Apparently, over the past 20 years in the United States, autism cases have increased about 300%.
Even in Malaysia, our Social Welfare Department has recorded a surge of 663% over the last 10 years, from almost 7,000 cases in 2013 to over 53,000 cases in 2023.
A study that analysed autism trends among school-age children in Malaysia over the years found that:
> Overall numbers of autism increased from 6.34 per 1,000 children in 2018 to 9.29 per 1,000 children in 2022
> Autism was highest among primary school pupils compared to preschool and secondary school students
> Among the states, Labuan has the highest rates of autism > Kelantan and Terengganu have the lowest rates of reported autism.
Autism has probably been around for a long, long time throughout history, but it was not defined or reported.
Recently, the Autism Spectrum Disorder (ASD) criteria and definition has been broadened.
This means that children previously not diagnosed as having autism are now being diagnosed as autistic.
This is the main reason why there appears to be so many autistic cases compared to previously.
The criteria for autism was first broadened in 1987 in The Diagnostic And Statistical Manual Of Mental Disorders, third edition, revised (DSM III R).
Then in 1994, the DSM IV was introduced.
In it, autism was described as a spectrum, which included other previously-separate disorders like Asperger’s syndrome and Pervasive Developmental Disorder (Not otherwise Specified).
This meant that many more patients who were not previously considered autistic and diagnosed with different disorders, were now considered to be under the large “autism” spectrum.
Finally, in 2013, the DSM V was introduced.
They replaced specific diagnoses with a single broad term: Autism Spectrum Disorder (ASD).
They also removed subcategories like Asperger’s syndrome.
A lot of psychiatric thought has gone into these revisions, especially with more and more studies about autism and the separate disorders being published.
But it was thought that it was easier to create one large unified Autism Spectrum Disorder, rather than individual disorders because the other disorders, such as Asperger’s Syndrome and Pervasive Developmental Disorder NOS, were on different points in the spectrum, rather than being completely separate.
Think of the spectrum like a rainbow arc.
Some symptoms are milder on the one side of the arc, while some are more severe on the other side of the arc.
DSM V was also trying to improve diagnostic accuracy and leave less things open to interpretation by individual psychiatrists.
They also combined Social and Communication issues into one single category and called it Social Communication/Interaction.
They added Sensory Issues, and also included symptoms present in early childhood.
This is not an easy disorder to diagnose yourself if you are a parent.
So if you suspect anything amiss, it is best to take your child to a paediatrician for further referrals and tests.
ASD is a developmental disorder caused by changes in a child’s brain.
Patients have two major sets of symptoms.
The first set is social and communication deficits, which include:
> Avoiding eye contact
> Not responding to their name by the age of nine months
> Not showing different facial expressions of emotion (e.g. happy, sad, angry) by nine months of age
> Not playing interactive games by 12 months of age, such as pat-a-cake
> Does not use gestures like waving hello or goodbye by 12 months of age
> Does not share interests with others by 15 months of age (e.g. showing you a toy)
> Does not point out something they find interesting by 18 months of age (e.g. pointing out an animal or tree when you take them for a walk or to the playground, or a toy shop when you take them to a mall)
> Does not notice when others are sad or upset by two years of age
> Does not notice other children or play with them by three years of age
> Does not playact by four years of age (e.g. pretending to play “house” or being a superhero)
> Does not sing or dance by five years of age.
Throughout all this, you may also notice that your child does not like to maintain eye contact with you or anyone else.
Their speech may be stilted and they cannot interpret ideas easily.
The second set of symptoms is restricted interests and repetitive behaviours, such as:
> Getting upset when you tidy up their toys or change how they are arranged.
Also, playing with toys the same way each time.
They also get upset over minor changes in routine.
> Repeating words and phrases over and over again
> Flapping their hands, rocking their body and spinning.
See StarLifestyle on March 2 for the causes and treatment of autism.
Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
