83 comments

[ 2.7 ms ] story [ 168 ms ] thread
Criminal is a strong and unwarranted claim.

TFA posits the 'the numbers keep rising' - that's not in contention so you can't use it as a counterpoint - though the idea that it's attributable to diagnostic changes isn't new.

I'm sure I read about this in one of the Freakonomics books, but can only find this reference to a paper they discussed on their site 15 years ago:

https://freakonomics.com/2007/06/revisiting-the-autism-epide...

In terms of credible causes, changes (in DSM) to diagnostics, and incentives around the subject have changed, and that seems to be a sufficient cause to explain the numbers.

Do you have other credible causes in mind, with some citations to accompany?

I stand by “criminal”. We live in societies that incentive us to have fewer kids and to have them later in live(considered risk factor for autism ). In the meanwhile pediatrics are not keeping up. So saying all is fine is criminally counter-productive.
I don't think anyone's asserting everything is fine. To me it read that TFA is saying the rise is numbers is a consequence of changes in diagnostics.

You asserted criminality originally because numbers are rising (not in contention) and credible causes have been identified - are you saying rises in numbers are purely due to trend of later-age in parents, or are there additional?

Do those explanations cover younger parent cohorts that also see a rise in diagnosed cases?

My opinion—we are now attributing autism to kids now that in the 60s, 70s, and 80s would never have got that diagnosis. Used to be we called kids today who are said to be “on the spectrum” words like “weird”, “troubled”, or “socially awkward”, and “nerdy”.

Know many folks from back in the day, including a good friend I have known for over 4 decades.

Don't forget "shy". I got saddled with this and all it's subsequent attempts to "break me out of [my] shell" and the vast majority of those attempts just drew unwanted praise/attention leading to me avoiding any situation where I'd be noticed for a very long time. It was not good for me when my parents crowed to anyone nearby if I had the temerity to respond to "hello" with "hello" -- to my parents it was a breakthrough, a thing to celebrate, but to me it was a struggle to fit in that was instantly crushed once their response drew attention. Took decades to fix.
Ahh yes, that was definitely adjective that was often used. “Quiet” is another.
I just feel as if folks have been "on the spectrum," all along, but people are looking for it, these days.

Nonverbal autistic people are still quite rare. I know a few (actually, I know their parents, and, through them, their children). Tough gig.

High-functioning autistic folks can actually have advantages. We can be socially awkward (usually, abruptness, and nonreactive to emotional stimulus). It would easily be brushed off as "He's just a bit odd." Doesn't seem to be an actual disability; especially if the person is a wizard at some skill.

In my case, I'm a really, really good programmer. I can map out a fairly complex system map in my head. It helps me to avoid writing things down, which affords flexibility. I am also anal about Quality and formatting. Most of y'all would probably laugh at my code.

An ex-employee of mine was absolutely jaw-droppingly good. He regularly stunned the scientists and engineers in Tokyo, and he had a high school diploma.

> Nonverbal autistic people are still quite rare. I know a few (actually, I know their parents, and, through them, their children). Tough gig.

Know a guy who’s son is non-verbal, definitely a tough gig.

My friend is highly creative as a writer, and definitely anal in terms of rewriting until a piece is perfect in word choice, tempo, etc. He struggled his entire life with close emotional connections, only after a divorce sought some introspective counseling which led to his understanding of where he sat on the spectrum. When he told me, it was like blinders were lifted and I spun back through dozens of interactions that we had had over the years and it was an *of course!* moment. Made perfect sense in hindsight.

Well, there's "just a bit odd" as in Dan Aykroyd and there's "just a bit odd" as in Christian Weston Chandler. Even within the verbal "high functioning" band, the autism spectrum is still a spectrum.

And it really is a social disability, not a superpower. We really only display advantages in things we train ourselves to be proficient in, which tend to he things that do not bore or frustrate us because of other people's expectations of us. I got proficient in computers because a computer was host to a tiny world in which I had absolute control. But a sufficiently motivated allistic person could get just as proficient in this field as I. In fact the advantage has swung back toward allistics because the MBAs have taken over computing as a profession, and through Agile, Scrum, and other methodologies and "best practices" enforce it as something to be practiced on their terms.

That’s why I’m working on my own, these days, I guess.

Not so sure “sufficiently motivated” folks could just learn this.

I have what I call my “fugue state.” It’s a fairly “timeless,” focused, self-centered state, where “everything flows.” I get a lot done, when in this state, but many hours can go by, and it’s exhausting.

I couldn’t describe what I’m doing, to save my life. In fact, the best way to break it, is to ask me what I’m doing. I stutter, grope for words, mumble, etc. I can write detailed, articulate code documentation, explaining it, but I can’t verbalize it. I sound like a blithering idiot.

I would not do well, with pair programming.

I also get pissed when I’m yanked from that state. I get quite cranky. Lasts for about half an hour, afterwards.

That kind of thing makes it hard to play well with others. When I was a manager, I didn’t have that issue.

> Not so sure “sufficiently motivated” folks could just learn this.

Pretty sure the ability is there in most people. Not that many do it, but the potential is there. All too many people are disengaged and trapped into apathy by their experiences.

> I have what I call my “fugue state.” It’s a fairly “timeless,” focused, self-centered state, where “everything flows.” I get a lot done, when in this state, but many hours can go by, and it’s exhausting.

Yup. That state was dubbed "flow" by Mihaly Csikszentmihalyi in 1975:

https://en.m.wikipedia.org/wiki/Flow_(psychology)

Among "normies" flow seems to often have a physical activity component, and is more common among athletes, musicians, artists, surgeons, and similar professions. Many gamers would recognize themselves in your description as well. The more purely mental version you experience is less common, though it isn't restricted to pursuits like math or coding. Writers (of types as diverse as journalists and fiction authors) can experience it too, for example.

> I also get pissed when I’m yanked from that state. I get quite cranky. Lasts for about half an hour, afterwards.

Oh my yes. I can get cranky enough to lose the whole rest of the day. Also note that the writer that gets cranky when interrupted is practically a trope.

It is worth noting that a state of flow, while extremely productive, may not be the best state for improving your skill (although it does allow polishing skills smooth, as it were), which is better served by deliberate practice of activities that are a just bit too challenging to allow entering the flow state (if they are harder than "a bit too hard", it may help to do it at half speed, which can feel a bit wierd for something like coding).

> That kind of thing makes it hard to play well with others. When I was a manager, I didn’t have that issue.

Well, there is such a thing as "team flow" but it doesn't seem to be cultivated deliberately much outside of team sports, improv, and group music. Something similar can occur in group brainstorming sessions, though.

> Among "normies" flow seems to often have a physical activity component, and is more common among athletes, musicians, artists, surgeons, and similar professions.

Who's to say it doesn't among programmers? One of the reasons why I vastly prefer mechanical keyboards is because their feedback smooths out the process of typing in flow state. It requires less mental effort to type on a mechanical, which means flow is less likely to get disrupted. Plus I can feel the rhythm of the keys beneath my fingers, and rhythms help keep my brain on track.

That's interesting. Do you have data on whether the tactile or auditory feedback is more important?
> That kind of thing makes it hard to play well with others. When I was a manager, I didn’t have that issue.

I'd suspect you just have adhd and not autism. But psychologists are just humans like everyone else and hears "social problems" and sets out to match anything you have to autism criteria, even though the person obviously isn't autistic.

The other things you talk about just maps to adhd as well, like being easily distracted, super focus on things you care about.

I have close family with ADHD (I used to steal their Ritalin, when we were kids). They are also a damn good engineer (hardware), but much better with people.

Think Jon Bernthal and Ben Affleck, except as geeks, instead of badasses, and without the cool Airstream.

> I am also anal about Quality and formatting

This is usually code speak for tab/space nazi.

I once met someone where the file add to end with a comment with the filename, otherwise he'd berate the code while foaming from the mouth.

(comment deleted)
Well...you could actually just look at the code, itself (I link to much of my work), before calling me a foaming-at-the-mouth nazi.

But where's the fun in that?

If you had read the article you would know that's exactly what it says. The definition has broadened. The pharmaceutical industry has a perverse incentive to medicate everyone. They are the invisible hand destroying America. They profit off of autism, ADHD, obesity, anxiety, and depression. The opioid epidemic is the tip of the iceberg.
> They are the invisible hand destroying America.

Eh, there are a lot of hands involved in that effort. American is being attacked by an invisible hekatoncheiros. (Actually, it's more an an emperor's new clothes thing. Everyone can see it.)

Please forgive my ignorance but is autism treated with medication?
Not directly, no. A range of meds are prescribed for specific manifestations of autism, such as aggression or self-injury, though none are broadly effective.

If there’s an industry making money here, it’s ABA therapy, not pharma.

Certainly the debilitating effects are treated with medication, for example the various anxieties that often manifest. I don't know if medication is being used to treat the underlying causes of particular autism cases.
The seven most frequently prescribed classes of psychoactive drugs were antidepressants, stimulants, tranquilizers/antipsychotics, anticonvulsants, hypotensive agents, anxiolytic/sedative/hypnotics, and benzodiazepines. The data on other relevant diagnoses indicate that children and youth are frequently treated with medication under an autism-spectrum diagnosis, even though the target symptoms may be commonly associated with other mental disorders. Age data indicate that about 70% of children with autism-spectrum disorders age 8 yr and up receive some form of psychoactive medication in a given year.

https://www.liebertpub.com/doi/10.1089/cap.2006.17303

A UCLA psychologist told my parents in the late 70s that I had "autistic tendencies" when they sought a second opinion after the Texas psychologists concluded I was just stupid.

I guess I lucked out, because that's about as close as you could get to an "on the spectrum" diagnosis before Lorna Wing's work recognizing the significance of Asperger's syndrome.

Yeah but those are all lay person vernacular insults. Now we have a scientifically shaped cudgel with which to institutionally beat the weird, troubled, socially awkward and nerdy. All the while claiming to be helping them with their "disability".
Can you try to make this into a point?

It sounds like you are saying an autism diagnosis does not help people, and also possibly that people who are not "actually autistic" are being labeled that way when they are actually socially awkward/nerdy/??. I don't actually know how being labeled autistic is hurting people... I see a few people who it really helps and many whose results seem unaffected by the label, for better or worse.

Source: colleagues on the spectrum (1 good result, 1 getting by, others no + or -), and a friend's child on the spectrum has absolutely, unquestionably benefitted.

I'm going to infer you have some anecdote about this... it's the semi-anonymous internet maybe it would be productive to share it so people see the other side.

My anecdata is that being labeled autistic is actually way better than being labeled weird/awkward/whatever.
What if we start count from the year 2k?
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.

"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.

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).

(comment deleted)
That is true of a very, very small portion of recent history. Functionally autistic people would have been fine, if not the slightly weird, eccentric guy in a group.
That is pretty ahistorical. It's a great story for elementary kids, but not true.

Lobotomy was mis-used, for a wide array of things it wasn't effective for, but that happens when you concept of psychological disorders consists solely of "insanity".

This.. is not really accurate? I mean first of all asylums as we know them now (or rather as they existed from like, the 1800s until about the 90s) and especially lobotomies (invented in the early 20th century) are relatively modern inventions.

For the most part people dealt with “weird” family themselves. Which was likely easier before the “atomic family” came about and made it harder to get help with complex situations.

That makes sense. I appreciate the correction.
I've lived in some small towns and farming commmunities, they get away with a lot more living there, meaning a lot of people I met then had ideas that would have been considered nuts in the city (and I don't mean politics, racism or other bigotries) and everyone was like "that's just how that family is, a bit off but who cares". People were nosier and knew each other's business more due to gossip and listening to police chatter, but they tended to leave each other alone more too and didn't bother if someone was off or strange unless they seemed dangerous.
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.
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!

(comment deleted)
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!"
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".
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.
(comment deleted)
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?

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.
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.

> Autism increase mystery solved?

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

1.

"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."

2.

"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...

3.

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

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

4.

read more: https://scholar.google.hu/scholar?q=prenatal+glyphosate+gut+...