Why are we seeing more autism?: “Environmental injury” vs. “better diagnosis”
A “possible link between autism and the environment” is the focus of the fifth edition of the Advocate, the publication of the Autism Society of America. The purpose of this special issue and of the ASA’s Environmental Health and Autism website is to “increase awareness about links between autism spectrum disorders and environmental toxins.” The ASA does not include the word “possible” with “links” on this webpage , as if to make the statement that there are indeed “links” between autism and the environment, and this claim is the subject of three feature articles, all of which can be read as PDF files:
- Time to Get a Grip Martha R. Herbert, M.D., Ph.D.
- Can Exposure to Environmental Toxicants Influence Autism Susceptibility? by Isaac N. Pessah, Ph.D.
- The UC Davis M.I.N.D. Institute: Uniquely Designed to Study Gene-Environmental Interactions in Autism by Robert Hendren, D.O.
Herbert presents a rhetorically charged argument for a link between the environment and why “the number of people diagnosed with autism has skyrocketed, both in the U.S. and in other countries.” She argues for a “gene-environment interaction model,” suggesting that this is why it has been so hard to identify genes for autism. By using a “whole body model” of autism—-by not seeing autism as a brain disorder—she asks if, instead of thinking of autism as “neurobiological” that
we need to ask whether the brain is the primary target, or whether the brain could be affected at the same time as—“in parallel” with—or even “downstream” of, other bodily changes, such as in the immune system. Perhaps the brain is “caught in the crossfire” of whole-body changes related to environmental stress.
If we can locate an environmental cause for autism—if we can know the specific environmental agent or agents that trigger autism in a child with a genetic predisposition for autism—then “autism recovery,” Herbert writes, is “scientifically plausible,” as we will have then pinpointed the cause of autism.
The rise in autism diagnoses, along with the rise in other immune and chronic illnesses, is really a wake-up call. Put alongside the warnings about the ecological instability of our planet, it shows that our situation is serious. It calls for pulling out all the stops and throwing our best intelligence, resources and organization into getting a grip. Autistic individuals may not be “different” from the rest of us but simply “more sensitive” to environmental injury—they may be the “canaries in the coal mine” warning us of impending greater disaster. If the level of environmental insults continues to rise, more children and more adults—and more of life on earth—will experience harm.
Herbert’s last phrase echoes “evidence of harm,” which is of course the title of journalist David Kirby’s book that argues for a link between mercury in vaccines and autism and by the end of her article, Herbert argues for a link between autism and an external, environmental agent—even a toxin, too. Like Kirby in his Huffington Post article, Herbert quickly dismisses the notion that this “rise” might be due to our better understanding of autism.
Some say that the increases are merely due to better awareness and diagnosis of autism, or expanded diagnostic criteria. However, we would need solid proof of this claim in order to dismiss the possibility that something new, different and harmful is going on with our children—and such proof does not exist. Autism increases point to a role for the environment, since genes don’t change that fast.
But the question that Herbert leaves hanging is, might it be possible that our understanding, our knowledge, of autism in our culture might change so fast that we have only begun to realize this?
Herbert outlines a number of “major environmental changes” in Time to Get a Grip —but these changes have affected all of us, and not only autistic persons: “We are all polluted,” she writes. The notion of “better understanding of autism, better diagnosis, increased prevalence” cannot simply be dismissed as Herbert and Kirby so quickly suggest. The changes in the diagnostic criteria for autism are evident if one reads the various versions of the DSM and, even more, if one reads Roy Richard Grinker’s account of how the diagnosis of autism (and of child psychiatric disorders) has evolved in Unstrange Minds: Remapping the World of Autism (forthcoming in February 2007).
Why are we so quick to dismiss the notion of how better understanding of autism within our culture can account for those “skyrocketing” autism rates? Why do we need to find “links” between autism and something else outside of us?
A thoughtful discussion of this issue would merit its own special issue of an autism journal. “Diagnosis,” after all, is from the classical Greek word diagignoskein, ” to discern, distinguish” (from dia, “through,” and gignoskein, “to know”). Perhaps it is that we need to wake up to the notion that we are better able to see what autism is now at the beginning of the 21st century, and this is to account for why there is a lot more of it. We live not, as Herbert ends Time to Get a Grip, “in this time of great challenge and danger,” but in a time of “broader shifts taking place in societies throughout the world” that are epistemological—about how we see and know the world—rather than environmental. From the Unstrange Minds website:
…….there is no evidence for an autism epidemic. Instead, the high rates of diagnosis today are instead evidence that scientists are finally, after all these years, counting cases correctly. And this is a good thing, not only for the US but for the world, including cultures that have only just begun to learn about autism.
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POSTED IN: Autism Lit, Autism Organizations, Books, Classics, Diagnosis, Environment, Genetics, Health, Treatment, Vaccines
10 opinions for Why are we seeing more autism?: “Environmental injury” vs. “better diagnosis”
mika
Dec 22, 2006 at 1:00 pm
I don’t mean to be off the subject but mabey someone can clarify this.
I went through an intense 80 hour/2week autism workshop in Chico (CA). The Butte County Selpa and ABC agency from Sacramento put it on last summer..
They mentioned that the numbers might be growing due to the expansion of the DMS IV with the “Autism Umbrella”.(”Autism Umbrella, PDD,RETT,etc.) They were saying I believe (correct me if I’m wrong) that children with three or four traits out of the areas defined for Autism in the DMS IV were considered in the spectrum.
I was wondering if anyone else knows about this .. Unfortunatley I don’t have my binder with me from the workshop. They also mentioned that they were going to put a sensory section in the new DSM V.
I’m optimistic to all the possible pieces of the puzzle.
mcewen
Dec 22, 2006 at 2:29 pm
I wish I had a scientific frame of mind. As I don’t I can only comment that it reminds me of large white elephants in the room, that no-one likes to mention but no-one can really ignore. Seasonal greetings.
Kristina Chew, PhD
Dec 22, 2006 at 6:11 pm
Yes, it is a very large, very white, elephant.
In the DSM-IV, a child needs to have “A total of six (or more) items from (1), (2), and (3), with at least two from (1), and one each from (2) and (3)”—(1) being “qualitative impairment in social interaction, (2) being “qualitative impairments in communication,” (3) being “restricted, repetitive, and stereotyped patterns of behavior, interests, and activities.”
The Unstrange.com website contains the changing DSM criteria here:
http://unstrange.com/dsm1.html
And go here,
http://www.dsm5.org/
on the DSM-V Prelude Project,
and here,
http://dsmivtr.org/
on the DSM-IV-TR (the TR standing for “text revision.”
Gerard Petillo
Dec 22, 2006 at 10:57 pm
The fact that everyone (including the scientific community) is talking about this is a good thing. From the scientific standpoint, as more and more research is published, the true hypotheses will stand the test of validity and reproducibility while the false ones will be disproved. This can only bring us closer to solving the puzzle.
Gerard Petillo
Parents of A.N.G.E.L.S.
Bronx N.Y
mika
Dec 22, 2006 at 11:25 pm
Thank you for clarifing that Kristina…
BY the way I really enjoy and look foward to reading your blog everyday…
Thank You
Mika=)
Autism Vox
Jan 15, 2007 at 5:53 pm
[…] Go here to read Why there’s no autism epidemic, but rather an epistemological epidemic—one involving how we see and know the world—to phrase Allen’s “epidemic of discovery” another way. ASD, Aspergers, autism, autism spectrum disorder, Books, children, epidemic, family, health, literature, memoir, PDD NOS, scienceAdd to: January 15th, 2007 | Permalink | No Comments » […]
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Jan 25, 2007 at 3:14 am
[…] Back to the 24 responses regarding “whether or not there is an autism epidemic” posted on the Autism Speaks website. A number more have been posted arguing for why there is no epidemic, though the current title of the website (Is Autism an Epidemic? Your Emailed Response - Yes, It Is! [my emphasis]) suggests otherwise. The name of each writer is included, though the writer’s personal and/or professional affiliation in regard to autism are not consistently noted. It is also not clear in what way each response has been edited (as my own response was), nor the total number of responses actually received, nor how many arguing that “there is no epidemic” or arguing that “there is an epidemic” were received. If some scholar some generations hence, even hundreds of years hence, even a few millennia, were to read Is Autism an Epidemic? Your Emailed Response - Yes, It Is!, what would she or he think? What gaps or omissions, what insufficiently defined terms, might she wonder about? Why did these people care so much about these terms, “epidemic” and “autism”? What intriguing epistemological questions were these people so caught up in—-what is “better diagnosis“? Were these the only responses sent in to the question in the title—-”Is Autism an Epidemic?”—-and how could they say “Yes, It Is!” when more than a few responses say the opposite? […]
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Feb 10, 2007 at 12:53 pm
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Dec 6, 2007 at 9:45 pm
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donald savitz
May 10, 2008 at 1:06 pm
I think that if you have 25000 childern each year sence 1997 with autism and with second side affact of infant mortatily of about of 10900 childern, I would say theat there is a austim epidememic
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