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March 25, 2006

Autism Epidemic?

So campaigners are claiming that there is an autism epidemic, something that may or may not be happening.

Liam Byrne, the health minister, said that 6,170 children under 16 had been diagnosed in England last year, compared with 3,100 in 1997-98. The number of cases including adults rose from 4,220 to 9,170 in the same period.

The numbers are up so how can I claim that it may or may not be happening?

However, the Government and bodies such as the Medical Research Council believe that the increase can be attributed to better diagnosis and changes in the way autistic spectrum disorders (ASPs) are defined.

For example, many children previously diagnosed as having attention deficit hyperactivity disorder are now being defined as autistic.

The National Autistic Society said: "We suspect that much of the increase can be put down to the fact that people are more conscious of the condition."

I tend to side with NHS Blog Doctor on such things. Leaps in diagnosis don’t actually mean rises in the specific problem. It can be changes in the definitions of a disease (like with ADHD) or as above, people becoming more aware of it.

As part of some paid work I do elsewhere I’ve had to read quite a bit of Simon Baron-Cohen’s work on the subject. His thesis is that autism is an extreme form of the "male type" brain. As men are more likely to be systemizers than women (and women more empathic than men), then, something like autism or Asperger’s, where people are excessively interested in systems and almost unaware that empathy itself even exists, well, an interesting thought, eh, that this group of diseases (? diagnoses perhaps) is simply an expression of an extreme form of this.

It also ties in with one explanation of the greater variability of men in almost every genetic condition (a la Larry Summers), that the Y chromosome is such a runt that if there’s something wrong with a chromosome on the single X we carry then we don’t have the alternative to cover up. Women do, making them, gentically, the stronger and less variable sex.

The genetic explanation rather falls down in the face of one mooted reason for the formation of what Baron-Cohen calls the "male"and "female" type brains (and men and women can have either) which is exposure to foetal testosterone. Or should that read exposure to testosterone while a foetus?

No, I’m not a geneticist so this is of course only mildly informed speculation.

To go on to be wildly less informed:

Some campaigners talk of an autism epidemic and blame factors such as pesticides or childhood vaccinations.

The vaccinations one has been pretty well debunked I think, that MMR story and so on. Pesticides? Ah, c’mon, the amount of synthetic pesticide in our diets is so tiny as compared to the natural ones that it’s horribly difficult to believe that they have any effect whatsoever (with the obvious exception of people who’ve actually been sprayed with the stuff).

Personally, on the basis of no evidence whatsoever, I think that at least part of the rise in diagnoses is that what in the past would have been regarded as simply "a little odd" is now a disease or a syndrome. Just as behaviour which a generation ago would have been regarded as "boys will be boys" is now ADHD, something which must be drugged out of them. One explanation of which out there is the "feminisation of society".

March 25, 2006 in Health Care | Permalink

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Comments

Baron-Cohen argues, IIRC, that because we mix in wider circles now, we are more likely to marry someone with similar likes to ourselves, so nerds will marry nerds and produce supernerds with autism. There's a name for this idea, which I've completely forgotten.

Posted by: Rub-a-dub | Mar 25, 2006 12:29:29 PM

Theory; Autism isn't on the rise because of the feminisation of society. It's on the rise because the more sensitive of people are hiding inside their own heads instead of dealing with the hideously loud sensory impedimenta that modern society throws at them. TV, radio, gaming, advertising, pow pow pow all the stimuli just don't stop coming. It's impossible to tune everything out. They just need more peace, so they find it where they can.

Test of hypothesis - incidence of autism in rural as opposed to urban areas? Influence of healthy diet? More stats please.

Tim adds: Interesting, yes, but the very point about autism is that people appear to be insensitive to the feelings of others.

Posted by: auntymarianne | Mar 25, 2006 4:27:54 PM

There's a name for this idea, which I've completely forgotten.

It's assortative mating, coupled with increased mobility. This is somewhat related to the theory that geeks have better paying jobs now and are more likely to marry.

These theories don't explain the numbers though, nor do any environmental trigger theories. Taking California as a reference, it is pretty clear there is no autism epidemic.

Posted by: Joseph | Mar 25, 2006 6:17:20 PM

Interesting, yes, but the very point about autism is that people appear to be insensitive to the feelings of others.

That's a stereotype no different to suggesting that blacks like chicken or are good at basketball. Please consider that.

Tim adds: I’m working from Simon Baron-Cohen’s stuff there. His musings on empathizers, systemizers and so on. as far asthere is science in this field that’s my source for it.

Posted by: Joseph | Mar 25, 2006 6:21:50 PM