I am obsessed with the question of widespread misinformation and even of stupidity among otherwise intelligent and formally educated people. That’s one big reason why I listen to National Public Radio.
On a recent episode of “Meet the Nation,” there is a far-ranging discussion of autism. The discussion begins well with a report on studies which show differences in frequency of diagnosis of autism according to socioeconomic status (some studies, predictably, with race as a stand-in) and also, according to spatial patterns. The latter, is important. It means that there are geographic clusters of autism. A New York sociologist showed that those patterns are not geographical in a simple physical sense but that they vary according to school district boundaries.
Now, physical clusters of many things, including illnesses, are common because space serves as a proxy for many different kinds of living conditions: Ordinary people in the South eat more and more fat than do ordinary people in the West. Californians get more sun exposure than do New Yorkers. Suburban children don’t play the same sports as urban children. And, of course, there is the water, the quality of which varies from town to town. A dentist tells me that there are more cavities in Santa Cruz than in Salinas a few miles away, and poorer, and less educated on the average than Santa Cruz. You guessed it: city water is fluoridated in Salinas but not in Santa Cruz.
At any rate the point is that the discovery of physical clusters of a phenomenon should always constitute the beginning of an analysis, not the end. That’s not the way NPR treats the subject.
Immediately, the discussion veers to the ability of parents to obtain publicly funded help for their autistic children. The key here is that in many school districts no public resources are available if the child is not officially diagnosed as autistic. Hence, the race to diagnosis. And everything we know tells us that richer parents and more educated parents are often more likely to go after what they want and also more likely to obtain it. That’s true irrespective of the objective validity of what they want. That’s true if what they want is completely stupid.
The NPR story tries to make the whole phenomenon of clusters a simple expression of social injustice. The clear assumption is that autism is widespread in all classes but that white upper-middle class parents obtain help while poorer parents, and of course, parents who are “people of color,” are left to struggle with often desperate family situations linked to autism. No other interpretation is examined. NPR’s single-mindedness on this issue contributes – again – to the general impression that the American society is grossly, perhaps criminally unfair. NPR does this sort of things all the time.
NPR also reports on the curious fact that the geographic clusters correspond to school district boundaries without taking the obvious next steps. Here they are: Parents gossip outside of and around individual schools. School districts aggregate those gossip patterns. Parents don’t gossip much across school district boundaries. The propensity to want one’s children to be recognized as autistic follows parental gossip patterns rather than social-class. Social class itself is only loosely related to school district. On superficial examination it, social class, can seem to stand for school district and therefore, for gossip pattern.
If I were to deal with the spatial clusters of autism as a social scientist who tries to remain respectable, below is what I would do. If I were a journalist pretending to intellectual responsibility, I would seek the advice of a respectable social scientist such as myself, or better, of several respectable social scientists.
- Are the clusters real? Check the counting method again. Check the results again. Look for anything that raises a red flag or even a pink flag. Counting anything pertaining to humans is not easy. Some social science facts turn out to not be facts but illusions. Some become unkillable legends.
- I would list all the alternative explanations I and my varied advisers could come up with. This, to avoid unconscious biases.
Here is one alternative explanation that imposes itself on me with blinding clarity: Autism is yet another fashionable illness. Like its long-standing predecessor, breast cancer, it ‘s real enough but its frequency is routinely grossly exaggerated. (Here is an exercise for you: Out of 100 American women who died last year, the number who died of breast cancer is approximately ___. Correct answer soon on this blog if anyone asks me.)
When an illness becomes fashionable it’s usually because the exaggeration of its prevalence serves the purposes of a particular social group or category, or of several of them. The prevalence of breast cancer is exaggerated because it serves the myth of the neglect of women’s health by a male-dominated medical establishment and by patriarchal government bureaucracies charged with public health. The focus on breast cancer specifically is pure public relations genius. First, it’s one of the few diseases that strikes women to a dramatically disproportionate extent. You could not get the same demonstration effect from heart disease for example because its frequency between the sexes is too close to being equal. Secondly, for subjective (and completely understandable) reasons breast cancer strikes a terror in women’s hearts that no other illness comes close to achieving. Breast cancer exaggeration is the feminism of women who are too busy or too distracted to be feminists in any other way. It’s the poor woman’s feminism. It may be the last gasp of vulgar feminism.
The fashionableness of autism equally serves some social purposes.
First, it’s a mild case of Münchhausen Syndrome By Proxy. I say “mild” because in its extreme form, this mental illness refers to mothers who deliberately harm their children to draw attention to themselves. I speculate that the ever-increasing dramatic quality and variety of allegedly realistic television shows focused on women leave ever-larger numbers of ordinary women feeling left out. There are also reasons to believe that the same regular women do not receive the same amount of male attention their mothers and their grandmothers did. This would contribute to the sense of neglect. I can’t develop this theme right now. Having autistic children, even mildly autistic children, is a sure way to obtain attention for a long time. Incidentally, I believe that a “mildly” autistic little boy would be indistinguishable from a 1950s boy who “does not like to talk.”
Second, a diagnosis of autism is a good, scientific-sounding excuse for having a dull child. What sounds better:
Although his father and I are intellectually above average, although we give our child an exceptionally stimulating home environment, our child’s performance is average;
or: Our child is very bright, unfortunately, he suffers from the serious illness of autism?
Incidentally, the fact that autism is reported as heavily sex-linked, affecting mostly boys, makes me suspicious. Of course sex-linked pathologies exist. But the sex linkage points to a genetic origin of the illness, a subject the autism publicists are not eager to raise. The sex linkage suggests to me the verifiable hypothesis that behavior that is widespread in boys and natural in them but not in girls artificially gets treated as a pathology. Note that I would not even be able to articulate this simple hypothesis if I believed that there are only slight anatomical differences between boys and girls. The liberal gospel hardly allows one to formulate the obvious!
I suspect that there is a ready-made cultural client base for this kind of thinking. (Autism is prodigiously on the rise. The authorities neglect the illness unless you are rich.) That would be the legions of half-educated mothers who are too busy for serious intellectual pursuits but not busy enough to avoid torturing their minds about their self-worth. The client base also includes the many mothers who are under the impression that they abandoned a serious career to rear their children and who are assailed by doubts about their choice.
I mean two things by “half-educated.” First, I include people who attended college but not classes and who never read a book while there. (That would have been a good third of my former students in the expensive university where I taught for twenty-four years.) Those are people who know that they are educated because they have a college degree but who are not educated enough to know that they are not educated.
Second, I include in the category people who graduated with a major in any number of worthless subjects, such as my old subject, “Management,” and mediocre grades. I mention the qualification of mediocre grades because good students, those with good grades, are all the same: They educate themselves, whatever their major may be, even if it’s the proverbial underwater basket-weaving.
The intensity of the feelings shoring up the pseudo-scientific vision of the world behind the claim of an “epidemic” of autism surprises even me. Why, a few weeks ago, a friend of twenty-five years broke up with me in dramatic terms! She did it because I did not repress my skepticism when she told me she had no fewer than than four nieces and nephews, from three different sets of parents, afflicted with autism.
It turns out, my former friend is dabbling in herbal medicines. She does it without formal training. I think she meets with some successes because some plants you can read about on the Internet actually possess some curative virtues. (After all, aspirin, which really, really works, is an extract of willow bark!) My ex-friend is resourceful and energetic. She can find the relevant info. However, her sense of self- importance could not be satisfied forever simply with making it easier for some of her friends to sleep better, or with helping alleviate chronic pain a little in others. Her self-esteem required that she tackle a more serious problem. Autism fits the bills. I suspect my ex-buddy made her hapless nephews and nieces “autistic” so she would have something important to treat. The parents, her brothers and sisters, did not object because they are part of the same potential cultural client base.
I know that I am going charged with cruelty for crimes I did not commit. I repeat that I do not deny that there is a severe mental and emotional disturbance that is loosely known as autism. I recognize that it has severe forms that are destructive of the children affected and even more of their families. However, I am skeptical of the claim that the disease itself, as opposed to the ability to diagnose it, and as opposed to the propensity to diagnose it, has progressed in giant steps in recent years. There is autism the illness and there is also autism the informal lobby. The lobby appears to have learned nothing from the debacle of the exposure of fake research linking autism to vaccination. It had learned nothing from the myth of “hyperactivity.”
Similarly, I do not make light of the devastating disease of breast cancer nor of the fear it inspires in women. I am only reporting that its frequency is greatly exaggerated and that there are good sociological reasons that would explain why it is so.
Back to my original topic: The fact that conservatives like me keep going back to NPR and that they keep coming back annoyed simply indicates that we need something like NPR. I mean a large syndicated network that is unabashedly intellectual, that uses many hours of broadcast to deal with topics of national interest other than politics and including scientific research. The network should be set up in such a way as to promote adversarial interactions because it’s the only way to avoid seeing it captured by a particular ideological family, as is the case with NPR now. I don’t even want to risk having such a public network captured by my own ideological family because it would do the family harm. A long time ago, before NPR, there were liberals who were intellectual giants. Nowadays, I doubt they exist at all. I blame the broad comfort NPR provides liberals for this specie extinction.
And as to the question of public funding: The NPR replacement as described wouldn’t need to rely to any extent on tax money. Many private parties like me would be glad to support it voluntarily.
If I don’t talk to you before that, I wish you all a merry Christmas. That’s the way I pointedly reply to those who wish me “Happy holidays,” “Merry Christmas.” There is no question that if we are celebrating anything, it is the birth of Issa, the Jewish kid who dropped out of high-school so that he had to become a carpenter. He spoke well, clearly and forcefully. He had good thoughts about many things. And, he stood up to the bullies of his time.
PS Of one hundred American women who died last year, four died of breast cancer.