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Thesis: It is believed that the rate of children diagnosed with autism is increasing due to hereditary factors, environmental factors, and a historically new definition of the disorder. I. Heredity plays a major role in the development of autism. II. Environmental factors are believed to help trigger the onset of autism. III. The definition and diagnosis of autism has become broader in recent years.

Purpose: To inform my audience of increasing autism rates and the reasons for the increase.

Formal Outline of Speech

Introduction:

I. Autism is a rather prevalent disease in today’s society, still, most people don’t know much about this unfortunate and devastating disorder.

A. The ASA, Autism Society of America, describes autism as a “complex developmental disability.” Autism keeps the brain from functioning normally and is usually diagnosed by the first three years of life. Every day 60 children in our country are diagnosed as autistic.

II. Autism has no specific cause, making diagnosis a challenge.

A. No medical tests are available to diagnose autism; instead a child is diagnosed after careful and strict observation of their communication, their actions, and their interactions.

B. Signs of having an autism disorder include a lack and delay in communication, a lack of emotional and physical contact, and a lack of desire to make friends.

III. Although these behaviors cannot be cured or outgrown, they can be treated and improved.

IV. Autism is not unique to our country; an article in the Economist from April of 2008 discussed autism in England.

A. In 1990 an average of 40 in every 100,000 British children had autism, compared to the 400 in every 100,000 children today living with the disorder.

B. That is a ten percent increase in the last 18 years, with the rate now one of every 250 children.

V. Rates in the United States appear even higher; Bernadine Healy, a writer for U.S. News & World Report, puts autism rates in America at one in every 150 children.

VI. These rising rates, at home and abroad, prompt researchers to try to uncover what is responsible.

VII. (Thesis) It is believed that the rate of children diagnosed with autism is increasing due to hereditary factors, environmental factors, and a historically new definition of the disorder.

VIII. (Preview) Let’s examine each of these theories of why autism rates are on the rise. Heredity is a good place to start.

Body:

I. Heredity plays a major role in the development of autism.

A. Genetics is one of the most obvious and common ideas of why certain children are autistic and others are not.

1. Doctors and researchers believe that some children are born with a “vulnerability” to the disorder.

a. In other words, as the Autism Society of America explains, these children are more likely than others to develop autistic behaviors.

2. These experts believe that children with a family history of autism or similar disabilities have a greater chance of being autistic.

a. For example, if language disorders are common in a family, children of this family have a higher risk for becoming autistic versus a family without this pattern.

3. In addition, the ASA notes that children born with any type of abnormality in their brain or nervous system have a higher chance of being autistic.

a. An article posted on the ASA website, “What Causes Autism?,” discusses how brain scans of autistic children show “differences in shape and structure” than those of children not affected by autism.

C. Finally, according to the ASA, many experts believe genetic factors contribute to increased autism rates because when a child is born susceptible to this disability other factors can more easily trigger the start of autistic behavior.

a. A recent article in U.S. News & World Report identifies vaccines as a possible trigger. I will come back to this theory shortly.

(Transition) Along with genetics, our environment could be contributing to the increased rates of autism.

II. Environmental factors are believed to trigger the onset of autism.

A. The ASA explains that complications during pregnancy caused by harmful substances entering the body can cause a child to be vulnerable to the disorder.

1. They note, for instance, that fish, although often considered a healthy food, sometimes contains substances that could harm the fragile and weak fetus of a pregnant woman.

a. The most well-known and dangerous substance in fish is mercury, which can have negative effects on brain development.

B. Other toxins and pollutants such as lead and pesticides are also especially dangerous and can interfere with healthy brain development.

1. Researchers note, too, that these toxins are becoming more and more prevalent today compared to the amounts of them in the past.

a. One such expert, Dan Orzech, observes: “In the last half-century or so, more than 85,000 industrial chemicals have been registered in the United States, and many of them have found their way into our environment—and our bodies. Children, with their smaller and still-developing bodies, may be the ones most vulnerable to their effects.”

2. The amount of these harmful substances and the ease in which they find their way into our bodies is of special interest to researchers who believe they are a possible reason for the rising rates of autism.

(internal transition) While diet is one area of research, other researchers focus on how medicine may be a contributing factor.

C. Writing in U.S. News & World Report, Bernadine Healy explains a common theory that concerns many parents—the idea that childhood vaccinations contribute to autism.

1. Until 2002, childhood vaccines for measles, mumps, and rubella contained a mercury-based preservative, Thimerosal.

a. As I noted, mercury in fish is suspect and the same goes for its presence in what we inject into our children. Some researchers, including Healy, believe the rise of autism rates could be caused by these vaccines.

b. However, because numbers were still rising after Thimerosal was no longer used in vaccines, doctors were unsure whether these shots should be a concern.

2. Thimerosal remains suspect, though, due to its presence elsewhere, particularly in flu shots.

a. Women are encouraged to get the flu shot while they are pregnant, and the Thimerosal in the vaccine can be passed on to the baby in utero. Healy notes that Thimerosal could cause brain injury which, as previously discussed, is believed to contribute to a child’s vulnerability to autism.

b. This possible outcome reinforces the theory of harmful vaccines.

(Transition) Hereditary and environment may very well help explain the increase in autism rates, but another explanation is offered as well, one that focuses on how we go about recognizing the disorder.

III. The definition and diagnosis of autism has expanded in recent years.

A. In 2007 the Centers for Disease Control & Prevention observed that the new definition of autism focuses on “identifying an overall presence of autism rather than attempting to identify specific subtypes of autism.”

1. By grouping all children with autistic signs together, the definition of autism has expanded and is no longer as specific as it once was.

2. Also, as mentioned earlier, there are no medical tests to diagnose autism.

a. This lack of a common instrument allows observers to form their own diagnoses with limited guidance, quite possibly stretching the boundaries as they do so.

b. If everyone applies the criteria differently, an increase is certain to occur.

c. These wide-ranging boundaries may help explain why, as Janice Hopkins noted recently in the British Medical Journal, “the prevalence of autism increased more than eightfold in the United States, from 5.5 per 100 000 children in 1980 to 1983 to 44.9 per 100 000 in 1995-1997.”

B. A good example of how autism is too readily assumed comes from a study by Susan Bryson, published in The Canadian Journal of Psychiatry.

1. Within a group of individuals who had an intellectual disability 28% of them were also diagnosed with autism.

2. This poses the question of whether people are being diagnosed with two disorders when the problem could be categorized under only one disorder.

C. A similar studied was documented by the Economist.

1. Dorothy Bishop tested 38 individuals who were diagnosed with language disorders earlier in their life.

2. She observed them under today’s standards of autism and found 12 of them to be on the autistic spectrum.

3. This poses yet another question. Are people who recently weren’t included as having autism being added to the “list,” contributing to the increasing rates?

a. Bishop thinks this may very well be the case, asking, “Is this more of a fashion trend?” She challenges what has become conventional wisdom, stating: “It now looks unlikely that there are more autistic people around than there used to be. It is just that it is now fashionable to acknowledge their existence.”

(Transition) Autism rates may well continue to rise because the disease is incurable, however with this information in hand we can perhaps get a better understanding of the numbers, as well as be more informed, in general, about the disorder.

Conclusion:

I. Given what we know, the implications are clear for those of us who plan to start a family someday.

II. Parents must be aware of their family history, and if disorders like autism are prevalent, they must take extra precautions when pregnant.

III. Parents must also closely monitor the health care their children receive, being informed on vaccines and the presence of toxins that could affect their child.

IV. The definition of autism and how we diagnosis it must be refined and applied correctly to ensure that everyone diagnosed with autism does, indeed, have the disorder.

V. Although it is hard to say if the percentage of children with autism will ever decrease, we must be aware of what autism is and how we can possibly prevent it.

Works Cited (Formatted in MLA)

Autism Society of America. Autism Society of America 30 Sept. 2008

Bryson, Susan. “Prevalence of Autism Among Adolescents With Intellectual Disabilities.”

Canadian Journal of Psychiatry 53 (July 2008): 449-459. Ebscohost. SEMO Lib., Cape Girardeau, MO. 22 Oct. 2008

Healy, Bernadine. “Fighting the Autism-Vaccine War.” U.S. News & World Report 144 (21 April 2008): 73. Ebscohost. SEMO Lib., Cape Girardeau, MO. 8 Oct. 2008

Hopkins, Janice. “Increase in Autism Due to Change In Definition, Not MMR Vaccine.” BMJ (Jan.15 2005) BMJ Journals.

“Not More, Just Different.” Economist 387 (12 April 2008): 89. Ebscohost. SEMO Lib., Cape Girardeau, MO. 6 Oct. 2008

Morbidity and Mortality Weekly Report. 9 Feb. 2007. Centers for Disease Control & Prevention. 20 Oct. 2008

Orzech, Dan. “Environmental Toxins and Child Development.” Social Work Today 7 No. 2 (March/April 2007): 37. Chemical Kids. 19 Jan. 09