A few days ago, the Centers for Disease Control and Prevention reported that 1 in every 88 children in the United States has some form of autism. On the same day, research from the London School of Economics and the University of Pennsylvania calculated that the annual costs associated with providing care for these persons is a stunning $126 billion in the United States alone. This news is understandably alarming to potential parents as well as to those who care for and fund efforts to help these individuals.
Currently, "autism" actually refers to a family of disorders that at their core involve difficulty relating to others, problems with communication and very restrictive behaviors and interests. On one end are individuals who have significant cognitive impairments, who do not speak and who seem to be unaware or uninterested in other people. These are persons who are now diagnosed as having "autistic disorder." On the other end are those who are at or above-average in IQ and can speak well — sometimes quite eloquently. However, these individuals do not seem to be able to relate to how others think and feel and are quite rigid and concrete in their behavior. Those who fall on this end of the autism continuum are now being diagnosed with "Asperger's disorder."
However, next year the American Psychiatric Association — which publishes the diagnostic criteria for all psychological disorders — is communicating that it will change the language for the diagnoses and combine them under one term: "autism spectrum disorders." The next edition of this guide (referred to as DSM-5) comes out in May 2013 and if these changes stand they will actually result in fewer people being diagnosed with autism. In a strange sort of way, some people who have the diagnosis today will be "cured" of autism next year.
The major concern with many families and professionals in the field is that regardless of their label, children who have these difficulties need significant clinical and educational assistance. There is great trepidation that not having the label will result in the loss of these essential services. In fact, there are many parents who now press professionals to have their child labeled with autism because it results in a whole array of help not otherwise available.
A great deal of research is under way to understand the very complex genetic and neurobiological causes of what we are seeing as many "autisms." The increases in these diagnoses are undoubtedly a combination of biological (for example, the rising number of chemical toxins that might trigger the disorder) as well as political (the increased awareness of the disorder, for example).
At the same time, research like that being conducted at USF St. Petersburg focuses on helping families deal with these sometimes challenging children, and we are finding that our new treatments can lead to improved quality of life for these families. Children and adults with these difficulties continue to need our help and we should be focused on this real and urgent concern.
V. Mark Durand is a professor of psychology at the University of South Florida St. Petersburg, co-editor of the Journal of Positive Behavior Interventions and author of the book "Optimistic Parenting: Hope and Help for You and Your challenging Child."