Watch the TV segment at the link above, or read the transcript below for information on this topic.
WCAX: Tonight we are talking about autism, and here to help us understand the disorder and what appears to be a growing number of people being diagnosed is our friend Dr. Mark Rettew. Dr. Rettew, thanks for being here.
Dr. Rettew: Good to be back.
WCAX: I might just have you remind folks at home what exactly is autism. We hear about it a lot, but what is it?
Dr. Rettew: Sure. Autism is a term that describes kids who have real trouble with social communication and social interactions as well as very restricted interests, or very repetitive behaviors. It was something that people thought was quite rare. About 40 years ago, the idea was that it affected maybe one in 5,000 kids, but that number has been steadily increasing, and today the estimates are about one in 68, and even more common 1 in 50 boys.
WCAX: I’m calling you Mark because I’m texting my twin brother. David Rettew. You’re on all the time. I know that. People hear those numbers from one in thousands to one in 68. That sounds huge, like a huge discrepancy there. What is behind these new numbers here?
Dr. Rettew: Sure, it sounds alarming, doesn’t it? Almost like an epidemic. I think that this rise has led to a lot of people looking for the big causes of this, including the idea that it might be linked to vaccines, and that idea has been thoroughly debunked with research. A lot of people think that this rise might not actually be a true increase, that it may represent some other things. One of those things is the idea that the diagnostic threshold, in other words, what counts to be severe enough to be autism has been steadily dropping over the past 40 years or so.
WCAX: You say there’s new evidence out to kind of support this idea. What does that show?
Dr. Rettew: Right. People have suspected that this has been going on for a long time. We really haven’t had a lot of direct evidence. Just last week there was a new study that was published that directly showed that this affect seems to be happening. They tracked new cases of autism over a period of many years, and basically demonstrated this.
WCAX: When we say one in 68, parents at home may be thinking, “That’s a couple of kids in my son or daughters grade, or multiple people in our school.” Is it a good thing that we seem to have gotten a different grasp on what these numbers look like?
Dr. Rettew: In my opinion, and there’s a lot of debate about this, I think this is mostly a good thing. You need a diagnosis, you need a term to open the door to things like some specialized services at school, or some other considerations, or just having something that allows for people to have something to treat. On the other hand, there may be some downsides too. It’s a pretty big diagnosis to carry. It probably carries some stigma, and there may be other doors that close because of the diagnosis too. It’s a bit of a mixed bag, but I’d say mainly a good thing.
WCAX: There are few disorders that I hear about that are possibly as hotly debated as autism. Talk to me about the science behind it, and how scientists can confirm or affirm a diagnosis here?
Dr. Rettew: Well, it’s difficult, because autism spectrum is truly a spectrum, which means it’s a continuum, like height. We are all on the autism spectrum, and until there is a specific lab test, or some kind of brain scan that can really point to whatever is causing autism for us to identify that, it’s going to be kind of a clinical judgment. In the diagnostic criteria, there are terms like clinically significant or impairing that are somewhat subjective, and that’s what leads to this debate about people who have some trouble but are not more extreme in their symptoms as to whether or not that should really count as a diagnosis.
WCAX: Doctor, how do we empower parents here who may suspect that their child has autism? What do we say to those folks?
Dr. Rettew: Well, don’t go it alone. At this point, pediatricians are screening for autism very early. Those kinds of thoughts have already been occurring to the pediatricians and family physicians already. If they have questions, they should ask people that they trust. Don’t go just onto the internet where you can find a lot of information, but you can also find a lot of misinformation too.
WCAX: What is the best advice once somebody gets a confirmed diagnosis?
Dr. Rettew: Follow the advice of your treatment providers. Autism, there is no medicine to treat the core symptoms of autism. There are a lot of things that have been shown to really help, and one of the keys is really try to promote language development as much as you can.
WCAX: Is that one of the biggest hurdles? What are the biggest mistake or misconception people might have?
Dr. Rettew: Well, I think a lot of people think that maybe we’re diagnosing too many people with autism. That any kid who’s a little atypical is getting the diagnosis, but I think if you use the criteria carefully, that’s really not the problem here.
WCAX: It sounds like if parents have questions, you say ask.
Dr. Rettew: Absolutely. Yes.
WCAX: All right. Dr. David Rettew, I appreciate you being here.
Dr. Rettew: My pleasure.