Wednesday, August 4, 2010

Affluence and Autism. Does one cause the other?

Have you seen this new University of Wisconsin study that correlates an increased prevalence of autism with greater household affluence?

This isn’t the first study to reach that conclusion. But what does it mean? Many researchers dismiss research like this by saying wealthier people have more resources to get an autism diagnosis. They say more educated people are more likely to pick up subtle differences in their kids. And perhaps they’re right.

Does that account for all the difference?

The incidence of autism combined with intellectual disability is not strongly (1.3 to 1) correlated with affluence. It’s only the less severe forms of autism that are more common in wealthier homes. Is that because autism combined with ID is obvious, but the less severe condition is not?

Maybe . . . but maybe not . . .

Researchers note that intellectual disability by itself is inversely correlated with family affluence. That is, the more prosperous the family, the less likely they are to have an ID child. Knowing that, even a 1:3 to 1 correlation in the opposite direction may be suggestive of an unrecognized autism-affluence dynamic, even for the most severely affected kids.

The difference in non-intellectually-disabled kids is truly striking. For kids with autism, but without ID, there was almost a 3:1 ratio of autism in the highest socioeconomic group versus the lowest group. That’s a pretty shocking ratio.

This study has some pretty profound implications.

If it’s true that most of this 3:1 difference is due to more aware parents with better resources, then it follows that two out of three poor children with autism are going undiagnosed.

Sobering thought, isn’t it?

Seen in that light, I find it hard to jump to the conclusion that we’re failing to diagnose two out of three kids with higher functioning autism. I think the truth lies somewhere in the middle . . . there is some unknown reason that high functioning autism is associated with affluence, and we are still failing to diagnose a significant chunk of our less affluent population.

The researchers in this study seem to feel the same way.

This newest study attempts to address the question with some new methodologies. They looked at roughly half a million kids in a database compiled by the Centers for Disease Control, some of whom were diagnosed by doctors while others were diagnosed through schools. Some children had a pre-existing autism diagnosis, while others’ records were evaluated as part of this study.

Here’s the interesting thing:

No matter how you cut the study results, there is always a significant correlation between the incidence of autism and family affluence, even for kids who came into the study with no diagnosis. That sure suggests that there is some underlying reason that more affluent people are more likely to have autistic kids.

Do you remember Steve Silberman’’s Geek Syndrome article from Wired Magazine, some years back? It looks like he had it right . . .

I had actually not thought about that story recently, but my son and Alex Plank interviewed Steve about that at this year’s Autreat conference. You can see their videos of Steve here:

Autism Talk TV

Why might affluent people tend to produce autistic kids? What do you think? Why might more affluent people be more likely to have kids who are “different?”

A significant percentage of our affluent population became financially successful by thinking differently. Some of those people invented new things. Others solved problems that defied solution. A few devised novel strategies to analyze markets. What do those people have in common? They think “differently.”

Some people who think “differently” are just ordinary folks with a different thought every now and then. Others, however, are different all the time because their brains are different. Fifty years ago, such people were called eccentric. Today, more and more of those individuals are called autistic, or Asperger’s.

It’s an interesting thought . . . most adults with autism are not successful financially. They are disabled, and poor. Yet a significant percentage of highly successful people in engineering, analysis, and the sciences have autistic traits. Does a little bit of autism make you exceptionally successful, while a lot makes you exceptionally disabled?

I think so.

At the same time, our society has created institutions where geeky people with autistic traits congregate. Biotech companies. Electronic design firms. Research labs. Even Wall Street firms with their rooms full of mathematical savants. It should come as no surprise that males and females meet in those environments, and children result. To the extent that autism is genetic, we have created a unique environment for genetic reinforcement in those institutions.

What else is different, for affluent kids, and how might those differences lead to autism?

And what about the less affluent kids who are going undiagnosed? That is the less discussed but equally important finding of this research. How are we going to identify these kids so we can get them the help they need, and more important, where are we as a society going to get the money to pay for it with schools and autism service groups nationwide in a state of fiscal collapse?

8 comments:

Madmother said...

I think too, quirky people are appreciated more today, and in the last couple of generations since technology became a way of life. Could it be that more are forming relationships, having kids, perpetuating the cycle? I know I'm "out there", successful, but different, and hubbie is a science geek. We produced one gorgeous Aspie, and one little gifted and talented smart arse. Two very quirky boys.

Interesting to ponder who the next generation will produce, lol.

M said...

my guess is that the larger percentage of less successful AS folk are fairly disinterested in the question of how the smaller percentage of more successful AS folk got their dough.

a more important question is: how can i go about writing shorter sentences? the question of our times.

Dr. David Webb, PhD said...

http://www.bbc.co.uk/news/health-10929032

Brain scan test for adult autism

10 August 2010 Last updated at 22:01

New brain scan to diagnose autism
By Jane Hughes
Health correspondent, BBC News

The computer scan shows up a distinctive pattern associated with autism
A brain scan that detects autism in adults could mean much more straightforward diagnosis of the condition, scientists say.

gregory mathews said...

Something to think about...
I loved your book and appreciate your honest portrayal of your life. I have come to the conclusion, however, that I do not like the term, "neuro-typical" to describe non- aspergians. the term "typical" has a derogatory flavor that eludes common, ordinary, and average. I like to think of everyone as having unique qualities that make them who they are. As you have said, aspergers is not a disease and doesn't need to be cured. Your particular brain chemistry and architecture make you who you are just as my unique brain structure makes me who I am. But I am anything but typical. and neither are you. May I suggest the term "non-aspergian" if you want to delineate the species. But, I often wonder if we are all on the spectrum, even if ever so slightly. You were just one of the lucky ones who got some of the useful traits. I am passing on your book to a friend I have with aspergers who I know will enjoy it.

TherExtras said...

"Does a little bit of autism make you exceptionally successful, while a lot makes you exceptionally disabled?

I think so."

Autism is a diagnosis of extremes of behavior that in small quantity is 'typical'. So, gregory, now 'typical' is a 'discouraging word'? Sigh. Bashed as 'normal' was. Sigh. The word battles continue - to what effect?

What statistically correct term would diagnosed persons like to call the largest portion of the population for their common characteristics (middle of the bell curve)?

Barbara

BlackberryGirl said...

There are so many factors at play I would suspect...ages ago, I was fussing about my husband's family and after my grandfather observed them interacting, he actually sent me to a local college's library to look up AS. I had been very upset as to how they all treated and handled their babies and infants and they thought I was way off in how I handle and treat babies and children.

First, I thought it was because I came from an old Bluegrass family that has roots going back to the 15th century and we are still very much rural-farm people...horse farms, big farms, with lots of exposure to the outside world and education and they were all urban, engineers types with a very scattered and fractured, non-supportive background.

My children are now grown and way way outshine all the "cousins" in this family, even in photographs! They are graceful, good dancers, athletes, speak wonderfully, even their voices and inflection is different.

My husband is very different from his siblings and he insists it is because of the "nanny", and housekeeper he was handed over to after he was born and he is the youngest of six children. The siblings are all very very bright and driven but odd, odd odd in many ways.

Yet, what struck me the most was the way they raised, handled and treated their babies and children. I was made fun of for rocking my sons, singing to them, dancing with them as toddlers, reading to them when they were infants and lots and lots of hugging and kissing.

It broke my heart to watch the stiff, rigid way these people held their babies, the lack of eye contact, which any infant finds stressful, the coldness that manifested itself over and over again.

Nature versus nurture? My family is very large, educated, witty, clever, funny, good at music and poetry and we entertain and are very people oriented and even, are so much more "in" our bodies. If that makes sense?

I am very glad I stuck to my guns and lavished tons of attention on my boys and all the cousins...our house was always full of kids because they all loved to come over to our house.

I wish I could hug my grandfather for telling me all about AS and this was in 1975.

Take care.

Marigold Ran said...

From a biological perspective, I think there's a reason why average intelligence is not higher than what it could be. I think that for every point of IQ after a certain point, it carries a corresponding emotional cost.

Have you played D&D or other roleplaying games before? In order to boost one of the character stats to the maximum, like for example intelligence, you have to pay a cost in the other stats (e.g. charisma or dexterity).

testtesttesttest said...

You forgot to consider socio-economic attraction and breeding.

Poor-different guy = "potential psycho guy who can't get dates"

Rich-different guy = "eccentric billionaire that can mate with supermodels"

At least that's how society sees it.