J Autism Dev Disord DOI 10.1007/s10803-014-2160-4
BRIEF REPORT
Brief Report: Trends in U.S. National Autism Awareness from 2004 to 2014: The Impact of National Autism Awareness Month Elizabeth A. DeVilbiss • Brian K. Lee
Ó Springer Science+Business Media New York 2014
Abstract We sought to evaluate the potential for using historical web search data on autism spectrum disorders (ASD)-related topics as an indicator of ASD awareness. Analysis of Google Trend data suggested that National Autism Awareness Month and televised reports concerning autism are an effective method of promoting online search interest in autism. Keywords
Autism awareness Web 2.0 Google trends
Although many experts believe that observed increases in the prevalence of autism spectrum disorders (ASD) are at least partially due to increased awareness (Elsabbagh et al. 2012), this has not been substantiated with empirical data. We sought to evaluate the potential for using historical web search data on ASD-related topics as an indicator of ASD awareness. In December 2013, over 67 % of all Internet search queries in the U.S. took place on Google, making it the most popular U.S. search engine (comScore 2014). Trends in Google search patterns may be useful indicators of national interest and awareness in health-related topics (Lee 2010). We examined web queries for the search terms ‘‘autism’’ and ‘‘Asperger’s’’ from January 2004 through April 2014 within the United States using the Google trends tool (google.com/trends). We also conducted a Google trend search for ‘‘ADHD’’ to assess overall public E. A. DeVilbiss B. K. Lee (&) Department of Epidemiology and Biostatistics, Drexel University School of Public Health, 3215 Market St., Philadelphia, PA, USA e-mail:
[email protected] B. K. Lee A.J. Drexel Autism Institute, Philadelphia, PA, USA
interest in mental health issues of special interest to the younger population. We observed increases in Google search popularity for autism corresponding to every April from 2004 to 2014, except April 2005 (Fig. 1). Over the 10-year period, the increase in search popularity for ‘‘autism’’ from March to April averaged 26 %, followed by a 24 % average decrease in popularity from April to May. The greatest March to April increases have been consistently observed from 2007 onwards, with an average search popularity increase of 33 %. Additional, but smaller, increases in autism Google search popularity have been consistently observed in the fall of each year. The greatest search popularity for ‘‘autism’’ within this period was observed in April 2008. The single largest monthly increase was 80 %, observed from August to September 2007, while the second largest monthly increase was 55 %, reported from January to February 2005. Overall, there was sustained but not increasing interest in ‘‘autism’’ over the time period. In contrast, there was an overall increasing trend for ‘‘Asperger’s’’, with search popularity in January 2014 255 % search popularity in January of 2004. The highest peak in search popularity was evident for December 2012, an increase of 122 % over November 2012. Of note, seasonal trends similar to those observed with ‘‘autism’’ were observed for ‘‘ADHD’’, with noticeable increases in the spring and the fall. However, peaks were not evident for April, since the average increase in search popularity for ‘‘ADHD’’ from March to April averaged only 2 %. The peaks in autism interest every April are likely the result of the designation of April as National Autism Awareness Month in the 1970s. The largest overall peak in autism interest in April 2008 could be the result of the December 2007 designation of April 1st as World Autism Awareness Day by the
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Fig. 1 Google Search Trends in the U.S. The figure displays Google search trends for the following terms: ‘‘autism’’, ‘‘Asperger’s’’, and ‘‘ADHD’’ from January 2004 to February 2014. On a normalized scale from 0 to 100 (divided by 100, for the highest point on the
graph) points on the graphs reflect relative search frequency—in other words, how many searches have been performed for the particular term, relative to the total number of searches done on Google. Data Source: Google Trends (www.google.com/trends)
United Nations general assembly. The largest monthly increase in public interest took place in September 2007, which corresponded to a September 18, 2007 segment on The Oprah Winfrey Show featuring celebrities Jenny McCarthy and Holly Robinson Peete in regards to their affected sons (The Oprah Winfrey Show, 2007). The additional peak took place in February 2005, corresponding to a 10-part series on autism featured on The Today Show February 21–25, 2005 (The Today Show 2005). The increases observed in the fall (for autism and ADHD, and Asperger’s to a lesser extent) may be due to a number of seasonal factors. For example, fall is the time of year in which children are reporting back to school, and teachers may be more likely to notice differences in behavior at this time, following a summer break, as compared to the remainder of the school year. Search trends observed for ADHD may also be influenced by events that influence search popularity for autism, since autism and ADHD are often comorbid. A recent
study of over 14,000 children in the UK indicated that 19.9 % of children with ASD also had ADHD, while 24.1 % of the children with ADHD also had ASD (Russell et al. 2014). Given that ASD and ADHD may present similarly in young children, caregivers may search for both terms to find information. The predominant peak for Asperger’s disorder occurring in December 2012 corresponded with heavy publicity regarding the elimination of the disorder as a standalone diagnosis from the DSM-V. Since the trend in ADHD online interest during this period is relatively constant, the apparent increase regarding Asperger’s disorder between 2004 and 2014 does not appear to be due to an overall increase in online interest in mental health issues more broadly. In conclusion, the data suggest that Autism Awareness Month is an effective method of promoting online search interest, similar with what has been observed with annual
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breast cancer awareness campaigns (Glynn et al. 2011). The peaks for online search interest in autism in April do not appear to be due to general interest in mental health issues of relevance to the younger population. The data also suggest that televised reports on autism influence public interest in the topic, which underscores the responsibility of networks in disseminating factual and clear public health information. For research purposes, historical data on web queries may be an indicator of public interest and awareness that can be used to better understand evolving trends in all aspects of ASD, such as prevalence, diagnosis, treatment, and funding. Conflict of interest All authors declare that there are no conflicts of interest.
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