14. Autism In The USA

• DoH fond of saying how MMR is used safely in 32 countries, inc USA. But USA has clear evidence of autism epidemic. Other countries may also be becoming aware of increases (further details welcomed), including Finland (400% increase in cases since MMR introduced?)
• US has IDEA (Individuals with Disabilities Education Act). Picks up numbers of schoolchildren with developmental problems. Autistic pupils up from 12,222 to 53,561 between 1992-3 and 1998-9 (Source: US State data). So for every 2 cases in 1993, by 1999 there were nearly 9. Numbers will have risen since.
• Huge increases in some States - up 421% in Connecticut, 509% in Indiana, 663% in Iowa, 933% in Michigan, 548% in Pennsylvania, all in just six years (Source: US State data)
• Also very interesting that individual towns eg Round Rock Texas up from 6 to 115 in 8 years - just like Wakefield Local Education Authority in UK (up from 5 to 111 in seven years). So suggests UK increases may very closely match USA.
• Latest California increases (State with best database) showed autism up 19% in 1999 and up nearly 16% in 2000
• Brick Township (New Jersey) "autism cluster". Some 40 of Brick Township’s 6,000 3-10 year olds have autistic spectrum disorder. It has made Brick Township the "autism capital of the USA" - but note, East Surrey rates in UK are higher still. Federal investigators collected data on surface and ground water, sites of industrial spillages and waste dumping, and ensured that there had been correct diagnosis. They found nothing.
• US clearly has autism epidemic. US similar to UK, so reasonable to conclude UK probably has epidemic, too, but just hasn’t yet woken up to it.
• Dr Bernard Rimland, Autism Research Institute, US: "Some supposed experts will tell you that the increase reflects only greater awareness. That is nonsense. Any paediatrician, teacher or school official with 20 years experience will confirm there is a real increase, and the numbers are huge and growing". (Source: Dr Bernard Rimland, ARI, 4182 Adams Avenue, San Diego, California CA 92116)

• California has the best data in the world, going back about 25 years, so trends there have a worldwide significance.
• Latest California State Department of Developmental Services data shows 566 new cases (all children age under 10) with professionally-diagnosed DSM-IV criteria autism, entering the State system in the previous quarter-year.
• This does not include children with persistent developmental disorder, non-specific (NOS) developmental delays, Asperger’s or and other autistic spectrum disorder - it is therefore the tightest definition of the severe-case numbers.
• The 556 cases for the last quarter of 2000 compares with 667 cases for the entire year in 1994.
• It took 25 years from the establishment of the State developmental services system in 1969, to 1994, to reach a total of the first 5,100. Yet the second 5,100 was reached in just five years. In 1999, 200 and the first half of 2001, a further 5,100 cases will be added. So this third cohort of 5,100 cases will have taken just two and a half years.
• This will represent a 1000%+ increase in twenty years, and excludes all cases other than full-blown DSM-IV diagnosis.
• Originally, autism accounted for three per cent of the State system’s overall caseload. It now accounts for between 30% and 34% of the caseload.