"Epidemic," Bettelheim, Science: Simon Baron-Cohen on Autism

Most of us have heard of professor Simon Baron-Cohen, director of the Autism Research Centre. He's frequently dubbed a "leading autism expert"; he's written a number of books on autism (like this one and this one, which is about his "extreme male brain theory" of autism), and authored a number of research articles and many essays, and done tons of interviews. His latest publication suggests that the prevalence rate of autism in Cambridgeshire in the UK could be 1 in 64.

The June 3rd Forbes has an interview with Baron-Cohen in which he makes some quite direct statements about topics that keep recurring, including the question of whether or not there's an "epidemic of autism" and causation. Particularly interesting (to me) were some statements he said about the time period and cultural climate that we live in can color our understanding about autism.

First, the "epidemic" question. In response to a statement by Autism Speaks co-founded Bob Wright that compared autism with swine flu, Baron-Cohen said:

"I don't think it's the right way to think about autism, as an epidemic," he says, sitting in a room at the Chicago Hilton, where the 2009 International Meeting for Autism Research is taking place. He has reason to be wary of hyperbole and distortions. In 1998 British gastroenterologist Andrew Wakefield published a study in the Lancet linking autism to the vaccine for measles, mumps and rubella. The paper was based on only 12 subjects, and the theory has been debunked in much larger studies. Wakefield is being investigated by Britain's General Medical Council for, among other things, misrepresenting his subjects' medical records.

Baron-Cohen states that "'A good part' of the rise........can be explained by better diagnosis and an expanded definition of autism."

"Epidemic" being the controversial term that it is, I await comments to the contrary.......Baron-Cohen has some other things to say about which consensus will be more widespread (endemic?) on. On Bruno Bettelheim:

As late as the 1960s autism was thought to be a result of bad parenting. The main proponent of that theory was the Chicago psychoanalyst Bruno Bettelheim (1903--90), who recommended that children with autism be removed from their families. Today Bettelheim is a reviled figure among parents of children with autism. "I keep looking for him as I walk around," Baron-Cohen says. "I'm fascinated by how people work within the framework of the time [my emphasis]. He probably thought he was being kind ... and it led him to a form of practice which today just seems unthinkable."

I don't know when, but someday we'll be stepping back and casting a critical eye on the "framework of the time" that we're caught up in, a framework that hypothesizes autism as perhaps caused by "something" (some quite vague thing) in the environment, which is now quite broadly defined to include things like toxins and pollutants in the air as well as vaccines. Dr. Steven Novella recently wrote about the "backpedalling" going on among proponents of environmental/external agents as causes of autism; there's a tendency, he notes, to keep switching to different toxins, chemicals, etc. as potential agents. As the recent Newsweek article on the appeal and influence of Oprah showed, the belief in biomedical treatments and "bioidenticals" is not only the case for parents seeking "treatment" for autistic children. There's a faith out there that the medical information one finds oneself (via the internet; via Oprah) is at least as good as, if not superior to, what your doctor tells you. This belief exists among people (women in particular) getting older, among those seeking to lose weight, in anyone seeking fulfillment in their life, and self-improvement.

Alternative autism treatments have numerous overlaps with treatments prescribed for conditions and illnesses ranging form Lyme disease to Lou Gehrig's. So it's no wonder that parents seek out these treatments, which are being talked about as possible curatives for ailments that many are suffering. Shortly after we put Charlie on the gluten-free casein-free diet in 1999, we started to hear about the same diet as a treatment for multiple sclerosis (which Jim's father has) and various other conditions. How often does it happen that people these day want to find a treatment, a cure, for whatever ails them or their loved ones, and they, indeed, find one after doing the requisite "research on the web"?

A final quote from Baron-Cohen in the Forbes article is in fact about science:

"Science is quite a lot like what kids with autism do," he says. "You know, you look for repeating patterns."

Which is to say.........