Autism rates soaring in NSW public schools

A BLOWOUT in the number of autistic students at NSW public schools may have been triggered by doctors misdiagnosing children to secure extra funding.

Department of Education figures obtained by The Sunday Telegraph show one in 74 students at state schools is autistic despite the accepted Australian prevalence being one in 160.

The state government spends more than $1.1 billion each year on students with disabilities.

Doctors say the only way to secure extra funding for children who are borderline cases or who have learning difficulties is to stretch the diagnosis.

"Schools need labels and kids don't get funding until they have a label," said Dr Scott Dunlop from Sydney Paediatrics.

"You try to stretch things up a bit to get them into a label. Anecdotally it goes on a lot because there has been a sudden increase in autism, it is almost encouraged to prescribe the borderline cases."

Autism affects a child's development and ranges from severe to milder cases of Asperger's syndrome. Cases have skyrocketed 280 per cent in the past decade.

"My impression is the diagnostic label is used to get funding, particularly for borderline kids," Dr Dunlop said.

Dr Chris Ingall from northern NSW said parents come into his Lismore paediatric clinic twice a week with a letter from a school or preschool requesting a child be assessed for autism.

"If you have a diagnosis for ASD (autism spectrum disorder), the school can apply for funding to help the child learn. If it falls outside the guidelines yet we know the child is not going to get supported and the only thing they can do to get funding is to get a diagnosis, do you let him sink or get him help?"

Macquarie University research fellow Dr Linda Graham analysed figures and found NSW boys disturbingly over-represented as autistic nine boys to one girl, yet the accepted international rate is four boys to one girl.

Dr Graham believes "ASD is the new ADHD" and children are being diagnosed with things they do not have.

Research conducted in 2005 found 58 per cent of doctors admitted they had ticked the box for autism when they were unsure about the diagnosis.

They also admitted to exaggerating children's symptoms to obtain a diagnosis.

Rosemary Cowen's son was diagnosed with sensory processing problems when he was in year 1 at a Hills district school.

"The teacher said we don't get funding for that," Ms Cowen said. "The teacher just came out and said to me 'he's autistic', and it was so unprofessional. The whole thing was about funding."



what blowout?

What blowout? The number of children diagnosed with autism spectrum disorders (ASD) has grown 15% per year (doubled every 5 years) for the last 20-30 years ... not just in Australia or NSW. The growth in ASD diagnoses is not a new phenomenon. The figure of 1 in 160 was a point in Australia about 5 years ago. The AABASD (see recently revised its position on ASD prevalence in Australia.

Even 1 in 74 isn't that high since State schools have double the rate because few private schools enroll students with ASD.

Increasing ASD diagnosis is not due to changing diagnostic criteria. ABS data in 2003 showed clearly that the increase is not due to diagnosis of mild or moderate cases: the AIHW reported ...

Autism and intellectual impairment were associated with high proportions of severe or profound core activity limitation—87% and 75% of children with these respective conditions also had a severe or profound core activity limitation.


So even with prevalence more than doubling from 1998 to 2003, the vast majority of people with ASD still have severe or profound disability. If the increase were due to milder cases, then the rate of severe disability would have to be lower (at least below 75%).

Doctors are pretty careful about diagnosing ASD. Most diagnoses are now subject to some sort of review ... and diagnoses now mostly occur before the child enters school, and are done by a paediatrician or a multi-disciplinary team with specific knowledge of ASD. Diagnosis is not up to GPs ... or teachers.

Dr Graham believes ... the proper course for an academic is to present some actual evidence.