Dear Professor Baron-Cohen,

You are extremely stubborn.

You say, "If some note of alarm was needed, perhaps it should be over all those individuals who were missed in the old days, and who are now being better recognized."

Are you not alarmed over the stories told by so many parents of children with autism about their children's severe health problems, impairments, and distress?

How could children such as those described ever have been overlooked? If they were called by another name, what name was it? And where are they now?

A child who cannot speak does not grow up unnoticed.

Simon Baron-Cohen-

I read with interest your comment to Anne Dachel. Did I miss where you answered her question ? :

"Tell us about the adults who have autism like we see in children.(and I'll clarify this by listing: acute and chronic GI inflammation (diarrhea,reflux, colitis, constipation ),chronic bacterial infections especially streptococcus and clostridia, very high levels of aluminum, lead, and mercury via hair/stool/urine upon provocation with a chelator, brain inflammation- mitochondria dysfunction/damage - microglia activation, abnormal viral titers/patterns, hyper-immune/hypo-immune system ie-constant fever vs never runs a fever..) Where are they living and what are they doing?"..

...because this comment below completely misses the point and appears to be some sort of bizarre rationale, again, attached to your "speculative" theories-

"It makes me very sad that many able adults with Asperger Syndrome feel isolated and are unemployed.

Also, your comment-

"These are very high rates, especially compared to 30 years ago....."I think many children in the old days were overlooked and that we are getting much closer to the true rate in the population these days."

I want to point out that your comment starts out with "I think" which has no basis on any data or research. It is opinion and your opinion appears very biased and heading in some direction away from environmental discussions and biomedical evidence. You do not focus on the thousands of children who are in pain, physically, with autism ,yet you state that you are "not alarmed" yet your thoughts on the figures are "speculative". Where are those children of the olden days now?

You further state:

"The "assortative mating" theory remains speculative since it has not yet been tested."

This kind of inappropriate "speculating" without testing, data, and research is not only insulting but borders on reckless behavior. You have a position that gives you a type of authority and for you to post, publish, report, or comment on "speculative" theories that harm autism research, autism families, and especially individuals affected by autism is harmful and therefore puts you in a position of questionable motivation with your research.

Dear Ann Dachel,

Thank you for your letter. The new research that you referred to showing that autism spectrum conditions are now much more common than they used to be, and which was published in the British Journal of Psychiatry this month, was conducted by our group at the Autism Research Centre in Cambridge.

Using 3 different methods we found that the rate is now about 1% of primary school age children. This was a large study based on about 20,000 children. As you rightly pointed out, this study also found that for every 3 children who already have a diagnosis, there are two more who would meet "research diagnostic criteria". So, if one includes those who are undiagnosed, the rate goes up to 1 in 64 children.

These are very high rates, especially compared to 30 years ago, when the rates were thought to be 4 in 10,000 (using Rutter's estimates). Interestingly, other estimates from the same period (from Wing) suggested autism was much more common even back then (15-20 per 10,000).

I think many children in the old days were overlooked and that we are getting much closer to the true rate in the population these days. In that sense, the fact that more cases are being diagnosed could be seen as an achievement, that we are getting much better at identifying such children. If some note of alarm was needed, perhaps it should be over all those individuals who were missed in the old days, and who are now being better recognized.

I sense that you and some of your readers on this blog wonder why I am not alarmed at what some call an "epidemic" of autism. Personally, I prefer to restrict the term 'epidemic' for contagious diseases, though I recognize others may use it differently. My speculation (and that's all it is) is that we are nowadays much closer to identifying the "true" rate of autism spectrum conditions in the population. In other words, rather than there being some runaway escalation of autism, we have year by year simply become better at detection.

What I am alarmed about is not the increase but the state of services (or lack of them) available for people with autism and Asperger Syndrome. It upsets me deeply that parents may still feel grossly unsupported at home, or that adults with autism spectrum conditions feel totally ignored by the health and social services. It makes me very sad that many able adults with Asperger Syndrome feel isolated and are unemployed. I continue to highlight these major inadequacies in the system whenever I get the opportunity to do so, since we cannot remain silent whilst people are suffering.

With best wishes, and thank you for taking the time to write.

Simon Baron-Cohen

PS: I haven't replied to all the comments in your blog, for which apologies. Some brief final points though:

(1) the increased rate of autism spectrum we found in this new study was by no means just confined to the high functioning individuals.

(2) We have not "sat on this research for years" since as soon as the complex statistical analysis was complete we published it speedily. Research like this take literally years to conduct and complete.

(3) I completely agree that autism must involve both environmental as well as genetic factors (a point that nowadays hardly contentious).

(4) The "assortative mating" theory remains speculative since it has not yet been tested.

(5) The research into the waist-hip ratio was conducted by researchers at Bath university.

(6) I was pleased that your letter was polite and considerate, attributes that are always welcome.

http://www.ncbi.nlm.nih.gov/pubmed/11388783
Read this and you see the set up for autism and other disorders. Then thnk what vaccines do to such children. Your aha moment will come like it did to me...and that is..are we targeting certain children?

Dontcha know where all the adult autistics are? They all were spontaneously better by their 7th birthday. At least that's what the AAP is going with these days. So I'm just eating my bon bons waiting for my nonverbal, non-potty trained, brain damaged 5 year old to magically recover per the "experts"

Thank you, Anne. I agree with others that Baron-Cohen holds a substantial percentage of responsibility for each new, preventable case of autism diagnosed in the U.K. in the years since he started his hype campaign. He's also a partial "stakeholder" (you know, the old-fashioned kind of stake that people were burned at) in new U.S. cases, African cases-- any place in which his apologias were used in any sense to bolster and keep afloat unsafe practices and policies. The blood is on his hands, the drool, the shit, the agonized deaths, all of it.

Great article, much needed.

Baron-Cohen wouldn't at all look out of place in The Theatre of the Absurd. Beckett would be proud of him: " The characters of the play are strange caricatures who have difficulty communicating the simplest of concepts... The language used is often ludicrous, and following the cyclical patter, the play seems to end in precisely the same condition it began, with no real change having occurred. ... The focal point of these (absurdities) is often man's fundamental bewilderment and confusion, stemming from the fact that he has no answers to the basic ... questions. Absurd drama subverts logic. It relishes the unexpected and the logically impossible.

How about AoA contest for the best absurdist short play with B-C in the lead role. I'll donate my Autism 1:100 Why? t-shirts to go the winner – they have a vintage value in the UK already.

I love Mark's message, may I it nominate
for post of the week?

"Prof Baron-Cohen said: "We shouldn't assume that what we are currently diagnosing is the full picture, there is no room for complacency. But equally we shouldn't be alarmist and say we should be going out and actively looking for these cases. We should wait until those people want help. It is always better if the patient or their family is looking for help rather than it being thrust upon them."

He said the undiagnosed cases are likely to be at the mild end of the spectrum, are coping well with their families and may not need a diagnosis.

Prof Baron-Cohen said that for some families the autism label may 'raise anxieties' and be intrusive, rather than helpful. "

Someone just shoot me.