What's the deal with autism rates?
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A recent study tries to define "profound autism" as "nonverbal, minimally verbal, or IQ<50". They found a significant increase in US children aged 8 from 2000-2016 with profound autism. Non-profound autism increased much more, which makes sense given the broadening of criteria. The study is https://pmc.ncbi.nlm.nih.gov/articles/PMC10576490/
Anecdotally, any speech therapist with a long career will likely remark on a local increase of severe autism cases over the last 20-30 yrs. It's not as "skyrocketing" as ASD stats, but prevalence has likely increased substantially.
Population growth.
The Mental Health Parity Act passed in '96, and another passed in '08[0]. Together this leads to a significant increase in to those with mental health issues being treated. So while broadening of criteria might not be to blame for what you're discussing, the broadening of mental health care coverage might be.
[0]: https://en.wikipedia.org/wiki/Mental_Health_Parity_Act#Issue... [1]: https://www.ajmc.com/view/the-mental-health-parity-act-10-ye...
The changes in medical culture (over just 10y) are why my youngest was diagnosed but my oldest is not.
Kinda spitballing here though.
Male sperm begins to degrade sometimes around 30 iirc.
People having kids around 40 years old are significantly more likely to have offspring with a ton of issues. People are having kids much later, now.
This isnt my theory. It's been discussed at length and a google will give tons of info.
Advancing paternal age was not associated with an increase in risk for either Down syndrome or chromosomal disorders other than Down syndrome.
Multiple neonatal and pediatric disorders have been linked to older paternal ages.
The risk of paternal age has been difficult to estimate and interpret because children often have parents whose ages are similar and likely to be confounded.
For me, the question might be, can we get the data in check? Don't want to go another 20 years and still not be able to know the real data because we kept changing the definitions, the rules around diagnosis, who is eligible to be diagnosed, the cost of diagnosis, etc.
Overall am in strong agreement with you, the main thing is to nail down data and very little seems to be done towards that. I've followed these studies and articles since 2011 or so with increasing dismay. The headline-grabbing stats of "1 in X" growing every year are next to meaningless, and yet I believe much points towards prevalence of actual condition really increasing. But with scandalously amorphous definitions and abysmal longitudinal bookkeeping we don't know and can't know how much it's increasing and in what subpopulations.
- in 2002, 26.9% of the ~2300 cases of autism were 'profound'
- in 2016, it was 24.3% of the ~4800 cases
I must have missed some stuff, but this doesn't seem hugely significant to me?
> Evidence: Special-education records reveal a decline in “mental retardation” and other diagnosis counts with each uptick in autism during the 1990s. This is observed in many areas, at many points in time.
I have seen studies that correlate c-section deliveries with a somehat significant increased chance of autism, so that would track. I was born by csection myself, and both myself and my mom would have died if that wasn't an option.
I've never been evaluated for and am not diagnosed with autism, but given the broadened DSM criteria, it's possible they would have tested me and labeled me with something like that if I had been a kid today. Instead they just settled on "speech disability" and put me in weekly speech therapy for all of elementary school. I'm not sure if having a permanent disability label on me from a young age would have been a good thing to be honest.
I think older age of mothers are correlated with both?
I am skeptical of the idea that a CS itself produces any conditions for ASD. But it would make sense that those who would have otherwise died during child birth and survive are now likely to change present health demographics.
Honestly, a lot of autistic people are doing well in life, and in fact many are doing better than their neurotypical peers. Autistic traits need to be understood better because they provide better understanding of human cognition and its functionality.
1st 8lb. 2nd 8lb, 3rd 10.5lb, 4th and 5th 6.5lb ea (twins). None were c-section.
First 3 were home or birth center, last had to be hospital. My wife had good BMI for the start of each pregnancy.
A friend of mine has 8 childen and none are autistic. All were born at the hospital (this is where you give birth in France), all were notmal weight and so was the mom (and dad)
What led to increased diagnosis of autism was evaluating more kids who had autism.
Majority is just the average
I'm sure I would've been diagnosed autistic as a kid instead of just difficult. Not sure it would've changed anything. I still would've been very strong willed and confused about why people around me say one thing but do a different thing. I think what would've been different is maybe other people's reaction to me?
I think the biggest benefit to diagnosis is both the parent and the child are able to draw on resources for those disabilities - learn about coping mechanisms, get advice from other autistic people, etc.
> confused about why people around me say one thing but do a different thing.
I think it importantly helps shift this confusion from the framing of "Is something wrong with me?" which a lot of young autistic people feel
I communicate extremely clearly. Most people do not. They say half of what they want, or ignore half of what they read/hear. It's very odd. Life is much easier (read: less complicated, not more pleasant) when you communicate as if the other person isn't actually reading your thoughts and emotions. That applies for neuro- typical and divergent people equally.
i mentioned before the book "Speed of Dark" by Elisabeth Moon which explores this topic.
well that is the ethical question, isn't it? i mean for severe symptoms that cause obvious problems, sure. but what about lesser symptoms? where do we draw the line? the affected person should have a say in that, and, what i find much more important, outsiders need to be neutral. while those affected obviously can't be neutral about it, those outside often aren't either. we define what is normal, and we try to explain every deviation from normal as a problem that needs to be fixed.
i am not diagnosed, but i do have behaviors that i think are not normal. they are not getting in the way of my life, so i don't need them fixed, nor do i want to fix them, but if i were to be diagnosed then there sure is someone who would insist that all those diagnosed should be fixed whether they want it or not.
and even worse those that want to take away my autonomy because they believe that anyone diagnosed is not capable of leading a normal life and should not be allowed to do certain things, such as raising children.
did you see the movie "i am sam"? sam is one of those with severe autism who as you say don't have a frame of reference for their own disability. regardless of whether sam could be cured, or whether he should be cured, it should be possible to create an environment where he can live together with his daughter. who gets custody should not even matter. you don't separate siblings either just because one sibling is not able to care for the other. so why separate sam and his daughter? it's done in the belief that children better be raised by normal people and that the bond they have with their own less capable parents doesn't matter.
the point i am trying to make is, cure or not, first of all, as a society we need to make accommodations for those who are ill or disabled. we do it for those using wheelchairs or for blind or deaf people, so why not for autistic people as well?
instead of changing every individual to conform to society, i believe society should adapt to accommodate all individuals so each one can live a dignified life.
It's a brain pattern / way of thinking which doesn't fit the avg societies expectations.
It's a disability when it hinders me lifting my life but even then you allow the narrative be written by the others.
It is no different than say diabetes T2. Both are diseases which are caused by wrong levels something essential, both can be mitigated by a treatment which changes levels of that something. Both have significant societal impact on a life of the affected person. Yet, there is no doubt in the social networks that T2 is an illness, while ADHD is for some reason not afforded as much.
The difference is how difficult it was to obtain an autism diagnosis (here,then).
For the former, it was difficult to impossible to find someone who was ¹qualified and ²willing to consider autism.
For the latter, qualified specialists were readily available and the diagnosis was seamless.
If your numbers/data/chart/speech does not feature uncertainty, then (in a professional setting) you should be dismissed as a bullshitter or incompetent.
(The importance of thinking about how and how much you might be wrong is drilled out into the minds of students from the start of university for a good reason.)
Of course, the article makes the case that there's no epidemic so none of this is really important. We don't have to go "oh woe is me oh woe is me" constantly.
> So much spending on care for autistic people is wasteful. Someone with a mild case of Asperger’s does not need to hit a mandated spending cap for their condition, and someone with mental retardation who convinced a clinician to give them a more favorable diagnosis should not be receiving treatment intended for autistics and found to be useless for the merely mentally retarded.
More importantly, even if the article didn’t specifically address your concerns about metabolic health, it certainly gave a plethora of reasons for why the “rising autism rates” are not rising in truth.
> So remember this:
> There is not, and has never been, any credible evidence for a “real” epidemic of autism or for any of its proposed environmental causes. Answering the question of if there is a “real” autism epidemic has provided a complete answer to the question of why there might be.
Even assuming the first sentence is correct going from 0% prevalence to 100% prevalence of something with a 4x risk increase would explain only a very small part of the increase in the various proxies by which the prevalence is estimated, whereas (as the article argues) change in diagnostic criteria and reporting practices can easily explain all of it. So, sure, to the extent there is any real increase in prevalence (which is not at all clear), factors like parental obesity, parental age, and other things that have some indication of being either risk factors or proxies for unidentified risk factors may either play a role or be indicative of things that do, but we can be fairly certain what the main driving factor in the numbers is, and it is sufficient to explain the observations, and invoking anything else is a violation of the principal of parsimony.
I had older relatives who were obviously or probably autistic but were undiagnosed - because who had even heard of autism then. AHD meds and SSRI weren't yet a thing - but these folks mostly predated even Tricyclic ADs.
[0]: https://www.washingtonpost.com/news/wonk/wp/2015/09/22/the-s...
The common meme is that grandma with her spoon collection or grandpa and his HO scale trains was autism. It's not that autism came out of the blue.
Commonly the claim is that awareness and testing is improving. Right but that cant explain that away. The CAUSE of autism must still be present and increasing.
It's not vaccines, there's loads of unvaccinated autistic kids. 1 in 50 in somalia have autism but somalia is well known for not being well vaccinated.
Its not pesticides, this is anticorrelative when accounting.
RFK jr says the cause will be known by the end of the year. I did the research, im fairly confident I know the cause. I wonder if I figured it out.
This had also been observed by clinical psychologists working with autistic children as a curious anomaly (a friend has a PhD in this topic and has worked for 30 years with families who have an autistic child) that when first meeting the parents it was often observed that one of the parents (often the father) displayed ASD tendencies and was often undiagnosed.
One could therefore argue that the “resurgence of the nerd” has been partially a trigger for an increase in autism cases, but more than likely the higher incidence of diagnosis is the stronger factor.
Of course men are more likely to work in STEM.
As with all complex psychological divergences, it is highly likely that autism has a number of factors that can trigger it, and as we see in all highly specialized science topics, that in which you specialize is where you seek the answer. When all you have is a hammer…
Dickerson, A. S., Rahbar, M. H., Han, I., Bakian, A. V., Bilder, D. A., Harrington, R. A., … & Kirby, R. S. (2014). Autism spectrum disorder prevalence and association with parental occupation in the Texas Autism Surveillance Project. ScienceDaily.
Baron-Cohen, S., Wheelwright, S., Stott, C., Bolton, P., & Goodyer, I. (1997). Is there a link between engineering and autism? Autism, 1(2), 153-163.
Baron-Cohen, S., Scott, F. J., Allison, C., Williams, J., Bolton, P., Matthews, F. E., & Brayne, C. (2012). Diagnosed autism is more common in an IT-rich region. Cambridge University Research News.
Baron-Cohen, S., Wheelwright, S., Skinner, R., Martin, J., & Clubley, E. (2001). The Autism-Spectrum Quotient (AQ): Evidence from Asperger Syndrome/high-functioning autism, males and females, scientists and mathematicians. Journal of Autism and Developmental Disorders, 31(1), 5-17.
Dickerson, A. S., Rahbar, M. H., & Pearson, D. A. (2014). Parental occupation and risk of autism spectrum disorder in offspring: A population-based study. Research in Autism Spectrum Disorders, 8(8), 974-985.
Feldman, M., & Belsky, J. (2023). Parental STEM skills and risk of autism spectrum disorders in children. Journal of Political Economy, 131(4).
Lazic, S. E., & McLean, R. J. (2023). STEM-skilled parents and autism spectrum disorder in offspring: A case-control study. ResearchGate preprint.