Saying that the increase in reported prevalence is attributable to increased awareness and better diagnosis overly simplifies the position that there is not an actual increase in autism.
Here's one example that probably falls under "better diagnosis": diagnostic substitution. It is evident from examining CDDS data that as autism diagnoses increased - directly in response to changing the DSM criteria for Autism Disorder diagnosis and creating the Autism Spectrum (which includes PDD-NOS and Asperger's Syndrome) - the category of Mental Retardation decreased in an inversely proportional way. This is just one example of data that supports the lack of an epidemic.
Here is some further reading:
http://psych.wisc.edu/lang/pdf/Gernsbacher_autism_epidemic.pdf

Part of it is clearly that, while diagnosising may not have improved, the diagnosis is being given for less severe forms of autism spectrum disorder than used to be. It is also clear that that is not the full answer, and no one really knows what is. And the mercury and lead arguments have never made sense - the baby boomers were exposed to much more mercury and lead than current children are, so autism would be decreasing not increasing if either of those were at fault.

My youngest was the only baby to have a reaction to the MMR vaccine[which makes a person think about the SZ article above this one].She was also dx PDD-Asperger's at age 17. When I asked the psychiatrist who gave her that dx and removed Childhood Bipolar Disorder why no one, over all of the years of her life ever dx her that. He specifically said there are more cases now, due to "ability to diagnose better" than years ago.

There could be a defective vaccine batch that caused the increase of that time bracket. Once again, I think we could look at a viral connection. I've had talks like these for years, and no one has answers.

The final answer to me, has been "we have who we have" now. Decade of research and discussion, and no answers.

Virus' also are dormant in soil, and when new homes are built they are exposed, which could also be an interesting study on regional connections to high rate of autism, Schizophrenia, Bipolar, etc.

Psychiatrists generally don't discuss epidemiology stuff, anyone wanting more information on how even autism can be related to virus exposure, or toxins in the environment [and that means father and mother exposure, as well, because what parents are exposed to toxins at one time does matter in conception] Agent Orange for example: men who were exposed to this often have babies with health issues, etc. Also, regions where paper is made from pulp and bleached, harbors the same chemical as Agent Orange, and the toxin is airborne. Downwind from factories such as these can also be noted as pockets of many cancers,mental illness and immune problems.

What is IN the soil, lead etc, when a baby /toddler plays outside, can be lead from auto gas if near a freeway or roadway that was used before auto gas went lead free. It's still in the soil. Mom or Dad digs a garden, and exposes the baby pre-conception, the toddler plays in the dirt, etc.

Autism, and mental illness are complex as we know, and one concrete thing we all know is medication does not work, or works at less than best results.

There is no cure for either of these, which also means pharmaceuticals are temporary band aid solutions to minimize suffering, yet these very drugs can cause things to worsen.

Because of the environmental factors, there will be, in my opinion, no way to understand what/where and how these illnesses/autism begins.

Psychiatrists do not think broad picture, such as an environmental factor. Sadly, it is psychiatrists who dx most people, and their only answer is pharmaceuticals.[Because that is all they have to work with].

i agree that it's environmental. i don't understand though, philip when we're discussing the alarming jump in childhood bipolar it's "alleged" but when it's autism you don't make that distinction. i doubt you'd lump the huge increase in asthma in children in the "alleged" category either. bipolar, epilepsy, and autism all share symptoms, which makes me inclined to believe that they are all different aspects of a similar or same disease. and i believe there's something in the environment that has changed to instigate the surge in these illnesses.

With the weakening of the diagnostic criteria for autism, there are more kids getting that label which many believe is just as bogus as the child bipolar label. The job market has declined so in order to get a social security disability payment for your child, as well as health care, you have to get the kid labeled disabled somehow. Mix that with the nonsensical educational psychology classes that people take to get certified to teach in public school and the fact that most referrals for diagnosis come from these underpaid, under qualified teachers, along with what the media is finally acknowledging as the general sense of misery of the average US citizen who has no control over their financial life, career, housing or health care, as well as the fact that most Americans don't have the time or the energy to go outside as much as we should and that the outside world, as well as the inside world is dangerously polluted, and you've come a long way towards understanding the increase in labeling of autism, asbergers (an even more bogus and cruel label that child bipolar), and everything else including asthma and fibromyalgia.

On the other hand, google "mad hatters disease." Exposure to mercury really can cause insanity. And of course the schools are generally poorly ventalated and filled with mold, but the problem is for all humans not just some of us, so it's unfair to single for labeling and discrimination some of us.

Yes, exactly, the Childhood Bipolar dx is being replaced with PDD-Asperger's. I've seen it in other kids besides my daughter. Unfortunately, the name of the game is still medication. Risperdal being a popular one used in Autistic kids, for outbursts. I've worked with kids who became aggressive after Risperdal was added, so much so, that I asked if there were new meds being given to the child. The answer was yes. It was Risperdal, and that was back in 2005. Pharmaceuticals are being tossed about far too often. Hell, next thing we will read is that we are all PDD to some extent, forget the bipolar spectrum, and in the end we will all be given the antipsychotics. Unless we know better.

anon mom, the only reason i don't use the term alleged when talking about autism and increases in dx'ing etc. is because autism is not my specialty. i know a lot more abotu depression, schizophrenia and bp. when i'm more comfortable in my knowledge of autism perhaps i will use that term. but not yet.

There is no doubt that there has been an increase in 'autism spectrum' diagnoses (my son included), but you cannot call autism, in the classic sense, an 'alleged' disorder. The 'symptoms' of autism are acute, can be assigned to a discrete population. These are kids who can not speak, who do not relate to social cues, who have numerous sensory issues. It's an undeniable set of behaviors and developmental issues. You cannot consider it 'alleged' in any way. What a disservice.

On the 'spectrum' stuff, I for one and glad to be clumped into PDD rather than Bipolar for my son. It focuses our treatments/therapies in a more therapuetic and developmental way (treated with social skills building, therapy, diet, etc), rather than a "biological" way, only treated with meds. A rose is a rose is a rose and all, but when the semantic difference changes the way that the issues are dealt with, it is quite important.

I read this site regularly, and agree with a great deal of information and opinions here. One thing that is disturbing to me is the fact that people do not recognize that there are kids out there, with the PDD or Bipolar label, with real issues that cannot in any way be lumped into "perfectly normal child behavior." It is not always at the fault of the parent, it is not always because the child is eating a bunch of crap, it is sometimes because the child has some real behaviors and issues that need to be treated in one way or another. I prefer a certain way, but it doesn't make my son's behavior any less real or his need for interventions any less valid.

molly, I appreciate your comment here. I teach all spectrum kids and of course my daughter is so complex, that no one knows what "to do". because psychiatrists don't get autistic spectrum, and here's my daughter who hears voices and is high functioning, then went non verbal. her words come in waves, etc. anyway, i understand, and am glad to read your insights here. interesting about my daughter, she helped kids learn to read and do math before she crashed, in my special ed classroom. a cruel twist of fate for her now.sorry this is probably not making sense.

With all the problematic research we've already seen (SSRIs don't cause suicide, the zyprexa controversy) a skeptical observer could be forgiven for believing that the "proof" that no mercury-autism link exists is proof that it does exist.

Another thought regarding environmental[pollution, chemicals, lead, etc.]and connection with the brain.

Lead in the brain.

It may not be what people think about, but it's what a person was exposed to long before conception; family history of exposure to chemicals does not mean it cannot affect future generations. It's an interesting idea, and one we need to pay attention to, because it may not be about what shot was given now, or how the parent took care of themselves [women and men]pre-conception of children. It could be what was in the exposure of the several generations ahead of them.

I know I sat on the curb every day with gasoline swabbing off the tar from the beach from my feet. That was the norm, as a kid. Also, spraying DDT in the yard. Just like seatbelt laws, somethings are not learned until far too late. What I was exposed to, could very well have affected my kids. Just a thought.

Doctors want autism/vaccine theme television show off of the air, worries it will influence parents to stop vaccinating children for fear of autism.

ABC Doctor Drama TV- autism linked to vaccine script upsets doctors.