By Dan Olmsted
Last evening I climbed out of my home office/nest in the burbs and had a holiday drink in Washington's swanky Georgetown district with a friend and former colleague. I think I might have caught the Christmas spirit. The lights were twinkling in the elegant town houses, spirits were bright in the crowded pub, and a hint of the first big snow was in the air. There was a hint of something else as well -- something my friend happened to volunteer.
Knowing that I now work fulltime on autism and the "epidemic," he offered the following thought: "Why is it, when I have children two and six years old, that I don't know of a single child with autism? If it's 1 in 150, I should. All I know about is one child who got some kind of autism diagnosis, but he doesn't seem very autistic to me. He had some language problems but that was about it."
My friend has one of the best journalism barometers I've ever seen -- what a former editor called the "elevated common sense" that really good reporters bring to bear in new situations. Last night, he was detecting a change in the weather, it seems to me -- one that had nothing to do with the dropping temperature and threat of snow that promised to derail everyone's weekend plans.
Nor is he the only person who has said, in essence, the same thing: Autism ain't what it used to be. Younger kids with an autism diagnosis seem to be recovering in a way that older children do not -- at least their struggle often does not seem as long and their advances as painfully and provisionally incremental. Some of the big autism conferences seem to be drawing fewer parents of young children. Diagnosticians in Boston and elsewhere talk about "autism lite" -- not exactly Asperger's, but not exactly the full-syndrome Kanner autism we have all come to know, either.
What's up with that?, as Jerry Seinfeld, another acute observer of the passing scene, might ask. Well, what's up is that autism as we have known it may be declining, or diminishing in intensity, in ways that are not yet registering -- not in the California numbers, not in the hurry-up-and-diagnose-these-kids push by the CDC and the pediatricians, not in the fevered but fairly pointless ads from Autism Speaks. Ironically, over-diagnosis -- the bogus concept flung at those who have proven full-syndrome autism actually did soar tenfold in the past 20 years -- may finally be coming home to roost.
Come to think of it, I only know of one pre-school child with out-and-out autism from my own social circles -- a child I have not even met. He is a twin, and I'm told he and his sibling were premature, with low birth weights, and that something called caffeination (not just lots of Coke and coffee, apparently) was required to help them thrive. So -- special circumstances, high risk (his parents say he was different from birth). What I'm not aware of is a child of, say, four or five, without obvious risk factors, who has full-syndrome, regressive, treatment-resistant autism. I'm sure there are many (our readers' children among them), but as my friend pointed out, we can't help noticing that we aren't noticing them.
I told my friend that if his children were 9 and 16, I bet he would indeed know kids with just that kind of autism. And that's what made me stop and think. Is it the kids born in the '90s, who got the full brunt of mercury-and-live-virus combinations starting on the day of birth, who are bearing the brunt of autism? Is the government's laboriously compiled data a lagging indicator? Is something else entirely going on that we haven't gotten our minds around? Should we be paying less attention to databases from any one state or source, and more attention to the common-sense observations of my friend and people like him?
I'm starting to think we should.
Dan Olmsted is editor of Age of Autism.