Autism and adults

22 Sep

NHS National statistics have released a report entitled Autism Spectrum Disorders in adults living in households throughout England – report from the Adult Psychiatric Morbidity Survey 2007 . The key facts in this document that they list are:

  • Using the recommended threshold of a score of 10 or more on the Autism Diagnostic Observation Schedule, 1.0 per cent of the adult population had ASD. Published childhood population studies show the prevalence rate among children is also approximately 1.0 per cent.
  • The ASD prevalence rate was higher in men (1.8 per cent) than women (0.2 per cent). This fits with the gender profile found in childhood population studies.
  • There is no indication of any increased use of treatment or services for mental or emotional problems among adults with ASD. This is borne out by the recent National Audit Office publication “Supporting People with Autism Through Adulthood”.
  • A greater proportion of single people were assessed with ASD than people of other marital statuses combined. This was particularly evident among men.
  • Prevalence of ASD was associated with educational qualification, particularly among men. The rate for men was lowest among those with a degree level qualification and highest among those with no qualifications.

Understandably, the BBC have focused on an aspect not covered by these key points. The fact that the existence of a similar proportion of autistic adults to the proportion of children who are autistic undermines the idea that MMR vaccine has led to an increase in autism.

Latest autism figures should dispel any fears about the MMR jab being linked to the condition, say experts.

The NHS Information Centre found one in every hundred adults living in England has autism, which is identical to the rate in children.

If the vaccine was to blame, autism rates among children should be higher because the MMR has only been available since the early 1990s, the centre says.

Rather strangely the BBC provides a link on that news story to the JABS website, which continues to scaremonger about MMR and other vaccines. That editorial decision shows just how difficult it is going to be to ever disentangle vaccine conspiracy theories from autism.

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18 Responses to “Autism and adults”

  1. Joseph September 22, 2009 at 16:44 #

    Using the recommended threshold of a score of 10 or more on the Autism Diagnostic Observation Schedule, 1.0 per cent of the adult population had ASD.

    I’ve added a “final addendum” to my 2007 post titled High Prevalence of Autism in Adults.

    Not to brag, but I think I’ll borrow a line from the movie “I, Robot” at this time: You know, somehow, ‘I told you so’ just doesn’t quite say it.

  2. Sullivan September 22, 2009 at 18:11 #

    I need to read this closer, but it looks impressive.

    While styled as a survey, the study goes beyond that. They surveyed a random group and, based on the scores, selected 618 for an actual ADOS test (phase 2 of the study). Of these, 19 (about 3%) were found to be autistic. They were then able to calculate the prevalence in the overall sampled population based on the survey results.

    I suspect much criticism will be mounted based on the seemingly small number of autistics directly identified. In addition, the weighting methods used will likely be criticized (whether they are accurate or not).

    One factor worth noting is that this is the prevalence of ASD’s amongst adults in residential settings.

    The sample for APMS 2007 was designed to be representative of the population living in private households (that is, people not living in communal establishments) in England. People living in institutions are more likely than those living in private households to have ASD, however this group was not covered in the survey reported on here and this should be borne in mind when considering the survey’s account. At the time of the 2001 Census, 2% of the English population aged 16 years or over were resident in a communal establishment.

    This is a factor that would make the estimate (1%) lower than the real value.

    From Joseph’s comment:

    Not to brag, but I think I’ll borrow a line from the movie “I, Robot” at this time: You know, somehow, ‘I told you so’ just doesn’t quite say it.

    As a bit of irony–Andrew Wakefield beat you to that, claiming a 1% prevalence over 10 years ago.

  3. Joseph September 22, 2009 at 18:37 #

    One factor worth noting is that this is the prevalence of ASD’s amongst adults in residential settings.

    That’s right. If they go to “communal establishments” they might find that 30% or so of persons living there have ASD. If, say, 1% of all adults live in these institutions, then overall prevalence of ASD in adults could be as high as 1.3%.

    As a bit of irony—Andrew Wakefield beat you to that, claiming a 1% prevalence over 10 years ago.

    For adults?

  4. Laurentius Rex September 22, 2009 at 19:36 #

    Well not wishing to gloat amongst the told you so’s I will continue to be critical of this survey.

    It is still not good enough for me, because it fails to identify autism, it merely identifies what is currently considered to be autism amongst a select medical community, and of course that is all about to change.

    No it has not plumbed the full depths yet, because Autism is a cultural phenomenon (based on a neurological one) and the measures and methods used are wrong, they are heavily culturally biased and incapable of seeing what they do not seek to look for.

    Repeat it in ten years with the same people, using another diagnostic schedule and the results will be different. Look for something else that has not yet been named or elaborated and eventually they will find a proportion of that too.
    .

  5. healing autism September 22, 2009 at 19:46 #

    Have you heard about Jean Genet? I am looking into this Byonetics program of his which seems to have been incredibly successful with many autistic children. My nephew is autistic I am trying to help my brother find solid solutions.

  6. David N. Brown September 22, 2009 at 19:47 #

    It’s very interesting that autism was found to be more common (as measured by diagnoses) in the less educated. This is the inverse of what has long been thought, and one could further infer that autism is more common among the poor and otherwise isolated or marginalized. This will go a long way toward debunking any correlation between autism and vaccination, but might point toward correlations of autism with poor nutrition and/or various forms of pollution.

  7. Joseph September 22, 2009 at 20:16 #

    It’s very interesting that autism was found to be more common (as measured by diagnoses) in the less educated. This is the inverse of what has long been thought, and one could further infer that autism is more common among the poor and otherwise isolated or marginalized. This will go a long way toward debunking any correlation between autism and vaccination, but might point toward correlations of autism with poor nutrition and/or various forms of pollution.

    They didn’t say their families were less educated or poorer, right?

    So one could also infer that being autistic causes one to have less educational and economic opportunities.

  8. brian September 22, 2009 at 20:42 #

    I suppose this could be the final nail in the coffin of the heavily-promoted Blaxill/Olmstead/Kirby “hidden horde” argument for the existence of an autism epidemic.

    “Since the 2005 expansion of aggressive public relations and political lobbying efforts by SafeMinds and other organizations promoting vaccine-injury claimants’ agenda, the phrase “hidden horde hypothesis” and variants on the question, “where is the hidden horde of autistic adults?” have been invoked by a number of media campaigners, consultants, and parents persuaded to believe that their children were made autistic by vaccine poisoning.”

    http://neurodiversity.com/weblog/?c=History

    You just have to keep your eyes open.

  9. Clay September 22, 2009 at 23:09 #

    Yeah, I’m not at all surprised by these findings, or the numbers. They seem to be about right to me.

  10. K September 22, 2009 at 23:18 #

    “It’s very interesting that autism was found to be more common (as measured by diagnoses) in the less educated. This is the inverse of what has long been thought, and one could further infer that autism is more common among the poor and otherwise isolated or marginalized.”

    I once wrote basically verbatim that this was the common demographic in my AS support group (unemployed, poor, homeless, no college education and marginalized). It was suggested by one person, he knows who he is, that I was trying to blame autism for these things and then another said that my group was not necessarily a representative group, or something to that effect. Both persons I’m referring to are self diagnosed.

    Shakes head.

  11. David N. Brown September 23, 2009 at 06:25 #

    One thing about use of the upper class autism argument:
    I’ve seen it used by vaccine blamers to argue away a major problem: The vaccines blamed for autism were introduced decades before the 1990s rise in diagnoses. Hence, even vaccine causation would imply a “hidden horde” among adults. The blamers’ response is that in “19xx” the vaccines were only available to the upper class, and that at that time autism was limited to the upper class. The former assertion is certainly false, and the latter should be dispensed with too.
    To Joseph: The background of autistics is the next question to address. My thought is that, even if occurence of autism is uniform among all classes, there could easily be a correlation between poverty and more severe symptoms.

  12. laurentius rex September 23, 2009 at 07:55 #

    There is another possibility here, that is the social construction of “disorder” in that historically economically disadvantaged and socially devalued classes tend to get diagnosed with more heavy stuff.

    Our society can never admit that it disadvantages people so it gives them a diagnosis instead.

    Autism is in essence a socially created disability, whose disability is increased at the margins with the occurence of multiple disadvantage.

    I doubt if this survey is objectively measuring neurological difference at all, once again it is using a behavioral measure, and observational schedule of effect not any real objective measure, therefore it is impossible to determine the direction of causation here autism = poor education or poor education = autism.

    I suspect a complex interelationship.

    Above all this is NOT a valid survey of neurological difference, it is the prime example of the social construction of disability and the disabling of those it decides to lable.

  13. Laurentius Rex September 23, 2009 at 08:01 #

    Following on my last post, perhaps there is also a suggestion that the ONLY effective intervention in ‘autism’ is Education, in that as I said the true prevalence of neurological difference or diversity has not been studied, just it’s effects, those effects appear less if one has been well educated, however one looks at the pattern of school exclusions, and special schooling and realises how much all of this educational disadvantage is created. Special schools for whatever one wants to say about them, do not confer educational advantage as a rule, children from special schools tend to have lower attainment on leaving.

    I think the Sociologists need to take this study apart. As for Brugha, I have little to say in his commendation, another arrogant academic who refuses to look sideways at anything.

  14. Laurentius Rex September 23, 2009 at 18:24 #

    And while I am in the mood, and before the Aspie police get on my back for not taking this survey seriously enough. I do welcome it, but although it does state (to quote from python) “the bleeding obvious” we should not all jump to conclusions that this is proof, not until this is repeated, elsewhere, with a different methodology.

    Only when several studies come in showing consistent figures will it begin to approach validity, after all we should not drop our standards just because a study confirms what we want people to think, that is what the enemy do.

    So I think I am entitled to a certain scepticism. I would probably have done this differently, something less biased, more foolproof, but I will have to look at this properly first, at the moment I can’t even download the full version without registering first, and I don’t want to do that, the NHS has got enough of my data without me giving them any more :)

  15. Joseph September 23, 2009 at 18:48 #

    we should not all jump to conclusions that this is proof, not until this is repeated, elsewhere, with a different methodology.

    In general, that’s correct, but I see this is as a confirmatory study with better methodology than prior ones. It’s not really the first one on the question of how prevalent autism might be in adults, even though it’s the first actual prevalence study of autistic adults.

    It’s unlikely that in other parts of the world they will find autism to be rare in adults given all that is known. I’m sure other studies will follow.

  16. Catherina September 24, 2009 at 17:19 #

    Laurentius Rex, you can skip the registration – there is an option to click “no” under “would you like to register” and you will get to the survey and the Methods files.

Trackbacks/Pingbacks

  1. Preventing autism? Not so fast, Dr. Mumper… « Science-Based Medicine - March 25, 2014

    […] are reclassified as an ASD; and (3) intensive screening programs. We’ve noted that recent studies examining adult cohorts for ASDs using current-day criteria have produced estimates of autism […]

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