It could be the health care crisis that never was. The perception, over the last two decades or more, that autism was on the increase led to a desperate search for the cause.
In Britain that led to widespread fears of a link with the MMR vaccine for measles mumps and rubella.
But new research published today suggests that the huge increase in reported cases of autism since 1979 may simply be a result of more awareness, more knowledge and better record keeping.
Richard Watson reported.
Four-year-old Thomas Ziegel suffers from
seriously delayed speech. When he and his
twin brother Benjamin were toddlers their
mum noticed some minor repetitive
behaviour. They were both diagnosed on
the autistic spectrum last year.
Thomas used to do strange things with
toys. We asked what that was and everyone
said don't worry. Finally just threw at us
one day, oh, might be autism. We will see
you in six months. That was the attitude.
We then panicked and thought it wasn't
anything we had ever considered. We
never thought they were autistic because
they are friendly, happy little children.
The cases of Benjamin and Thomas Ziegel
go to the heart of the current controversy
surrounding the incidents of autism across
the world. Some researchers including
those behind today's report, argue a decade
ago they may well have been categorised
as developmentally delayed rather than
autistic. Today's report is based on medical
records of 186,000 children living in North
East London. The authors say the incidents
of autistic spectrum disorders rose from
1979 to 1992. But the figure levelled off to
45 to 50 new cases per year. Thomas and
Benjamin are given intensive therapy to try
to fully connect them with the outside
world. The researchers argue if there was
an outside factor at play such as the MMR
jab, you would see numbers continuing to
rise. Parents are angry alleging it is simply
a vehicle to discredit the author's
colleague. That is strongly denied.
PROFESSOR BRENT TAYLOR:
I'm interested in good science and our
paper is good science. Part of the scientific
method is see if you can confirm your
Beyond the narrow debate over MMR
there are still scientific disputes about the
prevalence of autism. Much of the new
thinking comes from the United States.
Californian state researchers say cases of
the most serious or classical autism were
steady during the 1970s at around 200
cases per year, but in the mid-1980s the
numbers began to climb. Today the total
number has reached more than 20,000; It
has doubled in the past four years alone.
Those with autism now account for 40% of
the state's entire special needs caseload.
A portion of the rise can be attributed to a
change in the way we interpret and use the
criteria for diagnosing kids. We don't
believe at this point that it could be 100%
attributable to that shift in the diagnostic
criteria. We suspect there could be other
factors contributing to the increase and
we're putting our energy into trying to
determine what that is.
The Californian state is funding a huge
study to examine whether environmental
factors can be linked to autism while
Britain still debates whether there is any
rise in case loads at all. Studies of twins
where only one is autistic proves that
environmental factors can have some
impact, perhaps even in the womb. Other
studies show a higher prevalence of autism
in children of parents who've contracted
rubella, or in the 1960s used the drug
DR IRVA HERTZ-PICCIOTTO:
This is the first comprehensive
examination of environmental factors in
autism. We are the first group to take on a
broad range of chemicals including
medications, PBDEs, metals, pesticides,
household products, chemicals that are in
personal care products, to see if they may
play a role in the development of autism.
But the American research suggesting that
outside factors may be at play is rejected
by the author of the British study.
PROFESSOR BRENT TAYLOR:
The evidence is that it's got the highest
genetic load of virtually any developmental
problem, at least 80%. I'm sure that the
evidence is that most of it originates and is
evident from very early in gestation in the
So 80% is not ruling out the importance of
some environmental factors?
PROFESSOR BRENT TAYLOR:
There must be some triggers that do it. I
think these are either inter-uterine or early
in life. The evidence that any external
force, like the MMR vaccine after the first
birthday might trigger autism, there is
nothing to support it.
Many parents don't agree. More cases are
certainly being diagnosed. In a recent
survey, 87% of Local Education
Authorities reported an increase in autism
cases. Putting pressure on funding. The
Ziegel family had to pay for eight months
of intensive treatment on their own.
Around £30,000 when their London
council, Richmond, refused to pay.
Our local authority doesn't want to fund.
They just ignored it. Our only option was
to go to tribunal special education needs
tribunal which we did at the beginning of
the year. That is a stressful experience and
very expensive. We did go and it was
worth while and we did win full funding
for 35 hours a week, which we finally got a
few months later.
More and more local authorities are
refusing to fund intensive therapy which is
why reports about rising case loads are still
politically hot. Today's report suggests that
1 child in 364 is being diagnosed with
autism in the north east London sample
That's much lower than the estimate from
the Medical Research Council of 1 in 167
and lower than the estimate from the
National Autistic Society of 1 in 86.
Today's report will offer some comfort to
the Government which has been keen to
back MMR, but as new thinking emerges
from California, many British parents will
press for more research here.
This transcript was produced from the teletext subtitles that are generated live for Newsnight. It has been checked against the programme as broadcast, however Newsnight can accept no responsibility for any factual inaccuracies. We will be happy to correct serious errors.