Utah has one of the highest autism rates in a 14-state study 1 in every 133 children. And the rate is higher still for boys, at 1 in 79, according to University of Utah researchers.
"With numbers like this, I think it qualifies as an urgent public health concern," said Judith Zimmerman, Ph.D., assistant professor in the department of psychiatry at the U.
The study, sponsored by the Centers for Disease Control and Prevention, concluded that Utah's autism rate is 20 times higher than it was two decades ago. The results were released Thursday.
Overall, Utah ranks third in terms of prevalence based on population, with a rate of 7.5 children per 1,000, placing it about 12 percent higher than the national average, said Zimmerman. New Jersey had the highest rate, at 1 in 94, while Alabama had the lowest rate. Among boys, Utah is No. 2.
Autism is characterized by impaired social, communicative and behavioral development. It varies in severity.
The cause has long been debated, with genetics, environment, even childhood vaccines being blamed by some. The CDC says it's likely there are multiple causes, "due to complex interaction of genetic and environmental factors." For most cases, it adds, the cause is not known although it tends to occur more frequently than expected with certain other medical conditions, including Fragile X syndrome, tuberous sclerosis, congenital rubella and untreated phenylketonuria (PKU).
Utah had the most striking difference in the rates of autism among males vs. females, at 7 to 1. The researchers aid they found no difference in the three counties examined Davis, Salt Lake and Utah in terms of prevalence.
Zimmerman said Utah's numbers may be slightly higher simply because Utahns are good bookkeepers. "We had great access to records," she said.
The Utah numbers, while alarming, also reflect progress, showing better diagnosis and referral of milder cases, said Dr. William McMahon, director of the Utah Autism Research Program at the U. and co-principal investigator for Utah's study. "However, our understanding of autism can be compared to medical understanding of fever in the 18th century. While we recognize the symptoms of autism, we have yet to discover the cause and translate that knowledge into cure and prevention," he said in a news release about the research.
The study also looked at intellectual disability, but those results are not yet published. It did show, though, that one-third of the Utah children with autism also have some cognitive impairment.
Utah leads in another way: More Utah children with autism have a history of regression and loss of skills one-third. That number was higher than in all the other states studied.
Zimmerman said goals for the study included measuring the incidence, looking at the scope of autism and examining some of the characteristics of cases. They hope also to identify potential risk factors and causes and have already linked the data to some prenatal issues identified on birth certificates in Utah.
They found, for instance, a higher ratio of breech births, C-sections and newborns who required more than 30 minutes of assisted ventilation among children with autism. "We could use information like that to determine a target population to screen," she said.
All children should be screened for autism spectrum disorder and developmental disabilities, Zimmerman said.
The study also provides the opportunity to link autism information with other health information, including hospital discharge and environmental databases. "We could look to see if there are clusters in areas."
They hope the information will help policymakers and families plan for services and understand the economic impact of the disorder. Other research indicates that for children from birth to 18, recent economic predictors say the cost of autism over a lifetime is $3.2 million dollars each.Others involved in the research at the U. included Judith Miller, Ph.D., and Dr. Deborah Bilder, both of the Department of Psychiatry at the U., and statistician and epidemiologist Robert Satterfield of the Utah Department of Health.