Bu the vulnerable: antipsychotics atypical among children and the elderly

 Pharmaceutical companies have recently paid out the largest legal settlements in U.S. history - including the largest criminal fines ever imposed on corporations - for illegally marketing antipsychotic drugs. The payouts totaled more than $5 billion. But the worst costs of the drugs are being borne by the most vulnerable patients: children and teens in psychiatric hospitals, foster care and juvenile prisons, as well as elderly people in nursing homes. They are medicated for conditions for which the drugs haven't been proven safe or effective - in some cases, with death known as a known possible outcome.

The benefit for drug companies is cold profit. Antipsychotics bring in some $14 billion a year. So-called "atypical" or "second-generation" antipsychotics like Geodon, Zyprexa, Seroquel, Abilify and Risperdal rake in more money than any other class of medication on the market and, dollar for dollar, they are the biggest selling drugs in America. Although these medications are primarily approved to treat schizophrenia and bipolar disorder, which combined affect 3% of the population, in 2010 there were 56 million prescriptions filled for atypical antipsychotics.

In a presentation this week at an American Psychiatric Association meeting, Dr. John Goethe, director of the Burlingame Center for Psychiatric Research in Connecticut, reported that over the last 10 years, more than half of all children aged 5 to 12 in psychiatric hospitals were prescribed antipsychotics - and 95% of these prescriptions were for second-generation antipsychotics. Many of these children didn't have a condition for which the drugs have been shown to be helpful: 44% of youngsters with post-traumatic stress disorder (PTSD) and 45% of children with attention deficit hyperactivity disorder (ADHD) were treated with them.

Pharmacologically, the ADHD prescriptions make no sense: FDA-approved drugs for the condition raise levels of the neurotransmitter dopamine, while antipsychotics do they opposite, lowering them.

Geothe also noted another study that showed that the number of office visits by children and teens that included antipsychotic drug prescriptions rose 600% from 1993 to 2002. "The obvious second-generation bias is very apparent in these data, as is the irrational use of antipsychotics for indications such as PTSD and ADHD for which there is no controlled evidence whatsoever that these are safe or effective treatments," says Dr. Bruce Perry, senior fellow at the ChildTrauma Academy in Houston. (Full disclosure: Dr. Perry is my co-author on two books.)

The situation may be similar in state-run juvenile detention systems. Late last week, an exposé by the Palm Beach Post revealed that antipsychotics were among the top drugs purchased by the Florida Department of Juvenile Justice (DJJ), and were largely used in kids for reasons that were not approved by the government - for instance, sleeplessness or anxiety. The Post reported:

In 2007, for example, DJJ bought more than twice as much Seroquel as ibuprofen. Overall, in 24 months, the department bought 326,081 tablets of Seroquel, Abilify, Risperdal and other antipsychotic drugs for use in state-operated jails and homes for children.

That's enough to hand out 446 pills a day, seven days a week, for two years in a row, to kids in jails and programs that can hold no more than 2,300 boys and girls on a given day.

Among the psychiatrists hired by the state to evaluated incarcerated kids, about a third received drug company money, the Post reported. Those 17 psychiatrists wrote 54% of the prescriptions for antipsychotics; the 35 doctors who did not take such payments wrote the rest. In other words, one-third of doctors - all of whom were paid by drug companies - wrote more than half of all antipsychotic prescriptions for the state's locked-down youth.

The statistics on children in foster care are equally alarming. Youth in foster care are not only three times as likely to be medicated as comparable low-income youth on Medicaid, but more than half are treated with antipsychotics. It is not likely that all or even most of these children have a condition for which antipsychotics have been approved by the government to treat.

Among the problems with unnecessary use of antipsychotic medications is that they can cause serious, sometimes irreversible, damage. Atypical antipsychotics are associated with weight gain and may double users' risk of Type 2 diabetes. Recent research also suggests that they may shrink the brain and there is little data on how they affect brain development during the teen years, when the brain grows more than at any other time but infancy. Indeed, youth are more vulnerable than any other group to the drugs' worst side effects (excluding death).

"The majority of antipsychotic medication use in children and adolescents has not been limited to the few age groups or conditions for which there is credible evidence of efficacy and safety," says Perry. "There is no reason to expect irrational prescribers to change their bad habits."

He adds that many experts would argue that if doctors began prescribing antipsychotics "responsibly and cautiously" - that is, being mindful of the lack of efficacy data and the evidence of harm - the rate of prescriptions in children would drop by 90%.

Meanwhile, rates of prescriptions for patients at the other end of the lifespan are also out of control. In nursing homes, 14% of residents have been given at least one prescription for a second-generation antipsychotic, according to a government investigation. A full 88% of these prescriptions are given to people with dementia, despite the fact that these drugs may double the risk of death in these patients (there is a black box warning on the drug to this effect). The investigation estimated that $116 million Medicare dollars have been spent filling antipsychotic prescriptions that never should have been written.

So why are these drugs so widely prescribed? Aggressive drug company marketing is only one part of the story. A key reason they are overused in institutional settings is that they are sedating, making patients easier to manage. Secondly, unlike other sedative drugs, they are not associated with misuse (with the possible exception of Seroquel, which has fans among some addicts). In fact, most people resist taking antipsychotics, which is why overmedication is much more common in settings where people are locked-in and compliance can be forced.

(More on TIME.com: U.S. Aims to Reduce Overdose Deaths, But Will the New Plan Work?)

The second point - that these drugs are not considered addictive - by itself probably accounts for a big part of why drug companies have been able to get away with so much misleading marketing and the resultant overprescribing. Although prescribing of traditional sedatives like benzodiazepines (Valium, Xanax), which are vulnerable to misuse, is limited by their status as controlled substances, few people enjoy misusing antipsychotics (side effects like weight gain, pleasurelessness, movement disorders and low energy and motivation are not generally sought by recreational drug users), so they can be prescribed for unapproved uses like behavior control and sleep-inducement in children and the elderly.

In other words, addiction is basically seen as a worse side effect than death. The fact that the most vulnerable youth and elderly often cannot advocate for themselves has made it easier to sweep the problem under the rug.

Fortunately, there is at least one bright spot in this depressing picture. The main patent on Risperdal expired in 2007, and those for Zyprexa and Seroquel expire this year. Geodon's patent expires next year, while Abilify's comes up in 2015. When most drugs go off-patent, drug companies' marketing pressure - and profits - will subside, perhaps keeping children and the elderly safer from inappropriate medication.

Prostate Cancer studies find advantage in daily acetaminophen and walks Brisk

POP a Tylenol and take a brisk walk for protection against prostate cancer? This is what the results of two new studies published this week suggested.

In the first study, published Monday in the journal Cancer Epidemiology, biomarkers and prevention, scientists have found that men who took a daily dose of acetaminophen (Tylenol) for five years had a 38% lower risk of developing cancer of the prostatecompared with men. In addition, daily acetaminophen has been associated with an of 51% reduced risk of developing an aggressive form of the disease. The men who took acetaminophen for less than five years saw no protective benefit.

Previous research has shown that taking aspirin or other drugs anti-inflammatory drugs (NSAIDs) every day can reduce the risk of prostate cancer. The authors believe that the same may be true of acetaminophen; While not an NSAID, it has anti-inflammatory properties.

For the study, researchers looked at data 78,485 men who participated in the longitudinal Cancer Prevention study II Nutrition cohort, answering questions on the use of food and pharmaceutical plan every two years from 1992. During the period of follow-up, there were 8,092 cases of prostate cancer - much less in the group who took acetaminophen daily for five years.

The second study, published Tuesday online research on Cancer, involved 1,455 men who had already been achieved in prostate cancer stage. Researchers at the University of California, San Francisco (UCSF) and Harvard School of Public Health, then the men from 2004 to 2009 and found that those who engaged in regular brisk walking after diagnosis were significantly less likely to see their progression of the disease.

Men who walked fast - at a rate of approximately 3 miles per hour or faster - at least three hours per week were 57% less likely to experience of the progression of the disease (including high levels of PSA)(, secondary treatment of bone metastases and prostate cancer-related deaths), compared with men who walked less and more slowly.

"The important point is the intensity of activity," Erin Richman, a postdoctoral fellow at UCSF, said in a statement. "The March must be rapid for men to experience an advantage."

Researchers have said that the effect of speed walking remains independent of age, diagnosis, type of treatment and characteristics of the disease. Average age of patients at diagnosis was 65. The findings are consistent with previous research, which suggests that physical activity can help reduce the risk of deaths from the disease in some cases of prostate cancer.

Why the association? Reports MedPage Today:

Richman and his colleagues have noted that brisk walking may reduce resistance to insulin, which reduces bioavailable,-1 (IGF1) insulin-like growth factor and increases adiponectin levels, which are all associated with the decrease in the risk of prostate cancer advanced or fatal in vitro and in vivo.

Another potential source of reduction is inflammation reduced due to low circulation of Interleukin-6, high levels of which "predicts risk of 73% increased to die of cancer of the prostate in men of normal weight."wrote the researchers.

Prostate cancer is the second leading cause of cancer death in men. According to the National Cancer Institute, men about 32,050 die of cancer of the prostate in 2010 and 217,000 new cases were diagnosed. More than 2.2 million of men to the United States with prostate cancer.

If children under 13 years is on Facebook?

In a perfect, law-abiding world, no child under 13 years of age has a Facebook account. But this world is quite far from being ideal, if tweens of 7.5 million - and younger children - fishing trolling social media giant are a gauge. Now, if Facebook founder Mark Zuckerberg gets its way, this already impressive number will explode.

Last week, Zuckerberg said top of the NewSchools Venture Fund in Burlingame, California, that he would like that young children to be allowed to attend his site. Technically, Online Privacy Protection Act (COPPA the MCH) prohibited websites that gather data on users access to any person under 13. In reality, however, COPPA is quite ineffective.

Reports of consumers (CR) recently announced the results of an annual survey which concluded that "" more than a third of minors of 20 million who actively used Facebook in the last year"have 13 years of age."

According to Techland of the TIME.com blog, "that number could be low, it is only based on the parents who knew that their minor children were members of Facebook:"

in fact CR found that more than 5 million 7.5 minors about Facebook were as young as "" 10 and less. "."... This is not the worst of it. CR also concluded that minor children using Facebook have been without supervision by parents. The site claims - not wrong - that this exposes them "malware or serious threats like predators or bullies."

Consider other issues raised in the report as: 15% of Facebook users all post "their current location or travel plans", 34% after their date of birth in full, and 21% of the children after the names and images of their children.

What privacy Facebook control, your bastion against all reprehensible things? CR found about "one in five" were not to use them.

Even Zuckerberg insists on the fact that the connection on Facebook - for purposes of educational, natch - is a must for young children. "This will be a struggle take us at some point," CNNMoney quoted him saying. "My philosophy is that, for the education you need start a really, really very young."

(Information on Time.com: Photos: around the world with Facebook)

Zuckerberg, not so remote age no welcome 13 itself, says that Facebook has not begun research on how to open the site for young children and to protect them at the same time. "Because of the restrictions we have not even begun this process, learning" he said. "If they are lifted, then we would begin to learn what works." We take many precautions to ensure that they [the younger children] are safe. ?

Phew. This is reassuring.

Still, it is undeniable that children will simply have the same powers of judgment as adults. Consider, for example, the New Hampshire young crying on Facebook that bin Laden did not first offed his mathematics teacher before being killed. "With hindsight, it is mortifiée that she said that, but it is a child of 13 years," mother of the girl, Kimberly Dell'isola, told a local television station.

(Information on Time.com: Alaina Giordano, Mom stage 4 Cancer, with Out spoke of losing her children)

This is exactly why the Publisher of Consumer Reports is not quite as cavalier as Zuckerberg on little ones friending and marking to their hearts content. Last Friday, the non-profit Consumers Union was concerned that children and adolescents do you really why it is so important to self-censoring which they share with the online world. "We urge Facebook to strengthen its efforts to identify and terminate the accounts of users aged 13 years of age and to implement more effective age-verification methods for users to sign new accounts""," Ioana Rusu, counsel for regulations for consumers Union, wrote in a letter to Zuckerberg.

According to the Los Angeles Times, letter of the Rusu comes on the heels of a congressional hearing to question the safety of minor users of Facebook:

, Chairman of the Committee of Senate Commerce John d. Rockefeller (D - va) said that it was "indefensible" that Facebook had only 100 employees to monitor the activities of its 600 million users.

At the hearing, Facebook Chief Technology Officer Bret Taylor said Facebook closes the accounts of persons recognized to lie about their age. But he acknowledged that Facebook depends on other users noted minor users.

The Union of consumer urges of Facebook is more "diligent and effective" to save the millions of minors who frequent the site. He suggested a few ways to do: make the default privacy minors setting one that facilitates sharing with "friends only" instead of "friends of their friends;" for the average user, which is equivalent to approximately 17 000 people. And to engage in an "eraser" button that users can click to remove embarrassing information posted on the site while they were minors.

Study: How a 'Fat gene' affects cholesterol and diabetes

Scientists know long that obesity is associated with a host of other conditions of health, including Type 2 diabetes and heart disease. Now, a team of researchers King's College London and Oxford University have do light on why: a gene, in adipose tissue acts as a "master regulator", by controlling the effect of a bunch of other genes that are linked to obesity, cholesterol and diabetes.

The master gene in question is called KLF14, and while it has been previously linked to diabetes Type 2 and cholesterol, new research says how – and offers a new target for the treatment of obesity-related diseases.

"This is the first major study that shows how small changes in a single master regulator gene can cause a cascade of other metabolic effects in other genes," said lead author Tim Spector, in a statement.

The research is part of a study large multinational scale called the MuTHER study (for multiple tissue Expression human resources). Scientists analyzed more than 20,000 genes fat female samples collected just under the skin of 400 pairs of twins in the United Kingdom. They found an association between the KLF14 and the expression of other genes, also found in fats, affecting a range of metabolic characters including levels of cholesterol and insulin and glucose body mass index.

To confirm the results, researchers more tested 600 fat samples from a group distinct from the Icelandic.

Interestingly, the researchers said, the activity of the KLF14 gene is inherited from the mother; the copy of the gene inherited from the father is disabled. How the gene KLF14 person may affect expression of other genes associated with metabolism is therefore dependent on the copy received from the mother.

The conclusions also corroborate the evidence existing as metabolic traits — everything from weight to insulin levels are intimately related - and that these relations have a genetic component.

Researchers hope their discovery will stimulate research and will one day help to improve the medical treatment of obesity and metabolic diseases associated with. "This has great therapeutic potential," said Spector. "By studying the large populations detailed as twins we hope to find more of these regulators."

The study was published in the journal Nature Genetics, May 15.

Alaina Giordano, Mom stage 4 Cancer, with Out spoke of losing her children (Time.com)

Divorce is often unpleasant, but from time to time, the details of a dislocation especially take ahold of the soul and let go. One such case involves Alaina Giordano, a mother of two who is struggling against stage 4 breast cancer. April 25 Giordano lost custody of her children, when a judge ruled that they must leave their Durham, N.C., living with their father to Chicago by June 17, because, essentially, the judge said, a healthy dad is preferable to a sick mother.

Giordano was surprised. It was expecting an open-and-shut case. Quickly, an elementary school friend jumped into action, gifles a Facebook page that he hoped would spread the word and help the Giordano to attract a pro bono lawyer who could challenge the decision of the judge Nancy Gordon. It seeks an altruistic Attorney being Giordano does earn income - she is a mother in the home (SAHM, natch), the most severe jobs - a fact which has been used against him at the battle of custody, triggering a wave of support from fellow SAHMers.

(Information on Time.com: should a mother losing custody of her children because she has Cancer?)

Concerned about health Giordano was also a primary problem in the custody battle. Cancer was diagnosed in 2007, approximately six months before she moved with her family to Durham so that her husband, Kane Snyder, could studying for his MBA at Duke University. The cancer has metastasized to his bones, which is not really a good thing. But his regimen is now the disease at Bay; She said that it will not propagate actively. And is anyone guess how long she will live.

In the meantime, she said that she was able to parent and, if his recent media schedule is a gauge, compete with the endurance a triathlete. On Wednesday, Giordano was in New York for an advertising blitz. She woke at 5 a.m. to arrive at the issuance of today with her children, aged 11 years Sofia and Bud of 5 years. She did her interview. his children met with Matt Lauer. Subsequently, it has eliminated another interviews shortly, including the Gayle King Show and CNN, where they were going to Michele Obama brother and Anderson Cooper.

Then, there was breakfast with dinner with the children at the Hard Rock Cafe and the cousin of Giordano (haunted Jekyll and Hyde Club having proved too spooky for Bud). They gallivanted through Central Park and ended the day of the hearing of "The Addams Family", a musical comedy. "I am fully functional," said Giordano.

(Information on Time.com: what we can learn from the demerger of Schwarzenegger-Shriver)

While waiting with his children for his flight back in North Carolina, Giordano talks with Healthland fighting words - for his life, but especially for its children. (Kane Snyder was also asked to comment for this post, but it does not return emails or phone calls).

Healthland: How do your children know about what is happening?

Giordano: They know there is a judgment of the Court and I had to tell them that the judge said that they have to move. I told them the night of the decision. I was still in shock, at the time there. I tried to be diverted. I said I wanted to stay with me, but the judge decided otherwise.

My daughter may be somewhat stoic, like me, but when it was just me and she, she began screaming, crying. She is not out of bed, did not want to leave the apartment. My son was very anxious. It won't let me out of his sight. He sleeps with me. They know that, when someone forces you to do something, this is not love.

HealthLand: What kind of relationship have your children with their father?

Giordano: He is their father, and I do my best to be honest with them but also be jealous of their relationship with him. They like their Daddy. When my son said: "Daddy hates you and you hate Daddy", I say, "I do not hate your father, but I'm not happy with his behaviour."

HealthLand: Is it visit frequently?

Giordano: I can't really say how often. He came to visit for a night in February, a night in March, and the judge ordered [the children] go there for the week of spring break, so that they did. Approximately eight weeks in the fall when he did not come to see.

HealthLand: What did you do before the birth of your children?

Giordano: I worked as a paralegal in Philadelphia. [Snyder] was a boy. I took the LSAT, but when I had children I stayed home, and it was his first degree and finishing work. In August 2005, he became a consultant at PricewaterhouseCoopers, so he was far away. ... I went on excursion [School]. I was the mother of the room. My children came always first.

HealthLand: It seems that there must be something going on in addition to your illness to justify a decision to guard it. There are allegations of fraud and abuse. What happens there?

Giordano: I admitted my cheating. He admitted his. In North Carolina, there is a link you get alimony, therefore he has really gone after me on this. ... It has always been an abusive relationship. Nothing in the documentation. I was a witness to testify that she had seen him physically assault me from my son. The judge learned that, and then writing there was no domestic violence which were eligible under what law he was.

HealthLand: What are your next steps?

Giordano: I need a lawyer to file this appeal ASAP. I had to borrow money for an attorney so I'm looking for pro bono. Outlawyered [Snyder] me like crazy. He left with everything.

I'm trying to do steps to regret. I believe that everything happens for a reason. After I get my children or get to keep them, I would like to see legislation enacted to protect people who are sick of losing their children.

HealthLand: What's your prognosis?

Giordano: Unknown. This is what makes the evil judge comfortable. No one knows. People live for five years, 10 years, more time. I get so many emails, saying: "I have stage 4 cancer and I raised my children." Emails are a great upside.

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Gay men are twice as likely to have Cancer

It does for an Adult Erotic Gay Video title, but are really more gay likely to develop cancer? A new study published in the journal Cancer found that gay men were almost two times more likely to report a cancer diagnosis than men to right. But why?

The study has not responded to this question. It is unclear, for example, if gay men were more likely to develop cancer than men of right, if they were more likely to be diagnosed or are they more likely to survive and to report to it.

Similar data for women found no difference in the rate of cancer by sexual orientation; However, the study concluded that lesbian and bisexual cancer survivors were more likely to self-assessment of fair or poor health than heterosexual women. State of health does not differ by the sexual orientation of men.

Researchers led by Ulrike Boehmer of Boston University School of Public Health analyzed three years data on more than 120 000 adults who completed the California Health Interview Survey. Among other issues, respondents were asked about their sexual orientation, and if they had never been diagnosed cancer.

51 000 Men, approximately 3,690 reported having had cancer: they represented 8% of gay men and 5% of the men of right. the increased risk among gay men is not due to other factors like race, income level or age.

Among 71 000 women, 7,252 reported a diagnosis of cancer, but the rate of diagnosis is the same regardless of sexual orientation. But who identified lesbian or bisexual women were more than twice as likely to fair health or bad report that straight women after surviving cancer.

Once more, the study did not delve into the reasons for the disparities in cancer diagnosis rates, but the authors say that the gay community is more vulnerable to cancer risk factors. For example, gay men and lesbians are more likely to abuse alcohol that their straight peers - they are known contributors to cancer and smoking.

Gays and lesbians are also less likely to get routine cancer screening and balances grounds of discrimination seen doctors, said Liz Margolies, Executive Director of the National of LGBT Cancer network.

The highest rates of HIV infection among gay men than men of right could also contribute to explain the difference: HIV patients have a higher risk of anal, lung and testicular cancer and Hodgkin's Lymphoma (HIV status was outside the scope of the étudeCependant).

Another factor that may affect health in the LGBT community is "minority stress," lead author Boehmer said, referring to psychological stress endured by the minority groups of prejudice or discrimination. MyHealthNewsDaily reported:

"it has been my experience that the quality of life that lesbians report after a diagnosis of cancer does not reveal as much on the specific diagnosis, but on our life experience in General, more particularly when facing a major crisis of life" as a diagnosis of cancera change in relationship or job loss, said Linda Ellis, Executive Director of the Atlanta Georgia Lesbian Health Initiative, which did not participate in the study.

It is not that lesbian or bisexual women walked more depressed than their straight peers, said Ellis. But each new outgoing person, be it the new nurse at the clinic of chemo or members of the cancer support group, took a lot of energy, she said. ... In addition, he is not unusual for Lesbian or bisexual women have broken ties with the family, this natural circle of a support person can be weakened, she said.

The current was not designed to measure the potential contributors to the risk of cancer and health in the LGBT community. But the results suggest that public health officials should pay more attention to the gay, Lesbian and bisexual population - especially when it's screening and prevention of cancer.

In April, a report by the Institute of medicine proposed to include sexual orientation information in medical records and studies of the Government as a means to increase the understanding of the health risks that may be specific to the gay and lesbian community.

"At a time when lesbian, gay, bisexual and transgender individuals - often referred to as the acronym LGBT umbrella - become more visible in society and more socially recognized, clinicians and researchers are faced incomplete information about their State of health""," said the report.

South Korean study suggests autism rate may be underestimated (Time.com)

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In the first large-scale study of its kind, U.S. and South Korean researchers report that the rate of autism spectrum disorders (ASD) may be significantly higher than previously thought, affecting as many as 1 in 38 children. The findings suggest that many youngsters may be going undiagnosed and untreated for the developmental disorder.

In a study that involved students in both special needs and regular elementary schools in the Ilsan district of Goyang, South Korea, scientists led by Dr. Young Shin Kim at Yale University School of Medicine found that among 55,266 children aged 7 to 12, the rate of ASDs was 2.64% (or one case of ASD for every 38 youngsters). That percentage outstrips the current U.S estimate of 1 in 110 eight-year-olds - around 1% - a rate that has itself risen in recent years.

(More on TIME.com: Brain Size, Early Growth: Clues to Autism's Causes)

The higher rate in South Korea does not mean that autism spectrum disorders are on the rise, the authors say. Rather, it reflects a better estimate of cases based on a more inclusive method of collecting data. "These children didn't just show up overnight," Kim says. "They have been there all along. We just didn't count them."

In the U.S., the Centers for Disease Control and Prevention (CDC) re-evaluates autism prevalence every two years by looking for autism diagnoses, as well as documented behavioral symptoms typical of the disorder (even without a diagnosis), among a sample of 8% to 10% of the nation's eight-year-olds. In order to turn around the surveillance data quickly, researchers count only existing cases of ASD or related symptoms noted in the children's medical records.

Such frequent surveying keeps researchers up-to-date on the changing incidence of autism disorders, say public health officials. But because this method relies on documented cases, it misses children who have not yet been diagnosed, and may underestimate the true prevalence of the condition. "We continue to say with every report from our network that our figures are likely an underestimate," says Dr. Marshalyn Yeargin-Allsopp, chief of the CDC's developmental disabilities branch. "We can't tell you magnitude of the underestimate, but we can tell you that it's likely an underestimate."

(More on TIME.com: Detecting Autism Early With a 5-Minute Questionnaire

Kim set out to figure out exactly how large that gap was. Her group sent a 27-item questionnaire to all of the parents of elementary school children in Ilsan. The questionnaire, which took five minutes to complete, was designed to identify children with any potential social and developmental delays typical of ASD. Once these children were flagged by the screen, they were brought in for further evaluation and possible diagnosis.

By conducting such a broad-based survey of the general population, the scientists likely recorded the most accurate estimate of autism prevalence in school-aged children to date, say experts. Among children enrolled in regular schools - not including those already in special education or disability registries - the researchers found a rate of autism of 1.89%, nearly double the rate in the U.S.

The researchers say they would expect to see similarly high rates of autism emerge in the U.S. and elsewhere if the same data collection strategy were used. "The kids picked up in Korea, many had never been recognized in medical records as having autism," says Geraldine Dawson, chief science officer for Autism Speaks. "That's what needs to be done, that kind of broad screening."

(More on TIME.com: Mind Reading: How to Live Well on the Autistic Spectrum)

The findings suggest that many children in mainstream classrooms who are currently having difficultly concentrating or focusing on their lessons may be unknowingly struggling with an autism spectrum disorder. In South Korea, these children - most of whom had a milder form of the disorder, according to the study - may blend into the classroom more easily than they would in the U.S., because classes in Korea are more structured and learning tends to be focused on rote memory. Such rigid lesson plans may actually help autistic children concentrate better and improve their ability to pay attention. "There are few transitions, and the school day doesn't have many surprises," Roy Richard Grinker of George Washington University, one of the study's co-authors, said in a telebriefing with reporters. "Many kids with autism who are doing well can adapt to that highly structured environment and may not be flagged with having any particular problems."

Still, says Kim, there were a fair number of children in the study who were struggling, if not academically, then socially. "These children in Korea were definitely having difficulties in terms of their social relationships and peer relationships," she says, noting common problems encountered by children with autism. "They didn't have friends, they were picked on, and they seemed not to fit in; they weren't invited by their friends or didn't participate in many activities outside of school."

That's why getting a more accurate reading of the rate of autism in the community is important, says Dawson. Even if children with milder ASD symptoms are able to get by in school, they may face challenges later. "Some children, when they leave school and go to a job interview, or start to interact with other adults, may begin to struggle and need services," she says.

Early diagnosis and early treatment can help, Dawson says. If children receive behavioral treatments early, it may help reduce or control symptoms and increase their chances of growing up to be independent and functioning adults. Researchers have recently reported success in using brain scans or simple developmental questionnaires to identify the first signs of developmental abnormalities in children as young as age 1.

(More on TIME.com: A Little-Known Problem in Children With Autism: Wandering Away)

Kim stresses that the results of her study shouldn't alarm parents into thinking that autism has suddenly exploded in schools. "It doesn't mean there is an increase in new cases," she says. "We just didn't know how to find them and diagnose them. Now we know there are kids with social problems who are not being treated, and we know how to help them."

Although Kim and her colleagues expected to uncover a higher rate of autism by looking for it in a broader population of youngsters, the extent of the increase still came as a surprise. "We knew we were going to have a little higher prevalence than previous studies because we were including a new population in our analysis," she says. "But to find it in 1.89% of children was a huge surprise to us. We looked at all possibilities to see if we had made an error."

They had not, but their results will need to be replicated and confirmed by other researchers. Meanwhile, autism experts are already hoping that the same population-based screening method can be applied to American schoolchildren to get a better account of how common autism is in the U.S.

"We have a portfolio of research for our surveillance and research activities," says Yeargin-Allsopp of the CDC. "This is certainly part of that and is a method we talked about. We realize it can complement what we are currently doing."

(More on TIME.com: Closely Spaced Pregnancies May Contribute to Autism)

Such population screens are expensive and labor-intensive. The South Korean study, which was funded by Autism Speaks, the National Institute of Mental Health and several foundations, took five years to complete. But, says Dawson, it's the best way to figure out the true rate of autism among schoolchildren. "We just don't know yet in the U.S. how many kids have autism. And we won't have a good and accurate estimate of that until we use this same approach that includes all children in a population, including those who might not already have received a diagnosis," she says.

The study is published in the American Journal of Psychiatry.

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