Indiana citizens with autism are 20 percent more likely to be medicated than their counterparts are nationwide, according to an ongoing survey by the Interactive Autism Network (IAN).
One of every two Hoosiers with autism receives medication, whereas the national average is 41 percent. The disparities hold across the three main diagnoses of Autism Spectrum Disorders (ASDs):
- Autistic Disorder - 22 percent;
- Asperger's Disorder - 20 percent; and
- Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) - 22 percent.
The IAN data also show that Hoosiers spend less out of pocket caring for those on the ASD spectrum than the national average, $3,952 in Indiana versus $6,082 nationwide.
IAN seeks to establish 'largest-ever data-set'
IAN was established in 2006 by the Kennedy Krieger Institute. It is funded by a grant from Autism Speaks and strives to "facilitate research that will lead to advancements in understanding and treating autism spectrum disorders."
One project arm is IAN Research, a "scientific study where individuals with ASDs, their families and qualified researchers throughout the United States work together to understand autism spectrum disorders," the Web site says. Participants submit via the Internet information about diagnosis, behavior, family, environment and services received. Participation is voluntary.
"Researchers from different institutions throughout the country will work with this information to learn about the effect and interaction of factors such as genetics, environment, and treatment, as well as the current situation and needs of those affected by ASD," the IAN Web site says.
In addition to the three diagnostically recognized forms of autism, IAN Research includes an "Other" category in its data-set. The site's "Advanced Builder StateStats" page includes responses across 11 indicators, including Diagnosis, Treatment Rank (Top 10) and Comorbidities.
As of Nov. 21, 2009, the IAN database reported 7,772 responses nationwide, 197 from Indiana.
How Indiana diagnostics compare
According to a handout from the Indiana Resource Center for Autism (IRCA), ASDs comprise three of five Pervasive Developmental Disorders (PDD). All are referred to as syndromes and are "defined by a spectrum of social, communication and behavioral impairments."
Autistic Disorder, also known as "full-blown autism," is the oldest and most recognized ASD. It was identified in the 1940s and was first included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980. Asperger's and PDD-NOS were not officially recognized as ASDs until the DSM-IV in 1994.
The IAN data show that Indiana diagnoses Autistic Disorders at roughly the same percentage of ASDs as the nation, 48 percent in Indiana, 47 percent nationally. But while it suggests that Asperger's Disorder is more likely to be diagnosed in the Hoosier state and PDD-NOS less, IAN says data in these two categories should be viewed with caution because of the low number of responses.
Asperger's is considered a "milder" form of autism in which individuals live normal, productive lives. A long list of historical figures have been retroactively identified as having Asperger's Disorder, including Thomas Jefferson, Albert Einstein and Wolfgang Mozart.
While sharing many of the same diagnostic criteria as the other two ASDs, PDD-NOS differs in other ways, like the age of onset, for example. Symptoms for Autistic and Asperger's Disorders appear before age 3, but PDD-NOS can manifest itself later in life.
Gender, treatment and simultaneous conditions
Data that IAN says are statistically significant suggest:
- Indiana's gender distribution is slightly more female than the nation's;
- State caregivers utilize a combination of speech and language, pharmacological and vocational therapies for treatment; and
- A higher number of Hoosiers with ASDs are also diagnosed with Attention Deficit Hyperactivity Disorder (ADHD).
Consistent with what studies across the nation have long shown, males in Indiana are four times more likely to be diagnosed with an ASD than females, by an 81-19 ratio. Nationally, IAN respondents put the measure at 83-17.
Across all diagnoses, Indiana caregivers rely most heavily on Speech and Language Therapy to treat Hoosiers with ASDs. Medications are second and Occupational Therapy third.
Of those three, only Medications ranks significantly different from national averages, 50 percent in Indiana versus 41 percent nationally.
ASD diagnoses are often "co-morbid," meaning the individual has multiple conditions. Nationally and in Indiana, the three most common are Motor Delay, ADHD and Anxiety Disorder.
Motor Delay is the most common additional diagnosis both nationally and in Indiana, 47 percent nationally and 39 percent in Indiana.
Indiana diagnoses ADHD and Anxiety Disorder at higher rates than the nation, 34-to-29 percent and 22-to-19 percent, respectively.