Autism spectrum disorder (ASD) is a developmental disability defined by diagnostic criteria that include deficits in social communication and social interaction, and the presence of restricted, repetitive patterns of behavior, interests, or activities that can persist throughout life. An article appearing in the medical journal Pediatrics in November 2018 reported: “The estimated prevalence of US children with a parent-reported ASD diagnosis is now 1 in 40, with rates of ASD-specific treatment usage varying by children’s sociodemographic and co-occurring conditions.”
The article further stated: “Parents of an estimated 1.5 million US children aged 3 to 17 years (2.50%) reported that their child had ever received an ASD diagnosis and currently had the condition. Children with parent-reported ASD diagnosis were more likely to have greater health care needs and difficulties accessing health care than children with other emotional or behavioral disorders (attention-deficit/hyperactivity disorder, anxiety, behavioral or conduct problems, depression, developmental delay, Down syndrome, intellectual disability, learning disability, Tourette syndrome) and children without these conditions. Of children with current ASD, 27% were taking medication for ASD-related symptoms, whereas 64% received behavioral treatments in the last 12 months, with variations by sociodemographic characteristics and co-occurring conditions.”
The CDC issued a report in April 2018 entitled “Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2014” in which it stated: “Findings from the ADDM Network, on the basis of 2014 data reported from 11 sites, provide updated population-based estimates of the prevalence of ASD among children aged 8 years in multiple communities in the United States. The overall ASD prevalence estimate of 16.8 per 1,000 children aged 8 years in 2014 is higher than previously reported estimates from the ADDM Network.”
The Autism and Developmental Disabilities Monitoring (ADDM) Network is an active surveillance system that provides estimates of the prevalence of autism spectrum disorder (ASD) among children aged 8 years whose parents or guardians reside within 11 ADDM sites in the United States (Arizona, Arkansas, Colorado, Georgia, Maryland, Minnesota, Missouri, New Jersey, North Carolina, Tennessee, and Wisconsin). ADDM estimates of ASD prevalence among children aged 8 years in multiple U.S. communities have increased from approximately one in 150 children during 2000–2002 to one in 68 during 2010–2012, more than doubling during this period. The observed increase in ASD prevalence “underscores the need for continued surveillance using consistent methods to monitor the changing prevalence of ASD and characteristics of children with ASD in the population.”
ADDM ASD prevalence estimates consistently estimated a ratio of approximately 4.5 male:1 female with ASD during 2006–2012. Other characteristics that have remained relatively constant over time in the population of children identified with ASD by ADDM include the median age of earliest known ASD diagnosis, which remained close to 53 months during 2000–2012 (range: 50 months  to 56 months ), and the proportion of children receiving a comprehensive developmental evaluation by age 3 years, which remained close to 43% during 2006–2012 (range: 43% [2006 and 2012] to 46% ).
ASD prevalence by race/ethnicity has been more varied over time among ADDM Network communities. Although ASD prevalence estimates have historically been greater among white children compared with black or Hispanic children, ADDM-reported white:black and white:Hispanic prevalence ratios have declined over time because of larger increases in ASD prevalence among black children and, to an even greater extent, among Hispanic children, as compared with the magnitude of increase in ASD prevalence among white children. Previous reports from the ADDM Network estimated ASD prevalence among white children to exceed that among black children by approximately 30% in 2002, 2006, and 2010, and by approximately 20% in 2008 and 2012. Estimated prevalence among white children exceeded that among Hispanic children by nearly 70% in 2002 and 2006, and by approximately 50% in 2008, 2010, and 2012.
The CDC concluded: “With prevalence of ASD reaching nearly 3% in some communities and representing an increase of 150% since 2000, ASD is an urgent public health concern that could benefit from enhanced strategies to help identify ASD earlier; to determine possible risk factors; and to address the growing behavioral, educational, residential and occupational needs of this population.”
What Causes Autism In Children?
According to the Eunice Kennedy Shriver National Institute of Child Health and Human Development, “Scientists don’t know exactly what causes autism spectrum disorder (ASD). Autism was first described in the 1940s, but very little was known about it until the last few decades. Even today, there is a great deal that we don’t know about autism. Because the disorder is so complex and no two people with autism are exactly alike, there are probably many causes for autism. It is also likely that there is not a single cause for autism, but rather that it results from a combination of causes.”
According to a Kaiser Permanente study published in 2017 in the medical journal American Journal of Perinatology, “Children who were exposed to complications shortly before or during birth, including birth asphyxia and preeclampsia, were more likely to develop autism spectrum disorder … Researchers found that children exposed to complications during birth were at a 10 percent increased risk of developing ASD, compared to children who did not experience perinatal complications. That number rose to a 22 percent increased risk of developing ASD for children exposed to complications before labor began … children exposed to complications both before and during birth had a 44 percent greater risk of developing ASD than children who did not experience perinatal complications.”
According to the study’s findings, the perinatal complications that had the highest association with ASD were birth asphyxia — deprivation of oxygen during the birthing process — and preeclampsia, a pregnancy complication characterized by high blood pressure and signs of damage to other organ systems. Other perinatal complications that were associated with ASD included premature separation of the placenta from the uterus, breech/transverse fetal presentation, fetal dystocia/abnormal size or position, and a prolapsed/exposed umbilical cord.
If your child has been diagnosed with autism and you suffered complications during pregnancy, labor and/or delivery, you should promptly seek the legal advice of a local medical malpractice attorney in your U.S. state who may investigate whether your child’s autism was due to medical negligence, and represent you and your child in a birth injury medical malpractice case, if appropriate.
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