The Causes of Autism: First Things First

So the news du jour regarding the causes of autism (which I used to keep track of when I wrote at Autism Vox) is........ have fewer firstborn children. Or, as a post in yesterday's Scientific Blogging puts it, "Forget Vaccines - Maybe We Can Lessen Autism By Having Fewer Firstborn Children---which is to say, have fewer children, period.

Not possible.

Scientific Blogging reviews a recent study by researchers at the University of Utah School of Medicine. The study, which is published in the April 27th Pediatrics, looked at children who were firstborn or breech or whose mothers were 35 or older when giving birth, and found that these children are at a significantly greater risk for developing an autism spectrum disorder. Or, as Scientific Blogging puts it, "Firstborn? Those are 50% of all kids in America"---so 50% of children in the US would be on the spectrum:

Women who give birth at 35 or older are 1.7 times more likely to have a child with an autism spectrum disorder (ASD), compared with women between the ages of 20-34;

Firstborn children were nearly 1.8 times more likely to have an autism spectrum disorder;

Breech born kids, meaning they were not born head first, were 2 times more likely to have autism, though the researchers say they didn't identify a causal relationship between breech births and autism.

Researchers looked at the birth records of now 8-year-old children who had been identified as being on the autism spectrum in a 2002 epidemiological study by the U.S. Centers for Disease Control and Prevention. The children lived in Utah's most populous counties, (Salt Lake, Davis, and Utah); researchers compared birth records for children on the spectrum with "unaffected" children who were born in those three counties in 1994. Of that group, 196 were identified as being on the autism spectrum.

I have one reaction when I read about research on the topic of "causes of autism": I review the criteria quickly and consider whether any of it applies to Charlie.

In regard to this study: Yes, Charlie is our firstborn (he can't help it; he's an only child). No, he wasn't a breech baby (his quite large head had something to do, we speculate, with him taking quite a long time to be born). I am currently closer to 35 now than I was when he was born (I'm 40, so you know).

Of course, different families will have different responses to the study. I found myself worrying much more over these sorts of studies, and over the general issue of "what causes autism?" much more when Charlie was 5 and under. After that, I started to become much more aware of how Charlie is similar to Jim and to me---as I wrote back in October as a panelist for the Science Blogs Book Club:

He's not just because of a shot." My husband, Jim, a historian at Fordham University, often says this about Charlie. As each day passes and we learn more about Charlie, learn about how he communicates (he is minimally verbal) and what his strengths and talents are (not reading, not anything academic---Charlie is far behind his peers in school), we see more of ourselves in Charlie. Hyper at night and happiest when in motion: That's Jim. Able (quite obsessively) to focus on one thing and liking things to be in their places: Ca, c'est moi.

Charlie's Charlie because he's the child of Jim and me. He's very, very like both of us; many things about him seem a sort of Jim-and-Kristina-Irish-Chinese-Catholic-Classicist-Jerseyite-Californian combo (for one thing, Charlie's physical appearance: He's looked like "me as a boy" since he was born, but his height and body type are clearly inherited from Jim's side). However Charlie got to be Charlie----well, I do find it interesting to consider new theories and ideas, but, even more, I like to take the long view. How Charlie became Charlie: That was something that happened once upon a time and now it's now and I'm looking at tomorrow, and thinking about all that lies ahead for Charlie.

One thing i know is that Charlie does best in a highly structured setting in which he has a clear idea of what to do and of what's expected of him, with some "wiggle room" for spontaneity, variation, flexibility. He was sleepy Monday morning after a week off from school for Spring Break but once Jim got Charlie down the stairs, Charlie was all excited running up and down the parking lot, and running onto the bus, and having one fine day. Nerves got to him in the afternoon---my parents are leaving today on a plane and Charlie knows that full well---and he pulled himself through it and we all went to the pool for an early evening swim. (For Charlie and me; my parents don't swim, but after an April day in the high 80s, the water was just the thing to cool our heads and heels.) Afterwards my parents treated us to Chinese takeout (from the "we don't use MSG" restaurant) and we sat on the living room floor with three kinds of noodles with chicken and some extremely spicy tofu and vegetables that Charlie particularly enjoyed, between big sips of water.

And there's my news du jour about my (yes) firstborn boy, who's on the autism spectrum.

Image from massal.net.