Prevalence of autism and parentally reported triggers in a north east London population
R Lingam1, A Simmons, N Andrews
1Centre for Community Child Health, Royal Free and University College Medical School, Royal Free Campus, University College London, London NW3 2PF.
Insights
Autism prevalence plateaued after 1992, suggesting increased recognition rather than a true rise. Earlier diagnosis of autism spectrum disorder indicates improved detection methods.
Area of Science:
- Neurodevelopmental disorders
- Pediatric medicine
- Public health
Background:
- Rising recorded prevalence of autistic spectrum disorders (ASD) in recent decades.
- Concerns linking Measles, Mumps, and Rubella (MMR) vaccine to a "new variant" of regressive autism and "autistic enterocolitis".
Purpose of the Study:
- To estimate the prevalence of autism spectrum disorders.
- To assess changes in parental perceptions of autism onset and causes.
Main Methods:
- Analysis of 567 children diagnosed with ASD in North East London (born 1979-1998).
- Examination of trends in autism prevalence and age at diagnosis.
- Assessment of parental attributions, specifically regarding MMR vaccine, over time.
Main Results:
- Autism prevalence, excluding Asperger's syndrome, increased until 1992 and then plateaued around 2.6 per 1000 live births.
- Age at diagnosis for childhood and atypical autism decreased significantly between 1983 and 1998.
- Increased parental mention of MMR vaccine as a trigger after August 1997.
Conclusions:
- The apparent rise in autism prevalence (1979-1992) likely reflects improved diagnostic recognition and recording, not a true increase.
- The plateau in prevalence and decreasing age at diagnosis suggest enhanced detection and awareness.
- A notable increase in parents attributing autism to the MMR vaccine was observed post-August 1997.
Background:
The recorded prevalence of autistic spectrum disorders has risen over recent decades. Measles, mumps and rubella (MMR) vaccine has been blamed, by causing a "new variant" form of "regressive autism" associated with "autistic enterocolitis".
Aims:
To estimate the prevalence of autism and to assess any changes in parental perception regarding the onset or causes of autism.
Methods And Results:
A total of 567 children with autistic spectrum disorder in five districts in north east London were identified, born 1979-98. Reported autism, excluding the 94 cases of Asperger's syndrome, increased by year of birth until 1992, since when prevalence has plateaued. This flattening off persisted after allowing for expected delay in diagnosis in more recent birth cohorts. The age at diagnosis of autistic spectrum disorder was estimated to have decreased per five year period since 1983, by 8.7% for childhood autism and by 11.0% for atypical autism. There was some evidence that MMR was more likely to be mentioned as a trigger after August 1997 than before.
Conclusions:
The prevalence of autism, which was apparently rising from 1979 to 1992, reached a plateau from 1992 to 1996 at a rate of some 2.6 per 1000 live births. This levelling off, together with the reducing age at diagnosis, suggests that the earlier recorded rise in prevalence was not a real increase but was likely due to factors such as increased recognition, a greater willingness on the part of educationalists and families to accept the diagnostic label, and better recording systems. The proportion of parents attributing their child's autism to MMR appears to have increased since August 1997.
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