According to the CDC

The rate of autism has steadily increased, according to the CDC. The CDC estimates that approximately 2% or more of children from birth to 21 years of age have Autism Spectrum Disorder (ASD) in New Jersey.

Autism is a complex condition. No single factor can explain why more children are being identified with ASD, although a combination of genetic and environmental factors play a role. In addition, some of the increase in the rates in the CDC's study may be due to: changes in the diagnosis and treatment, greater awareness, and better record keeping.

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Previous CDC Autism Prevalence Study Results

A Decade of Data

With the report released in March 2014, we now have a decade of surveillance data utilizing consistent methodology that presents a clear picture of the trends since 2000. Here are the numbers:

1 in 68 (US); 1 in 45 (NJ)
Report Year: 2014
Surveillance Year:  2010

CDC’s ADDM Network reported that about 1 in 68 children had an ASD (based on children who were 8 years old in 2010). Data from 11 AADM Network Sites were reviewed, including New Jersey. New Jersey's rate was approx. 21.9 per 1,000 or 1 in 45.  See 2014 Report.

1 in 88 (US); 1 in 49 (NJ)
Report Year: 2012
Surveillance Year:  2008

CDC’s ADDM Network reported that about 1 in 88 children had an ASD (based on children who were 8 years old in 2008). Data from 14 AADM Network Sites were reviewed, including New Jersey. New Jersey's rate was approx. 20.5 per 1,000 or 1 in 49.  See 2012 Report.

1 in 110 (US)
Report Year: 2009Surveillance Year:  2006 

CDC’s ADDM Network reported that about 1 in 110 children had an ASD (based on children who were 8 years old in 2006).
Data from 11 AADM Network Sites were reviewed.  New Jersey was not included in this report.  See 2009 Report.

1 in 150 (US); 1 in 94 (NJ)
Report Year: 2007Surveillance Year:  2002

CDC’s ADDM Network reported that about 1 in 150 children had an ASD (based on children who were 8 years old in 2002).
Data from 14 AADM Network Sites were reviewed, including New Jersey. New Jersey's rate was approx. 10.6 per 1,000 or 1 in 94. This report combined results from 2002 with those from 2000.  See 2007 Report.

1 in 166 (US); 1 in 101 (NJ)
Report Year: 2007Surveillance Year:  2000

CDC’s ADDM Network first reported that about 1 in 166 children had an ASD (based on children who were 8 years old in 2000).
Data from 6 AADM Network Sites were reviewed, including New Jersey.  New Jersey's rate was approx. 9.9 per 1,000 or 1 in 101.  This report combined results from 2000 with the data from 2002.  See 2007 Report.

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Other Prevalence Studies/Surveys

National Survey of Children's Health -- 1 in 50 (US)

Report Date:  March 20, 2013
Survey Period:  2011 to 2012
Report:  http://www.cdc.gov/nchs/data/nhsr/nhsr065.pdf

Statistics as reported by parents of school-aged children (ages 6–17 years) in 2011–2012.  Data were drawn from the 2007 and 2011–2012 National Survey of Children’s Health (NSCH), which are independent nationally representative telephone surveys of households with children. The surveys were conducted by the Centers for Disease Control and Prevention’s National Center for Health Statistics with funding and direction from the Health Resources and Services Administration’s Maternal and Child Health Bureau.  Prior report of data from 2007 survey indicated a rate of 1 in 86 children (ages 6-17).

http://www.autismnj.org/prevalence-rates 

How to Think About the Risk of Autism

A recent Study by the New York Times

A study published last week found that the brains of autistic children show abnormalities that are likely to have arisen before birth, which is consistent with a large body of previous evidence. Yet most media coverage focuses on vaccines, which do not cause autism and are given after birth. How can we help people separate real risks from false rumors?

Over the last few years, we’ve seen an explosion of studies linking autism to a wide variety of genetic and environmental factors. Putting these studies in perspective is an enormous challenge. In a database search of more than 34,000 scientific publications mentioning autism since its first description in 1943,  over half have come since 2008.

As a statistically minded neuroscientist, I suggest a different approach that relies on a concept we are familiar with: relative odds. As a single common measuring stick to compare odds, I have chosen the “risk ratio,” a measure that allows the bigger picture to come into focus.

For a variety of studies I asked the same question: How large is the increased risk for autism? My standard for comparison was the likelihood in the general population of autism spectrum disorder.  Here’s an example. Start from the fact that the recorded rate of autism is now 1 in 68, according to a report released last week by the Centers for Disease Control and Prevention. If babies born in purple farmhouses have a rate of autism of 2 in 68, this doubling means that the purple farmhouse carries a risk ratio of 2. However, correlation is not causation, and there is no need to repaint that farmhouse just yet.

We can improve our chances of finding true causes by looking before the age of 2, when it becomes possible to diagnose autism. The risk ratio can give perspective where isolated news stories don’t. Media reports have focused on the risk associated with becoming a mother or father in one’s late 30s or after. The story has obvious appeal: Delayed parenthood is common, and readers are understandably anxious. However, parents-to-be should consider that the individual risk to the child is only around 1.4.The risk associated with enhanced or accelerated labor in full-term babies is about 1.2, after other complications are taken into account. And of course, the risk from vaccination is slightly less than 1 — there is no added risk. Even worse, incorrect beliefs about vaccines come with a cost. The return of measles in communities with falling vaccination rates is one recent example.

One might argue that any added risk is too much. But it is essential to put risk into perspective. The early research in the 1950s that first linked smoking with lung cancer gave a risk ratio around 25 for a pack-a-day smoker. In the case of autism, the risk associated with parental age is dwarfed by the impact of inheritance.

Comparing twins who grow up in the same environment allows researchers to focus on the effects of shared genes. A majority of children with an autistic identical twin are likely to be diagnosed with autism as well for a risk ratio somewhere around 80. A lower risk ratio comes from sharing half of one’s genes, as for fraternal twins or siblings. For these reasons, researchers believe that autism’s roots are largely genetic.

The human genome is dotted with hundreds of autism risk genes. Individually, each gene is usually harmless, and is in fact essential for normal function. This suggests that autism is caused by combinations of genes acting together. Think of genes as being like playing cards, and think of autism outcomes as depending on the entire hand. New mutations can also arise throughout life, which might account for the slightly greater risk associated with older fatherhood.

Although autism has a gene-based beginning, growing brains are also influenced by their environment and external events. Looking at when these risks are greatest can provide clues about when the growing brain is most vulnerable. Based on a large body of evidence, the known hazards occur before birth and fall into three broad categories: prematurity, prenatal stress and brain development.

Many known risks for autism occur during late pregnancy and birth. Premature birth is a risk for developmental disability, including autism. Notably, elective cesarean section is associated with an autism risk ration of 1.9. Since a substantial proportion of early deliveries are elective, without a compelling medical reason, this risk is preventable.

A highly under-appreciated prenatal risk is stress. For pregnant women who take the sometimes-wrenching step of emigrating to a new country, for example, the risk ratio is 2.3. In the fifth through ninth months of pregnancy,  getting caught in a hurricane strike zone carries a risk ratio of about 3. Maternal post-traumatic stress disorder during pregnancy is associated with a similar effect. These events are likely to trigger the secretion of stress hormones, which can enter the fetus’s bloodstream and affect the developing brain for a lifetime. Stressors may also lead to maternal illness, the immune response to which may interfere with brain development. 

Stress might account for other findings as well. Recent news coverage has speculated on the influence of air pollutants, which carry risk ratios around 1.4. This risk might be caused by chemicals — or by the stress of living in a poor or crowded neighborhood, where pollution is worse. A larger risk comes from households that already have an older sibling under 1 year of age, where newly conceived children have a risk ratio for autism of 3.4. So sure, parents should avoid smog — but also might think about spacing their children at judiciously chosen intervals.

After birth, known risks diminish. But the baby’s brain acquires a new need: social experience. In one group of Romanian orphanage children, babies were nearly isolated from social contact, and some later showed autism-like symptoms. Developing brains go through sensitive periods during which they require a minimum level of normal experience. Extreme deprivation may affect a critical period of the brain’s social and emotional development.

Risk ratios are good not just for parents, but also for researchers, who can follow them to new areas for in-depth study. The statistics suggest a conceptual framework in which fetal brain development stays on track unless it is driven awry by genetic hits, by adversity in late pregnancy, or a combination of the two.

In my laboratory, risk ratios have led us to examine particular brain regions. Many brain regions in autistic people show abnormalities, but it is not known whether some malfunctioning regions cause other regions to go off track. In one study focusing on detailed long-term outcomes in 51 children, damage to the cerebellum at birth leads to a risk ratio of about 40. The cerebellum links information arriving from different senses and communicates with nearly all regions of the cerebral cortex. Many known risk genes for autism are turned on together in the cerebellum in early life. Although cerebellum injury is rare, we think the cerebellum might be important in using sensory experience to guide normal brain development.

Large Study Supports GI Link to Problem Behaviors in Kids with Autism

A large new study on a diverse group of children supports earlier evidence that children with autism experience high rates of GI distress. The findings also linked this distress to more frequent behavior problems such as social withdrawal, irritability and hyperactivity.

The study, funded in part by Autism Speaks, appears in this month’s Journal of Autism and Developmental Disorders.

“This study brings forward evidence that adds further support to what parents have been telling the scientific community for years," says Autism Speaks Chief Science Officer Rob Ring. “Gastrointestinal dysfunction in autism is real.”

Last year, Autism Speaks-Autism Treatment Network helped develop the first treatment guidelines for managing GI disorders in children with autism. At medical conferences and community meetings, its clinicians have been urging doctors to look for and treat underlying medical conditions – including GI distress – that may be contributing to autism-related behaviors.

This is especially important before considering any behavior-modifying medications, says Autism Speaks Vice President for Medical Research Paul Wang. “Whenever medical issues are exacerbating behavioral problems, treatment should be directed at the underlying root causes, rather than using psychoactive medications as Band-Aids,” he says. “Doctors taking care of these children should proactively evaluate them for these problems, especially since many of these young patients can’t communicate the pain and distress they feel.”

A large, ethnically diverse study
In the new study, researchers at the UC Davis MIND Institute looked at 960 children in the Childhood Autism Risks from Genetics and the Environment (CHARGE) Study. The children were 2 to 5 years old when they enrolled. Roughly half were white and one-third Hispanic. The remainder came from diverse backgrounds. Just over half (499) had a confirmed diagnosis of autism.

The children's parents completed two questionnaires. One assessed GI symptoms such as abdominal pain, diarrhea and constipation. The other measured problem behaviors including irritability, social withdrawal, repetitive behaviors and hyperactivity.

* The parents of children with autism were six-to-eight times more likely to report that their children experienced frequent bloating, constipation, diarrhea and food sensitivities than were the parents of typically developing children.

* Parents of children with autism and GI distress more frequently reported irritability, social withdrawal, repetitive behavior and hyperactivity than did parents whose children with autism didn’t have GI symptoms.

"Although the biological mechanisms behind GI issues remain an active area of research, these findings continue to teach us that autism is a whole-body disorder in some individuals,” Dr. Ring comments. “Therapeutic development in autism must include targets beyond the brain."