Just wanted to point out your terminology that the rise in autism is a "increased rate of disease" is misleading, because autism is a neurological condition/disorder, not a malady or sickness like, say, hepatitis or something. Calling autism a disease is a something a lot of people do, and I think it really pathologizes autism into being something that can and should be fixed. Autism spectrum disorder (ASD) covers a very wide net over social interactions, communication, and restrictive/repetitive behavior. The diagnostic criteria has changed over the years (ex: I was diagnosed with Aspberger's in elementary school, when it was a new category, but was removed from the category in high school because the criteria is different now). I think that's why you get a lot of people who were maybe considered "oddballs" in the 80's, but then we hit the 90's and started recognizing that it was a shared neurological condition that causes these traits.

We have to be careful when we talk about autism to NOT tar the parents, or insult those who have ASD (not "suffering", have). My little brother is autistic, and it is horrifying what my mum has been told by other parents, nurses, even doctors, and naturopaths (the WORST, at least the one my mum went to, she left humiliated and in tears). My mother has been told that she didn't socialize my brother properly, that she used to much antibiotic soap, that by getting an emergency C-section she did this to him, that she didn't feed him properly (an nearly all meat-seafood-vegetable-rice diet), that she shouldn't have vaccinated him (already been disproved, move on), that maybe breastfeeding him for 2 years (2 whole years!) wasn't long enough, that she ignored him as a baby, that she was a cold mother, that she should have taken probiotics, and, most of all, that she could just "fix him" if she only did "____" treatment! She's had people walk up to her and say she shouldn't have kept her son in such a sterile environment (we grew up on a farm). Random strangers will tell her she HAS to give him these vitamins, and then he will just stop being autistic like magic!

Now that my brother is old enough, and communicative enough, he can talk for himself. He has become more and more high functioning, after an initially very slow development. He is one of the rare folks who has a photographic memory, which is pretty amazing to experience (you should see him learn languages! He's trying to learn Latin right now). He still has some issues, he is overwhelmed by big crowds, loud noises, and stressful situations (birthdays, Christmas etc). He smells things to manage his anxiety, and tries to tease apart the components of the different smells (if anyone leaves a jacket at our house, we can just get him to smell it and he knows who's it is!). He has the occasional full-fit meltdown, which can be very intimidating if you don't know him as he is now a 170 lb 19 year old. He has very sensitive feelings and cries easily. He is really, really fascinated by animals, especially cats.

We are really, really close, ever since I had been initially diagnosed with Asperger's (then later had it dropped, and side note, my older brother had the exact same situation). We've talked about what HE wants people to know about ASD, and it boils down to a single demand: he does not want to be fixed. He does want to be able to manage the unpleasant aspects of his condition, including the anxiety and emotional outbursts, and that are many techniques and methods to cope and improve his comfort so he can lead a more "normal" life. But at the end of the day, being autistic is a huge part of who he IS as a person. He wrote an essay in high school (he's not a big writer, so it was a big project) called "If I wasn't autistic" under the promptings of the school counselor, and in the essay he basically boils it down to the fact that if he wasn't autistic, he would not be who he is. He wouldn't even be close.

I always feel the need to remind people (in a very long-winded manner, haha, sorry about that, get a little passionate) of the point of view held by people who ARE autistic and their families, because otherwise we risk talking about trying to "scourge" these "damaged children" without really understading that, at the end of the day, their brain just works a little differently. I don't mean to glamorize autism, or make it sound like a walk in the park that everyone should have a crack at, but I just want to remind people to stay respectful in your speculations.

I know how tempting it can be to hypothesize that we can fix autism spectrum disorders with diet and lifestyle (and, to be sure, proper diet would help enormously in general), but I think we need to be aware of the whole picture. This increase is due in large part to greater awareness of autism spectrum disorders, a very broad definition of what exactly constitutes ASDs, and increased reporting. Until we learn what exactly causes these disorders, it's difficult to assign a treatment. A child who is labeled as highly functioning Asperger's today may have been labeled the shy, awkward kid in school as little as 35 years ago. So we have to figure out if this increase a true increase in prevalence or if it's just a matter of more sophisticated diagnosis. That's not to say that there ISN'T an increase, but we just need to be aware of what other factors may be at play here.

I think it is multi-factorial.

In addition to what you have already mentioned there are many medicalised pregnancy & birth practices that are not evidence-based:

The use and increase in ultrasounds during pregnancy.

The rise in C-sections.

The rise in epidurals, pitocin and other drugs during labor.

The rise in inductions, (not letting baby initiate labor) resulting in more premature births.

The rise in antibiotic use in labor (due to Group B Strep screening.)

The rise in vitamin-D deficient Moms (and therefore D-deficient babies.)

All of these interventions are creating stress on Moms & babies that never was a regular part of our birth process until about 50-60 years ago.

ETA: I forgot to mention immediate umbilical cord clamping, which is still standard hospital protocol even though it has been shown to have a negative impact on babies' development.

As an autism researcher, I find this line of discussion always frustrating. It ends up leading parents in the direction of putting children on radical diets in childhood, or massive amounts of "detoxification" drugs (note I've seen kids take upwards of 20 "natural" pills per day at the age of 8 followed by trips to remote locations, and hours in detoxification saunas) in the hopes of "curing" their children. Autism is a neurological condition and once present, changes in diet will not modify the diagnosis. It is still to be determined whether some changes in aberrant behaviour and self-immposed dietary restrictions can be altered with changes to the diet. However, this does not make a treatment for autism. This makes a treatment for some behaviour, or some food issues (not unlike many people in the population). That being said, I hope we continue to support autism research into both causes and treatments. However, there are effective evidence-based treatments for autism (early behavioural intervention "ABA") and parents should be steered in this direction until further research is conducted. At this point, we have NO EVIDENCE to support the idea that vaccines influence the presentation of autism.

Part of the problem is the rise in bisphenol A (BPA) and other endocrine disrupters, linoleic acid, and other substances that interfere with GAP-43 expression (including inflammation).

From an excellent study done on post-mortem human autistic (and control) brains, Changes in prefrontal axons may disrupt the network in autism (emphasis mine):

Neuronal migration appears to be intact in autism, since neither neuronal density nor cortical depth was affected, at least in the parts of the three areas studied (Supplemental data: Cytoarchitecture of ACC, OFC, and LPFC). Our data suggest that the insult occurs later, when axons connect with other areas in the presence of high GAP-43 expression, and possibly other growth factors, which may remain elevated in adulthood in response to inflammation (Vargas et al., 2005). The associated signaling pathways need to be investigated for therapeutic interventions in autism.

GAP-43 is up-regulated by a variety of external factors as well, including estrogenic agents that disrupt endocrine function, such as bisphenol A, used for lining plastic food and drink containers, linoleic acids found in some oils, and by immunosuppressive and psychiatric drugs used for a variety of common disorders, including psoriasis, asthma, rheumatoid arthritis, depression and anxiety (Wong et al., 1989; Jyonouchi et al., 2001; Granda et al., 2003; Croen et al., 2005; Ostensen et al., 2006; Sairanen et al., 2007; Nguyen et al., 2009; Brown, Jr., 2009). Several of these substances came into heavy use in the early 80s at a time when the prevalence of autism began to rise (Blaxill, 2004). Epidemiologic studies are necessary to investigate if these events are merely coincident or if the cumulative effects of dietary factors and drugs change the uterine and postnatal environment and perturb the expression of factors implicated in axon growth and guidance in autism.

The key here is that the rise in ASD highly correlates with the increased use of BPA, especially in things like baby bottles. When the bottles are heated in hot water on the stove, or in the microwave, the BPA can leach out into the formula. This doubtfully accounts for all of the increase, but I bet it accounts for a lot of it. Here we have a clear mechanism for neural changes that are found in autistic brains. I think the question above is a great one, and I think this study shows that there are things we can do to reduce the incidence of ASD, one being, get rid of BPA in plastic bottles (and in can liners), and cut out linoleic acid from infant formula (and other foods).

I just wanted to add that I'm working my way through a self-diagnosis of Asperger's syndrome at the moment (I read a blog that someone posted on Facebook of traits and how females aspies felt - it was me, my whole life, so as an aspie would, off I went to find out as MUCH as possible... describes who/what I am - as well as a classic case of ADHD/SPD).

I'm 36. Asperger's wasn't a diagnosable condition/syndrome when I was a child.

I don't think that there's necessarily been an increase per se, it's just that people are more aware and with the school system changing so much from just 10 or 20 years ago, the way that kids are "labelled" has changed too. My selective mutism in nursery (kindergarten) was seen as shyness by my teachers and me "having us on" (having a joke) by my parents. The teachers suggested a psychiatrist, but my parents thought that I was just too clever for my own good :-/ I'm unsure whether I want to pursue an official diagnosis as that could impact my future (it could be beneficial too though), but perhaps people are realising that their kids are getting the support that they need with an official diagnosis?

There is also the statistics that autism affects 4 times as many males as it does females - it's thought by the "experts" that this ratio is likely 2:1, as many female aspies have been missed (like myself), or misdiagnosed with bipolar, anxiety, depression etc.

And, of course, access to information plays a MASSIVE factor in it all too. Who'd be able to read about ASDs or speak directly to someone who they don't know on Twitter or a forum in the past? We're all able to access information that was forbidden to most of us in the past!

Being neurodiverse is not necessarily a disability - perhaps it is in our world and culture? What about a neurodiverse culture with the minority being neurotypical?

Is autism such a bad thing? Is there really an increase?

I've no doubt that ASDs are epigenetic and multifactorial. My own personal family history attests to this.

Paleo helps with a lot of my symptoms - my insomnia which I'd put down to leptin resistance (although I'd had it my whole life since being a small child as a skinny little thing), is probably linked to the AS/ADHD through a hormonal/chemical pathway (serotonin & melatonin are big players from my limited reading so far).

And, FWIW, we're suspecting our DS (3) may have AS. He hasn't had his MMR and is still breastfed (but I probably have a leaky gut).

No conclusion, just giving some information that's specific to me and my family!

I would also like to put out there that, in another age, the individuals who are living with what is now called ASD (or Aspergers, etc.) would likely have been singled out as very special individuals -- their particular talents (because most of these individuals ARE highly talented -- some in multiple areas) and eccentricities would have been considered by many cultures to mark them as "sacred", and they would likely have taken roles as shamanic apprentices, etc. In truth, many of the behaviors that have, historically, marked prophets, oracles, artists, writers, and philosophers, in our CURRENT society are considered "aberrations" that must be "fixed" to make this person "normal" -- and as a result, I believe we are stifling much of the unique, creative aspect of people in our culture in our attempt to 'normalize' their behavior and keep them from standing out or making others 'uncomfortable'.

Perhaps it is a personal bias of mine, and I am willing to accept that. In order to "fit" into society, I myself had to abandon practices that are inherent in my nature, but which would be considered "aberrant"... Oracles no longer hear the voice of the universe and dream sacred dreams - instead, we are considered "delusional" and our dreams considered "escapist pathology". In a similar way, all four of our children are artistic -- and we were HEAVILY pressured while they were in school to drug them -- they "daydreamed too much", and "insisted on writing down LIES (ie, fantasy stories) in their journals instead of FACTS about their daily life", and "disturbed the classroom with their exuberance and insistence on examining everything"... We chose to support our children's individuality and creativity, rather than succumbing to societal pressure to start them on Ritalin and anti-depressants, and, interestingly enough, they grew to be brilliant artists, musicians, and all around -good- people as adults... shrugs So if I am biased, I suppose I will retain that bias and give the children who exhibit these variances of character and personality the benefit of the doubt, help them as I am able, and learn, if I can, to appreciate their unique perspectives on the "outer" and "inner" worlds in which they reside.

I do not belittle, in any way, the challenge of raising a child like this. Gosh knows, I was a complete HANDFUL for my parents, as were our children for us... but seeing the result when their individuality of experience is cherished... irreplaceable.

I think autism is one of those conditions like MS or IBS that is extremely complex and individualistic. I definitely wouldn't call it a disease. We love to pathologize anything that isn't in a narrow range of "normal" and that is terribly damaging to people as individuals. We would love to find a "miracle cure" because it's not easy for parents to raise a child like this in a society that glorifies, rewards and caters to the neurotypical.

THat said, I have come across in my reading a certain amount of evidence that autism spectrum conditions involve the gut-brain axis in some way, much like depression. Most autistic people apparently have digestive difficulties. So do most schizophrenics, for what it's worth. Question: is there any cause and effect here, and if so, which direction does it run in? And for me, the million dollar question is: how is the microbiome involved?

here's a link to an article in New Scientist magazine that might be of interest: http://www.newscientist.com/article/dn19011-gut-bacteria-may-contribute-to-autism.html?DCMP=OTC-rss&nsref=online-news

One possibility is that the gut bacteria in children with autism are producing toxins that might interfere with brain development. One of the compounds identified in the urine of autistic children was N-methyl-nicotinamide (NMND), which has also been implicated in Parkinson's disease.

We know next to nothing about most of this. The one thing we DO know is that it's not simple and straightforward. For people who have not been there to make suggestions that parents are screwing something up is the worst kind of ignorance. Instead, they should admire their courage and celebrate the wonderful aspects of their children with them.

I think you should look into the GAPS (Gut and Psychology Syndrome) Diet by Dr. Natasha Campbell-McBride. She makes the case that Autism, as well as other neurological conditions, results from a leaky-gut, an imbalance in good/bad bacteria and an overload in toxins that result from these two conditions. She is a Medical doctor of Neurology, and also went back to school to get a degree in nutrition, after her son was diagnosed with Autism at the age of three. She developed a diet protocol that removes offending foods (including all grains [very Paleo in my opinion] and starches) and is heavy on bone broth and probiotic-rich foods (WAPF) to both heal the gut lining, as well as bring bacteria back to an optimal balance. This is not a quick fix; she says it can take at least two years for an individual to fully heal. Most incredibly, she cured her son of Autism with this protocol! She said this won't happen with all children (especially if they start on the diet later, since it's harder the longer they have had whatever condition they were diagnosed with). But, it's a compelling argument, and very much worth reading. Check it out: http://www.gapsdiet.com/Home_Page.html

WHatever is going on, at the risk of sounding ignorant and oversimplifying, I'm going to wager that it's mostly about the food (not just mothers but maybe even several generations of what the families ate). Food is the biggest drug we take liberally multiple times a day, every day of our life, and we've inherited nutritional deficiencies over generations ontop of our own crap diets and we already food causes most of our diseases (including some theories on things like Alzheimers). Let's just stop eating shit and then scratching our heads about all our new medical mysteries.

(and yes...I know it's definitely more complex than that)

I think Kurt Harris's observations are pertinent here: http://paleohacks.com/questions/107257/is-paleo-a-band-aid/107912#107912

I think this is potentially promising for many conditions. We are missing whole working parts to our immune system and we may be seeing the results, which is why diet looks like a promising therapy, but in fact may only be a band-aid and not a cure.

I read a recent article about how some experts are trying to get the DSM-IV definition of Autism defined because so many docs are quick to diagnose autism when a child may have 1 or 2 commonalities of autism. I took a test that measured autistic tendencies and based on the result, I should be autistic, yet I'm not. Point being, I think like ADHD was over-diagnosed when I was a child, autism is over-diagnosed. That said, I have a severely autistic child near and dear to my heart. He really is barely functioning. I believe diet has helped a little, but the point is that he does not have a mild form of autism and no amount of good diet will turn him into a normal functioning person.

I work in autism research. I blogged about the latest CDC figures here: http://questioning-answers.blogspot.co.uk/2012/03/cdc-and-autism-numbers-game.html

The increase in cases is most likely due to various factors which include increased awareness of the condition, a broader definition of autism (something for which the debate on the proposals for DSM-V have created quite a few news column inches) and better and earlier detection of the spectrum of conditions.

I personally don't think that these factors alone explain all the increase and as per the Nature series on autism last year - a significant proportion of the increase is probably due to 'other factors'. Precisely what those factors are is still up for discussion although one area that perhaps needs a little more inquiry is the growing science of epigenetics - changes to gene function not due to genomic changes - which brings factors such as diet, pollutants, vitamin and mineral deficiency and stress into the frame.

The latest figures are quite startling and, if anything else, reiterate the need for society to makes sure it provides, takes care of, and gives appropriate opportunities to those on the spectrum.

I hate to say it but its 99 percent environmental/ and diet causing the rise.