I will bold some parts - read or do not..just saying..here are some numbers... prevalance rates-- regarding France... see large bold...
I do not have a "modern total" later than 1993 and I cannot find anything about loower incidences in France... in fact you may have heard that ireland seems to have higher incidences but in these studies france is higher than ireland....
I will say I have learned one thing today.. and that is the Kanners is also known as infantile autism... the criteria seem more broad (some langauge delay note4d BY 3 yeras old) as opposed to regression....
here is incidence rates chart (very well researched/backed up)
Note the studies that were excluded and the silly reason why... but note that FRANCE had the higher incidence (in 1972 and 1976) AMAZING to me that studeis have been done for so many years.. also that NOS PDD was also a category even then...
European Child and Adolescent Psychiatry, Vol.2, Issue 2, April 1993, pp.61-74 Hogrete & Huber Publishers
The Definition and Prevalence of Autism: A Review
The Centre for Social and Communication Disorders, Elliot House, 113 Masons Hill, Bromley, Kent, BR2 9HT, UK
________________________________________________________________________________ ______________ Sixteen studies of the prevalence of autism in childhood, using epidemiological methods in defined populations in Europe, the USA and Japan, in English or with English summaries, were found in the published literature. Age specific rates varied from 3.3 to 16.0 per 10,000. Eight studies gave rates for a sub-group of 'typical' autism varying from 1.2 to 8.4. Reasons for variations were sought by examining geographic and demographic details of the populations screened, methods for initial screening and final examination of possibly autistic children, demographic and clinical details of children identified as autistic, and criteria used for diagnosis. There was evidence, independent of diagnostic criteria, of a higher prevalence among children of first generation immigrants to Europe from 'exotic' countries. Apart from this, all differences could be due to variations in diagnostic practice and increasing awareness of the manifestations of autistic conditions throughout the range of intelligence, from severely retarded to average and above. However, it remains possible, though not proven, that rates do vary over place and/or time. The problems of defining a sub-group with 'typical' autism among the wide spectrum of children with the triad of impairments of social interaction, communication aud imagination are discussed and the value of such a sub-grouping questioned. ________________________________________________________________________________ ______________
Kanner's classic paper (1943) outlined the behaviour pattern, present from early in life, which he named 'early infantile autism'. Prior to this, there were, in the literature, occasional accounts of individual children whose behaviour fitted the picture Kanner later described; the most famous of these was Victor, the wild boy of Aveyron (see translations into English of J. M. G. Itard's reports by Lane, 1977). But, since no one prior to Kanner had published a series of such cases, no infomation exists as to the prevalence of autism before the second half of the twentieth century. Kanner (1943) described only the autistic children referred to his clinic and, later on, those attending a particular special school (Kanner, 1973). He made no estimates of the numbers in the general population, but thought that his syndrome was rare.
Twenty six years ago, Lotter (1966), working in the Medical Research Council Social Psychiatry Unit at the London Institute of Psychiatry, published the first paper to give the results of an epidemiological study of autistic conditions in a complete, large population of children of all levels of intelligence living in a defined geographical area (the former County of Middlesex, England). At about the same time, but independently, Birte Hoeg Brask (1972) was identifying children with 'childhood psychosis' in touch with psychiatric and mental retardation services in Aarhus, Denmark. Since then, there have been a number of other studies of the prevalence of autism, with varying results.
In this paper, a quarter of a century of work in this field is reviewed in order to consider possible reasons for the differences in the reported findings. The studies to be described in detail and tabulated are those meeting the following criteria; they use defined diagnostic criteria; they cover geographically defined populations; the initial selection is made from a wide range of children including those not previously diagnosed as autistic; final identification is based on clinical examinations of selected children by the authors or by the direct care clinical staff who provide information requested by the authors as part of the study. Only papers published in books or journals in English or with detailed English summaries are included, not unpublished reports.
The results of the studies of the prevalence of autism are summarised in Tables I to S. Each is identified by the name of the area in which it was carried out. The authors of the papers, the full names of the areas studied, and the abbreviations of these names used in the tables are listed below, in the order in which they appear in the tables:
- Lotter (1966; 1967a; 1967b) Middlesex, England (Midx)
- Brask (1972) Aarhus, Denmark (Aarh)
- Wing & Gould (1979) Camberwell, London, England (Camb)
- Hoshino et al.(1982) Fukushima-ken, Japan(Fuma)
- Bohman et al. (1983) Västerbotten, Sweden(Väst)
- Cialdella & Mamelle (1989) Rhône, France(Rhôn)
- Matsuishi et al. (1987) Kurume, Japan (Kuru)
- Tanoue et al. (1988) Ibaraki, Japan (Ibar)
- Sugiyania & Abe (1989) Nagoya, Japan (Nago)
- Burd et al. (1987) North Dakota, USA (NDak)
- Ritvo et al. (1989) Utah, USA (Utah)
- Gillberg (1984) Göteborg region, Sweden (Göt1)
- Steffenburg & Gillberg (1986) Göteborg city, Sweden (Göt 2)
- Bryson et al. (1988) Nova Scotia, Canada (NoSc)
- Gillberg et al. (1991) Göteborg city, Sweden (Göt 3)
- Ishii & Takahashi (1983) Toyota, Japan (Toyo)
For the studies in Fukushima, the Rhône, and Utah, the authors gave reasons for considering that the rates found for particular age groups within the total range studied were the most accurate. The findings for these age groups are given in Tables 1 and 2. For the second and third studies in Göteborg the authors also gave rates separately for rural Bohuslän, but only the findings for city Göteborg are quoted in Tables 1 and 2. However, for all these studies, the data in Table 5 refer to all the children finally diagnosed as autistic because, for some of the papers, this was the only information given.
Nine studies were excluded from the tables because they did not meet the criteria listed above.
They are briefly described below.
The prevalence of autism was examined in Kyoto-fu, Gifu-ken, Toyama-ken and Hokkaido in Japan by, respectively, Haga and Miyamoto (1971), Nakai (1971), Tanino (1971) and Yamazaki et al. (1971). Only short English summaries are available for these four studies. Since diagnostic criteria are not given in the summaries the results are not included in the tables. However, from the dates of publication and the references, the diagnoses were most likely to have been based on Kanner's papers. The rates found ranged from 0.9 to 5.02 per 10,000.
One study was excluded because it was based only on inforation from computer print-outs. Treffert (1970) examined the prevalence in Wisconsin, USA among children, aged 3 through 12, seen by psychiatric or mental retardation agencies in the years 1962-67 and diagnosed as having 'Childhood schizophrenia'. He reported a total age-specific prevalence of 3.1 per 10,000 of whom 0.7 were considered to be classically autistic without any known organic cause.
Two further papers were excluded because diagnosis was based on examination of the case notes only. Aussilloux et al. (1989) studied the notes of 6-12 year old children, born 1966-73, known to the relevant services in the Hérault department, France. Using DSM-III criteria, the age-specific rates found were 4.7 per 10,000 for 'Infantile autism' and 1.8 per 10,000 for 'Childhood onset pervasive developmental disorder'. Fombonne and du Mazaubran (1992) carried out a study in four regions in France (Aquitaine, Ile de France, Lorraine and Picardie). The case notes of two annual birth cohorts of children born 1972 and 1976 respectively) known to the relevant services were examined and diagnoses made using the French system of classification (Mises, 1990). The age-specific rate for the combined categories of 'Kanner's autism' and 'Other forms of infantile autism' was 4.9 per 10,000.
The study by Steinhausen et al. (1986) was excluded because the search for children was confined to two sources only, one being the university clinic for child psychiatry and the other a centre providing a programme for autistic children. The authors used Rutter's criteria (see below) to identify children with 'nuclear' autism aged under 15 and living in West Berlin, Germany on June 1, 1992. The age-specific prevalence found was 1.9 per 10,000.
Finally, one study, by McCarthy et al. (1984), was excluded because, although the authors examined the selected children, the initial selection was made by asking child psychiatrists and the staff of relevant institutions for the names of children diagnosed as autistic. Using criteria similar to those in DSM-III (see below), the authors found an age-specific prevalence of 4.3 per 10,000 children aged 8, 9 and 10 years, who were born in the Eastern section of Ireland in 1965-68.