The mall I go to now opened in 1950! I also remember going to malls in a suburb of Caracas, Venezuela in the 1960s (we moved from Venezuela to Bloomington, MN).

I grew up in the 1960s, I remember there were lots of stores, commercials, and lots and lots of catalogs. It was all about the materialism post World War II (and some of the late 1960s counter culture was a reaction to that).

And no shopping magazines? I guess you’ve never heard of the Sears Catalog, which has been around since the 19th Century.

No. Materialism is not the cause of autism. And being obsessed with things isn’t the same thing as being materialistic. If you’ve got an autistic child obsessed with dinosaurs, this is not comparable to somebody with a $16,000 credit tab from a year’s worth of shopping sprees at the local mall. Plus, most autistic people don’t enjoy shopping malls in the least, which are very stimulating environments.

thanks for the clarification.

So they do screen, but this is substantially different from a prevelence study which might take a smaller group of children and screen for possible ASD, then test those potentials with ADOS or ADI type tests. Correct?

As to Shattuck (Waisman Center alum, if I recall correctly) and Mandell—they are two very respected researchers to those of us here at lbrb. We have a “Mandell” category, and I recently discussed Dr. Shattuck’s grant to look at adolescents.

Thank you for the kind words about the Waisman Center.

I can understand how making distinctions based on those terminologies can seem ambiguous. The ADDM Network methods screen existing records and evaluations, as opposed to directly screening all children. For children showing signs of ASD, de-identified information is sent to an expert reviewer who assigns a surveillance case definition comparing the abstracted information to DSM-IV criteria. The children who are given an ASD case definition are counted (enumerated) over a geographically-defined population.

We also record if a child has been previously diagnosed, and there is some interesting work by Shattuck and Mandell looking at disparities in identification and age of diagnosis of ASD in the US.

thank you very much for taking the time to respond here. We here at lbrb have a great admiration for the Waisman Center.

I appreciate your comment—I am somewhat confused by the description of methods in the ADDM (as cited in the paper) which includes discussion of screening vs. the CDC’s statement that the ADDM uses “case enumeration”.

Just as a clarification, the ADDM Network identifies ASD cases independently of a previous diagnosis. Children who have been to a health care provider and did not get diagnosed could still be considered a case. This does not, however, completely rule out the possibility of ascertainment bias due to SES.

I should have written “Children of parents who did not complete their secondary education were less likely to have a local diagnosis of autism.”

A more recent study by Baird (2006) found that parental education was a factor in diagnosis. Parents who did not complete their secondary education were less likely to have a local diagnosis of autism. But once this was controlled for, socio-economic status was not a significant factor.

It is possible there are actually more wealthy autistics. Wealthy parents are more likely to have attended college, and therefore be older when they have children. Also, wealthy parents are more likely to have math or engineering backgrounds, which tend to be over represented in the autism community.

It’s possible. But, very unlikely to be a factor of 2.6 as noted in the paper. Keep in mind that they are using ADDM data. The CDC lists the prevalence data they use as being collected by “case enumeration”. They count already identified cases. My recollection is that Wisconsin had the largest gap in prevalence based on ethnicity, which to me is a clear sign that they are not counting everyone. Race/ethnicity has been studied and it is either not a factor or not a very large one.