Another challenge to know how often a disease is showing up in the community is that the definitions may change. In times past, the behaviors seen in a child with autism would be called mental retardation. So are there more children with autism or fewer kids with mental disabilities? Clinical skills in applying the criteria also make a big impact. A doctor, like anyone else, sees what they know. If I only know about childhood schizophrenia, I might see certain characteristics of that in autistic children, or if I don't know something, I may not give it any name at all.

Perceptions change because our awareness increases with information. If Newsweek or Oprah Winfrey has tearful parents recounting their story, the next week others will step forward and say they now know what has been Johnny's problem all along. Johnny hasn't changed, only our perception has.

What is frustrating for me and a million times more so for parents of children with autism is that the argument continues. I, for one, believe it is more common. We need to think and study the many factors that could be making an assault on the developing brain. I don't like saying "autism" to a parent. I would much rather say, "Let's do this and prevent it, and by the way, your baby is cute and cuddly."

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Joseph Cramer, M.D., is a fellow of the American Academy of Pediatrics, practicing pediatrician for more than 25 years and an adjunct professor of pediatrics at the University of Utah. He can be reached at jgcramermd@yahoo.com.