Much of the rise in autism is likely a statistical mirage | Hacker News Reader

Much of the rise in autism is likely a statistical mirage

geneticliteracyproject.org

68 pointsleephillips77 comments

"Now researchers believe they know what’s responsible for the bulk of the rise: Nothing. Much of the rise in autism is likely a statistical mirage."

I've kind of always thought this, ever since I read a tumblr post about how the sudden change in toddlers would have been called "my child being switched with a changeling", and other such tales.

Also, I think most of pre-industrial life would have been more bearable for autistic people: No sudden noises like ambulance sirens, solid routine and repetitive jobs, not as many large crowds.

> tumblr post

Was it this one?

https://writingonthecastlewalls.tumblr.com/post/181877541942...

In many old books there is some form of 'Larry, he never leaves the farm.' We will never know what Larry had, but the meme was common enough several hundred years ago.

Hey there! I tried to google this but just found another one of your comments from a few months ago haha, any chance you could share some examples?

To kill A Mockingbird. Been about 30 years since I read it, but there was the guy who they concluded just liked to stay home. Or something like that, as I said been years. Many other books written in the 1800s have something similar.

Not quite sure what the parent comment is referring to either but it made me think of Lennie from Of Mice And Men. Lennie just likes to pet things on the farm

There’s a similar thing with ADHD, i think, also allegedly on the rise and alarming people: modern life is just a lot more distracting, and we have so many more things in our lives that disrupt concentration that you can’t really say with certainty that people who are adhd weren’t just far less likely to fall through the cracks before.

Ironically, it’s likely adhd people (and other neurodivergent people) who basically built that modern world that’s no longer particularly well suited to us (or at least to us being employed).

There is circumstantial evidence that in pre-industrial Europe, many autistic people were sent to become monks or nuns. It's impossible to prove now, but some of them probably would have fit in fairly well with those communities.

OT, but thanks for summarizing the article in one sentence. How I yearn back to the days where it was considered good form to use headlines as a summary instead of an invitation to click.

From the abstract of the cited study: "Changes in reporting practices can account for most (60%) of the increase in the observed prevalence of ASDs in children born from 1980 through 1991 in Denmark."

In other words, 40% of the increase could not be accounted for changes in reporting practices. That's quite a bit and not consistent with the tone of the essay.

One has to be careful with these types of arguments, at least in the US, because clinicians tend to use different diagnostic standards, especially with things like autism. If they don't fit one definition, they use a "not otherwise specified" or "not elsewhere classified" diagnosis. That is, even if the DSM or ICD or whoever changes its criteria, it doesn't necessarily impact clinicians, who might have been using a different standard all along.

That article was a bloated mess, and the author seemed to have it out for conspiracy theorists.

tl;dr is expanded diagnosis criteria and relaxed reporting requirements.

Over half of the article is a polemic preamble against various theories, that usually means they don’t have a good case (not sure in this instance). Diagnostic substitution and increased diagnosis probably account for some of the increase. Even if 60 percent of the increase is not real, there still is a very large real effect that remains unexplained.

> Even if 60 percent of the increase is not real, there still is a very large real effect that remains unexplained.

A major plausible proposed cause that didn't get a mention is assortative mating (the effect may not be strong enough to account for all the remaining increase, though):

https://pubmed.ncbi.nlm.nih.gov/31200929/

In short: This is an 'epidemic' of diagnosis, caused by expanding the definition, not an actual increase of cases. From requiring full set of signs and diagnosis before age 3 to allowing anything on the spectrum and any age, that immediately qualifies many cases who wouldn't begin to qualify in the '80s, and of course awareness by physicians and parents also increases diagnosis.

It's good to see a team really examine a good and huge dataset and apply some proper science.

Yeah, I've seen some people here say things like "adhd and autism is the same thing", which is ridiculous if you are used to what qualified as autism and adhd in the 80's.

Nowadays it seems like all you need for an autism diagnosis is that you struggle in social situations. But I've seen a class of autism/asperger cases in the 80's, they started speaking very late as kids, have strange walking styles, don't run smoothly so run way slower than you'd expect for their size, are bad at sports for the previous reasons, have strange/unnatural sounding speech/voice etc. Many of them still do very well in school however. Compare that to adhd, who have none of those problems but can't direct their attention properly and therefore have problems in many social situations where you need to be patient, class at school being the major one, there is no way you'd mistake one for the other.

I'm skeptical of the "it's just selection criteria"

When the Somalis came to settle in Minneapolis, they called Autism the "Minnesota Disease".

Now, that could be because it was suddenly diagnosed, but the impression I got is that it was unknown in the homeland.

I also read once that autism tracked cable as it installed into neighborhoods.

All of this is of course unsourced. But I think some of autism spike has a real component and my suspicion is that it has something to do with sun exposure, to link to the other non-coding post of the day: vitamin D, skin cancer, and sun exposure.

https://rtc.umn.edu/autism/ https://slate.com/technology/2006/10/tv-might-cause-autism.h...

Wouldn’t having cable television in the 1980s be a pretty reliable indicator of a family’s socioeconomic status? Which would also be a pretty reliable indicator of the level of care, especially behavioral and mental health care the family could access?

This seems a lot like “increased ice cream sales causes increased robberies” to me.

Your comment about the Somali immigrants and the Minnesota healthcare system reminds me of a really fantastic book I’d long since forgotten called The Spirit Catches You and You Fall Down: https://en.m.wikipedia.org/wiki/The_Spirit_Catches_You_and_Y...

it was unknown in the homeland.

Somalia's child mortality under five is 20 times that of the US - it was, for many years, one of the most troubled spots on earth.

https://data.worldbank.org/indicator/SH.DYN.MORT?locations=S...

You'd still expect to see some autistic people, unless for some reason autistic people died more often. I don't see any reason for that though

Click through to the graph, we're talking about an environment in which nearly 20% of children did not survive to age five. For 30 years.

I read a lot of Pierre Loti books, on rural Brittany pre-industrialization, i can totally understand how non functioning autistic children would die between the age of two to ten more easily than Asperger or non autistic children. In fact, any dyspraxic child in a coastal village would likely drown at a certain point.

Culture plays a major factor in how disorders like schizophrenia manifest. A schizophrenic in the U.S. whose delusions emerge as and regress into debilitating paranoia (e.g. cameras everywhere, government out to get you) might have developed if raised in another society a different set of delusions which could functionally fit into the culture (e.g. classic example is as a spiritualist or oracle; an example which also speaks to our inability to imagine acceptable social roles and modern connotations regarding religious thinking.) And not just different, but less severe delusions. The stress which particularly violent delusions cause--directly (fear) and indirectly (detachment from society)--effect the progression and severeness of the disorder.

I wouldn't be surprised if the same was true for autism.

This makes a lot of sense to me. I've grown up with my feet in two communities, my smaller ethnic community and the greater local community. My ethnic community is really tight, and most people get along with one another. There's a shared kinship, so even the awkward kids are invited to hang out often. I've always felt the 'awkward'(as in seems stereotypically autistic) kids in my ethnic community were a little better at socializing and a little less anxiety-ridden than at school.

I really think having a social environment makes a huge difference in severity of these kinds of things for those that are high functioning. Unfortunately, our greater society isn't very good at being an inclusive community. It's very dog eat dog, and most people don't have strong family and friend networks anymore. It's something that used to be important to humans, and was necessary to survive really. We don't need it anymore and as a result, neglect it. Why wouldn't that play a part in severity and presentation of autism?

See this paper from 2015: "Increasing prevalence of autism is due, in part, to changing diagnoses"

https://science.psu.edu/news/increasing-prevalence-autism-du...

> Autism increase mystery solved?

> No, it’s not vaccines, GMOs, glyphosate—or organic foods

"Gut microbiota and neurological effects of glyphosate"

https://www.sciencedirect.com/science/article/abs/pii/S01618...

-> "Gly impacts on central nervous system and others neurobiological disorders, due to the gut-brain axis."

"Perinatal exposure to a glyphosate-based herbicide causes dysregulation of dynorphins and an increase of neural precursor cells in the brain of adult male rats"

https://www.sciencedirect.com/science/article/pii/S0300483X2...

"Urinary glyphosate concentration in pregnant women in relation to length of gestation"

https://www.sciencedirect.com/science/article/abs/pii/S00139...

1/150 is still quite rare though. i assumed it would be higher given all the attention it has gotten and famous ppl like elon being on the spectrum.

Can a brain scan detect autism? Is it objectively detectable without interviews or behavioral observation?

No, it isn't detectable like that.

At least not yet.

Has there been a study done yet similar to the racial bias in medical imaging study to see if a neural net can detect it?

>similar to the racial bias

can you give pointers please.

I think it sorta is, but those are specifically tests that monitor brain activity when someone is thinking about stuff. Autistic brains are like a bit less organized in where thoughts happen or something like that iirc

Like most "brain" problems, like schizophrenia, ADHD and bipolar, the answer is no.

There is no imaging or biochemical test to diagnose any of these conditions.

It all comes down to whether someone with authority likes the "patient" and deems them "worthy of life".

I’m not a woke SJW or anything, but man I absolutely HATE this kind of language from the article - “Mothers are understandably concerned”. Sexist and demeaning to men, no different than the commercials that still play on the “omg a father is trying to do something with his young child, disaster will ensue” trope.

The writing in the article cringey and trite.

Inb4 "no double-blind vaccine studies have been done" and "chelation therapy/the Andy Cutler protocol cured my autism-like symptoms, which turned out to be chronic mercury poisoning all along according to my pet 'mercury-literate' doctor".

How about tv?

That is to say, this evolving technology for delivering illusions. Books, radio, tv, internet, videogames. More and more accessable and popular. More and more people spending a large part of their day focused on tiny illusions dancing in their head.

That seems like a good cause for autism.

Just wait till vr ramps up. The whole population is gonna check out.

And yes, I'm thinking that it propagates to the tv-enthusiast's fetus.

I'm sure you're going to get downvoted, but I do agree with Jerry Mander's ideas back in the day about how television can't be reformed and might be causing many of these issues that are prevalent in 2022.

It's been a long 5 year journey to break free from most of it and it's hard given I work in big tech, but my attention has come back and I'm able to do much more than I ever thought before. All because I ditched television and most importantly consumerism of digital media.

I moderate as much as I can and still have much more work to do. Progress!

Happily, VR should work in the opposite direction to books, TV and the internet.

In addition to some games involving intense cardio work, it also forces the brain to constantly judge distances and using your arms and hands to interact with visual stimuli keeps you engaged while transferring attention between objects and concepts.

At least, that's the thinking. I don't have a source to prove any of that.

> Happily, VR should work in the opposite direction to books, TV and the internet.

[snip details]

> At least, that's the thinking. I don't have a source to prove any of that.

You have a very narrow conception of games that will be played in VR. I rather imagine that 3D immersive environments will be popular for many sorts of activities, including ones diametrically opposed to your exemplars, such as puzzle type games that reward hyperfocus, voyeuristic immersive drama and reality shows (algorithms like NERF are about to make converting SPoV video into 3D environments and content straightforward), and narrative heavy interactive fiction.

I'm not at all certain what genres and formats will prove popular, particularly with the general public, but I'm pretty sure that none of it is going to save people from their own impulses and obsessions.

“The drawers, he knew, were full of beetles. Hundreds of thousands of beetles. He was free, now, to do nothing with his time but study them, sketch them, annotate them, classify them: specimen by specimen, species by species, decade after decade. The prospect was so blissful that he almost keeled over with joy.” — Greg Egan, Permutation City

Puzzle games that reward hyperfocus and minimal-movement and minimal-thinking are always always going to be preferred to be played on other platforms than VR, mostly because of the convenience factor but also because of VR's anti-convenience factor of a heavy weight on your face, lenses fogging up, etc. These issues are never going away.

I feel like the rest of your comment kinda proves my point more than it proves the opposite? Forcing yourself to engage in cerebral activities simultaneously utilising different motor, language and problem-solving skills is GOOD.

I'll say though that quoting Greg Egan is putting the cart before the horse, because his brand of end-point transhumanism sorta assumes that we WON'T destroy ourselves through Huxwellian dystopias before getting to that level of technology.

Read Egan's Zendegi for a more realistic take for how that technology integration will go down.

Desire runs the world. The future consists of progress in our ability to realize our desire. I think we can agree on that.

2 ways to realize desire. 1) Impose my desire upon the real world and 2) create a fantasy.

The second is easier.

So the future (for everybody but scientists, mystics and other such weirdos) is a deeper dive into fantasy.

We busily work to that end.

> Forcing yourself to engage in cerebral activities simultaneously utilising different motor, language and problem-solving skills is GOOD.

I'll concede the point, because I wasn't contesting the utility, but the popularity.

Ah yes, the more verbose version of "IT'S BECAUSE YOU'RE ALWAYS ON YOUR DAMN PHONE!"

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