Nearly 1 percent of children nationwide have autism - with the disorder more than four times more common in boys than girls, according to new figures released by the U.S. Centers for Disease Control and Prevention.
The report, which is in keeping with recent studies that tried to put a number on the puzzling neurobiological disorder, finds an average of one out of every 110 8-year-olds showed symptoms of autism, a sharp increase from the widely cited 1 in 150 figure from the CDC's study on autism's prevalence issued two years ago. Another recent report, based on parent surveys, found autism in 1 in every 100 children.
Researchers and therapists have long known that autism affects boys more than girls. The new study underscores that disparity: 1 in 70 boys was diagnosed with it compared with 1 in 315 girls, according to the CDC data, considered the most comprehensive estimate to date on autism.
In Maryland, the figures mirror the national average, with as many as one out of every 109 8-year-olds diagnosed with autism - a wide range of disabilities known as autism spectrum disorders, marked by impaired communication and social interaction.
Catherine Rice, a behavioral scientist with the CDC and the report's author, said the figures reveal a "significant public health issue" and underscore the need for unraveling the causes of autism and coordinating a response to better serve people struggling with the disorder.
"This is a major issue," said Dr. Gary Goldstein, president and chief executive of the Kennedy Krieger Institute in Baltimore, which specializes in children with developmental disabilities. "We need a system for this. We need to have recognition and early intervention and we need research to understand what's causing all this stuff."
The figures come from 2004 and 2006 data collected from 300,000 children in 10 states, including Maryland, where researchers analyzed school records in six counties. They also gathered diagnoses from such local institutions as Kennedy Krieger, the University of Maryland Medical Center and Mount Washington Pediatric Hospital.
More may be at risk
Researchers aren't sure why the numbers appear to be increasing but say they can't rule out that more children are at risk for developing autism.
For years, the disorder has baffled scientists, who have been trying to unlock the mysteries of autism and determine whether there is a true increase in its prevalence. While some specialists think genetics are its main cause, others see environmental factors or a combination of the two. And many experts attribute some of the growth to increased awareness and better diagnosis.
Still, while more children may be getting diagnosed, the CDC data suggest it isn't happening early enough.
Many children are not diagnosed until they reach kindergarten - and by then, it's too late for critical early interventions, Goldstein said.
CDC data from 2006 show that children are being diagnosed on average just a month earlier than in 2002. The average parent showed concern that his or her child might have autism at age 2, but a diagnosis didn't come for as long as three years later.
"That's not good enough," Goldstein said. "We don't have enough people doing [diagnosis], I don't think we're out there recognizing children and doing it for all the kids that need it. And we don't have the trained professionals."
Goldstein says he has seen the increase in autism over the past decade as more parents walk through Kennedy Krieger's doors seeking help for their children.
Fifteen years ago, a Kennedy Krieger treatment program for 2- to 4-year-olds with autism had just four children, and specialists wondered whether it was worth keeping. Today, the program has 75 slots and is always full, with a waiting list.
The new figures present a challenge for school districts that will undoubtedly see increasing numbers of children with autism in their classrooms, said Goldstein. "How are they going to cope with this problem and provide early intervention?" he said.
Maryland's special-education administrators have been trying to prepare for what they expect will be about a 6 percent increase in the number of children with autism next school year, said Karla Saval, who coordinates the Maryland State Department of Education's initiatives for youth with autism with other agencies.
Last year, 7,510 children with autism were educated in Maryland public schools. That figure was just 260 in 1993, when the agency began keeping track, she said.
The department trains its teachers to better serve autistic children, including a program where preschool teachers get training from specialists at Kennedy Krieger, Saval said.
'Public health crisis'
"We are definitely feeling the impact across local school systems," she said. "We have to assist local school systems in meeting the academic, social and vocational needs of children with autism. Autism just presents such a wide array of challenges in all those areas."