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    Autism: Taming a nightmare

    No cure, no cause, but still some options

    In many ways, autism is a nightmare condition for health plans. Its prevalence appears to be skyrocketing, it typically requires long-term treatment, diagnoses are being made at younger and younger ages, there is a plethora of therapies (some evidence-based, some entirely fanciful), and some therapies can be very expensive.

    Oh, and there’s no cure for the condition, nor even a firm evidence-based etiology for it.

    Fortunately, a few things do mitigate what might otherwise seem like an overwhelming situation.

    How many cases?

    Allison SingerMost prominent is the fact that, despite some scare-mongering, autism has not actually surged out of control.

    Talk of an “autism epidemic” is misleading, says Allison Singer, MBA, president of the Autism Science Foundation. “We know there’s an increase in measured prevalence, but we don’t know if there’s an increase in incidence.”

    When Singer’s older brother was diagnosed with autism in 1968, she explains, autism’s prevalence was estimated at 1 in 10,000. It was a time when diagnostic criteria for autism were much more restrictive than those currently used.

    Autism in the 1960s was still often diagnosed as “childhood schizophrenia.” It wasn’t until 1980, and the publication of the Diagnostic and Statistical Manual (DSM)-III that autism was distinguished as a separate condition. In 1994, the DSM-IV added Asperger syndrome, and in 2013, the DSM-V rolled all subcategories into the autism spectrum disorder (ASD) diagnosis.

    So it should have been no surprise when the Center for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report for March 28, 2014, estimated that (per 2010 data) one in 68 U.S. 8-year-olds has an ASD diagnosis (not classic, severe autism per se.) Even though the CDC noted that the 1-in-68 figure was not necessarily reflective of the U.S. population as a whole, the number was large enough--and enough of an increase over the 2012 estimate of one 8-year-old in 88--to fuel renewed media coverage of an “autism epidemic.”

    Next: ASD cases might actually be on the rise


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