BMJ  2004;328:226-227 (24 January), doi:10.1136/bmj.328.7433.226-c

Letter

Autism seems to be increasing worldwide, if not in London

EDITOR—It would be wonderful if autism had reached a plateau in northeast London, as reported by Mayor.¹ Unfortunately, this has not happened anywhere else.

In Cambridgeshire one in 175 children in school had a diagnosis of autism in 2001 (F Scott, personal communication). According to a recently reported study by the Highland Council Education Department, as many as one primary schoolchild in 49 has been diagnosed with, or is awaiting diagnosis of, autistic spectrum disorder in the Inverness area.²

In the United States, where criteria from the Diagnostic and Statistical Manual, fourth revision have been exclusively used since 1994, 28 813 children aged 6-21 with autism attended school in 1995-6 compared with 118 603 in 2002-3, an annual increase of 18-26%, according to official reports to Congress.³ The California Department of Developmental Services reported that 3577 children with new cases of autism accessed services in 2002 (10 cases a day) compared with 633 in 1994. With an increase of 97% in the past four years, autism has become the top disability requiring initiation of services in the state. The last yearly increase of 31% is the largest in 33 years.⁴

In Canada's Province of Quebec the number of children with pervasive developmental disorders in schools increased by 63% in two years, from 1388 in September 2001 to 2267 in September 2003 according to the Ministry of Education of Quebec (C La Haie, fourth international medical conference on autism, Montreal, November 2003).

Lastly, in Saudi Arabia (population under 23 million) there were 42 500 confirmed cases of autism in 2002, and many more cases remain undiagnosed.⁵

Taylor's raw data have remained inaccessible since 1999, when he first denied any connection between autism and measles, mumps, and rubella vaccination, in a study that neither had a population based cohort design nor sufficient statistical power to detect an association.^{w1 w2 w3}

TL Autism Research, 70 Viewcrest Drive, Falmouth, MA 02540, USA TLAutStudy{at}aol.com

---

References w1-3 are published on bmj.com

Competing interests: Grandfather of a boy with regressive autism, typical "autistic" enterocolitis, and evidence of measles genomic RNA in the gut wall.

References

1. Mayor S. Apparent increase in autism in children has stopped, study shows. BMJ 2003;327: 248. (2 August.)[Free Full Text]
2. Shock as incidence of autism soars in city. Inverness Courier 2003 Dec 5. Available at: http://www.invernesscourier.co.uk/news.asp?storyvar=8469 (accessed 15 Jan 2004).
3. Twenty-sixth Annual Report to Congress on the Implementation of the Individuals with Disabilities Education Act. To Assure the Free Appropriate Public Education of All Children with Disabilities (Section 618). Washington, DC: US Department of Education, 2003.
4. California Department of Developmental Services. Autism spectrum disorders. Changes in the California caseload. An update: 1999 through 2002. Sacramento, CA: Department of Developmental Services, 2003. (www.dds.ca.gov/autism/pdf/AutismReport2003.pdf)
5. Ramadan G, Alkhereiji M. Animal-assisted therapy works wonders. Arab News 2002 Oct 9. Available at: www.najaco.com/travel/news/saudi_arabia/2002/october/9.htm (accessed 16 Jan 2003).

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