INCREASED recognition of “autism-lite” may be behind a sharp rise in those diagnosed with autistic-spectrum disorder, according to the country’s leading expert on the condition.
Professor Louise Gallagher said today’s broader definition of autism is probably the main factor in the rise in diagnoses, which have increased dramatically in recent years, new figures show.
Autism was previously diagnosed only in profound cases, typically where the sufferer could not speak and had intellectual disabilities. This meant those with less obvious difficulties — but with debilitating social and communication problems — were left undiagnosed and untreated.
The criteria for diagnosis has been widened over the years and now includes those with “milder” autism, as well as Asperger’s syndrome, which is often called “autism-lite” or little professor syndrome, due to the high IQ levels associated with it.
Statistics show the numbers of children undergoing autism evaluation in Ireland have risen dramatically since the assessment of need process was made law in 2007, following the introduction of the Disability Act.
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HSE records reveal that, over the past seven years, the numbers of children being referred for assessment on suspicion of having an autistic spectrum disorder have grown from just 16 in 2007 to 636 in 2011.
For the past two years, these numbers have tapered off to 553 in 2012 and 515 last year.
These nationwide figures are a strong indicator of diagnosis, as those who are deemed in need of an assessment referral in the first place normally end up with a diagnosis, according to those working in the area.
Gallagher, a consultant psychiatrist at HSE autism services, said: “Increasing figures across the developed world is a much disputed phenomenon. Some believe it is about increased awareness, some say it points to an increase in prevalence, there is also the fact that there are more trained staff to deal with the numbers presenting.
“Others say it is about the changing diagnostic boundaries. Personally, I think it is to do with better diagnosis and a broadening of the criteria for autism. A lot of children I would see today [who have autism] would not have got an autism diagnosis 10 years ago,” said Gallagher.
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She said that while increased awareness is a good thing, and allows detection of more people affected, broadening the criteria can be “a bit of a nuisance”.
“It doesn’t allow us to directly compare prevalence rates over time; apples and oranges. It should lead to the inclusion of clinical presentations that are related, otherwise you end up with a catch-all category that is not useful from a clinical or research perspective,” she said.
Kevin Whelan of Irish Autism Action said: “These figures show an increased awareness and number of assessments. But there are still very long waiting lists in certain pockets of the country. Waiting lists are the issue because it is known that early diagnosis and early intervention provides the best long-term results and has a major impact in limiting the impact of the disability.”
A HSE spokesman said it is committed to working in partnership with service providers to achieve maximum benefits for children and adults and that additional funding of €20m was provided to strengthen primary care services last year.