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Objective: To determine the incidence of autism among children in Olmsted Coun ty, Minnesota. Design: Through the Rochester Epidemiology Project, all inpatient and outpatient diagnoses are indexed for computerized retrieval. This computeri zed diagnostic index was used to identify children with any developmental disord er. A glossary of symptoms of autism was used to review medical and school recor ds of these children for symptoms consistent with Diagnostic and Statistical Man ual of Mental Disorders, Fourth Edition (DSM-IV) criteria for autistic disorder . Setting: Olmsted County, Minnesota. Subjects: All residents of Olmsted County 21 years or younger between 1976 and 1997.Main Outcome Measure: The incidence o f research-identified autism based on DSM-IV criteria for autistic Results: Th e age-adjusted incidence of researchidentified autism was 5.5 (95%confidence interval, 1.4-9.5) per 100000 chidren from 1980 to 1983 and 44.9 (95%confid ence interval, 32.9-56.9) from 1995 to 1997 (8.2-fold increase). This incre ase was confined to children younger than 10 years who were born after 1987.Con clusions: The incidence of researchidentified autism increased in Olmsted County from 1976 to 1997, with the increase occurring among young children after the i ntroduction of broader, more precise diagnostic criteria, increased availability of services, and increased awareness of autism. Although it is possible that un identified environmental factors have contributed to an increase in autism, the timing of the increase suggests that it may be due to improved awareness, change s in diagnostic criteria, and availability of services, leading to identificatio n of previously unrecognized young children with autism.
Objective: To determine the incidence of autism among children in Olmsted Coun ty, Minnesota. Design: Through the Rochester Epidemiology Project, all inpatient and outpatient diagnoses are indexed for computerized retrieval. This computeri zed diagnostic index was used to identify children with any developmental disord er. A glossary of symptoms of autism was used to review medical and school recor ds of these children for symptoms consistent with Diagnostic and Statistical Man ofalntal Disorders, Fourth Edition (DSM-IV) criteria for autistic disorder. Setting: Olmsted County, Minnesota. Subjects: All residents of Olmsted County 21 years or younger between 1976 and 1997. Main Outcome Measure: The incidence of research-identified autism based on DSM-IV criteria for autistic Results: Th e age-adjusted incidence of research identified autism was 5.5 (95% confidence interval, 1.4-9.5) per 100,000 chidren from 1980 to 1983 and 44.9 (95% confid ence interval, 32.9-56.9) from 1995 to 1997 ( 8.2-fold increase). This increse was confined to children younger than 10 years who were born after 1987. Con clusions: The incidence of researchidentified autism increased in Olmsted County from 1976 to 1997, with the increase occurring among young children after the i ntroduction of broader, more precise diagnostic criteria, increased availability of services, and increased awareness of autism. Although it is possible that un identified environmental factors have contributed to an increase in autism, the timing of the increase suggests that it may be due to improved awareness, change s in diagnostic criteria, and availability of services, leading to identificatio n of previously unrecognized young children with autism.