Well Being

What if there is no autism epidemic?: Roy Richard Grinker in Time magazine

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There is No Autism Epidemic was the title of a post in the Huffington Post last week in which Evidence of Harm: Mercury in Vaccines and the Autism Epidemic – A Medical Controversy author, journalist David Kirby, proclaimed with heavy irony that there is indeed “no autism epidemic” and then went on to suggest that the many children now called “autistic” with various severe symptoms do not have autism, but some other disorder caused by environmental toxins. The deeply sarcastic tone of Kirby's article was underscored by his closing sentence in which he refuted the thesis of his own book, “Columbus was not in the Indies, mercury doesn't cause autism, and there is no autism epidemic.”

This week, another article presents an argument for why “there is no autism epidemic.” But this time, the claims behind the argument, and the evidence, are real and made to advance our understanding of autism, not (as is the case with Kirby's article) as a rhetorical exercise.

What Autism Epidemic? is the title of an article by Claudia Wallis in the January 11th issue of Time magazine in which George Washington University anthropologist Roy Richard Grinker “persuasively argues” that there is no epidemic of autism: “In Unstrange Minds: Remapping the World of Autism, Grinker uses the lens of anthropology to show how shifting cultural conditions change the way medical scientists do their work and how we perceive mental health.”
Unstrange Minds: Remapping the World of Autism
Fives points are noted:

  • BROADER DEFINITIONS Grinker and others say 50% to 75% of the increase in diagnoses is coming in these milder categories [of PDD-NOS and Asperger's Syndrome].
  • SCHOOL POLICY U.S. schools are required to report data on kids who receive special-education services, but autism wasn't added as a category until the 1991-92 school year. No wonder the numbers exploded–from 22,445 receiving services for autism in 1995 to 140,254 in 2004…………..
  • MORE HELP, LESS STIGMA As services have become more available for kids with autism, more parents are seeking a diagnosis they would have shunned 30 years ago, when psychiatrists still blamed autism on chilly “refrigerator” mothers.
  • FINANCIAL INCENTIVES In some states, parents of children with autism can apply for Medicaid even if they are not near the poverty line. A diagnosis of mental retardation doesn't always offer this advantage.
  • RELABELING For all the reasons above, many kids previously given other diagnoses are now called autistic.

Wallis notes one argument that will likely be raised to challenge Grinker's analysis: If there is no real increase in the incidence of autism, why is there such a “mysterious paucity of autistic adults”—–if 1 in 166 children are estimated to have autism, then there ought to be 1 in 166 autistic adults out there too. Dr. Robert Hendren, executive director of the M.I.N.D. Institute at the University of California, Davis, is quoted as saying that “‘”I think we would be recognizing them in institutions'”; Grinker's response is that “autistic adults are out there but wearing other labels.”

The idea of an epidemic is “reassuring,” Grinker observes. Thinking that some “mysterious environmental trigger”—such as lead or mercury—-has caused a dramatic increase in the incidence of autism is simply “‘easier,'” he notes, and much more so than understanding how the increase has arisen from a complicated combination of “‘multiple causes, shifting definitions and a scientific reality we are only just beginning to understand.'”

In his forthcoming Unstrange Minds, Grinker indeed writes that “the prevalence of autism today is a virtue, maybe even a prize” (p. 171). We see so much autism because we know what autism is. And because we know so much about autism, many more educational and school programs and services that are geared to autistic children, and that work, have been developed that did not exist before: We don't need an “autism epidemic” to explain why we need the best education and services for autistic children and adults; we need the best education and services for autistic children and adults because they need them, period. These programs and services need to continue to be supported as we continue to learn more about autism, about more ways to teach autistic children and support autistic adults; as we continue to seek effective and, as Grinker writes in Unstrange Minds, “real solutions”:

“I am not so sure why people are so resistant to the idea that true autism rates may have remained stable over the years, and that there is no real epidemic……If there is no real epidemic, we might just have to admit that no one is to blame. Their desire is understandable. But we cannot find real solutions if we’re basing our ideas on false premises and bad science.” (p. 171)