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1、 美国孤独症患儿比例达到 1/50：数字的背后 The US Centers for Disease Control and Prevention (CDC) has released new figures for autism prevalence in the United States. They now give a prevalence of 1 in 50, but this story, like most autism-related stories, goes deeper than the numbers. 美国疾病和控制中心（ CDC）发布了美国孤独症患病率的最新数字。
2、如今，他们给出的数字是 1/50，但与大多数与孤独症有关的文章一样，本文没有停留在这些数字之上，而是进行了更深的挖掘。 First, this prevalence estimate doesn t focus only on 8-year-olds, the population used for deriving the 1 in 88 number reported in 2012. Instead, it encompasses the number of diagnosed autistic people walking around in 2011 and 2012 who wer
3、e ages 6 to 17. The 2007 percentage of the population fitting that description was 1.16%. These new numbers put that value for 2011-2012 at 2%. 首先，此次患病率估算不仅仅针对八岁儿童， 2012 年时 CDC 就曾取样该年龄段儿童并得出了 1/88 的结果。而此次研究包括了 2011 至 2012 年间 6 至 17 岁的孤独症确诊人数。 2007 年，符合该描述的确诊病例占人口比例为 1.16%。新数据显示， 2011 至 2012 年的这一数值达到
4、了 2%。 From the CDC s report PDF: 摘自 CDC 的报告： The magnitude of the increase was greatest for boys and for adolescents aged 1417. Cohort analyses revealed consistent estimates of both the prevalence of parent-reported ASD (autism spectrum disorder) and autism severity ratings over time. Children who w
5、ere first diagnosed in or after 2008 accounted for much of the observed prevalence increase among school-aged children (those aged 617). School-aged children diagnosed in or after 2008 were more likely to have milder ASD and less likely to have severe ASD than those diagnosed in or before 2007. 患病率增
6、幅最大的群体是男孩和 14 到 17 岁的青少年。队列分析显示，父母报告的孤独症谱系障碍（ ASD）患病率和自闭症严重程度数据两者相互吻合。 2008 年或以后首次确诊的患儿数增长占所观测到的 6 到 17 岁学龄儿童患病率增长的很大一部分。相较于 2007 年或以前确诊的病例， 2008 年或以后确诊的学龄儿童患有轻度 ASD的可能性更大，而患有重度 ASD 的可能性更小。 According to the CDC, hidden within these numbers is the finding that most of the increase from 2007 to now oc
7、curred in school-aged children. In other words, given that it s possible to diagnose autism as early as age 18 months and usually by age 5, many of these new autism diagnoses were in children who received them relatively later. Children who were, therefore, walking around for quite a few years with
8、autism that went unrecognized and uncounted. That fits with the idea that a lot of the increase in autism we ve seen in the last decade has much to do with greater awareness and identification. 据 CDC 报告，这些数字中所隐含的信息是，从 2007 年至今增加的病例大多出现在学龄儿童群体。换言之，鉴于孤独症的早期确诊甚至可在婴儿 18 个月时做出，并且通常是在 5 岁前就被发现，许多新增病例是较晚才确
9、诊的儿童。因此，一些确实患有孤独症的儿童，患有孤独症多年而未被发现并且没有被计入在内。这契合了一个观点，即过去十年里我们所见的许多孤独症新增病例与孤独症认识提高和鉴别能力增强有很大关系。 The CDC s information comes from parent reports, acquired by random telephone surveys. Parents answered questions about the ASD diagnosis and severity, and the age and year the child was diagnosed. When the
10、 CDC did this study in 2007, the results relied on information for 63, 967 children; for 2011-2012, that number was slightly higher at 65, 556. CDC 的信息来自于随机电话调查所掌握的家长报告。家长们回答了关于 ASD 诊断和严重程度的问题，以及患儿的年龄和确诊年份。 2007 年美国疾病和控制中心做此研究时，最终结果是基于 63,967 名儿童的信息；在 2011到 2012 年间，样本人数稍有上升，为 65,556 人。 From 2007 to
11、2013, parent-reported autism prevalence increased significantly in all age groups in the 6-17 range and increased for boys from 1.8% to 3.23%. Girls also showed an increase, but not as dramatic, from 0.49% to 0.70%. Autism among children ages 14 to 17 was up more than 1%, compared to children in the
12、 youngest, 6 to 9 age group (0.5%). In 2007, this older group, born in the 1990s, was less likely to have ASD than younger children. 从 2007 到 2013 年期间， 6 到 17 岁间各年龄组家长所报告的孤独症患病率显著增加，且男孩群体患病率从 1.8%增至 3.23%。女孩群体患病率也有所增加，但没有那么明显，从 0.49%升至 0.7%。 14 到 17 岁年龄段儿童的孤独症患病率增幅超过 1%，相比之下， 6 到 9 岁年龄段患病率增加了 0.5%。
13、2007 年，与较小年龄组的孩子相比，90 后出生的较大年龄组患 ASD 的可能性更低。 Autism severity ratings (or, as a friend of mine analogizes, octane rating) also was revealing. Children ages 2 to 13 in 2007 and diagnosed by that year and who were thus 6 to 17 in 2011-2012 showed no changes in ASD severity across years. However, childr
14、en in the 6 to 17 bracket who were diagnosed after 2007 were more likely to be rated as having “ mild” ASD (6.9% for 2011-2012 versus 16.9% for 2007), suggesting that greater awareness and diagnostic capture explain the ASD increase in this group. 孤独症严重程度评级（我的一位朋友将其类比成“辛烷等级” 交通工具所用燃料的抵抗震爆指标 译注）也能说明些
15、问题。 2007 年确诊的 2 到 13 岁的儿童（在 2011 到 2012 年间为 6 到 17 岁）在 ASD 严重程度上没有随着时间的推移而表现出变化。然而， 2007 年后确诊的 6 到 17 岁儿童更有可能被评为患有“轻度” ASD（ 2011 到 2012 年间的比例为 6.9%，而 2007 年的比例为 16.9%），这说明认识以及诊断捕捉的改善是该群体中 ASD 患病增加的原因。 The CDC authors observe that the 14% of children ages 14 to 17 who were diagnosed at age 7 or later
16、 received their diagnosis “ well beyond” the time when autism signs and symptoms become clear. In addition, more than half these children were classified as having “ mild” ASD, according to their parents. The CDC authors say, CDC 撰写该报告的作者们注意到， 14 到 17 岁的儿童中有 14%是在 7 岁或以后被确诊的，而孤独症迹象和症状远在这以前就已经显现出来了。此外，根据这些孩子的父母所提供的信息，其中超过一半的人患有“轻度” ASD。CDC 的作者写道： Together, these findings suggest that the increase in prevalence of parent-report
