Prevalence and Misdiagnosis

There has been a great deal of attention given by the media to the staggering, skyrocketing increase in the number of children identified with autism. It has been legitimately described as an epidemic.

Years ago, it was estimated that 1 in 10,000 individuals was autistic. In the 1990s, the estimate narrowed to 1 in 1,000, then 1 in every 500, then 1 in every 250 children. The statistics are growing closer and closer all the time. Most recent tallies, such as that proffered by Time magazine in 2002, suggest that 1 in every 150 children under the age of ten has autism.

According to a 2002 study commissioned by the California legislature, during the past fifteen years in the state of California alone, the number of children identified with autism has leapt by 643 percent. Another recent statistic estimated that 1 in every 5 children has autism, dyslexia, attention deficit hyperactivity disorder, or some form of uncontrollable aggression.

Data released by the Centers for Disease Control and Prevention in 2009 indicate 1 in 110 children is on the autism spectrum. As noted earlier, this rise is occurring without any single known cause or indicator.

Where does this leave our understanding of the prevalence of Asperger's Syndrome? With so much attention being given to young children newly diagnosed with autism, those with Asperger's Syndrome are not usually identified and tracked in the same manner by doctors or our education system.

One may speculate that there are a number of reasons for this:

  • One or both parents may have Asperger's Syndrome and do not detect anything out of the ordinary in their child.

  • Families who live in isolated or rural areas, or have limited contact with others with similar-aged, typically developing children, may not recognize their child's differences or may be distanced from proper support systems to obtain a diagnosis.

  • Family practitioners and other physicians may be unaccustomed to identifying the symptoms of autism, let alone understanding the criteria for Asperger's Syndrome. They may have little to no experience with Asperger's or limited resources from which to gather more information.

  • The child of school age undiagnosed with Asperger's may be labeled as noncompliant or lazy. Parents and teachers may believe she is simply not applying herself to her full potential.

  • The child may be seen as simply quirky or especially gifted, leading to the “Little Professor” moniker that has become a popular way of describing children with Asperger's who present as technically proficient miniature adults.

  • The child may have a diagnosis of hyperlexia, an experience that may outwardly present itself as similar to Asperger's in that the child may be highly fluent. Hyperlexia is marked by a precocious capacity for reading that far exceeds the child's chronological age; however, the child may be unable to comprehend all that has been read. The child may be fascinated with numbers, may need to keep specific routines, and may be challenged in social interactions.

  • The child has a “ballpark” diagnosis but, as noted earlier, it is labeled as PDD-NOS or high-functioning autism. As such, it is not specifically identified as Asperger's.

Because the clinical criteria for Asperger's calls for no significant cognitive or developmental delays, it is often undetected until a child is past the age of eligibility for early intervention services. It is also possible for Asperger's Syndrome to go undiagnosed altogether, because it can be so subtle.

It could also be misdiagnosed as another issue such as a learning disorder, attention deficit disorder, attention deficit hyperactivity disorder, sensory integration disorder, dyslexia, schizophrenia, generalized anxiety disorder, Tourette's syndrome, obsessive-compulsive disorder, oppositional defiant disorder, bipolar disorder, intermittent explosive disorder, or depression — all mental health experiences listed in the DSM.

Given all this, what do we know about the prevalence of Asperger's Syndrome? Like autism, Asperger's knows no social, cultural, or economic boundaries. And, also like autism, it is four times more likely to be found in males than females (again, for reasons currently unknown). Until recently, Asperger's was believed to be largely a male experience, but as our culture is becoming more aware and better educated to such social issues, more females with Asperger's are being identified.

Conservative estimates conclude that 1 in every 1,000 children has Asperger's Syndrome. However, as with autism, the increasing recognition of Asperger's will surely prompt that statistic to increase in the near future.

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