Aristotle on the Spectrum

By Pollnow, Audrey | First Things; A Monthly Journal of Religion and Public Life, March 1, 2017 | Go to article overview

Aristotle on the Spectrum


Pollnow, Audrey, First Things; A Monthly Journal of Religion and Public Life


Aristotle on the Spectrum NeuroTribes: The Legacy of Autism and the Future of Neurodiversity BY STEVE SILBERMAN AVERY, 560 PAGES, $19

The alleged link between vaccination and autism has been thoroughly studied and debunked, but its appeal is understandable. The symptoms of autism typically begin to appear around the same age when many vaccines are given (which can lead parents to take a correlation for a cause), and there has been a massive increase in the reported incidence of autism over the past fifty years. Today one in sixty-eight American children is diagnosed as having Autism Spectrum Disorder. But one part of the story often goes untold: The diagnostic criteria have changed; a broader group of people now qualifies as autistic. Because of this, we can't know whether- or by how much-the actual rate of autism has increased over time.

Steve Silberman's NeuroTribes tells the story of autism's shifting diagnostic criteria, taking into consideration the -medical factors which motivated the proponents of different standards. Autism was first described in a public lecture in Vienna, given by Hans Asperger, in October 1938. Seven months after the Anschluss, it was clear that the Third Reich did not look kindly on the disabled.t Just a year later, Hitler would sign his involuntary euthanasia decree. Hoping to protect the children in his clinic, Asperger presented autism not as a disorder, but as an unusual personality with accompanying superpowers. To this end, his lecture focused on his high-functioning patients: "this boy's positive and negative qualities are two natural, necessary, interconnected aspects of one well-knit, harmonious personality.... [His] difficulties-which particularly affect his relationships with himself and other people-are the price that he has to pay for his special gifts." With the correct cultivation, Asperger argued, autistic children might turn out to be immensely useful to the Third Reich.

Three years later an American named Leo Kanner claimed to have made an independent discovery of what he called, without reference to Asperger's work, "early infantile autism." (Whether Kanner was really unfamiliar with Asperger's work on autism is questionable; one of the researchers on Kanner's autism team had worked in Asperger's autism clinic as a diagnostician.) Given contemporary psychiatric trends in the U.S., Kanner defined autism much more narrowly than Asperger had, with the result that a very small fraction of American children were diagnosed.

Asperger's work remained largely unknown in the Anglophone world until a British psychiatrist named Lorna Wing rediscovered it in the 1970s. Wing, whose daughter had been diagnosed with autism (under Kanner's definition), believed that a much broader range of children would benefit from an autism diagnosis. Finding Asperger's approach more compelling than Kanner's, she popularized it in a 1981 paper and worked behind the scenes to replace Kanner's definition of autism with something much broader. This led to an increase in diagnoses, which led in turn to an increase in public interest, funding, and resources for autistic children-all good things for the parent of an autistic child.

Because of these diagnostic changes, Silberman argues, we have no reason to think that autism incidence is actually increasing. Unfortunately, he refuses to engage with some compelling and well-established reasons for thinking that it is. For instance, we know that delayed reproduction-by parents of either sex-is a risk factor for autism, and that delayed reproduction has been increasing since the 1950s. We also know that autism is highly heritable, and that autism rates are higher in families containing engineers, physicists, or mathematicians. Our economy is increasingly structured to sort people by type, particularly when it comes to technical skills. Cambridge neuroscientist Simon Baron-Cohen has proposed that changing social conditions coupled with assortative mating-the phenomenon in which people are attracted to, and disproportionately reproduce with, people who are similar to themselves-may lead to an increase in incidences of autism. …

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