Today (April 2) is World Autism Awareness Day. April is National Autism Awareness Month. "In order to highlight the growing need for concern and awareness about autism, the Autism Society has been celebrating National Autism Awareness Month since the 1970s," according to the Autism Society. At the time autism was identified as a public health concern in the 1970s, 1 in 10,000 children was identified with the condition. Now it is close to 1 in 50--almost a 200-fold increase.
When autism experts and advocates are interviewed about autism awareness, their main recommondation and hope is that more children will be identified earlier with their autism because of greater awareness and vigilance. This leaves two questions -- (1) When will we reach a limit in the autism rate? (2) Can we ever reverse autism considering the steady rise in the condition over the last 35 years we have become increasingly concerned about it?
The latest rise in autism has been announced by the Centers for Disease Control and Prevention and noted with alarm. It is now 1 in 68 kids (and a much higher rate for boys) compared with 1 in 88 two years ago--that's heading towards 2 percent from a little more than 1 percent. But all of this pales, as noted, with the nearly 200-fold increase from the roughly 1 in 10,000 diagnosed cases of autism in 1980.
Dr. Nancy Snyderman, NBC's medical director, appeared on MSNBC's "Morning Joe" last Friday to explain this phenomenon to AM Joe's largely liberal audience. This explanation has three key elements:
1. The rise in autism is real, sort of. Like many liberal commentators uncomfortable with this astronomical rise in such a debilitating condition in our modern medical era, Snyderman both acknowledges the rise and discounts it. That is, she notes the greater tendency to identify broad autism "spectrum" conditions, which inflates the number of kids who are diagnosed.
But this cannot account for the astronomical rise in these figures, and the obvious increase in the most severe, unmistakable cases. The contradiction the "more-diagnosis" explanation creates for Snyderman, among many others, is that this suggests the possibility of overdiagnosis, at the same time as she (and the other members of the Morning Joe panel) all agree that more and earlier diagnosis and treatment of autism are essential and beneficial.
2. The rise is real because it is biological. As I have written, we are only allowed to label a condition as "real" if we can make some sort of claim, however implausible or inadequate, that it has a biological basis. Synderman thus noted a study finding a difference in brain structure predisposing adults to autism that "proves" the reality of autism.
But genetically-based differences in brain structure cannot possibly account for a 100-200-fold increase in the condition within a generation--to imagine that it does grossly misunderstands the most fundamental tenets of epidemiology. There is a need for such explanations, however, because to attribute autism to child-rearing or parenting styles is simply verboten today.
3. Hysterical, conspiracy-based explanations (i.e., vaccinations) have been ruled out by the liberal plurality. Snyderman is at pains to discount the vaccination explanation for autism. She must do so because the CDC, Institute of Medicine, World Health Organization, UNESCO, American Academy of Pediatrics (what else do you have) have all thoroughly refuted such claims. But, when a frightening epidemic like autism arises, people desperately seek explanations.
And, so, Snyderman hands her iPad to Mika Brzezinski because of the onslaught of e-mails and texts she knows she will receive decrying her denial that vaccination causes autism. And these will come from generally upper-middle-class viewers, a significant portion of whom have now ceased inoculating their children, in turn leading to outbreaks of previously disappeared whooping cough (pertussis) and measles. And each such epidemic causes a certain number of childhood fatalities.
Where does this leave us? Something is causing a real rise in autism. And autism is not the only childhood condition that has risen since the 1980s--so too have childhood depression, ADHD, bipolar disorder, and virtually very other diagnosable childhood emotional disorder. What is going on? We can't put our finger on it, but something culture wide is impacting our children. It is hard to say what this is, but it represents something in how our children are raised.
When Americans arrive in other countries (like France) they are struck by the differences in how French and American parents deal with their children. French kids are left far more to their own devices and, as result, are far more independent. These differences have been linked to a much lower rate of ADHD among French than among American children, and to outraged denials by American parents that this is possible.
What this tells us is that, as a culture, we don't seem to have achieved an optimal mix of parenting styles so as to avoid critical risk factors for our major emotional, mental, or whatever-autism-is conditions, and we are panicked over it--as well we should be. But our panic is creating gaping pockets of communicable diseases, some of which are fatal. And our modern medical era was defined by our ability to lick these epidemic illnesses. We are now reversing that success.
I am sorry that I don't have a more definitive answer to offer to all of this--as they say, if the answer were obvious, we would already know it. Instead, I will end with a definitive declaration about a radical culture-wide shift in child rearing that does have a colossal impact. Whether this impact is related to autism, ADHD, and bipolar disorder, I don't know. But I do know that we can be overtaken by changes in parenting styles that are seemingly beyond our individual, and cultural, control.
Here is someone declaring a lamentable lack of independence we allow our children, at the same time as she notes that she participated in this radical shift in parenting styles, and doesn't know even now how she might have done otherwise:
I used to puzzle over a particular statistic that routinely comes up in articles about time use: even though women work vastly more hours now than they did in the 1970s, mothers--and fathers--of all income levels spend much more time with their children than they used to. This seemed impossible to me until recently, when I began to think about my own life. My mother didn't work all that much when I was younger, but she didn't spend vast amounts of time with me, either. She didn't arrange my playdates or drive me to swimming lessons or introduce me to cool music she liked. On weekdays after school she just expected me to show up for dinner; on weekends I barely saw her at all. I, on the other hand, might easily spend every waking Saturday hour with one if not all three of my children, taking one to a soccer game, the second to a theater program, the third to a friend's house, or just hanging out with them at home. When my daughter was about 10, my husband suddenly realized that in her whole life, she had probably not spent more than 10 minutes unsupervised by an adult. Not 10 minutes in 10 years.
It's hard to absorb how much childhood norms have shifted in just one generation. Actions that would have been considered paranoid in the '70s--walking third-graders to school, forbidding your kid to play ball in the street, going down the slide with your child in your lap--are now routine. In fact, they are the markers of good, responsible parenting. (Italics added.)
Stanton Peele has been at the cutting edge of addiction theory and practice since writing, with Archie Brodsky, Love and Addiction in 1975. He has developed the on-line Life Process Program, and has written (with Ilse Thompson), Recover! Stop Thinking Like an Addict.