Intended for healthcare professionals

Rapid response to:

Clinical Review State of the Art Review

Autism spectrum disorder: advances in diagnosis and evaluation

BMJ 2018; 361 doi: https://doi.org/10.1136/bmj.k1674 (Published 21 May 2018) Cite this as: BMJ 2018;361:k1674

Rapid Response:

Autism among school children is 4 times the upper figure given in this "State of the Art " report three years ago and 20 times that in 1999

Dear Editor

In 1999 according to a carefully conducted survey for the geographical region ‘Great Britain’ the rate of autism in schools was 0.3%. As many of us realised at the time there was already a dynamic increase: there were twice as many cases (0.4%) in primary school (4-11) as secondary (12-18)  (0.2%) although secondary students had a longer time to gain a diagnosis and were monitored by the same services (p.33 Table 4.1, listed as ‘a less common disorder, Pervasive Development Disorder) [1].

In 2021 in Northern Ireland, the one region where there is serious attempt to count, the figure is now around 6% [2,3]. This is also now 4 times the rate at the high end of Zwaigenbaum and Penner’s “state of the art” projection just three years ago [4,5]. Two-thirds of those with a diagnosis are severely disabled being at Education Stage 5 [2].

The difference between Northern Ireland and the rest of the United Kingdom is probably only that in Northern Ireland they make a conscientious attemp to collect the data. Time to stop playing at news management and address real problems?

[1] Meltzer et al, ‘The mental health of children and adolescents in Great Britain’, 1999, https://webarchive.nationalarchives.gov.uk/20160107072821/http://www.ons...

[2] John Stone, ‘5.8% of 13 year-olds in Northern Ireland have an autism diagnosis’, 20 May 2021, https://www.bmj.com/content/366/bmj.l4564/rr-11

[3] John Stone, ‘Re: 5.8% of 13 year-olds in Northern Ireland have an autism diagnosis’, 20 May 2021, https://www.bmj.com/content/366/bmj.l4564/rr-12

[4] Zwaigenbaum and Penner,  ‘Autism spectrum disorder: advances in diagnosis and evaluation’, BMJ 2018; 361 doi: https://doi.org/10.1136/bmj.k1674 (Published 21 May 2018)

[5] John Stone, ‘ Re: Autism spectrum disorder: advances in diagnosis and evaluation’, 21 May 2018, https://www.bmj.com/content/361/bmj.k1674/rr

Competing interests: AgeofAutism.com, an on-line daily journal, concerns itself with the potential environmental sources for the proliferation of autism, neurological impairment, immune dysfunction and chronic disease. I receive no payment as UK Editor. I also moderate comments for the on-line journal ‘The Defender’ for which I am paid. I am also a member of the UK Medical Freedom Alliance

11 June 2021
John Stone
UK Editor
AgeofAutism.com
London N22