15 ms·

First, and foremost, the rise in autism rates is due to more sensitive instruments, a broadening of some inclusion criteria between DSM 4 and 5, more awareness

First, and foremost, the rise in autism rates is due to more sensitive instruments, a broadening of some inclusion criteria between DSM 4 and 5, more awareness of autism, less stigma associated with autism, services attached to autism diagnosis. I believe current research suggests these don't account for all the rise, but does account for most of it. If I were to include additional biological possibilities, I'd include: a) birth control -> waiting to have children until a later age, more de novo mutations due to age. b) assortive mating, since some careers tend to attract those on the within and on the edges of the spectrum., c) perhaps controversially, and with the very little research on the subject, endocrine disruption from plastic waste exposures.

throw939ii44 20d ago
Severe autism is on raise as well, and that has stable diagnoses over several years. Plus general cognitive decline in last a few decades is also documented. Is it politically correct to write about later stage pregnancies? It would be insta ban only a few years ago. Perhaps soon we will be able to openly discus something else, that may cause endocrine disruption, not just plastics!
- javanissen 20d ago
  We already know that most of the increase, even in diagnosis of level 3 autism, is due to diagnostic shifting/switching (as explained pretty well here: https://youtu.be/BdpSfrD3Nzs https://youtu.be/BdpSfrD3Nzs). We also know there are reasonably well supported risk factors that are increasing in prevalence; e.g. father aged >50 at the time of birth. > general cognitive decline According to whom? The Flynn effect famously says the opposite: https://en.wikipedia.org/wiki/Flynn_effect https://en.wikipedia.org/wiki/Flynn_effect
longhaul 20d ago
@SubiculumCode - replying as you are a researcher in this field. There is an increase in profound autism globally (I think this is the new naming to differentiate severe autism) which isn’t explained by sensitive instruments or inclusion criteria. You just don’t need them to identify profound autism, it is that obvious. Affected people need caregivers for life also causing severe mental and financial stress. It will only help your research to investigate this increase which perhaps will lead to medical breakthroughs.
- SubiculumCode 20d ago
  I agree 1000% that the full spectrum of autism must be included into autism research. My research for the last 10 years has been dedicated to collecting and analyzing data for the Autism Phenome Project [1]. Unlike almost all autism neuroimaging research, we include the full spectrum of autism, with a third of our participants with severe intellectual disabilities, closely matching their share of the autistic population, as well as those who are non-verbal, have extreme specific phobias and anxiety, sensory sensitivities, self-injurious behaviors: the full spectrum. It still frustrates me to no end that almost every neuroimaging study you read by default excludes those with IQs less than 80, while our cohort has managed, through very hard work, managed to image individuals with IQs in the 20-60 range with regular success. [1] https://pmc.ncbi.nlm.nih.gov/articles/PMC8801875/ https://pmc.ncbi.nlm.nih.gov/articles/PMC8801875/
  - amdsn 20d ago
    >It still frustrates me to no end that almost every neuroimaging study you read by default excludes those with IQs less than 80, while our cohort has managed, through very hard work, managed to image individuals with IQs in the 20-60 range with regular success. I appreciate the effort it takes to include that group. My brother has severe/low functioning autism and he also has very limited language capability (limited vocabulary with simplified grammatical constructions, mix of ASL/SEE signs and spoken words, difficulty producing certain sounds). I've always found it odd that even studies that mainly use data gathered by imaging or other medical tests that don't rely on the subject's mental capacity to participate almost always have no subjects that resemble him at all. I've always assumed it's because it's significantly harder to manage such subjects and probably also very likely for their families to be unable to bring them in for testing in studies that span years.
    - ahazred8ta 20d ago
      You'd think that subjects who are institutionalized would not have this access problem.
DoctorOetker 20d ago
> If I were to include additional biological possibilities, I'd include: a) birth control -> waiting to have children until a later age, more de novo mutations due to age. Surely it should be easy to collect the data to plot such a hypothesis: incidence rate vs age of father and vs age of mother at conception, and at birth.
- inigyou 20d ago
  Be careful of reverse causation. Being autistic makes you more likely to have children later (if at all) and we know it's at least partially heritable.
  - DoctorOetker 20d ago
    reverse causation? if the stated premise were true, it should be easy to plot.

throw939ii44 20d ago

Severe autism is on raise as well, and that has stable diagnoses over several years. Plus general cognitive decline in last a few decades is also documented. Is it politically correct to write about later stage pregnancies? It would be insta ban only a few years ago. Perhaps soon we will be able to openly discus something else, that may cause endocrine disruption, not just plastics!

javanissen 20d ago
We already know that most of the increase, even in diagnosis of level 3 autism, is due to diagnostic shifting/switching (as explained pretty well here: https://youtu.be/BdpSfrD3Nzs https://youtu.be/BdpSfrD3Nzs). We also know there are reasonably well supported risk factors that are increasing in prevalence; e.g. father aged >50 at the time of birth. > general cognitive decline According to whom? The Flynn effect famously says the opposite: https://en.wikipedia.org/wiki/Flynn_effect https://en.wikipedia.org/wiki/Flynn_effect

longhaul 20d ago

@SubiculumCode - replying as you are a researcher in this field. There is an increase in profound autism globally (I think this is the new naming to differentiate severe autism) which isn’t explained by sensitive instruments or inclusion criteria. You just don’t need them to identify profound autism, it is that obvious. Affected people need caregivers for life also causing severe mental and financial stress. It will only help your research to investigate this increase which perhaps will lead to medical breakthroughs.

SubiculumCode 20d ago
I agree 1000% that the full spectrum of autism must be included into autism research. My research for the last 10 years has been dedicated to collecting and analyzing data for the Autism Phenome Project [1]. Unlike almost all autism neuroimaging research, we include the full spectrum of autism, with a third of our participants with severe intellectual disabilities, closely matching their share of the autistic population, as well as those who are non-verbal, have extreme specific phobias and anxiety, sensory sensitivities, self-injurious behaviors: the full spectrum. It still frustrates me to no end that almost every neuroimaging study you read by default excludes those with IQs less than 80, while our cohort has managed, through very hard work, managed to image individuals with IQs in the 20-60 range with regular success. [1] https://pmc.ncbi.nlm.nih.gov/articles/PMC8801875/ https://pmc.ncbi.nlm.nih.gov/articles/PMC8801875/
- amdsn 20d ago
  >It still frustrates me to no end that almost every neuroimaging study you read by default excludes those with IQs less than 80, while our cohort has managed, through very hard work, managed to image individuals with IQs in the 20-60 range with regular success. I appreciate the effort it takes to include that group. My brother has severe/low functioning autism and he also has very limited language capability (limited vocabulary with simplified grammatical constructions, mix of ASL/SEE signs and spoken words, difficulty producing certain sounds). I've always found it odd that even studies that mainly use data gathered by imaging or other medical tests that don't rely on the subject's mental capacity to participate almost always have no subjects that resemble him at all. I've always assumed it's because it's significantly harder to manage such subjects and probably also very likely for their families to be unable to bring them in for testing in studies that span years.
  - ahazred8ta 20d ago
    You'd think that subjects who are institutionalized would not have this access problem.

DoctorOetker 20d ago

> If I were to include additional biological possibilities, I'd include: a) birth control -> waiting to have children until a later age, more de novo mutations due to age. Surely it should be easy to collect the data to plot such a hypothesis: incidence rate vs age of father and vs age of mother at conception, and at birth.

inigyou 20d ago
Be careful of reverse causation. Being autistic makes you more likely to have children later (if at all) and we know it's at least partially heritable.
- DoctorOetker 20d ago
  reverse causation? if the stated premise were true, it should be easy to plot.