Autism More Common Than Previously Thought: CDC Report Shows One in 54 Boys Identified

The U.S. Centers for Disease Control and Prevention estimates that 1 in 88 children in the United States has been identified as having an autism spectrum disorder (ASD), according to a new study released March 29 that looked at data from 14 communities. Autism spectrum disorders are almost five times more common among boys than girls -- with 1 in 54 boys identified.

The number of children identified with ASDs ranged from 1 in 210 children in Alabama to 1 in 47 children in Utah. The largest increases were among Hispanic and black children.

The report, Prevalence of Autism Spectrum Disorders -- Autism and Developmental Disabilities Monitoring Network, 14 Sites, United States, 2008, provides autism prevalence estimates from 14 areas. It was just published in the Morbidity and Mortality Weekly Report.

"This information paints a picture of the magnitude of the condition across our country and helps us understand how communities identify children with autism," said Health and Human Services (HHS) Secretary Kathleen Sebelius. "That is why HHS and our entire administration has been working hard to improve the lives of people living with autism spectrum disorders and their families by improving research, support, and services."

"One thing the data tells us with certainty -- there are more children and families that need help," said CDC Director Thomas Frieden, M.D., M.P.H. "We must continue to track autism spectrum disorders because this is the information communities need to guide improvements in services to help children."

Zachary Warren, Ph.D., director of the Vanderbilt Kennedy Center's Treatment and Research Institute for Autism Spectrum Disorders at Vanderbilt University, says effective early identification and treatment of autism is a public health emergency.

"The new CDC data is the best evidence we have to date that autism is a very common disorder. While recent estimates have varied, we have always known the individual, familial, educational and societal costs that go along with autism are tremendous," Warren said. "We are now seeing autism in more than 1 percent of the population, which highlights how challenging it will be for systems of care to meet service needs."

The results of CDC's study highlight the importance of the Obama administration's efforts to address the needs of people with ASDs, including the work of the Interagency Autism Coordinating Committee (IACC) at the U.S. Department of Health and Human Services. The IACC's charge is to facilitate ASD research, screening, intervention, and education. As part of this effort, the National Institutes of Health has invested in research to identify possible risk factors and effective therapies for people with ASDs.

Study results from the 2008 surveillance year show 11.3 per 1,000 8-year-old children have been identified as having an ASD. This marks a 23 percent increase since the last report in 2009. Some of this increase is due to the way children are identified, diagnosed and served in their communities, although exactly how much is due to these factors is unknown. "To understand more, we need to keep accelerating our research into risk factors and causes of autism spectrum disorders," said Coleen Boyle, Ph.D., M.S.Hyg., director of CDC's National Center on Birth Defects and Developmental Disabilities.

The study also shows more children are being diagnosed by age 3, an increase from 12 percent for children born in 1994 to 18 percent for children born in 2000. "Unfortunately, 40 percent of the children in this study aren't getting a diagnosis until after age 4. We are working hard to change that," said Boyle.

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5 things athletes should know about concussions

5 things athletes should know about concussions...Dr Rotenberg in the news....

As summer comes to an end, thousands of young athletes head back to the field for football, cheerleading and other sports. And the question is posed – who is paying attention to their heads?

The bad news: there are approximately 3.8 million sport and recreation-related concussions in the United States each year.

The good news: Texas law (as of Aug. 1) now requires school districts to make sure children get the standard of neurologic care required to limit the long-term damage concussions can impose.

According to the new law, districts must establish a “concussion management team” that includes at least one physician, and any student-athlete showing symptoms of concussion must be removed from competition and not may not return until evaluated by the physician and at least one other member of that team.

The University Interscholastic League threw in its two cents to the law by adding a rule that also went into effect Aug. 1 stating that high school athletes competing in a University Interscholastic League-sanctioned sport are no longer allowed to return to games or practices on the same day they are injured.

“Concussion is a mild traumatic brain injury,” said Dr. Joshua Rotenberg, pediatric neurologist and medical director of Stone Oak-based Texas Medical and Sleep Specialists, in a press release.

“While the state guidelines are excellent and exceedingly important,” he added.

“They don't replace a parent's keen eye and gut intuition. Parents need to know what to look for and what to do if a child is injured during a game on or off the field.” Rotenberg offered the following tips to identify and properly treat this type of traumatic brain injury.

Remove the athlete from play. Look for signs and symptoms of a concussion if your athlete has experienced a bump or blow to the head or body. Early brain and body rest will speed recovery.

Know the signs and symptoms of a concussion. Some of the common symptoms children, teens and young adults may experience include, but are not limited to:

• Appearing dazed, stunned or confused
• Forgetting sports plays
• Moving clumsily, slowly or hesitantly
• Answering questions or thinking slowly
• Loss of consciousness
• Inability to recall events before or after the hit or fall
• Headache or “pressure” in head
• Nausea or vomiting
• Double or blurry vision
• Sensitivity to light and noise

Be proactive. If you notice changes in behavior, seek immediate medical attention. You can't see a concussion and some athletes may not experience symptoms until hours or even days after an injury.

Follow a step-wise process prior to returning to play. Although most concussions are mild in nature, it is still important to proceed with caution. Consider having your child evaluated by a specialist in all aspects of head injuries.

Don't dismiss too quickly. Post concussive syndrome, which may include headaches, dizziness and sensitivity to light, can last for up to a year or more after the injury and is not associated with the severity of the initial injury. If these persistent symptoms appear immediately or weeks or months after the injury, take your child to see a specialist.

According to Rotenberg, most people with a concussion will recover quickly and fully. But for some people, the signs and symptoms of concussion can last for days, weeks or longer.

Because some neurologic abnormalities can only be detected by specialists, Rotenberg said pediatric neurologists might recommend a neuropsychological evaluation in addition to a specialized neurologic examination.

Texas Medical and Sleep Specialists may be reached at 249-5020 or www.txmss.com for more information.

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