Autism “Cluster” Reported Among Somalis

Under cover: Too little sunlight — leading to vitamin D deficiency — may be to blame for higher rates of autism among Somali children.

Researchers in Minneapolis and Sweden are investigating reports of so-called autism clusters among children from immigrant Somali populations. Some scientists say the clusters may be the result of a vitamin D deficiency — a largely untested hypothesis.

A report from Swedish neurologists, published on 1 August, says the prevalence of autism spectrum disorders in Somali children aged 7 to 17 years in Stockholm is nearly four times higher than in non-Somali children.

In Minneapolis, Somalis account for 6 percent of the city’s public school population, but make up 17 percent of early childhood special education students who have been labeled autistic, according to data aggregated by the Minneapolis Public Schools.

Epidemiologists are generally skeptical of disease clusters, and this one is no exception.

“Those numbers are strikingly different, but it’s not really an appropriate comparison,” says Judy Punyko, an epidemiologist at the Minnesota Department of Health.

The Minneapolis statistics include only children from certain age groups and only those attending public schools, Punyko notes. What’s more, Minneapolis autism programs have an open-enrollment policy, meaning that they often accept children from other school districts, potentially skewing the prevalence numbers for the district. “I want to get the real numbers and understand these numbers before we move on,” Punyko says.

In August, Punyko created a study group of 12 experts — including epidemiologists, physicians, school administrators and special education teachers — to compare the autism prevalence across all Somali children in the city with age-matched controls.

Even then, she adds, educational data may be incomplete or inaccurate. The 13 special education categories reported to the state and federal government are intended to help provide a child with the best available educational services. If a child has two conditions, such as autism and developmental delay, they can only be assigned to one primary category; Minnesota does not require a medical diagnosis of autism to be included in the category. Finally, some schools, especially those in poorer districts, often overlook mild forms of autism.

Population data used for the analysis also comes from the 2000 census, which may be vastly different than current numbers. “The population of Somalis is a fluid number in Minnesota,” says Punyko.

Minnesota and Sweden both have large numbers of Somali refugees who fled from their war-torn country over the past two decades. A diagnosis of autism, all but unknown in Africa, is seen as a stigma within these immigrant communities.

“Somali parents here call it ‘the Swedish disease,’” says Elisabeth Fernell, a pediatric neurologist at the Karolinska University Hospital in Stockholm and lead author of the Swedish report. Based mostly on discussions with teachers and clinicians at the three autism habilitation centers in Stockholm County, “We’ve had a suspicion that it’s more common in children with a Somali background for years,” she says.

…read the rest of my article at Simons