The terms “autism” and “autism spectrum disorders” are used to describe a very diverse range of symptoms. There are also strongly opposing perspectives regarding the etiology of autism and the appropriateness of prevention and intervention strategies.  A NY Magazine article covered this issue a couple of years ago.

We recently published a paper investigating whether autism is more prevalent in wealthier neighborhoods.  We divided the population into thirds, and found autism to be nearly twice as frequent in the upper third compared to the lower third. This wasn’t just comparing the extremely wealthy to the very poor–the effect was fairly robust.

Our study was mentioned in a post on the NYT Freakonomics Blog and, as a free article, anyone can read our paper.  I thought it would be interesting to see how the NYT readers reacted to our findings.  After 1 week, I created (fairly arbitrary) categories to summarize the ‘theme(s)’ described in each of the comments.

When I did this (22 July 2010), there were 83 comments, and they mentioned the following topics (not mutually exclusive, sum exceeds 100%):

• SES-related bias (26%)
  22 Comments  indicated on some level that the socioeconomic gradient we observed had to do with children of wealthier parents having some advantage that leads to the higher observed rate. (Access to services, able to avoid the stigma of another diagnosis, etc)
• SPAM / WTF (16%)
  13 Comments  had no obvious connection to the article.
• Smart parents breeding (15%)
  12 Comments suggested that ASDs may be  inherited from parents with milder symptoms, and those parents were more likely to be successful in their careers.
• Judged the study  based on their own experience (13%)
  11 Comments either accepted (4 comments) or rejected (7 comments) the validity of the study based on anecdotal or personal experience. (e.g. “My son has autism and I am not rich. “)
• Vaccine-related (13%)
  11 Comments mentioned vaccines–either suggesting it as a cause (8 comments) or rejecting/mocking this idea (3 comments)
• Parental Age (11%)
  9 Comments raised the possibility that older parents were more likely to be in the higher-earning phases of their careers, or have delayed parenthood to go to school and are therefore wealthier. (The conviction with which one commenter declared it was paternal and not maternal age that mattered was fascinating in its own right.)
• Perinatal or Ultrasound (8%)
  7 Comments suggested perinatal factors or ultrasounds could pose an increased risk of autism.
• Environmental Causes (8%)
  7 Comments suggested environmental agents such as toxins, electromagnetic waves, vitamins, or diet.
• Expressed Outrage / Not a disease (6%)
  5 Comments indicated displeasure that risk factors for autism were being studied.  One commenter (who implied he had autism) attributed discovery of electricity and the inventions of computers and running water to people with autism.
• Hygiene Hypothesis (5%)
  4 Comments described the “hygiene hypothesis”–higher SES children were more likely to live in “hyper clean” conditions.
• Sleep (2%)
  2 Comments mentioned correlations between sleep disorders and autism.

This sample of comments isn’t necessarily representative of any group (other than NYT Blog readers?), and these subjective methods fall well short of “rigorous”.  And–of course–it is absolutely incorrect to interpret the popularity of any topic as a measure of its plausibility.

But, I think this does show that people often discuss autism with a very specific idea of what autism is.  To some, autism is a natural variation that carries substantial advantages.  To others, it is a debilitating disease with a long list of suspected causes.

I tend to think that these differing perspectives aren’t always referring to the same condition, but there aren’t adequate terms to describe the variety within the autism spectrum.