Comment by didibus
2 days ago
That study is at risk of the same effects of diagnostic rules, case-finding, service incentives, record linkage and diagnostic substitution as any other. So it can explain the increase shown here as well. That said, you're right, we don't know if there is within that an increase or not being masked. But it's very possible there isn't, or if there is, it's pretty small. Which wouldn't really mandate as much worrying as is happening now.
For me, the question might be, can we get the data in check? Don't want to go another 20 years and still not be able to know the real data because we kept changing the definitions, the rules around diagnosis, who is eligible to be diagnosed, the cost of diagnosis, etc.
I think the definition of "profound" they chose (nonverbal, minimally verbal or IQ < 50) has much less wiggle room than the broad ASD/autism diagnosis, and also fewer incentives towards inflation. Diagnosis replacement vis-a-vis intellectual disability is still a worry, and I wish there was a way to contrast with an ID stat for the same population.
Overall am in strong agreement with you, the main thing is to nail down data and very little seems to be done towards that. I've followed these studies and articles since 2011 or so with increasing dismay. The headline-grabbing stats of "1 in X" growing every year are next to meaningless, and yet I believe much points towards prevalence of actual condition really increasing. But with scandalously amorphous definitions and abysmal longitudinal bookkeeping we don't know and can't know how much it's increasing and in what subpopulations.