Differing Diagnostic Trends in Autism Spectrum Disorders Between Ethnic Groups Reflecting Potential Etiological Risk Factors
Main Article Content
Abstract
Introduction: Autism spectrum disorders (ASDs) are a group of developmental disabilities characterized by impairments in social interaction and communication, and by restricted, repetitive, and stereotyped patterns of behavior. Symptoms typically are apparent before age three years.
Aim: To determine the prevalence of ASD amongst children along ethno-religious lines, where differences might point to potential trigger factors in its causation in a middle to high-income country.
Methods: Diagnostic trends of ASD over the past 18 years were examined over a wide geographical area of central Israel, encompassing a database of 331,169 children, aged 3-18 years. Special importance was attached to statistics from different religious and ethno-cultural groups as potentially reflecting discrepancies in diagnosis, reporting, and possible environmentally- related factors in the presentation of a genetically determined syndrome.
Results: Overall prevalence was 0.005 (1/200 live births), well below figures from other similar studies abroad and in Israel. Prevalence figures for the ultra-orthodox Jewish community were low (0.0021), when compared with the general population and similar that among Israeli Arabs (0.0017). Time trends indicated a surge in diagnosis of ASD among Israeli Arabs between the years 2008 and 2011, in contrast with a general flattening of figures for the orthodox community.
Conclusions: Results indicated that besides discrepancies in diagnosis and reporting factors, there exists a possible relation between the actual expression of ASD, its genetic predisposition and socioeconomic/cultural status as impacting as part of the epigenetic factors in the causality of autism. Our prevalence rates are currently lower than those of ASD in Europe and the USA.
Keywords:
Autism, autism spectrum disorder, Arab, Jews, prevalence
Article Details
How to Cite
DIAMOND, Gary; JABER, Lutfi.
Differing Diagnostic Trends in Autism Spectrum Disorders Between Ethnic Groups Reflecting Potential Etiological Risk Factors.
Medical Research Archives, [S.l.], v. 10, n. 8, aug. 2022.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/2976>. Date accessed: 26 apr. 2024.
doi: https://doi.org/10.18103/mra.v10i8.2976.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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29. Goines PE, Croen LA, Braunschweig D, Yoshida CK, Grether J, Hansen R, et al. Increased midgestational IFN-gamma, IL-4 and IL-5 in women bearing a child with autism: A case-control study. Mol Autism 2011;2:13.
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31. Krakowiak P, Goines PE, Tancredi DJ, Ashwood P, Hansen RL, Hertz-Picciotto I, et al. Neonatal cytokine profiles associated with autism spectrum disorder. Biol Psychiatry 2017;81(5):442-51.
32. Zerbo O, Yoshida C, Grether JK, Van de Water J, Ashwood P, Delorenze GN, et al. Neonatal cytokines and chemokines and risk of Autism Spectrum Disorder: the Early Markers for Autism (EMA) study: a case-control study. J Neuroinflammation 2014;11:113.
33. Lampi KM, Lehtonen L, Tran PL, Suominen A, Venla Lehti P, Nina Banerjee N, et al. Risk of autism spectrum disorders in low birth weight and small for gestational age infants. J Pediatr 2012;161(5):830-6.
34. Moore GS, Kneitel AW, Walker CK, Gilbert WM, Xing G. Autism risk in small and large-for-gestational-age infants. Am J Obstet Gynecol 2012;206(4):314.e1–9.
35. Abel KM, Dalman C, Svensson AC, Susser E, Dal H, Idring S, et al. Deviance in fetal growth and risk of autism spectrum disorder. Am J Psychiatry 2013;170(4):391-8.
36. Kuzniewicz MW, Wi S, Qian Y, Walsh EM, Armstrong MA, Croen LA. Prevalence and neonatal factors associated with autism spectrum disorders in preterm infants. J Pediatr 2014;164(1):20-5.
37. Leavey A, Zwaigenbaum L, Heavner K, Burstyn I. Gestational age at birth and risk of autism spectrum disorders in Alberta, Canada. J Pediatr 2013;162(2):361-8.
38. Krakowiak P, Walker C, Bremer AA, Baker AS, ,Ozonoff S, Hansen RL. Maternal metabolic conditions and risk for autism and other neurodevelopmental disorders. Pediatrics 2012;129(5):e1121-8.
39. Li M, Fallin MD, Riley A, Landa R, Walker SO, Silverstein M, et al. The association of maternal obesity and diabetes with autism and other developmental disabilities. Pediatrics 2016;137(2):1-10.
40. Li YM, OU JJ, Liu L, Zhang D, Zhao JP, Tang SY. Association between maternal obesity and autism spectrum disorder in offspring: A Meta-analysis. J Autism Dev Disord 2016;46(1):95-102.
41. Walker CK, Krakowiak P, Baker A, Hansen RL, Ozonoff S, Hertz-Picciotto I. Preeclampsia, placental insufficiency, and autism spectrum disorder or developmental delay. JAMA Pediatr 2015;169(2):154-62.
42. Elsabbagh M. State of the Art Review. Linking risk factors and outcomes in autism spectrum disorder: is there evidence for resilience? BMJ 2020;368:l6880.
43. Kinney DK, Miller AM, Crowley DJ, Huang E, Gerber E. Autism prevalence following prenatal exposure to hurricanes and tropical storms in Louisiana. J Autism Dev Disord 2008;38:481-8.
44. Li J, Vestergaard M, Obel C, Christensen J, Precht DH, Lu M, et al. A nationwide study on the risk of autism after prenatal stress exposure to maternal bereavement. Pediatrics 2009;123:1102-7.
45. Gitau R, Adams D, Fisk NM, Glover V. Fetal plasma testosterone correlates positively with cortisol. Arch Dis Child Fetal Neonatal Ed 2005;90:F166-F169.
46. Sarkar P, Bergman K, Fisk NM, O'Connor TG, Glover V. Amniotic fluid testosterone: relationship with cortisol and gestational age. Clin Endocrinol 2007;67:743-7.
47. O'Connor TG, Heron J, Golding J, Glover V. Maternal antenatal anxiety and behavioral/ emotional problems in children: a test of a programming hypothesis. J Child Psychol Psychiatry 2003;44:1025-36.
48. Baron-Cohen S, Auyeung B, Nørgaard-Pedersen B, Hougaard DM, Abdallah MW, Melgaard L, et al. Elevated fetal steroidogenic activity in autism. Mol Psychiatry 2015;20(3):369-76.
49. Teman E, Ivry T, Bernhardt BA. Pregnancy as a proclamation of faith: Ultra-Orthodox Jewish women navigating the uncertainty of pregnancy and prenatal diagnosis. Am J Med Genet 2011;155A:69-80.
2. Baxter AJ, Brugha TS, Erskine HE, Scheurer RW, Vos T, Scott JG. The epidemiology and global burden of autism spectrum disorders. Psychol Med 2015;45(3):601-13.
3. Christensen DL, Baio J, Van Naarden Braun K, Bilder D, Charles J, Constantino JN, et al. Prevalence and characteristics of autism spectrum disorder among children aged 8 years - Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2012. MMWR Surveill Summ 2016;65(3):1-23.
4. Hallmayer J, Cleveland S, Torres A, Phillips J, Cohen B, Torigoe T, et al. Genetic heritability and shared environmental factors among twin pairs with autism. Arch Gen Psychiatry 2011;68(11):1095.
5. Risch N, Hoffmann TJ, Anderson M, Croen LA, Grether JK, Windham GC. Familial recurrence of autism spectrum disorder: evaluating genetic and environmental contributions. Am J Psychiatry 2014; 171(11):1206-13.
6. Bauman ML, Kemper TL. Neuroanatomic observations of the brain in autism: A review and future directions. Int J Dev Neurosci 2005; 23(2-3):183-7.
7. Kim YS, Leventhal BL, Koh Y, Fombonne E, Laska E, Lim EC, et al. Prevalence of autism spectrum disorders in a total population sample. Am J Psychiatry 2011;168(9):904-12.
8. King MD, Bearman PS. Socioeconomic status and the increased prevalence of autism in California. Am Sociol Rev, 2011;76(2):320-46.
9. Rai D, Lewis G, Lundberg M, Araya R, Svensson A, Dalman C, et al. Parental socioeconomic status and risk of offspring autism spectrum disorders in a Swedish population-based study. J Am Acad Child Adolesc Psychiatry 2012;51(5):467-76.e6.
10. Raz R, Roberts AL, Lyall K, Hart JE, Just AC, Laden F, et al. Autism spectrum disorder and particulate matter air pollution before, during, and after pregnancy: A nested case-control analysis within the Nurses’ Health Study II Cohort. Environ Health Perspect 2015;123:264-70.
11. Raz R, Weisskopf MG, Pinto O, Levine H. Differences in autism spectrum disorders incidence by sub-populations in Israel 1992-2009: A total population study. J Autism Dev Disord 2014;45:1062-9.
12. Senecky Y, Chodick G, Diamond G, Lobel D, Drachman R, Inbar D. Time trends in reported autistic spectrum disorders in Israel, 1972–2004. Israel Med Assoc J 2009;11:30-3.
13. BMDP Statistical Software. Editor: Dixon WJ. Los Angeles, CA: University California Press, 1993.
14. Gurney JG, Fritz MS, Ness KK, Sievers P, Newschaffer CJ, Shapiro EG. Analysis of prevalence trends of autism spectrum disorder in Minnesota. Arch Pediatr Adolesc Med 2003;157:622-7.
15. Kawamura Y, Takahashi O, Ishii T, Ishii T. Reevaluating the incidence of pervasive developmental disorders: Impact of elevated rates of detection through implementation of an integrated system of screening in Toyota, Japan. Psychiatr Clin Neurosci 2008; 62:152-9.
16. Keyes KM, Susser E, Cheslack-Postava K, Fountain C, Liu K, Bearman PS. Cohort effects explain the increase in autism diagnosis among children born from 1992 to 2003 in California. Int J Epidemiol 2012;41:495-503.
17. Nassar N, Dixon G, Bourke J, Bower C, Glasson E, de Klerk N, et al. Autism spectrum disorders in young children: effect of changes in diagnostic practices. Int J Epidemiol 2009;38:1245-54.
18. Saemundsen E, Magnússon P, Georgsdóttir I, Egilsson E, Rafnsson V. Prevalence of autism spectrum disorders in an Icelandic birth cohort. BMJ Open 2013;3:e002748.
19. Yeargin-Allsopp M, Rice C, Karapurkar T, Doernberg N, Boyle C, Murphy C. Prevalence of autism in a US metropolitan area. JAMA 2003;289:49-55.
20. Jaber L, Halpern GJ, Shohat T. Trends in the frequencies of consanguineous marriages in the Israeli Arab community. Clin Genet 2000;58:106-10.
21. Lyall K, Croen L, Daniels J, Fallin MD, Ladd-Acosta C, Brian K. et al. The changing epidemiology of autism spectrum disorders. Annu Rev Public Health 2017;38:81-102.
22. Ladd-Acosta C, Fallin MD. The role of epigenetics in genetic and environmental epidemiology. Epigenomics 2016;8(2):271-83.
23. Liu Y, Li X, Aryee MJ, Ekström TJ, Padyukov L, Klareskog L, et al. GeMes, clusters of DNA methylation under genetic control, can inform genetic and epigenetic analysis of disease. Am J Hum Genet 2014;94(4):485-95.
24. Joubert BR, Felix JF, Yousefi P, Bakulski KM, Just AC, Breton C, et al. DNA methylation in newborns and maternal smoking in pregnancy: Genome-wide Consortium Meta-analysis. Am J Hum Genet 2016;98(4):680-96.
25. Ladd-Acosta C, Shu C, Lee BK, Gidaya N, Singer A, Schieve LA, et al. Presence of an epigenetic signature of prenatal cigarette smoke exposure in childhood. Environ Res 2016;144(Pt A):139-48.
26. Argos M. Arsenic exposure and epigenetic alterations: Recent findings based on the Illumina 450K DNA methylation array. Curr Environ Health Rep 2015;2(2):137-44.
27. Brown AS, Sourander A, Hinkka-Yli-Salomäki S, McKeague IW, Sundvall J, Surcel HM, et al., Elevated maternal C-reactive protein and autism in a national birth cohort. Mol Psychiatry 2014;19(2):259-64.
28. Zerbo O, Traglia M, Yoshida C, Heuer LS, Ashwood P, Delorenze GN, et al. Maternal mid-pregnancy C-reactive protein and risk of autism spectrum disorders: the early markers for autism study. Transl Psychiatry 2016;6:e783.
29. Goines PE, Croen LA, Braunschweig D, Yoshida CK, Grether J, Hansen R, et al. Increased midgestational IFN-gamma, IL-4 and IL-5 in women bearing a child with autism: A case-control study. Mol Autism 2011;2:13.
30. Abdallah MW, Larsen N, Mortensen EL, Atladóttir HÓ, Nørgaard-Pedersen B, Bonefeld-Jørgensen EC, et al. Neonatal levels of cytokines and risk of autism spectrum disorders: an exploratory register-based historic birth cohort study utilizing the Danish Newborn Screening Biobank. J Neuroimmunol 2012;252(1-2):75-82.
31. Krakowiak P, Goines PE, Tancredi DJ, Ashwood P, Hansen RL, Hertz-Picciotto I, et al. Neonatal cytokine profiles associated with autism spectrum disorder. Biol Psychiatry 2017;81(5):442-51.
32. Zerbo O, Yoshida C, Grether JK, Van de Water J, Ashwood P, Delorenze GN, et al. Neonatal cytokines and chemokines and risk of Autism Spectrum Disorder: the Early Markers for Autism (EMA) study: a case-control study. J Neuroinflammation 2014;11:113.
33. Lampi KM, Lehtonen L, Tran PL, Suominen A, Venla Lehti P, Nina Banerjee N, et al. Risk of autism spectrum disorders in low birth weight and small for gestational age infants. J Pediatr 2012;161(5):830-6.
34. Moore GS, Kneitel AW, Walker CK, Gilbert WM, Xing G. Autism risk in small and large-for-gestational-age infants. Am J Obstet Gynecol 2012;206(4):314.e1–9.
35. Abel KM, Dalman C, Svensson AC, Susser E, Dal H, Idring S, et al. Deviance in fetal growth and risk of autism spectrum disorder. Am J Psychiatry 2013;170(4):391-8.
36. Kuzniewicz MW, Wi S, Qian Y, Walsh EM, Armstrong MA, Croen LA. Prevalence and neonatal factors associated with autism spectrum disorders in preterm infants. J Pediatr 2014;164(1):20-5.
37. Leavey A, Zwaigenbaum L, Heavner K, Burstyn I. Gestational age at birth and risk of autism spectrum disorders in Alberta, Canada. J Pediatr 2013;162(2):361-8.
38. Krakowiak P, Walker C, Bremer AA, Baker AS, ,Ozonoff S, Hansen RL. Maternal metabolic conditions and risk for autism and other neurodevelopmental disorders. Pediatrics 2012;129(5):e1121-8.
39. Li M, Fallin MD, Riley A, Landa R, Walker SO, Silverstein M, et al. The association of maternal obesity and diabetes with autism and other developmental disabilities. Pediatrics 2016;137(2):1-10.
40. Li YM, OU JJ, Liu L, Zhang D, Zhao JP, Tang SY. Association between maternal obesity and autism spectrum disorder in offspring: A Meta-analysis. J Autism Dev Disord 2016;46(1):95-102.
41. Walker CK, Krakowiak P, Baker A, Hansen RL, Ozonoff S, Hertz-Picciotto I. Preeclampsia, placental insufficiency, and autism spectrum disorder or developmental delay. JAMA Pediatr 2015;169(2):154-62.
42. Elsabbagh M. State of the Art Review. Linking risk factors and outcomes in autism spectrum disorder: is there evidence for resilience? BMJ 2020;368:l6880.
43. Kinney DK, Miller AM, Crowley DJ, Huang E, Gerber E. Autism prevalence following prenatal exposure to hurricanes and tropical storms in Louisiana. J Autism Dev Disord 2008;38:481-8.
44. Li J, Vestergaard M, Obel C, Christensen J, Precht DH, Lu M, et al. A nationwide study on the risk of autism after prenatal stress exposure to maternal bereavement. Pediatrics 2009;123:1102-7.
45. Gitau R, Adams D, Fisk NM, Glover V. Fetal plasma testosterone correlates positively with cortisol. Arch Dis Child Fetal Neonatal Ed 2005;90:F166-F169.
46. Sarkar P, Bergman K, Fisk NM, O'Connor TG, Glover V. Amniotic fluid testosterone: relationship with cortisol and gestational age. Clin Endocrinol 2007;67:743-7.
47. O'Connor TG, Heron J, Golding J, Glover V. Maternal antenatal anxiety and behavioral/ emotional problems in children: a test of a programming hypothesis. J Child Psychol Psychiatry 2003;44:1025-36.
48. Baron-Cohen S, Auyeung B, Nørgaard-Pedersen B, Hougaard DM, Abdallah MW, Melgaard L, et al. Elevated fetal steroidogenic activity in autism. Mol Psychiatry 2015;20(3):369-76.
49. Teman E, Ivry T, Bernhardt BA. Pregnancy as a proclamation of faith: Ultra-Orthodox Jewish women navigating the uncertainty of pregnancy and prenatal diagnosis. Am J Med Genet 2011;155A:69-80.