Autism rates have increased

Here are all of the reasons why.

RFK Jr. is lying to you. His lies are so vile and hateful I will not repeat or amplify them.

Notice how he is using his words to instill fear of the "other."

Notice how he points at something science has demonstrated keeps us safe -- vaccines -- and tries to convince you they are dangerous.

Notice how he has identified the “causation” of a developmental disability and will develop "science" to support this lie, rather than identifying a developmental disability and investigating the many things that could cause it -- microplastics in our bloodstream, proximity to superfund sites, PFAs in water, toxins in the air, inadequate access to maternal healthcare, poverty and poor maternal nutrition. These other, more obvious things are part of the capitalist machine and will not be investigated because their benefactors have purchased our politicians’ silence through lobbying and campaign donations.

Notice that he has vowed to end autism.

The increase in autism rates is not wholly attributable to there being more autism, although that is surely part of it. This increase is also attributable to there being increased surveillance, better diagnostic tools, and a broader definition of what a diagnosis of autism encompasses – notably, the merging of the Asperger’s diagnosis into the broader diagnosis of autistic spectrum disorder. It is also, in part, because our schools are overcrowded and underfunded.

As recently as the late 1990s, the definition of autism was narrow. Children with an autism diagnosis had social and communication delays, sensory and feeding challenges, and learning disabilities. Some were profoundly disabled. Many were not. For children who were not profoundly disabled, it was difficult to meet the criteria of an autism diagnosis.

This diagnosis is important, though, because to access early intervention services and supportive services in school, a child must have an IEP, which requires a medical diagnosis. An IEP gives student broad educational rights that they did not have prior to the enactment of Individuals with Disabilities in Education Act (IDEA)[1]. Having an IEP in place meant that autistic children were entitled to be educated in the least restrictive environment and ensured that they had access to the same educational opportunities as other students.

You may remember hearing the term Asperger's. Asperger's became an official diagnostic term in 1992.[2] Asperger’s was a standalone diagnosis, not a subset of autism, because before Asperger’s there wasn’t an appropriate diagnosis for children who met some, but not all of the diagnostic criteria for autism. These children also had therapeutic and enhanced educational needs, but there was no clear path to having their needs met. Children who received an Asperger’s diagnosis had similar social and communication delays and sensory challenges as autistic children but did not have learning disabilities. With appropriate supports in place to address their social and sensory needs, these children are able to thrive academically and socially.

The 1990s was when we started to think about developmental disorders like autism as a spectrum – some children are profoundly disabled, some children need minimal supports but still have some challenges, most fall somewhere in the middle. Back then, doctors were still learning how to diagnose and treat autism. To arrive at a diagnosis of autism or Asperger’s, your child would be tested for absence seizures, have bone age scans and bloodwork, and undergo many evaluations by psychologists, psychiatrists, developmental pediatricians, and finally, a neurologist.

Today, autism is typically diagnosed by a developmental pediatrician or a mental health provider. Most pediatricians, and many educators, understand autism well enough to identify it and refer children to a specialist when they are a toddler. This is key – early intervention makes a big difference both at home and in school.

The diagnosis of Asperger’s was retired from the DSM-5 in 2013 and the ICD11 in 2019. Children who formerly had, or would have been given a diagnosis of Asperger’s, were moved under the umbrella of autistic spectrum disorder. The increase in autism diagnosis rates on the CDC’s website tracks this timeline.[3] So, it’s not that there are suddenly more autistic people, it’s just that two disorders were consolidated into one diagnosis.

Why did the diagnosis of Asperger’s fall out of favor?

Hans Asperger was an Austrian pediatrician and eugenicist. He was a vocal proponent of Nazi “race hygiene” policies, writing[4]:

Just as the physician often has to make painful incisions during the treatment of individuals, we also have to perform incisions on the national body [Volkskörper], out of a sense of great responsibility: We must ensure that the diseased who would transmit their diseases to remote generations, to the detriment of the individual and of the Volk, are stopped from transmitting their diseased hereditary material.

By 1938, the Law for the Prevention of Hereditarily Diseased Offspring[5] of July 1933 had already resulted in 220,000 individuals being forcibly sterilized in Germany. Asperger gave lectures exhorting physicians to adhere to this law.

After Austria was annexed by Germany in 1938, Asperger fell in line with the eugenicist polices of the Third Reich. Doctors were compelled to report to the government people who were required to be forcibly sterilized and children who had “mental deficiencies” who were slated for euthanasia.

While there is some debate about whether or not Asperger was a useful idiot or knew that Am Spiegelgrund[6] was a euthanasia facility (many of his records are missing, but in 1938 he began signing his diagnostic reports with Heil Hitler) Spiegelgrund was where he sent his profoundly disabled patients – the ones, according to National Socialism (and RFK Jr.), who would never offer anything to society.

Asperger focused his efforts on treating the children who were closer to the neurotypical end of the autistic spectrum.

And if we help them [the abnormal children] with all our dedication, we also render the best service to our Volk; not only by avoiding that they burden the Volksgemeinschaft with their dissocial and criminal acts, but also by trying to ensure that they fulfill their duties as productive individuals in the living organism of the Volk.[7]

Pay attention to the words the Republican regime uses when speaking about autistic children.

Notice how similar they are to Nazi racial hygiene policies.

RFK Jr. is crafting a eugenicist policy that singles out autistic people and pushes a false narrative that they are less than full members of society. Unspoken in all of this is the false premise that a person’s value is rooted in what they can contribute to society. Every human has value.

So how do underfunded schools increase autism diagnosis rates?

Autism is a spectrum, and it’s challenging to distinguish between autism, ADHD, trauma, and the stressors of living in poverty. All of these things similarly impact executive functioning and cause sensory and social issues. There are many kids who need extra support in school whose learning is impacted by trauma and poverty. However, these things do not entitle children to educational support services. I would argue that because of the pandemic and what are now expected and routine school shootings – complex traumas that have gone unaddressed in any meaningful way by our country -- MOST children require extra support in school.

The path to getting support for your child is a medical diagnosis. Because schools are strapped for funding, even more so now, schools often deny IEPs for students who have an ADHD diagnosis and instead shuttle them into 504 plans, which aren’t worth the paper they’re written on to a student who needs help. Schools count on uneducated and overwhelmed parents not pushing back when their request for an IEP evaluation is denied.

Autism is a medical diagnosis which absolutely qualifies a student for educational support services under IDEA. ADHD falls under the category of Other Health Impairment (OHI). There is plenty of grey area in this category which enables schools to deny requests for IEP evaluations.

Parents have learned from experience that in order to access supportive services for their child, they need to seek an autism diagnosis rather than an ADHD or mental health diagnosis. Schools will not provide extra services unless they are compelled by law to provide them – they simply do not have the funding. An autism diagnosis compels the schools to provide services and find the funding to do so.

This is not to say that people are looking for their children to have autism -- they are not. They are doing what they must in order to access appropriate supportive educational services for their child. Every child deserves supportive services regardless of what their social and academic challenges are. Schools should not be denying valid requests for IEPs because they lack the funding to provide supportive services.

A child who has sensory issues and information processing delays cannot learn in a noisy, overcrowded elementary school classroom. Sensory issues and information processing delays can be the result of any number of things, as mentioned above, but they alone do not qualify a student for supportive services like access to a quieter learning environment; assigning an extra teacher to the classroom; information being presented in a format that helps the student better process it; or offering more time for test-taking.

The only way to compel a school to give your child these extra services is by obtaining an IEP. As schools are less able to provide these services, I suspect we will see an even greater increase in autism diagnoses which will compel them by law to provide them. And, as always, our poorest children – the ones who do not have access to adequate healthcare – will be the students left behind.

All of these things combined – increased surveillance, advances is medical science, improved access to medical care, streamlined diagnostics, the consolidation of diagnostic codes, and insufficient school funding – are why it looks like there has been a dramatic increase in autism rates over the past twenty years. You would hope that the person in charge of addressing the multifaceted challenge of providing access to healthcare and services to autistic children would understand this but clearly, he does not.

The nexus between vaccines and autism has long been disproven. This red herring implies that it is better for your child to die from a preventable illness than it is to have an autistic child. It is a lie. It is distraction from the ever-expanding chasm of inequity into which the bottom rungs of the socioeconomic ladder are falling. It is eugenicist policy.

---

[1] Originally The Education for All Handicapped Children Act, enacted in 1975, provided disabled children with equal access to educational opportunities in the least restrictive environment. This Act was renamed and amended in 1990 as IDEA, which expanded the educational rights of disabled students. There have been numerous subsequent amendments, all of which increased funding, services, and protections for disabled students.

[2] https://www.autism.org.uk/advice-and-guidance/what-is-autism/the-history-of-autism/asperger-syndrome

[3] https://www.cdc.gov/autism/data-research/index.html

[4] https://www.autism.org.uk/advice-and-guidance/what-is-autism/the-history-of-autism/asperger-syndrome

[5] https://encyclopedia.ushmm.org/content/en/timeline-event/holocaust/1933-1938/law-for-the-prevention-of-offspring-with-hereditary-diseases

[6] https://ahrp.org/1940-1945-special-childrens-ward/

[7] Asperger H. Das psychisch abnorme Kind. Wien Klin Wochenschr. 1938;49:1314–7.