Peter Scragg

Bio: Peter Scragg is an academic researcher. The author has contributed to research in topics: Cross-sectional study & Population. The author has an hindex of 1, co-authored 1 publications receiving 201 citations.

Prevalence of Asperger's syndrome in a secure hospital.

Abstract: BACKGROUND The hypothesis that Asperger's syndrome (AS) may go unrecognised in forensic populations was examined by ascertaining the prevalence in Broadmoor Special Hospital. METHOD The entire male patient population was screened by examination of case notes. Identified cases were subject to the next stage of the study, which involved observation and interviewing of patients, and a semi-structured interview of key staff. RESULTS A prevalence of 1.5% (0.6% to 3.3%, 95% CI) was found. The addition of equivocal cases increased the prevalence to 2.3%. CONCLUSION The prevalence of AS in Broadmoor Hospital is greater than that reported for the general population.

The epidemiology of autistic spectrum disorders: is the prevalence rising?

Abstract: For decades after Kanner's original paper on the subject was published in 1943, autism was generally considered to be a rare condition with a prevalence of around 2-4 per 10,000 children. Then, studies carried out in the late 1990s and the present century reported annual rises in incidence of autism in pre-school children, based on age of diagnosis, and increases in the age-specific prevalence rates in children. Prevalence rates of up to 60 per 10,000 for autism and even more for the whole autistic spectrum were reported. Reasons for these increases are discussed. They include changes in diagnostic criteria, development of the concept of the wide autistic spectrum, different methods used in studies, growing awareness and knowledge among parents and professional workers and the development of specialist services, as well as the possibility of a true increase in numbers. Various environmental causes for a genuine rise in incidence have been suggested, including the triple vaccine for measles, mumps and rubella (MMR]. Not one of the possible environmental causes, including MMR, has been confirmed by independent scientific investigation, whereas there is strong evidence that complex genetic factors play a major role in etiology. The evidence suggests that the majority, if not all, of the reported rise in incidence and prevalence is due to changes in diagnostic criteria and increasing awareness and recognition of autistic spectrum disorders. Whether there is also a genuine rise in incidence remains an open question.

Autism and Asperger syndrome: coexistence with other clinical disorders

Abstract: Objective: To provide a clinically useful analysis of the extent to which autism and Asperger syndrome coexist with other disorders. Method: Selective review of the literature detailing data pertaining to symptoms and disorders sometimes encountered in connection with autism or Asperger syndrome. Results: A large number of medical conditions, psychiatric disorders and behavioural and motor dyscontrol symptoms are associated with autism and Asperger syndrome. Conclusion: Comorbidity is to be expected in autism spectrum disorders — directly or indirectly. Comorbid conditions may be markers for underlying pathophysiology and suggest a more varied treatment approach. There is a great need for in-depth research into this area, meaning that the exclusion criteria of current diagnostic manuals, i.e. those that rule out a diagnosis of autism in some disorders, and a diagnosis of certain other disorders in autism may have to be revised.

Outcome in Adult Life for more Able Individuals with Autism or Asperger Syndrome

Abstract: The paper reviews what is known about outcome in adult life for more able individuals within the autistic spectrum. Because of the problems associated with differential diagnosis, the results of studies involving high-functioning people with autism and Asperger syndrome are combined. The review focuses predominantly on long-term follow-up research and covers outcome in terms of cognitive, linguistic, academic and adaptive functioning; educational and employment history; independence and social relationships; and behavioural and psychiatric problems. The stability of IQ and other measures over time, and variables related to outcome, are also investigated.

Advances in Autism

Abstract: Autism is a common childhood neurodevelopmental disorder with strong genetic liability. It is not a unitary entity but a clinical syndrome, with variable deficits in social behavior and language, restrictive interests, and repetitive behaviors. Recent advances in the genetics of autism emphasize its etiological heterogeneity, with each genetic susceptibility locus accounting for only a small fraction of cases or having a small effect. Therefore, it is not surprising that no unifying structural or neuropathological features have been conclusively identified. Given the heterogeneity of autism spectrum disorder (ASD), approaches based on studying heritable components of the disorder, or endophenotypes, such as language or social cognition, provide promising avenues for genetic and neurobiological investigations. Early intensive behavioral and cognitive interventions are efficacious in many cases, but autism does not remit in the majority of children. Therefore, development of targeted therapies based on pathophysiologically and etiologically defined subtypes of ASD remains an important and achievable goal of current research.

The prevalence of autism spectrum disorders. Recent evidence and future challenges.

Abstract: Background: Until recently best estimate prevalence rates for autism spectrum disorders (ASD) were 0.5/1,000 for autism and 2.0/1,000 for the broader spectrum. Three recent studies have suggested a significantly higher prevalence rate for ASD of 6.0/1,000 (mean 95 % CI = 4.8–8.0). Method: Possible determinants of the apparent increase in the prevalence of ASD are outlined. Methodological aspects of the three recent studies are examined. Findings: Increased recognition, the broadening of the diagnostic concept over time and methodological differences across studies may account for most or all of the apparent increase in prevalence, although this cannot be quantified. Conclusions: Findings from ongoing studies should help confirm or disconfirm the putative rate of 6.0/1,000 for all ASD. The possibility that autism has been over-diagnosed in recent studies needs to be ruled out. Notwithstanding these outstanding questions, it appears likely that the current true prevalence of ASD is considerably greater than previously recognised. This has significant implications for our scientific understanding of ASD and for families and services. Future directions for epidemiological research are outlined.