Jan 23, 2014, Worcester (MA) Telegram: Autistic students affecting Worcester school budget
Jan 23, 2014, Forbes: Big Data Crushes Anti-Vaccination Movement
Jan 23, 2014, Philly.com: New Diagnosis Rules Could Lead to Drop in Autism Numbers
Jan 23, 2014, Fox News: Number of kids with autism may drop under new criteria
The enrollment of an unexpected number of autistic students means Worcester public schools will spend $1.2 million more than anticipated on providing services to those students.
The money will come from the almost $1.26 million the district received from the state when 143 students returned to the district from the Spirit of Knowledge Charter School, which closed in October.
The number of students with autism "jumped dramatically over the past five months," School Committee member Jack L. Foley told his colleagues Thursday night. Mr. Foley is chairman of the Standing Committee on Finance and Operations. .
Notice that the headline is all about autism and the budget, but the story doesn't really sound concerned about it. It's just one item.
143 autistic students will cost $1.2 million. That's about $8,000 each.
For years it's been relatively easy to ignite medical controversy with emotional (but often anecdotal) evidence. TV is a popular format for doing just that. It's quick, colorful and dramatic (and increasingly in high-def and big-screen). Add a well known celebrity (or two) and the effects can be powerful, long term and hard to refute.
Much of that power, however, is changing and will continue to change with large datasets that are freely available online - or soon will be. When we talk about the science of "Big Data" as a new discipline, it's often the datasets that we're referencing - and the visualization of those datasets can be equally powerful and dramatic. As a single example, I wrote about the release of one such dataset on hospital pricing released last year by the Government.
On Monday, Aaron Carroll (over at the Incidental Economist) highlighted another chart that was based on a dataset recently published by the Council On Foreign Relations. The chart shows "vaccine preventable outbreaks" around the world from 2006 to present day.
"Big Data"? The map of disease outbreak? What does that prove? I posted a number of comments.
The study estimates that if the new diagnostic guidelines had been in place in 2008, they would have lowered the prevalence of the disorder in a nationally representative database to one in 100 children.
The most recent estimate of autism prevalence from this database, according to the U.S. Centers for Disease Control and Prevention, is one in 88 children with the diagnosis.
Researchers say it's hard to tell how quickly the new guidelines will be put into practice. But some fear this change to how the condition is diagnosed may mask true increases in the number of children who develop symptoms that have been consistent with the disorder.
"The trend in the incidence of autism spectrum disorders has been one of pretty steady increases. Whether the switch to DSM-5 would offset that yearly increase remains to be seen," said study author Matthew Maenner, an epidemiologist with the CDC.
But advocates for children with autism say the ramifications of the new guidelines go beyond research. They say they're starting to see signs that children are being reclassified under the new criteria and that some may be losing access to needed services as a result. . . .
Researchers caution that it's still not clear how the changes will play out in the real world. Doctors, for example, could change how they look for symptoms to better fit the new criteria. It's also possible that kids who don't qualify for an autism diagnosis could receive a new designation -- something called social communication disorder.
The latter is what seems to be happening, said Michael Rosanoff, associate director of public health research at Autism Speaks, a nonprofit advocacy group.
Autism Speaks is surveying parents to find out how the changes are affecting their children. Though the results are still early, and it's not a scientifically rigorous sample, he said they are seeing indications that children are being reclassified using the new criteria.
"What we've seen from the first 600 persons participating in the survey, is that there is a percentage of individuals being asked to be re-evaluated by school districts or insurers using DSM-5 criteria," he said.
Insurers and school districts are asking to have certain children re-evaluated. Not a surprise.
The findings show that 81 percent of children in the study diagnosed with autism under the old criteria would still be classified as having the condition under the new criteria, which were released last year in the new edition of the psychiatric handbook called the DSM-5. . . .
The new findings should be reassuring to parents, said Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Steven and Alexandra Cohen Children's Medical Center of New York, who was not involved in the study.
"The overwhelming majority of children" who met the old criteria will continue to meet the new ones, Adesman told LiveScience. . . . The new study reviewed information from 8-year-olds living in 14 areas of the United States in 2006 and 2008. The estimated prevalence of autism in 2008 under the old criteria was 11.3 cases per 1,000 people in the population, but under the new criteria, the prevalence dropped to 10 cases per 1,000 people, the study found. . . .
Still on the rise
Diagnoses of autism have risen in recent years a trend not likely to be reversed by the adoption of new criteria, the researchers said.
Maenner noted that most of the children in the study who met the old criteria for autism, but failed to meet DSM-5 criteria, were off by only one symptom. (They had four symptoms instead of the necessary five.)
Many doctors are aware that a diagnosis of autism will qualify children for services, and it's possible that some doctors could be motivated to add more symptoms for children who are very close to meeting the diagnosis, Maenner said.
Because of the change in criteria, it will be challenging to compare newer estimates of autism prevalence to older ones, Maenner said. The new study "is a step we can take to begin to understand how to put those numbers in context," Maenner said.
So ... the good news is that 80 percent of autistic kids will keep their diagnosis..........too bad if your child is among the 20 percent who won't.
Is that guaranteed? Can 80 percent of parents count on that?
"Because of the change in criteria, it will be challenging to compare newer estimates of autism prevalence to older ones."
And maybe that was the whole purpose of the change anyway.
No place here for comments.