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IJE Advance Access originally published online on September 7, 2009
International Journal of Epidemiology 2009 38(5):1239-1241; doi:10.1093/ije/dyp258
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2009; all rights reserved.

Commentary: Diagnostic change and the increased prevalence of autism

Irva Hertz-Picciotto

Department of Public Health Sciences, M.I.N.D. (Medical Investigations of Neurodevelopmental Disorders) Institute, University of California Davis, Davis, California, USA.

E-mail: ihp@ucdavis.edu

Accepted 23 September 2008

The first 10% of the full text of this article appears below.

Parsing increases in autism diagnoses into the proportion arising from changes in criteria, awareness, diagnostic practices and methodology, versus the fraction representing a true rise in incidence, is not easy. Recently, we found three artefacts—younger age at diagnosis, change in the accepted criteria and inclusion of milder cases—accounted for about one-third of a 12-year rise in incidence in California.1 We did not tackle other factors.

King and Bearman2 undertook a daunting task to quantitatively estimate the contribution of diagnostic substitution to the rise in autism. The challenge is to determine how today's children would have been viewed through the eyes . . . [Full Text of this Article]


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