Autism rates rise: Disorder affects 1 in 88 children, CDC study finds

LOS ANGELES — Federal health authorities have significantly raised their estimate of the prevalence of autism in children, concluding in a new study of 8-year-olds that 1 in 88 has some form of the disorder.

For the analysis, released Thursday, researchers scoured tens of thousands of health and special-education records in 14 states, looking for an autism diagnosis or the symptoms that would add up to one.

It is the latest in a series of studies by the U.S. Centers for Disease Control and Prevention (CDC) showing autism rates climbing substantially in the past decade.

The previous estimate, from 2006, was 1 in 110.

The new figure, based on 2008 data, is sure to fuel debate over whether a growing environmental threat could be at work. But autism researchers around the country said the CDC data suggest that rising awareness of the disorder, better detection and improved access to services can explain much of the surge, and perhaps all of it.

Washington was not one of the states included in the study, and autism is not tracked by state health officials. But Dr. Bryan King, director of the Seattle Children's Autism Center, said the report of growing numbers of children with autism spectrum disorder wasn't news to those who work in the field. "We're up against a tidal wave of need," he said.

More than 1,000 families are on a waiting list for diagnostic and therapy services from Children's, he said. "Families are having to confront the difficulties in accessing services and providers are trying to keep up with the press of humanity at the door."

Nobody knows what causes autism, and there is no blood test or other biological marker. It is diagnosed by its symptoms — social and communication difficulties starting in early childhood and repetitive behaviors or abnormally intense interests — and has come to include a wide range of symptoms.

Milder forms are now recognized. One, Asperger syndrome, describes behavior that in the past might have been seen as peculiar and abnormal but not evidence of illness. Ultimately, a diagnosis comes down to clinical judgment.

Some experts questioned the validity of relying on records to estimate the disorder's true prevalence.

David Mandell, an autism expert at the University of Pennsylvania, said the CDC's numbers primarily reflect the degree to which the diagnosis and services have taken hold in different places and among different groups.

"As the diagnosis is associated with more and more services, this becomes a less and less rigorous way to determine the prevalence of autism," he said, referring to the CDC's methods.

The federal agency found that Utah, which has widespread screening programs, had the highest rate: 1 child in 47. The state was closely followed by New Jersey, which prides itself on its autism services, at 1 in 49.

At the bottom was Alabama, one of the poorest states. Its autism rate fell 20 percent between 2006 and 2008: from 1 in 167 to 1 in 208.

CDC officials acknowledged the limitations of their analysis. In surveillance areas where researchers had access only to health records, and not school records, prevalence estimates were generally lower.

"Our study really is more of a study of demographic differences and population differences," said Jon Baio, a CDC epidemiologist and principal investigator on the report.

The researchers hope, however, that the study will draw attention to the need for more vigorous screening early in children's lives. Research shows that early intervention offers autistic children the best long-term prospects

More than one-fifth of children identified as autistic by the CDC had no autism diagnosis in their records.

Dr. Coleen Boyle, director of the CDC's National Center on Birth Defects and Developmental Disabilities, said children "still aren't being identified enough."

In response to rising concern over the skyrocketing diagnosis rates in the 1990s, the CDC set up a network of surveillance sites nationwide. Researchers do not examine children but instead periodically review records of 8-year-olds.

In its first analysis, using data from 2000, the CDC estimated that 1 in 150 children had some form of the disorder. The latest estimate of 1 in 88 is already being touted as evidence that something in the environment is driving up cases.

"Autism is now officially becoming an epidemic in the United States," Mark Roithmayr, president of the advocacy group Autism Speaks, said at a news conference with CDC officials Thursday.

Others noted that as autism awareness has grown, health-care providers and school officials are more likely to label a child autistic or note autistic symptoms in the documentation that the CDC researchers rely on.

In all, the CDC identified 3,820 children with some form of autism, out of 337,093 in the surveillance areas.

As has been previously established, boys were much more heavily affected: The rate was 1 in 54, compared with 1 in 252 girls.

The rate for white children was 1 in 83, compared with 1 in 127 for Latinos and 1 in 98 for black people — but the data show those minorities have been closing the gap.

"What we're looking at is mostly due to practices and infrastructure and culture rather than some underlying biological phenomenon," said Dr. Daniel Geschwind, an autism expert at UCLA.

Autism often has devastating effects on families, and treatment requires time, skill and patience. Medical expenses for children with autism are six times higher than for children without the disorder. Behavioral therapy, often delivered one on one, can cost as much as $60,000 a year. The advocacy group Autism Speaks estimates autism spectrum disorders cost the United States $137 billion a year.

Why You Should Be Using The Female Condom

A program that gave away 200,000 female condoms to women in Washington, DC prevented 23 HIV infections, according to a study published in the journal AIDS and Behavior. Why female condoms rather than the more common male variety? The study authors wrote, "It is critical that there are HIV prevention interventions entirely under the control of women, and female condoms are the only such woman initiated intervention currently on the open market." But will women actually use them?

Women I talked to were skeptical. Said one, "I wouldn't use a female condom unless I had to. I prefer contraception to be relatively discreet, aesthetically speaking — whether as unseen as an IUD or the Pill, as removed from the moment as a diaphragm, and/or as clingy and sort-of camouflaged as a male condom — and my perception of the FC is that it's far from aesthetically pleasing or discreet, due to the ring hanging out. " Another said that she thought they were less effective than male condoms (true, at least for preventing pregnancy), more expensive (also true), and difficult to find (true, although it may be getting easier). A third said, "I guess I wouldn't be opposed, but I have to admit I don't think I've ever spoken to someone who has" used one. She added that if someone she knew had used one and liked it, she might be more inclined to try.
Planned Parenthood is hoping to make that more likely. Leola Reis of Planned Parenthood Southeast told me some pluses of the method. First of all, she says the new Female Condom 2 is way better than the old version — it's made of nitrile rather than polyurethane, so it's pliable and warms with the body. And it has some advantages over the male condom. It covers more of the outside skin of the vulva, reducing skin-to-skin STD transmission risk. And Reis says it can even increase a woman's pleasure, because the outer ring can rub up against the clitoris during sex.
The biggest drawback, according to Reis: women don't know how to use it. But in a project in Atlanta, Planned Parenthood held trainings to teach 600 women how to use the method, and gave them goodie bags with three female condoms to take home. Then they surveyed those 600 women, plus 350 who hadn't done the training. 85.5 percent of the women who did the training said they'd consider using a female condom, compared with 57.3 percent of women who hadn't. And 51.3 percent of training participants said they'd rather use a female condom than a male one (just 18.1 percent of non-participants said the same).
So a little information can make a big difference. For instructions on how to use a female condom, plus an animated video, check out Planned Parenthood's site.

Obesity can increase risk of breast cancer recurrence

Washington: Researchers have found that women who are overweight or obese when they are diagnosed with breast cancer are at higher risk of cancer recurrence or related death than leaner women.

This finding held true even though the study mandated that chemotherapy dosage be adjusted for body weight, and adds further to the evidence that lifestyle factors can influence cancer prognosis, according to the researchers.

Dr. Jennifer Ligibel, a medical oncologist at the Dana-Farber Cancer Institute, Boston, USA, and an Associate Professor at Harvard Medical School, and colleagues, studied data from 1909 patients who were enrolled into a study called CALGB 9741 between 1997 and 1999.

The study was set up to investigate different dosing schedules for adjuvant chemotherapy in patients where cancer cells were found in the lymph nodes (node-positive cancer). The presence of such cells in the lymph nodes means that there is a higher chance of cancer returning after surgery.

After extracting height and weight data from the patient records, they went on to evaluate the relationship between body mass index (BMI) with relapse-free survival (RFS) and overall survival (OS).

1.2 percent of the patients were underweight, 32.6 percent normal weight, and 32.9 percent overweight, and 33.3 percent obese. 49 percent of patients were menopausal, 65 percent had oestrogen-receptor positive cancers, where the presence of oestrogen encourages the tumour to grow, and 70 percent received the oestrogen-receptor blocking treatment, tamoxifen.
“Several other studies have shown that being overweight or obese at the time that a woman is diagnosed with breast cancer is linked to a higher risk of recurrence. However, questions have been raised in the past whether obese women were receiving relatively lower doses of chemotherapy due to their weight. Our study mandated that each patient received a chemotherapy dose adjusted to her weight, so these results suggest that treatment factors are not responsible for the differences in recurrence rates seen in heavier women,” Dr. Ligibel said.

“We found that BMI was related to both RFS and OS; for example, the ten-year RFS of a patient who was overweight was 70 percent; compared with 65 percent for one who was obese,” she stated.

The researchers intend to follow up their work by learning more about how weight-related factors could influence breast cancer outcomes.

A number of studies currently underway are looking at how changing lifestyle behaviours, for example losing weight, exercising more, and eating a better diet, affects the hormones in women``s bodies that have been linked with breast cancer. Ultimately, they say, they are interested in studying the impact of deliberate weight loss on the risk of recurrence in women with early breast cancer.

“Obesity is a modifiable factor, and although there is not yet enough evidence to say with certainty that losing weight or exercising more regularly will decrease the risk of breast cancer recurrence, there are consistent links between lifestyle factors such as diet, weight and physical activity patterns and breast cancer prognosis,” Dr. Ligibel noted.

“If future studies show that making changes in lifestyle behaviours for women with early breast cancer will improve survival rates, then lifestyle interventions may one day become a standard part of breast cancer care,” she concluded.

The finding study was presented to the 8th European Breast Cancer Conference (EBCC-8).

Cherry blossoms welcome DC spring

WASHINGTON - We cowered, waiting for a sharp blows of a seasonal bully.

Our long dresses, fiercely protective scarves and hats were to ward off attacks from winter's weapons, snow, ice, freezing temperatures and cold winds.

But winter never the country's capital hit with his usual misery and spring officially arrived Tuesday.

Winter is known for its official deadline to ignore, but we already have the spring feeling in the caress of mild temperatures and seen cherry blossoms in Lacy around the city.

This morning I walked over small, silky petals drifted down from the clouds of flowering of the trees around my apartment complex.

They reminded me of a Washington event that does not focus on partisan battles, House resolutions or other typical DC fare.

The National Cherry Blossom Festival the first day of spring and beginning of period 27 April. I like to think that even though Tokyo is not the view of the United States that famous cherry trees 100 years ago, the nation's capital would have the spring in one way or another to celebrate.

Cherry Blossom experts on the job here - nice work if you can get - predicted peak bloom dates the beginning of the first day of spring and continue through Friday.

As Texans look for bluebonnets to herald spring, we know it's that time of year when cherry blossoms appear.

Tornado season was always the most clear in Texas, considering the number of times I was in the bath or squatting passages, but in Washington, every season is distinguished.

Spring is one of the best in a part of the country where winter is a tyrant up with ice and summer is a hot, humid blanket smothering the Mid-Atlantic.

Back home in Wichita Falls, summer begins in February or March and barrels through October right when people eventually trade in flip-flops, shorts and tank tops for something warmer. This is how I remember it, anyway.

The worst of spring in the DC thunderstorms can pack the wallop, turning umbrellas inside out and cooked for travel.

Spring is a generous this year with miracles.

The Metro system announced weekend track work on spring break. It's going furiously for the last few weekends.

For Virginians and others, which means that the usual slow or weekend trip to Washington in a crawl. Weekend commuters time to read 50 pages in a novel, a new bucket list, go crazy and then get over it.

I would say civilizations rose and during the wait, but it would be exaggerated.

Now trains will move spit-spot, but more people are on them already this week.

The dark suits and solemn expression of commuters to mix with the T-shirts, athletic shoes and cars filled child of cherry blossom tourists from around the world.

They ask for directions from strangers who do not speak their language, shouting at each other to hold together (I think) and generally breaking a ban on the morning cheerful chitchat in the metro.

Obama to weed Trayvon Martin's murder

Washington - states that "if I have a son, he looks like Trayvon," President Barack Obama chose a highly personal way to the hot national debate over the death of Trayvon Martin, the black teenager killed by a neighborhood to see included volunteer in Florida.

Trayvon Martin

Obama has no opinion to express about the behavior of the shooter, George Zimmerman, or any legal aspect of the case beyond a call for a thorough investigation. "The Attorney-General reports to me so I have to be careful about my statements to make sure that we do not Obstruction of an investigation," he said.

Yet his comments Friday, a powerful influence on how the public regarded the case. It was a rare moment White House - a president to identify himself with a victim in a racially charged shooting. More generally, it drew attention to the way young black men by a predominantly white society seen.

Zimmerman or acted legally in the Feb. 26 shooting, and whether the Sanford, Fla., police had acted correctly in declining to arrest him turn into a big part on how the victim is considered.

Zimmerman, 28, claimed that he was Martin, 17, shot in self defense after he called police to say he is a person in his gated community in which he believed was acting suspiciously. Fans of Martin's family said the high school student is simply walking through the neighborhood on his way to a relative's house and that nothing about him reasonably could have been as suspicious or threatening.

Barack Obama

Martin's parents appear to recognize that Obama's public identification with their son that great symbolic importance.

"The president's personal comments touched us deeply," they said. The remarks "we wonder: If his son had looked like Trayvon and a hoodie, he would be suspicious?"

Rep. Frederica Wilson, D-Fla, in close contact with the Martin family, a view held by many black leaders expressed saying that targeted for violence "is the reality of a black boy in America."

"This is a problem for generations since slavery existed," she said, hopes that Obama's remarks can change how black men were observed.

"Every time the president is realistic about a situation, it helps the country grow and mature," she said.

Obama's comments were written in advance, aides said, but after a week in which the president is following the case. During a trip to Western countries over the past two days, he read articles about the shootings and comments private how the teen's family must feel, and how the news if he ever came to her through it.

On Thursday, Obama has the Rev. Al Sharpton, whose mother died that day, to express condolences. Sharpton was on his way to a meeting about the matter that he helped to organize. Aides said they accepted the two men talked about the shooting, although Obama did not explicitly tell them so.

Initially the president hesitated to publicly talk about the shooting that he would appear to try the outcome of the case to influence, but over the week, she considered moving. "He did not want an independent investigation to jeopardize," the official said, "but he also felt that we need to ask ourselves how this could happen."

On his way to the Rose Garden Friday morning, a nominee to head the World Bank to announce, said Obama aides that he comment on the Martin case if asked about it - a contrast to his regular practice of questions in the formal institutions to avoid if they stray from the topic of the day.

He was "speaking as a parent," the official said. "He was deeply upset by the death of a young man."

The comments from the White House position shifted a distance to keep the case. Tuesday, for example, the press secretary Jay Carney said that "we here at the White House is aware of the incident" and that "our thoughts and prayers go out to Trayvon Martin's family, but of course, we will not wade into a local law enforcement matter. "

In contrast, Obama said that "it is imperative that we all aspects of this investigation, and that everyone pulls together - federal, state and local - to find out exactly how this tragedy happened." People need the laws and the context for what happened, and the details of the incident, "he said.

Republican presidential hopefuls with Obama in his call for a thorough investigation.

"What Trayvon Martin is a tragedy," said Mitt Romney said in a written statement. "There must be a thorough investigation contact the public that justice is carried out with impartiality and integrity to be."

Campaign at a shooting range in West Monroe, La, Rick Santorum, Martin's death a "terrible event."

"It's cool to hear what happened," said Santorum. "The fact that law enforcement did not immediately go into and prosecution of this case is another example of cold, I would say, the terrible decisions made by the people in this case."

That consensus was a stark contrast to the last time that Obama as president, said a law enforcement matter and race. Early in his tenure, he was much criticized after saying that the police in Cambridge, Mass., had "acted foolishly" with the arrest of Henry Louis Gates, Jr., a Harvard professor, a friend of the president's.

At the moment, administration officials said Obama was surprised by the response to the statement. This time, he was more cautious. He did just what the racial aspects of the matter obliquely to the call of the way that his son would "look" and said that "we all have some introspection to find out how that happens."

She sees his words made more effective, said Douglas Brinkley, a presidential historian at Rice University in Houston.

"There are advantages to think and digest," Brinkley said. "He has the right amount of waiting time information collected, think about what he would say, and run how to do the right way.

"His words today are really healing gesture for the nation."