Something that really, really annoys me is reading a paper discussing a rich and complex data set in which the authors squink their eyes tightly and use statistics to zoom in and stare fixedly at one parameter. It happens all the time. It’s as if some scientists think it’s a triumph to reduce a phenomenon to one single simple cause, rather than appreciating the diversity of inputs.
The latest example is a study pegging yet another medical procedure as the cause for autism, in this case, early induction of labor and augmented delivery. Autism is probably a perfect target for these kinds of silly approaches; it almost certainly has a wide range of contributory causes, and it’s always a mystery to the parents of affected children, who look for answers. It’s the vaccines, they say. No, it’s the drugs we took during pregnancy. No, it’s the doctors who did funny business in the delivery room.
Fortunately, we’ve got Emily Willingham to actually look at the forest.
When she looks at the data, she finds that the authors are right, that there’s a correlation: if a mother gets both induction and augmentation, there’s a 27% increase in the chance that the child will later be identified as autistic.
What they don’t tell you is that the same data set shows that having a college-educated mother increases the odds of autism by 30-33%. And that smoking during pregnancy decreases the chance of an autism diagnosis by 14%.
Wait, stop! If you’re pregnant, don’t take these numbers as an indication that you need to start watching more Glenn Beck to make yourself stupider, and that you need to take up a tobacco habit. You’re looking at the tree again and ignoring the forest. What these correlations suggest is that we should be looking into some property of the population that unites them — that each one in itself is not necessarily causal, but that they are common symptoms of the true link. We need to see the big picture to puzzle out the answer.
And sometimes interpreting the phenomenology of a single parameter analysis would lead to a bad result: I can pretty much guarantee you that being a heavy smoker during pregnancy is much worse for the fetus than non-smoking.
Willingham does see the bigger picture.
This study didn’t show that induction or augmentation during childbirth substantially increases the risk for autism, although it hints at a greater influence of socioeconomic status and by implication, healthcare access. If anything, based on earlier literature, it adds a slight if only mathematical confirmation of the perception that births involving autistic children can be associated with more complications, such as the presence of meconium, gestational diabetes, and fetal distress, than births involving non-autistic children. And that points to induction and augmentation as useful in these situations, not as problematic, and certainly does not affirm them as a risk.
Oh, look, it’s practically a jungle!
So perhaps all of these “increases” are illusory: they are just increases in the chance of a child being diagnosed as autistic, rather than actual increases in the number of autistic children. The “cause”, if one can put it that way, is wealth and access to medical care. People with wealth and medical care access are:
– Less likely to smoke
– More likely to have access to access to hospital births with induction and augmentation
– More likely to have access to doctors and be vaccinated
– More likely to be college-educated
– And finally, more likely to have access to medical/mental health care providers who will diagnose their children as autistic.
People who carry matches have a higher rate of cancer, therefore matches cause cancer.
Chief among them is genetics. Autism has a strong genetic component.
A heritability of 90% is very high.
The genetics are complex with a 100 or so genes involved, all with slight effects, in combinations that we don’t really understand.
Seem to be getting cause and effect confused here.
Autism is still being examined in more detail. Although Asperger’s was put on the Autism spectrum not all that long ago, recent studies involving EEG scans of the brain have found very distinct differences in Aspergers vs other Autistic individuals. This is a big problem with using statistics in general…it can, and regularly does, obscure some very important details that get overlooked as a result.
If, in fact, there is a correlation between socio-economic status and diagnosis of autism, is it unreasonable to also check and see if that’s as much because EVERYTHING GETS DIAGNOSED MORE WHEN YOU ACTUALLY HAVE DECENT MEDICAL CARE??
Parents who are poor and brown have kids who are trouble makers, criminal and stupid. Parents who are not have kids with issues. And that’s WITHOUT any underlying neurological issue.
GAH, I’m cynical.
It’s not always a mystery. I have two children on the autistic spectrum. Also: me, my brother, possibly my husband; my mother and a maternal uncle also show some traits.
I wonder if age is a factor. If a woman is more educated, she might have put off having a baby until she (and the father) were older.
As already pointed out, educated women have babies later, have access to healthcare, and will get proper diagnosis of a child’s problems. It may also mean that autistic children just actually get born, complications and all, whereas poor women may be more likely to lose an autistic baby during gestation.
Using the faulty logic displayed in the paper above, you could probably say that prenatal medical care causes a rise in all infants born with an illness or disease, since lack of care resulted in fewer sick babies being born alive.
And yet, that isn’t accounted for either way in most studies I see of these correlations. I have two children, one on the autistic spectrum and one neurotypical. Everything about their pre-natal environment was the same except for one being the first and one being the second. My health was the same for each, the birth process was the same for each except that the one on the spectrum was the one who wasn’t induced, everything about where they grew up and which doctors they went to and what they ate and which shots they got were all identical.
ledasmom @ 7.
I think I was a bit of a mystery… until my little brother was diagnosed autistic thanks to a language delay, and it occurred to Mom that a lot of my ‘quirky’ traits were milder forms of autistic traits. Because my case didn’t have any language delays or really non-neurotypical traits, I likely would have gone un-diagnosed for much longer.
jolly @8
IIRC (don’t have the link handy), if you look at cases of kids with autism who lack family members on the autistic spectrum, there’s a correlation with their father’s age at the time of birth — kids born to older fathers are more likely to develop autism than those born to younger fathers. Which, as you note, older parents probably correlate with other traits.
@raven
#4
On that point, what are your views on parents sterilizing children with severe autism at an early age?
I’m not talking about high functioning autistic, I’m talking about those with mental faculties stuck at the sub-elementary school level.
On one hand, it’s a clear human rights issue (or children rights issue).
On the other hand, early sterilization means.
1. No chance of pregnancy. So for woman, no chance of needing abortion. For man, less urge to try to force himself on other woman (autistic or otherwise).
2. Suppress physical growth, so that they’re easier to take care of (easier to take care of a 90 lb under-developed autistic child than a 160 lb grown man who can break your bone because he doesn’t know what he’s doing).
Happened to a family friend, child has mental faculty of around 2nd grader. Cannot get him to stop groping women (he will stop for a while, and gets right back to doing it), and gets violent when anyone tried to tell him to stop. He’s pretty much banned from every mental care facilities (due to the groping and the violent tendency).
All they have to do is put a few key words in Google. It was what took me a whole 10 seconds to do to get to the Wikipedia summary. Or the National Library of Medicine.
While the heredibility is high at 90%, it isn’t 100%. Presumably, these correlation studies are looking at that environmental 10%.
????
This is a Gordian knot. It also isn’t a medical problem, it is a societal and ethical problem. I’m not sure there is any consensus as of yet.
For patients with noncontrolled sexual behavior.sometimes LHRH blockers are used. This shuts down the sex hormones. Again, this is a societal and ethical problem, not a medical problem. If the alternatives are worse, it might have a use.
In the case you mentioned, what are the alternatives? If it is solitary confinement in a lockup, it might be worth looking at.
Sometimes there are no good answers. One family has a vaguely similar child. She is large, active, healthy, and has an IQ less than a cat’s, literally. Right now, she is in state care in a facility with a 1:1 ratio of caregivers to patients. The state she is in is wealthy and has a history of a generous social safety net. In another state, Cthulhu knows what would have happened to her.
WharGarbl,
No, just no.
I don’t know what would be a good idea, but what you are suggesting… it’s making me nauseous.
re. point 1:
Talk about slippery slope. At which point should the society decide that someone is too mentally impaired? Where’s the cut-off?
re. point 2:
Same as point 1, with an extra jesus fuck what’s wrong with you?
Yeah, it’s easier to take care of a smaller and more defenseless human being, so we should suppress growth of disabled people to make them easier to take care of? Whattheeverlovingfuck?
I can’t imagine how difficult it must be for your friend’s family, but I can’t see how violating their son that way can in any way be a preferable option. Easier for them -yes. But then again, just locking him up in a room and giving him food through the cat door would make it easier for them too and I can’t imagine you suggesting that. But stunting his growth…. oh yeah, that’s fine.
@Beatrice
#15
I argue that its the parent’s decision. Ultimately, it will be them who will be responsible for the child’s future.
Again, up to the parent. The alternative COULD be a child that no one can safety keep safe (without getting hurt themselves).
Ever dealt with a 160 lb mentally challenged child who’s prone to physically lash out whenever things don’t go his way?
Unfortunately, they’re already past that decision point (he’s already mostly past puberty, hence 160 lb).
He’s on drugs, but even then he occasionally lash out.
It’s not just the “Easier for them” issue. It’s the issue with the child’s future. Right now, both his parents are still relatively healthy. But what if they grow too old to take care of him?
If the goal is to stunt growth as well as prevent pregnancy and the development of an adult sex drive, I assume what WharGarbl is describing is the Ashley Treatment.
I sympathize with parents dealing with a situation like this, but there still has to be some respect for the child as a human being. Especially since no matter how profoundly disabled an autistic child might be assumed to be, that can’t speak for their internal life. Please try to imagine for a moment that you are overwhelmed by the world and can’t communicate your frustrations with others in a way that they understand–and perhaps you try to cope in ways that are very upsetting or confusing to allistic people, or even hurt people–and then your family takes you to a doctor to treat you like a Bonsai tree. You can’t make anyone listen. All they see is that you’re being “difficult” again. Just because someone isn’t speaking like an allistic adult doesn’t mean they can’t be violated.
It’s an incredibly difficult task to care for someone in a situation like what’s described above with WharGarbl’s friends. There isn’t enough support and, yes, parents aging, dying or becoming ill themselves are inevitable complications. There have to be better options for supporting families in situations like this, but drastic, permanent surgery without informed consent can’t be the answer.
Thank you, Mellow Monkey, for making a much better comment than I did.
I cannot see a future where WharGarbl’s suggestion becomes a reality. However, I think it very likely that we are not too far from having prenatal diagnostic testing that can establish a risk level for autism, along with a whole bunch of new risk factors. At that point people may decide to abort a pregnancy with a high risk of autism, but they will be the ones with better access to healthcare.
@Mellow Monkey
#17
That’s what I was asking about. Although the precise detail may vary, but the end goal is the same.
Yes, but how about those who have to take care of him, now and in the future.
Well, what other options do parents have right now other than just giving up their child for state ward (assuming they accept him) when they grow up to be unmanageable? How about those without the financial resource to put him/her through therapy to at least keep their behavior under a more tolerable level?
@Dutchgirl
#19
It’s already a reality. The procedures exist. People use it (at least in Taiwan before I came to US). It’s effect is well understood (stunt growth).
Which is why I mentioned “either way” – I’m thinking specifically of the ones that tout the link between X and autism as causal without seeming to discuss what about the people who have X and no autism even when they have the same genetics as the ones who have autism.
@Carlie 21
I’m not sure what you mean here.
The heritability is 90% from identical twin studies.
So that leaves 10% as environmental.
If you meant, why is one twin autistic and the other not, 10% of the time, well, who knows?
They keep running correlation studies but correlation doesn’t necessarily prove causation. In the case above, birth difficulties seem to have more to do with developmental problems caused by autistic genotypes than birth difficulties causing autism. The cause and effect are reversed.
You also have to remember identical twins are uncommon. Austism is uncommon. Getting huge numbers of identical twins with autism isn’t possible.
Whargarbl: That’s monstrous of you to even propose. No, you cannot treat other humans as bonsai, why the hell do you even think that’s a thing to ask? You are talking about human beings, and all you can do is lament that they’re not more convenient for their carers. Yes, the lack of care options is a thing that needs to be addressed, it all usually falls on female family members, but for fucks’s sake, how the hell is mutilating other humans without even a thought for their consent or humanity a thing you propose?
Whargarbl, while I can’t say I’m surprised to see such a clueless, loathsome attitude from you, I am surprised to see such utter stupidity entwined with an utter lack of empathy. You should be flat out ashamed of your so-called contributions in this thread, and learn to think before you attempt any more so-called contributions.
What in the fuck… if you believe “severe autism” looks like this often enough that it’d even make sense, just logical sense, to consider any across-the-board action as a preventive measure…
I’m out of words before I even get to your scary lack of empathy. Yes, scary.
@katherinemuzykzka
But also depressingly accurate. *sigh*
I am practically tearing my hair out at Whargarbl’s comments. What the ever loving fuck is wrong with that… person? Autistic people ought to be sterilised and have their growth stunted? What. the. fuck!?
A lack of a social safety net that adequately supports people with ASD and their families means you think the proper response is to chop out a child’s gonads on the off-chance that when they hit puberty they might be sexually inappropriate?
WHAT THE FUCK
I had given you some credit in my first response here, assuming you just hadn’t thought through what you said and didn’t realize the implications. Clearly, I was wrong.
The way to deal with these problems is to fight tooth and nail for better support. The solution is not to treat people like bonsai trees. An autistic child is going to turn into an autistic adult someday. Surgically altering them to try to maintain the illusion of childhood (and let us not forget the nice eugenics side of sterilizing them) to make it easier to cart them around is so outrageously repulsive I don’t even know what to say. A lack of money is not an excuse to carve someone else up for your convenience. It is a terrible injustice that more is not done to support people, but that doesn’t mean that the person who needs the most support should be surgically altered. It means we need to make sure better support is available.
Thanks for drawing my attention back to this, Happiestsadist. This is what I get for giving someone the benefit of the doubt. Ugh.
@David
#25
@Thumper
#27
Go back and read it again. I was asking if the option should be available to the parents to do so, if they believe it to be necessary. I do not, and will not, advocate for mandatory Ashley treatment.
@Happiestsadist
#23
@The Mellow Monkey
#28
And when can you promise that? When can you promise adequate care is possible? And that adequate care is affordable? Can you promise that their child won’t become homeless once they’re dead or incapable of caring for them? Next year? Next decade? Next century? And what happen when that support didn’t become available in time? Oh too fucking bad, they’ll just have to become homeless or live in solitary confinement for the rest of their life?
Of course it is fucking monstrous! The very situation itself it fucking monstrous! Have you EVER take care of any autistic child on the far end of the spectrum? The ones that will attack you at the slightest provocation, and is more than capable of sending you to the hospital? Ones that NO mental health group/home/facility is willing to take because he’s a danger to other people? Have you ever have to worry about saving enough money to pay for specialized care for an autistic child for the rest of his life AFTER you’re dead?
The only reason I knew of the procedure (not by the name Ashley treatment, but the general idea of growth control through sterilization) was that the child’s parents discussed it. They’ve seen other parents going through with the procedure and the results. They’ve met parents with children on the far-end of the autism spectrum that made their life a living hell. They constantly worry about what would happen to their child IF they pass away.
WharGarbl! I’ll put this in simple form so you can understand, given the limits of your intellect:
SHUT. THE. FUCK. UP.
GO. AWAY.
There, simple. Now do it, you fuckwitted doucheweasel.
Nobody has the right to decide to maim another person for their convenience.
Nobody.
And WharGarbl? Go step on a Lego.
What Caine and ischemgeek said. The problem is of a lack of resources, not to mutilate people against their wills. I hope you’re never in charge of anything beyond maybe a houseplant, Whargarbl. And even then I’d pity the plant.
@Happiestsadist
#32
Yes, if the resources are available, then there’s no need for such a practice (and I’ll be beyond happy when such a thing becomes reality, that every autistic child, regardless of severity, can be taken care). But right now, for the parents trying to find a solution, what should they do? Should that option be considered at all? They don’t know if there will be such resources for their child. They don’t know if they themselves can provide enough resources to take care of their child. As far as they know, this gives their child the best chance of being provided for even after their death.
Should they be considered monsters for considering such an operation?
Yes, you absolute dipshit! You still don’t get to mutilate people, even when it’s difficult! No, you don’t get to have your happy little eugenics party for any fucking reason!
No, it is not ever okay. NO.
What the fuck is so hard to accept about the concept that other people are people and their bodily autonomy matters?
Full stop.
No, you don’t get to decide who gets rights and who doesn’t. No, you don’t get to pick and choose whose body gets mutilated and whose doesn’t. No, you don’t get to sterilize those undesireable to you. No, no, no.
WharGarbl!
FUCK OFF. NOW.
@Whargarbl #29
<blockquote
Go back and read it again. I was asking if the option should be available to the parents to do so, if they believe it to be necessary. I do not, and will not, advocate for mandatory Ashley treatment.
[emphasis of my quote is whargarbl’s]
Fuck you Don’t even try and make out that changing that word has somehow made your proposition more ethical. Let’s have a pop quizz!
What is the moral difference between:
A – “I think all autistic children ought to be sterilised and have their growth artifically inhibited”
B – “I think parents of autistic children ought to have the option of sterilising and artificially inhibiting the growth of their children”
Answer: Negligible.
Autistic people are still people, arsehole. They still have rights. The right not be sterilised and have your growth artificially inhibited without your consent are pretty fucking basic human rights. Parents do not own their children, and they do not have the right to subject them to this, regardless of what handicaps the child may or may not have.
Again, whargarbl, just in case you missed it the first time: fuck you.
Fuck you too, Borkquote; why would you strike now!?
Everything before my footnote in square brackets was meant to be in a blockquote.
WharGarbl:
The suggestions you make are violations of bodily autonomy. There is never an excuse to treat any human being in such a manner.
I am gobsmacked that you would even propose sterilizing children.
Well, that’s why I wrote “consider”. You even quoted it.
Has it ever occurred to you that children aren’t property of their parents?
Private people saving money for medical care?
It’s a question of political will whether anyone has to pay medical expenses on their own! You should campaign for universal healthcare instead of for letting parents turn their kids into bonsai.
Why isn’t this painfully obvious to you?
Ooh. Now I see: you have a delusion of being Necessarily Evil, maybe even going this far.
Snap out of it.
There is no lack of resources. In the US, you could slash and burn the budget of the military, and nobody would notice, definitely not the terrorists. In the EU, you could merge the 27 armies*, the 26 air forces, and the probably 19 navies** and save a lot of money… There’s a lack of political will.
* Even Luxemburg has one.
** Even Slovenia has one.
WharGarbl, it is never right to make the most vulnerable people in society pay such a dreadful price for the faults of the society in which they are born. Even if the current situation is dire, due to the lack of will of those who have the ability to change things for the better. How dare you suggest otherwise? Demand support, not the right to inflict brutality on the disabled!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Until this thread, I would never have believed that anyone would prefer horrific surgical abuse was inflicted on helpless people than put in the effort to lobby their government to spend money on healthcare instead of the military. The last time I checked Wikipedia, I read that the amount of military spending of the USAian government exceeds the military spending of the next ten or fifteen countries combined.
Here.
A tiny fraction of that sum, which (as DM said above) likely wouldn’t be missed at all*, would ensure that every neurological difference, every disorder, every disability and every disease would be recognised at the earliest possible opportunity, people would have appropriate treatment and support to ensure they had the best possible outcome, and would have the facilities available for them to live in dignity, regardless of family means or ability.
*Except by the people making a profit from the way things are done at the moment. The current system, wherein some people get astonishingly wealthy off the back of an obscene military budget while ordinary, tax-paying citizens face financial ruin should they, or anyone dependent on them, be less than totally healthy, seems to me to be as wrong as any system can be. Yet I sometimes see, on the TV, ordinary Americans rallying for their right to be fleeced to pay for immoral foreign wars, and against any kind of medical support. I find it baffling.