Autism: A Disease of the Rich?

The higher rates of diagnosed autism among the wealthy has long been thought to be a result of higher rates of diagnosis (or “diagnostic?ascertainment bias”) – i.e., wealthier families having better access to those who diagnose autism. However, a new paper argues that the disease itself might actually be more common at the higher end of the income spectrum. The paper relied on “abstracted data from records of multiple educational and medical sources to determine the number of children who appear to meet the ASD case definition, regardless of pre-existing diagnosis. Clinicians determine whether the ASD case definition is met by reviewing a compiled record of all relevant abstracted data.” Within all ethnic groups, wealthier parents were more likely to have autistic children, and the pattern held for undiagnosed autistic children as well. Neuroskeptic hypothesizes that paternal age may be partially responsible for the disparity. (HT: Marginal Revolution)[%comments]


Drill-Baby-Drill Drill Team

If I were a young intern and I had to pick a specialty, it is a NO BRAINER.

I would specialize in the DISEASES OF THE RICH, preferably Billionaire's Disease.
"Does it hurt when I poke your wallet?"

Henry Lahore

Autism is probably actually related to amount sunlight that the mother got. The richer mothers do not get outdoors as much. There are a many studies showing an association of autism with latitude, season, darkness of skin, rainfall in the region, smog, ... There are some clinical trials underway testing for the decrease in autism when the pregnant mother takes vitamin D. For more information look at VitaminDWiki under the category Diseases / Other

Melody

@18 - You got it! Also, parents of lower socioeconomical status are more likely coined as having 'poor parenting' skills. As a result, they are less likely to bring up issues if they DO go to a medical clinic.

Christian

My sister is autistic and we grew up relatively poor in Appalachia. Its disheartening when I read all the ridiculously uninformed opinions on this blog. If you don't have any real experience with autistic folks why would you bother putting your two cents in?

Melanie

There was a great article on autism that Wired did a way back, and it covered the huge jump in childhood autism diagnoses in Silicon Valley in the 90s (something like a 400% increase, so extreme that some employers there now offer extra insurance riders for autism).

The conclusion of the authors, which may or may not have been medically-based, was that the parents were on the autistic spectrum, but high-functioning enough that they may not have known, or at least they weren't seriously affected by it. When these folks started to migrate to Silicon Valley and started to mate, however, their children were born with serious autism, inherited from the parents.

Maybe it's only in the last few decades that ASD-correlated skills (math/science/engineering) correlated with greater wealth, and maybe it's only in the same time frame that these kinds of people were able to find each other easily and mate?

I get the feeling that Aspies of yore didn't have as much opportunity to mate, given the social shortcomings of the disease.

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Tom

I don't have an answer but I do have a possible method for finding out what caused the autism epidemic. I don't buy into the idea that it's genetic or caused by vaccines although I'm sure both of them have impacted diagnoses on the margins.

What someone really needs to do is compile every change that took place in both pre-natal care and post-natal care between say 1980 and 1998. Then use autism rates as the dependent variable and each of these changes at the independent variable. This is one of the first steps in building any sort of regression model and yet it doesn't even look like the medical community has tried. They keep on trying to disprove the Vaccine Theory, suggest that it's just more awareness, or claim that it's related to genetics. Maybe it's something as simple as doctors have been recommending massive doses of Vitamin XYZ since 1986....I don't know.

But, someone should at the very least analyze all the changes that took place in pre-natal and post-natal care between about 1980 and 1998. That to me seems like a sensible place to start rather than speculation about genetics, vaccines, pollution, awareness, etc. Maybe there's a high correlation between autism and one of these changes. If we don't experiment and mine the data we'll never find the answer. But, I doubt it's any of the speculation that has been mentioned so far.

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Tom

"As the father of twin sons, one with full blown autism, the other with the diagnosis of PDD, I can unequivocally state that autism is a disease of the rich."

Just out of sheer curiosity have you had them take sleep studies yet. There is a high correlation between sleep disorders and autism. It's a correlation that is much higher than even the correlation between autistic children and wealthy/well-educated parents. Sleep apnea, poor REM sleep, and poor slow wave sleep are just some of the sleep disorders common to children with autism. All the Best!

Kaos

A disease of the wealthy? Gee, that must be the only association my extended family has ever had with wealth. My mother had ASD, as did all of her children (four of them), my children (three of them), and all my grandchildren (four of them). Although there are some brilliant IQs in the lot, there are also some very average IQs. My mother, no more than average IQ, had us in her 20s. Noone in the extended family was well educated--most had not even finished high school, and only one ever went to college (yours truly). Noone ever suggested any of us were ASD. Lots of outlaws in the family. Nobody had the luxury of going to a doctor, for any reason (dirt poor). We had those vaccinations required by law.

So, I don't give the theory a lot of credence--I adamantly believe that wealthier people have a higher incidence of REPORTED ASD in their families, at least for the most part. But I do think that when two people who have ASD, but function "well enough" get together (likely to happen in such fields as computer technology and academia), the chances of having a child who has ASD is greatly increased. Although the wealth equation doesn't work in my family, the heredity factor certainly does.

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BW

I believe there is some information out there indicating ultrasounds could be a cause of autism. Would make sense as the wealthy patients are more likely to get an early ultrasound than poorer patients. Also, ultrasound testing is a newer technology.

Eric M. Jones

So far it seems unlikely that the causes, treatment, prevention of autism will be found by comparing anecdotes.

When my brother and I were four and five, we dug out the brick outhouse pit of an old school that had existed from 1830 to WWI. It was black and dirty work, but what this might have done to our immune system can only be guessed at.

The very newest ideas regarding autism can be found at:

http://www.sciencedaily.com/search/?keyword=autism

bensmyson

If I write a book about ignorance in America, this discussion will be chapter one.

Edward

Perhaps the same socio- and psychodynamics lead to overdiagnosis of 'depression' or 'ADHD' among the upper-middle-classes also explains the overdiagnosis of 'autism/PDD'... that people with a certain level of education and wealth have a higher disposition towards medicalizing 'divergent' behavior or seeking grandiose explanations for life's peccadillos? Or as a way to delegate away parental responsibility to medical professionals and explian away shortcoming as unavoidable 'circumstances'?

Ed Hall

Intelligence tends to be hereditary. Aspies are generally very intelligent, and tend to come from very intelligent parents. It's a good bet that those intelligent parents have managed to become rich, or at least upper middle class.

R

I presume the research method was to measure wealth at date of copnception. Surely the costs of intervention and education will deplete most wealth of families and earning power of parents suffer due to caregiving and stress of ASD. Cause lies in genes and not in the bank account and perhaps in part by by IVF realted procedures, ICSI. I find of greater interest the number of ASD or delayed twins in early education intervention pre-schools.

Julie

I work for a non-profit, providing information and referrals to resources having to do with autism spectrum disorders. In this capacity, I talk daily to all sorts of people, including parents, social workers, individuals with autism, educators, and medical personnel. I do not talk to rich people all day, by any stretch of the imagination. Rich people are just the ones that can be reliably interviewed, counted and tallied. Period.

Barbra Agazzi

My son is autistic, diagnosed 16 years ago. We are not, and do not come from, wealth of any kind. I was 27 when he was born, my home is kept up in an average fashion.

All of this type of nonsense takes away from studying the real issues. How do we truly help people with autism ? How do we do it with safety ? How do we do it without bankrupting the families ? How do we make a governed organization that licenses the endless businesses that survive by promising cures to desperate parents. And ...... what are our states going to do when the large numbers of autistic people hit adulthood ? The financial implications are huge.

Pat McGee

One speculation I've heard is that many cases of autism are related to ultrasound use during the period of intense neural development. Has anyone seen any real data to support / refute this?

Maurine Meleck

The comments and the main piece here are just ridiculous. People read this article and right away buy into a study that is as relevent to autism as a hearing aid is to a blind person. It belongs in the same catagory with the previous studies on refrigerator moms, old dads, too much rain, too much television, young mothers, --------------throw away catagory. New study out-very relevent: Influence of pediatric vaccines on amygdala growth and opioid ligand binding in rhesus macaque infants--and yes, major difference between those vaccinated and those that weren't.
Vaccines cause autism--or rather pediatricians cause autism.

Gesa I. Barto

Good grief! Look at the websites of the big autism organizations, the zillion support groups all over the country, the many volunteers, the parents that step out of their skin and educate themselves, cooperate with schools and outreach programs. There is help if you can read, write and understand basics. Yes, for now Autism it is what it is. The last 15 years have provided us with a wealth of knowledge how to address autism of all severities and the results are good - one often can change the course of autism with intervention. Professional intervention and a sound program is fabulous and not everyone is so lucky to be able to put a team together and map out a plan for various scenarios of the future. But if you are serious about helping your child, go and seek out the resources - most of them are free and with the help of an outreach program you can learn to help your child tremendously, meaning: becoming a deeper, knowlegeable, stronger parent. Labeling Autism a 'disease' of the rich' - (or is meant 'for' the rich???) is just bad taste. The state of Florida as an example, has CARD (Center for Autism and Related Disabilities) in place at all universities with strong and modern outreach teams to work with families on all social levels. All other states have similar service structures in place. Most of the families who register have no financial resources, therefore the help is free - the taxpayer picked the tab up already. You just need to start moving instead of complaining and whining.

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Sceptical

Rich people tend to procreate later in life.

Rich people tend to have small -- or single-child -- families.

Parents in small/1-child families have the time & resources to be "helicopter" parents.

Expect a lot of ASD from the Chinese 1-child policy.