Skip to main content

Cities and Autism! Diagnostic Rates are not Incidence Rates

Over at Just a 'Lil Blog (a blog I recommend reading) there is the following:
Interview with a Unicorn

How did we come to be in front of the camera? Well, it started with the University of Pittsburgh. See, they're doing a study on the effects of environment on the prevalence or symptoms of autism in the surrounding area. Apparently Pittsburgh is quite a little hotspot for it, and so this study is geared toward…well…something about the their words, "The Research Study of Environmental Risk Factors for Childhood Autism is a multi-year study which began in 2010. It is being conducted in southwestern Pennsylvania (Allegheny, Armstrong, Beaver, Butler, Washington and Westmoreland Counties) by the University of Pittsburgh's Graduate School of Public Health. The aim of the study is to help identify environmental and other factors that may put children at risk for developing conditions within the ASDs."
— from
When I read these stories about "autism prevalence" I cringe. There are a number of potential complications, represented by past studies and their questionable "findings" about autism prevalence — which tends to confuse diagnostic rates with actual incidence rates of autism.

Simply because autism is more likely to be diagnosed and labeled in certain places, does not mean the incidence is higher than elsewhere.

Consider the following "rates" of autism as a percentage of disabilities among students from 2005 IDEA statistics:


An interesting trend can be detected in most autism prevalence studies in the United States:
  • Cities have higher reported rates of autism than rural areas.
  • Cities with more universities and health research centers have higher rates of autism diagnoses.
  • The education level of parents correlates to diagnostic rates… and more people with advanced degrees live in cities.
  • Proximity to freeways was correlated to autism diagnostic rates… and cities have more freeways.
  • Higher rates were found among some minority populations… and again, you can guess the urban vs. rural split.
Now, we could conclude any of the following:
  • Universities correlate to autism.
  • Tech centers correlate to autism (for many years, Asperger's was called "The Geek Syndrome").
  • Cities correlate to autism.
So, avoid cities, universities, and freeways?

The lowest diagnostic rates are in the rural Deep South and in the rural Great Plains. The highest diagnostic rates include the areas around Los Angeles, San Francisco, Chicago, Salt Lake City, Minneapolis, Pittsburgh, and parts of New York.

Ask yourself the following:
  • Aren't places with autism specialists more likely to have accurate diagnostic statistics?
  • Aren't educated, middle-class and upper-class families more likely to be able to obtain diagnoses?
  • Aren't the schools and other institutions in higher-income areas more likely to provide screening and supports?
Rural areas have a physician shortage. They also have a serious mental health care deficit. Clinicians and researchers work at… universities and large hospitals. These institutions are in cities. We could easily overlay population maps with demographic maps of income, higher education, and technology companies.

And while the "Amish don't have autism" nonsense has been discredited (I've blogged on that myth several times), there is a simple truth: rural residents are less likely to be diagnosed with medical and mental health conditions because they lack access to specialists.
The German-speaking Amish do have autism, at a rate of approximately 1:250 to 1:200, which is lower than the national average, but oddly close to the rates in other parts of rural PA, OH, and WV. So, that leads to other questions about clusters of autism and why some areas have substantially lower diagnostic rates -- with or without vaccination. 
Never assume that diagnostic rates corresponds to actual incidence of any medical diagnoses. Consider all the variables.


  1. You're absolutely right, Christoper.

  2. Has anyone considered the amount of exposure to electronics by pregnant women? If the brain cortex doesn't develop properly beginning at the 19th week, See how much these women are exposed. I'm guessing hospital workers have higher autism rates with their children.


Post a Comment

Comments violating the policies of this blog will not be approved for posting. Language and content should be appropriate for all readers and maintain a polite tone. Thank you.

Popular posts from this blog

Autism, Asperger's, and IQ

"Aren't people with Asperger's more likely to be geniuses? Isn't genius related to autism?"

A university student asked this in a course I am teaching. The class discussion was covering neurological differences, free will, and the nature versus nurture debate. The textbook for the course includes sidebars on the brain and behavior throughout chapters on ethics and morality. This student was asking a question reflecting media portrayals of autism spectrum disorders, social skills difficulties, and genius.

I did not address this question from a personal perspective in class, but I have when speaking to groups of parents, educators, and caregivers. Some of the reasons these questions arise, as mentioned above, are media portrayals and news coverage of autism. Examples include:
Television shows with gifted characters either identified with or assumed to have autistic traits: Alphas, Big Bang Theory, Bones, Rizzoli and Isles, Touch, and others. Some would include She…

Listen… and Help Others Hear

We lack diversity in the autism community.

Think about what you see, online and in the media. I see upper-middle class parents, able to afford iPads and tutors and official diagnoses. I see parents who have the resources to fight for IEPs and physical accommodations.

I see self-advocacy leadership that has been fortunate (and hard working, certainly) to attend universities, travel the nation (or even internationally), and have forums that reach thousands.

What I don't see? Most of our actual community. The real community that represents autism's downsides. The marginalized communities, ignored and excluded from our boards, our commissions, our business networks.

How did my lower-income parents, without college educations, give me a chance to be more? How did they fight the odds? They did, and now I am in a position of privilege. But I don't seem to be making much of a difference.

Demand that your charities seek out the broadest possible array of advisers and board members.…

Life Updates: The MFA Sprint

Life is okay, if more than a little hectic at the end of this first month.

With one month down, I'm 11 months away from my MFA in Film and Digital Technology. Though things might happen and things do go wrong, so far I'm on schedule and things are going well —— though I'm exhausted and working harder than I did for any other degree. Because the MFA requires projects every week, this isn't as easy to schedule as writing. Even researching a paper can be done from the comfort of home, at any hour.

You cannot make movies by yourself, at any time of day. It doesn't work that way. Filming takes time, and often requires a team of people. It's not comparable to working alone on a degree in writing or rhetoric.

The team-based nature of film is exhausting for me, but I enjoy the results. I also like the practical nature of the skills being taught. You either learn how to adjust ISO, f/Stop, shutter speed, and other variables or you don't. You can have theories …