What is causing the “Autism Epidemic”? Maybe.. noithing
August 30th, 2008
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Every time I write a post about vaccines and the whole issue of the claim that they cause autism I tend to end up with a lot of feedback demanding that vaccines MUST be causing autism because autism rates are rising. It used to be the bulk of the claim that it was “mercury” in vaccines, due to the fact that a trace preservative compound (thimerosal) contained a mercury atom. Now that most vaccines don’t contain it anymore, the new claims tend to involve claims of aluminum, toxic chemicals, auto-immune responses and so on. The MMR vaccine has also been blamed, possibly because it is administered around age three, approximately the same time that autism normally becomes diagnosable.
Thus, the battle cry becomes “Well, if it isn’t vaccines then what the hell is causing the rise in autism rates???”
But to answer this question, the first thing that must be asked is whether the rates of autism are rising. At first glance, it sure looks like they are:
But I think we might need to stop and consider something here. What autism has come to mean in recent years, as both a diagnosis and a condition has changed quite a bit. Autism is a social disorder with varying degrees of severity and many who are diagnosed with autism or “autism spectrum disorders” today are not nearly as disabled as what has become the classic image of an autistic child of years past. A severely autistic person is generally not able to function in society, at least without sticking out like a sore thumb. They tend to be profoundly socially inept, incapable of relating to others, express extreme difficulty communicating and have trouble maintaining self-control or understanding information presented.
Yet today many who are diagnosed as autism spectrum disorders don’t seem like this at all. These individuals may generally appear to be normal, if perhaps a bit inept socially or reserved. Such individuals are diagnosed in a modern society and medical community that no longer reserves the term for the most sever individuals and is far more willing to diagnose the issue, and according to some, possibly over-diagnose it. In years past, someone with an autism spectrum disorder might have gotten a less clinical label like “kinda shy and awkward” or “a bit of a dweeb.”
But what of those who clearly have full blown autism? Surely they could not have been hiding all these years just to be noticed recently. Well, I happened to find an excellent page that presents an intriguing explanation. Perhaps these very disabled individuals were placed in another category in years past:
Yes, the graphs are nearly perfect mirrors, and when the two are added together and adjusted for the general decrease in disorders the relationship becomes even more dramatic, indicating that the rate of retardation and autism combined is nearly perfectly linear in prevalence in the population. This actually should not be a surprise because autism has been known for some time to be a hereditary condition that has not been linked to enviornmental issues.
That being said, there is the potential that the condition could become expressed more or less dramatically due to enviornmental factors, like socialization or stress, especially in border-line cases. I’m not a doctor or a psychologist, but I did happen to grow up with a condition myself. In my case, it was ADD and a touch of dyslexia which I have since (mostly) grown out of. Based on this my feelings on the whole issue is that parents should not make an unnecessarily big deal about it. If a kid is diagnosed with an autism spectrum disorder that is not profound and disabling, then offer them any support they need, but don’t make it a huge deal; don’t make them feel like they’re badly disabled; don’t make it seem like they’re different than everyone else or that they have some kind of problem that makes them less capable than others or means they need special services to get along. Again, this is not medical advice or anything, but my experience is that insisting that a kid be constantly singled out and reinforcing the idea that they have some kind of problem really does not help at all with their own self-confidence or social development.
This entry was posted on Saturday, August 30th, 2008 at 2:35 pm and is filed under Bad Science, Good Science, Quackery. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
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August 30th, 2008 at 2:47 pm
Excellent information! I suspected it was always there, but if anything is causing an apparent amplification of preexisting social problems I think it might be cultural. Maybe the less mild cases were not noticed in normal kids because they used to gain more social skills and work this stuff out more naturally. (and no I’m not starting a natural is good artificial is bad debate). The fact is that now both parents work most of the time and as soon as a woman has a kid the first thing she wants to do is figure out how soon she can get back to her full time job. I’m not blaming women though, because men are just as bad. Having two committed parents? ha! Kids are lucky to get one half-committed parent.
These days the way to shut up kids is to have a DVD player in every car with the kids pacified like zombies watching sponge-bob so they don’t make noise being driven around. When I was a kid, I poked my sister and she argued with me and I looked out the window and asked mom what the big truck was and that kind of thing. Yes, it would be more annoying but it was a two-way thing and I learned to work out problems and interact and everything. I sure was not constantly watching television or on the internet or in an impersonal daycare. I was out with my friends, often getting scrapes and bruises, which my family didn’t even make a big deal about!
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August 30th, 2008 at 5:16 pm
Statistically, an increase, in and of itself, might not mean anything if you have a changing definition of what defines your y variable over time. Clearly, autism’s diagnosis and definition has changed over time as the medicine has refined its ability to understand what it actually means to be “autistic.”
I would be much more concerned about vaccines if we saw an increase in something where the diagnosis has remained the same since 1993, like leukemia. It’s pretty easy to count cases of leukemia, and there has been little shift in the definition of the disease since our t = 0 point on that graph.
One thing that would also really cause concern is if vaccinations per capita had increased since t = 0. I’m inclined to believe that vaccinations per capita have remained constant since t = 0, suggesting that what you’re seeing is a lot of people regressing a horizontal (or even slightly decreasing) line on a slightly upward line.
It would be interesting to see what happens if we regress per capita vaccination on an amalgamated retardation + autism y variable, assuming that the amalgamated y variable captures the broad range of developmental disorder afflicted children, instead of going after a variable whose definition has shifted over time.
If, in that case, there is a statistically significant relationship, we might **** our eyebrows for a second. Even then, you might be seeing a spurious correlation, as vaccinations also tend to increase per capita with affluence. Then again, so does better medicine and diagnosis, so you have to control for that as well!
Not an easy thing to figure out, even if people think they have found the smoking gun.
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August 30th, 2008 at 5:24 pm
For the record, the word that was ****ed out was “kock” with a c. I suppose a good alternative would be “raise.”
Carry on.
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August 30th, 2008 at 5:32 pm
Autism Spectrum Disorder is distinguished by pattern of behavior rather than one single symptom. The main characteristics are impairments in social interaction, restricted interests and repetitive behavior. However if one looks at these ’symptom” closely we can see that they can also be described as able to work alone, can concentrate, and can stay on routine. And in fact several people that would be diagnosed as on the spectrum, are not only fully functional, but valued by there employers for just those traits. I have know several people working in high-tech over the years that manifested all of the symptoms, were almost devoid of social skills, impossible to interact with nominally, but whose companies depended upon. And this goes back thirty years.
What was happening is that these folks live isolated lives, saying forever with aging parents, or by themselves in relative isolation. But the internet has changed all that and these people are getting together, getting militant at what they feel mistreatment by neurotypicals (a term they coined), and hooking up with each other. I understand there are school districts near Silicon Valley with huge numbers of autistic student whose parents work in high tech.
Of course people can be seriously handicapped by this condition, and I am not trying to suggest otherwise. But there is a community, that self-identifies, and has no more interest in being ‘cured’ then members of the gay community do, and as demanding to be accepted as is, and valued for their contributions to society.
As for misdiagnosing mental retardation as autism, I believe it. A physician facing distraught parents may well find that calling it autism lessens the blow especially in communities where the term mental retardation invokes more ridicule than sympathy.
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August 30th, 2008 at 5:45 pm
DV82XL said:
Or perhaps vice-verse where a severely disabled child in the past may have been rubber-stamped as restarted. There may be more than one issue here with misdiagnosis.
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August 30th, 2008 at 11:58 pm
DV82XL said:
I disagree about autism spectrum disorders being something that makes people become isolated. Yes, there are people who are severely autistic and handicapped by it and can’t communicate and can’t live like a normal person. My nephew is now 22 and in college and he was diagnosed with Aspergers (sp?), which is an autism spectrum disorder and I know him and his family well because we live in the same town. He is very social and seems very normal. He is very social. When he was a young child he was very quiet and he got very shy when people wanted him to talk, especially that he didn’t know. He seemed like he had stagefright when ever people talked to him he’d be very shy. He was not shy with people he knew well. He had friends in school and everything, but he was a little goofey not in a bad way . I do not know if this is enough to call someone autism-spectrum disorder because I am not a doctor. It just seems to me like a nerdy kid but this is apparently what is considered an ASD these days? I don’t know. Not everyone with it has the same thing.
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August 31st, 2008 at 12:08 am
DOUG AK said:
That’s my whole point, that was the way it was, now things are different.
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August 31st, 2008 at 12:20 am
Well, there are certainly people profoundly disabled by autism, but for those with “spectrum disorders” I’m wondering if we might be getting a little diagnosis-happy. Most mental conditions don’t have a really hard line between normal and a disorder.
Every person worries about things, but when does it become a stress disorder? Everyone gets some anxiety in certain social situations but when is it a social disorder? Everyone has highs and lows, but when is it manic depression?
There are some people who clearly have a mental disorder but there’s a large gray area. There are a lot of times when the question of a disorder becomes subjective. For example: When does a kid have ADD versus the fact that all kids get distracted and don’t have an infinite attention span?
I’m wondering if we are getting a bit diagnosis-happy in this society. I don;t know one way or the other, but I’m just speculating that these days there are a lot of people who might go looking for a “disorder” to explain why their kid is sometimes upset or not always 100% social or something. It might have been chalked up to “he’s kinda shy and a quiet kid” in the past. It could be muddying the waters between who has a real disorder and who is just borderline and doesn’t really need to be treated like they’re handicapped.
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September 2nd, 2008 at 4:00 pm
Improved neo and prenatal care may reduced the numbers of children born with mental retardation. There also appears to be some correlation between premature birth and autism. As the quanity and survival rate children born prematurely increase autism will also increase. So the same technologies that are reducing retardation may be increasing autism.
Personally I like the idea that IT and the internets have enabled the “autistically recessive” to meetup and have children. But it is too simple an explanation and therefore likely wrong. It might be fun to throw together a chart with a slope showing incidence of children born to families where both parents have a degree in computer/math/science/engineering.
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September 2nd, 2008 at 4:10 pm
The Americans with Disabilities Act has caused a lot of this. If you can come up with some “disability” then it becomes illegal to “discriminate” against you.
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September 2nd, 2008 at 4:18 pm
JParker said:
Speculation is fine, but it must always be separated from fact and a hard wall placed between what we know and have evidence for and what we think might be the case.
Lets therefore not forget that we have no proof or compelling evidence for this, but it is simply a rough hypothesis that some may favor as being a likely apparent source.
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May 17th, 2010 at 4:11 am
Your argument is misleading. Autism’s behavioral qualities are severe and specific. They are not easily misdiagnosed or over-diagnosed. Retardation is obviously not autism: retarded children are socially interested, for instance, and they tend not to bang their heads on walls or repeat cyclical behaviors endlessly. And no parent, doctor or teacher searches for a autism diagnosis.
Also, the statistical rise of autism is not on one scale alone. Asperger’s Syndrome is on the rise and so is autism, but the two diagnoses are not now being combined into one statistical unit.
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