Trump Focus On ASD Misplaced, Advocates Say
At a White House gathering this week, President Donald Trump expressed concern about a “tremendous increase” in autism, but experts caution that his rhetoric doesn’t tell the whole story.
During what was billed as a “listening session” with parents and teachers, Trump inquired about autism after Jane Quenneville introduced herself as the principal of a Virginia special education center.
“So what’s going on with autism?” Trump asked. “When you look at the tremendous increase, it’s really — it’s such an incredible — it’s really a horrible thing to watch, the tremendous amount of increase. Do you have any idea? And you’re seeing it in the school?”
Advertisement - Continue Reading Below
Quenneville said her school does serve more kids with autism than it used to and noted that 1 in 68 American children are on the spectrum, which is consistent with the latest data from the U.S. Centers for Disease Control and Prevention.
Trump followed up by saying “and now it’s coming even lower than that which is just amazing” before adding “well, maybe we can do something.”
The president’s comments appear to stem from rising CDC prevalence estimates in recent decades. The agency has revised its estimate of autism prevalence upward four times since 2002 when the rate was pegged at 1 in 150.
However, experts stress that there’s tremendous complexity behind these numbers.
“The language used to discuss how often autism spectrum disorders are recognized, diagnosed and/or occur in the population is confusing to scientists — and incorrect use of incidence versus prevalence are common,” said Susan Hyman, a professor of pediatrics at the University of Rochester and the immediate past chair of the American Academy of Pediatrics’ autism subcommittee.
Hyman noted that there are many factors at play. Evidence suggests that doctors may be better at spotting autism and that more children may be served in schools under this label given greater awareness of the condition and the availability of more interventions, she said.
Meanwhile, the diagnostic criteria for autism has also changed significantly in recent decades with updates to psychiatry’s Diagnostic and Statistical Manual of Mental Disorders, said Alison Singer, president of the Autism Science Foundation.
“You can’t really compare autism rates over the last three decades, because the criteria for diagnosing autism have changed dramatically with revisions of the DSM,” Singer said. “The criteria for autism in previous versions of the DSM were much more narrow and restrictive. The range of disorders that meet the definition of ASD is now much broader.”
At the same time, there are signs that the CDC estimates may be stabilizing. Last year, the agency reported that autism rates remained consistent with the estimate released in 2014, marking the first time since 2002 that the CDC released new autism figures that showed no rise.
Rather than raise alarm bells about autism rates, advocates said they’d like to see the administration prioritize policies that help people on the spectrum.
“People naturally have an inclination to look to authority figures like the president for trusted, reliable information and it’s disappointing to see that power taken so lightly,” said Julia Bascom, executive director of the Autistic Self Advocacy Network. “We continue to recommend that any administration focus on the most pressing needs of our community — research to improve quality of life across the lifespan, services to support self-determination and community inclusion and protecting the civil and human rights of autistic people everywhere.”