An epidemic of autism diagnosis

There’s no autism epidemic, argues George Washington University anthropologist Roy Richard Grinker in Unstrange Minds; Remapping the World of Autism, Grinker, who has an autistic 15-year-old daughter, finds references to autistic behavior long before the diagnosis became common. He attributes the sharp rise in diagnoses to better understanding of the disease and the desire to make children eligible for extra help in school.

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  1. Cardinal Fang says:

    The people who argue that autism rates are going up point to the most severely autistic kids. There seem to be more of them now than there used to be. It’s easy to imagine how, in previous decades, higher-functioning autistics and people with Asperger’s could have fallen through the cracks, but there’s no way that a severely autistic kid could have been “missed”; it would have been obvious in any decade that a kid who was severely developmentally delayed and didn’t speak had something wrong.

    So, if autism is not increasing, how come there are more of these severely autistic kids? It can’t be that they were previously diagnosed as retarded, because there is no concomitant decrease in retardation diagnoses to go with the increase in autism diagnoses.

  2. I think in previous generations those severely autistic kids were shunted off to institutions. Hence one never just saw them around. My 2 cents.

  3. wayne martin says:

    In the fall, a Cornell study was released suggesting a relationship between TV and autism:,3566,222481,00.html

    Study Suggests Possible Link Between TV Viewing and Autism in Children

    Friday , October 20, 2006

    By Daniel DeNoon

    Too much TV time for toddlers may trigger autism, according to a study by Cornell business professors.

    Over the past few decades, there’s been an amazing increase in the number of children diagnosed with autism. Some experts think this is due to broader diagnostic criteria for autism. Some point to vastly increased services for autistic children. Others think that something in the environment is triggering an autism epidemic.

    Other information and Autism Resources:

  4. Cardinal Fang says:

    Janet, I guess I didn’t explain the argument correctly. You are right to observe that in previous generations, severely retarded people, including autistic people, were shunted off to institutions.

    But suppose we say, “Oh, yes, just as many people were severely autistic then; they were housed in institutions with the rest of the retarded people.” I take it that’s what you’re saying. But nowadays we separately diagnose severely retarded and severely autistic people– and even though we’ve subtracted out the autistic people from the rest of the retarded people, there are still just as many retarded people as there used to be (by percentage), and in addition there are all these severely autistic people. So the percentage of people who are either severely retarded or severely autistic has gone up– apparently because there are more autistic people.

  5. I don’t have first-hand experience with autistics but from reading and TV documentaries I don’t think autistism could be easily mistaken for a retardation. I’m thinking more along the lines of drug-resistant schizophrenia. The bizarreness of the behavior of an autistic is, I think, different in character then the behavior due to retardation.

  6. Cardinal Fang says:

    Well… 70% of autistics have IQs below 70 and a lot of autistics don’t have language. So one can easily see how in previous generations they’d be warehoused with other people who were retarded.

  7. I think there’s a genetic link. In days past, weird Cousin Harold didn’t marry, didn’t reproduce. Today, and I’m not trying to be a jerk, he gets an IT job, meets a woman with the same interests and recessive gene, and has a kid who’s on the spectrum.

  8. wayne martin says:

    Another paper just published suggests genetic flaws:


    Ped Med: Autism tied to neural ‘cracks’

    SAN FRANCISCO, Jan. 15 (UPI) — In prying beneath the brain surface of autistic patients, researchers have discovered “cracks” in a system of nerve cells called mirror neurons, which under normal circumstances permit people to see a clear reflection of the actions of others and respond appropriately to them.

    Electroencephalograph, or EEG, recordings of 10 individuals with autism revealed that their mirror neurons — also dubbed “monkey-see, monkey-do” cells — responded only to their own doings, not to those of others, scientists said.

  9. Cardinal Fang says:


    Check out the “assortative mating” theory of Simon Baron-Cohen. Basically, he says what you’re saying- that nowadays nerds are marrying nerds and having autistic children.

  10. Cardinal Fang wrote:

    Well… 70% of autistics have IQs below 70 and a lot of autistics don’t have language.

    But 100% of autistics have to display one or another of the behaviors classically associated with autism otherwise how is the diagnosis of autism to be made? That suggests that retardation is a symptom of autism and displays to varying degrees just like the other symptoms.

    Between the bizarre classical autistic behaviors, the high prevalence of retardation and the inevitability of outbursts of angry behavior, I can see autism being identified as some variant of schizophrenia.

    The use of psychotropics, which have no useful effect on autistics, allowed the schizophrenics to be identified and treated. What was left was, I believe, autistics. Since autistics are no longer being misidentified as schizophrenics their numbers might well appear to be on the increase.

  11. I haven’t read all of the comments yet, but I’d like to chime in on Cardinal Fang’s observation that the question (for me and others) concerns an apparent rise in numbers of severely autistic people such as my own two autistic children.

    Having been agnostic on this issue for years, I’ve more or less come down on the side that the rise is real for two reasons.

    First, parents, pediatricians, and special ed teachers and administrators have been saying for years that incidence of autism is rising.

    People working in special ed are particularly compelling; these people have to create more classes, hire more teachers, etc.

    When we moved to Westchester I asked the head of the BOCES autism program whether she thought the increase was real.

    She told me Westchester had been swamped with severely autistic children for years (since the year my second autistic son was born, in fact).

    She’d had a long career in special ed, so she had a point of comparison. She was sure it was the case that some kids who were called “mentally retarded” twenty years ago are called autistic today.

    But, she said, “There’s no way we could have missed all those kids. There are just more of them.”

    Second Not long after that conversation I talked to Ezra Susser, who is, I gather, one of the best epidemiologists in the world, and who was at that time developing an interest in autism.

    I asked him about the status of “anecdotal” reports such as those from pediatricians, parents, and special ed professionals.

    Should we take them seriously?

    He said absolutely, yes.

    People “on the front lines” are the first to notice a change; they are the people supplying clues to epidemiologists.

    Parents, pediatricians, and special ed personnel could all be wrong, he said, but the fact that so many of them were seeing an increase was something “we have to take very seriously.” (I think those are close to his exact words.)

    After talking to Ezra I changed my position to a tentative “Yes, the increase is real.”

  12. Cardinal Fang says:

    Right, allen, but then you’d expect that there would have been a decline in the number of schizophrenics, as autistics were no longer misdiagnosed as schizophrenic, and AFAIK there hasn’t been any such decline.

    Also, doesn’t schizophrenia start to manifest itself in young adulthood, whereas autism would be noticed in toddlers? So that would make it less likely that autistic people would be misdiagnosed as schizophrenics.

  13. “I think there’s a genetic link. In days past, weird Cousin Harold didn’t marry, didn’t reproduce.”

    It’s not just autistics. In the past, there was very, very strong social pressure against men marrying before they could support a family as well as against reproduction outside of marriage. That meant that the retarded rarely reproduced, either. It’s possible to be retarded rather severely and still work menial jobs, but those jobs have never paid enough to be even half of the support for a family. (Nor should they; for normal people, these are the jobs you do as a teenager when you don’t need to be self-supporting.) Now, the retarded can reproduce, with or without marriage, and welfare picks up the tab.

  14. Cardinal Fang says:

    Markm, I don’t have a position on whether autistic people (or retarded people, for that matter) should be reproducing, but the theory of assortative mating as applied to autism is not that autistics are having autistic children. Instead, it is that non-autistic people who tend to be “systematizers” marry other non-autistic people who are “systematizers” and some of those pairings result in autistic children. I live in Silicon Valley, and I personally know of at least seven couples where one techie married another techie, and they had a child on the autism spectrum.

  15. Kristin Chew has a well balanced review of this book for anyone considering a purchase.
    Best wishes

  16. Indigo Warrior says:

    I think there’s a genetic link. In days past, weird Cousin Harold didn’t marry, didn’t reproduce. Today, and I’m not trying to be a jerk, he gets an IT job, meets a woman with the same interests and recessive gene, and has a kid who’s on the spectrum.

    In days past, Weird Cousin Harold, if he was intelligent and responsible, was more likely to be socially tolerated. He likely held a routine job in a low-tech office where the bosses and HR types didn’t care about social glitz. WCH would have likely married a nice “un-liberated” supportive motherly woman and sired offspring with mostly “normal” genes.

    It was the 1945-1965 and 1975-1995 eras (very approximate) when the educational establishment cracked down most strongly on nonconformists. The WCH of those times, if he didn’t jump off a bridge at 16, never married. After 1995 or so was when WCH found his soul-mate in Silicon Valley.

  17. The people who say it was because weird Harry didn’t marry and now they do that there are alot of autistic children are grossly misinformed, not to mention insulting to all developmentally disabled people.

    My husband and I are both lawyers from Ivy league schools and valedectorians of our high school classes. We are not techies or geeks and we have no genetic history of autism, metal retardation or any other developmental disability. And we have an autistic child as do many other parents like us.

    It is this kind of ignorance that we have to face every day.