The number of autism diagnoses has risen steadily in recent years and currently stands at one in 45 American children diagnosed each year. There’s been concern that the increase is being fueled by environmental causes, but a new history of autism research says the condition has always been common and is widely misunderstood.
In NeuroTribes: The Legacy of Autism and the Future of Neurodiversity, SteveSilberman walks us through the history of autism research, including the work of Hans Asperger and Leo Kanner, the first to describe autism. While Asperger’s work was remarkably insightful, Kanner’s 1943 definition of autism was too narrow, Silberman argues.
For example, Kanner would exclude children if they had seizures.
“Now we know that seizures are very, very common in autism,” Silberman told WCAI.
Why does that matter now?
Because of the dramatic rise in autism diagnoses.
“If you read a story in the New York Times about the rise in autism it will say, ‘It’s a mystery, it’s a puzzle, it’s a baffling enigma.’ Really? Is it really such a bloody puzzle?” Silberman said.
Silberman argues that for decades the numbers were artificially deflated by Leo Kanner’s overly exclusive model.
In his view, there is no tsunami of autism caused by a mysterious environmental agent. A much more likely explanation is that there has been a stable population of autistic people all along. He points to a study in England that sought out undiagnosed autistic adults and found that the rate of autism among adults is exactly the same as it is among children.
“What there are are millions of autistic adults out there who were never diagnosed or were misdiagnosed and who need our help,” he said.
Silberman has sympathy for families of autistic children who took stock in Andrew Wakefield’s widely discredited study that purported a link between vaccines and autism.
“It’s a very believable and emotionally compelling story,” Silberman said. “It just happens to be false.”
Similarly, concerns about other environmental factors causing a rise in autism should be viewed with caution, he said. For example, Hispanic families in Florida have a low estimated prevalence of autism.
“Now, is it really true that Hispanic families in Florida are protected from whatever this mysterious alleged thing is that is causing this rise in autism?” he asked.
More likely: they haven’t had access to diagnostic health care.
Good things are coming out of the movement to diagnose autism accurately and recognize the strengths of people with autism. Silberman applauds companies like SAP and Walgreens, which created a distribution facility staffed by autistic people and other people with other kinds of cognitive disability.
“It was their highest performing distribution center in the whole country,” he said. “What we are finding is that people with autism are really a boon to our workplaces, our communities, and our schools.”