or was it a chicken and an egg, I can never remember.

To be fair, the first point above is semi-valid.  The diagnostic criteria for autism did change in 1994 and it did become broader - but not that broad.

The paper is a rehash of earlier studies filled with fancy statistics and analysis designed to make you doubt that the autism is increasing.  So the question that comes to my mind is why does iyt matter if autism is becoming more common?

I think that the real issue here is the underlying theory of what causes autism.  

If autism is not increasing then we can keep looking for the genetic smoking gun that is the culprit and no one can be held accountable.  

If autism is increasing then it cannot be mainly a genetic disorder.  If it is not a genetic disorder then something is "causing" it and people are going to start demanding answers. 

I think many people are afraid of that happening.