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COMMENTARY

 'Geeks' Get Lucky

 Mark Blaxill

      Autism experts have a long tradition of displaying contempt for the parents of autistic children. Most famously, Bruno Bettelheim propounded the theory of the "refrigerator mother", while boasting that "all my life, I have been working with children whose lives were destroyed because their mothers hated them" (1). More recently, Chistopher Gillberg turned the spotlight to socially unfit fathers, speculating in a peer-reviewed article that autism might be increasing because of "indirect associations of maternal immigrant status and paternal Asperger's syndrome", creating a situation in which "men...with increased risk of fathering children with autism and with difficulty in finding a native partner, might have children by women from far-away countries, who would not immediately identify the social anomalies or ascribe them to a difference in culture" (2).
      I have used Gillberg's odd contention in recent presentations as a joke. It's a reliable laugh line. To Gillberg's modest credit, his speculation was buried deeply in a long paper in an obscure journal. He certainly did not seek to call attention to it.
      But now, Simon Baron-Cohen has taken this "geeks get lucky" theory out in the open. In a recent essay (3), Baron-Cohen develops Gillberg's speculation into a full-fledged argument. Autism increases, Baron-Cohen claims, are the direct consequence of advances in transportation and information technology. Dads of today's autistic children, "would traditionally have not competed well in the competition for mates, as appearing socially odd might have either put off prospective females from choosing them, or put off prospective parents-in-law from arranging such a marriage for their daughters."
      Too bad, lonely geek! But in the modern world, claims Baron-Cohen, "two massive changes hit the planet: the airplane and the computer. The airplane has allowed unprecedented opportunities for changing your culture. And when you go from your native culture into another one, your social oddness may be far less obvious." Score one for the dating strategy of the mysterious stranger.
      But that's not all of the good news for our strange friend. Now he can even get a job! "In just 50 short years, there is now no office in the developed world where computers are not essential, and we need those people with the cool, razor-sharp logic to fix them, reconfigure them, develop them, adapt them, program them. The autistic mind was sitting around for centuries, even millennia, under-employed, because how many jobs were there for mathematicians and scientists, who also needed this style of thinking?"
      It's hard to make this stuff up. Under most circumstances, one would be tempted to write this off as lunacy from some out-of-touch crackpot. But here is the astonishing part. Baron-Cohen is an autism expert, and a respected academic as well. As Professor of Developmental Psychopathology and Co-Director of the Autism Research Centre at Cambridge University, he has published widely on autism and is one of the small cadre of epidemiological researchers who have been responsible for investigating the prevalence of autism and how it is detected. Most notably, he led a research effort that tried to develop tools (4) for diagnosing autism in infants. He failed (5). Neglecting to notice that this failure might actually support a case for an increase in regressive autism (why did the early detection tools fail to find over 60% of the infant autism population if autism is determined in utero?), he has now moved on to unsupported theories of natural selection and new-economy mating patterns.
      But this is pure nonsense. Malicious nonsense. And we must expose nonsense when we see it. Especially when it comes from Cambridge professors with international reputations as autism experts. Bruno Bettelheim was one of the most celebrated psychologists of his time: can we calculate the emotional damage he inflicted on a generation of mothers? As for Baron-Cohen, I suspect he would prefer that those of us he would judge as unfit to mate would simply to withdraw to our computer programs. We must not. We need to hold him accountable for his theory.
      I would suggest that the scientific method is the best way to hold the good professor accountable. He has a theory.  Can he provide plausible evidence to support it? Can he provide a rigorous test for it? Can he defend it against the simple standard of common sense? More specifically, he offer two hypotheses: *          The mobility hypothesis. Baron-Cohen argues that social mobility created by air travel has allowed "geeks on the go" a chance to mate. If this were true, then Baron-Cohen would have to explain why other increases in cross-cultural mobility and mating would not have produced similar increases in autism.  The mobility hypothesis would predict higher autism incidence in: historical periods of high migration; periods of involuntary mating (e.g., war); societies with higher rates of internal migration; cross-cultural and mixed race marriages; female populations with lower degrees of social standing and ability to attract "normal" mates; and countries with high and rising rates of immigration. There is no evidence whatsoever of any such patterns in autism prevalence. If Baron-Cohen wants to offer a serious hypothesis, however, he would need to follow its implications. Where is the data? *            The occupational hypothesis. Baron-Cohen is pleased to cite that paragon of epidemiological science, Wired Magazine, as proof that rates of autism are higher in areas with high concentrations of computer professionals. This is the sole apparent basis for his suggestion that the new economic viability of the autistic mind ("geeks in the money?") is the driver of the increase in autism rates. Perhaps he is behind in his reading, but the occupational hypothesis has actually been examined in quite a number of autism prevalence studies. Early studies in the U.S. (6) and Japan (7), found some evidence for higher rates of autism born to fathers in professional occupations. These studies were conducted well before the revolution in information technology, however, and were not supported by follow-up studies (e.g., 8). There is some evidence in developing countries for higher rates of autism among children of parents in elite social classes (9,10, 11). Yet these studies offer more support for the vaccine theory of autism that Baron-Cohen rejects (elite children would have greater access to public health services) than for his computer theory, since none of these countries had significant computer usage. If Baron-Cohen wants to resubmit a new theory as new, he should be expected to do his homework. Where is the due diligence?
      More to the point, what is the reason to offer such nonsense in a public forum? Why would such a prestigious researcher make such unsupported claims? Who else in this man's circle of professional colleagues shares his views? What are the implications for progress in autism science if these ideas are taken seriously? What are we to make of the significance of this theory? I cannot claim to offer the answer to all these questions, but I can offer an interpretation, albeit speculative, of his motives.
      Let me be blunt. This man is one of the small group of academics that has shaped the science of autism for many years. He has been carrying on studies of the rates of autism in the middle of the largest increase ever seen in a developmental disorder and has failed to detect the changes or to sound the alarm. He has a large number of colleagues who have joined him in this pattern of error. Now, in the face of failure and contradictory evidence, he has resorted to concocting one of the most absurd arguments one could imagine in order to reconcile a genetic model with the inescapable evidence. This is a thinly veiled attempt to diminish the significance of the increases by diminishing the fitness of the parents, just as the attempt to dismiss AIDS as the "gay disease" was an attempt to minimize the gravity of that epidemic.
      This is bad science. It is malicious propaganda. It is supported by no research and refuted by every shred of available evidence. Yet, like Bettelheim before him, Baron-Cohen commands respect in the scientific community and his arguments will have a way of creeping into the discussion and gaining respectability as they are whispered in corridors of leading institutions. So we all must challenge them. We must call out nonsense when we see it and, most important, hold these so-called experts accountable for their errors. If it weren't all such a tragedy, we could all share a good chuckle. 
      Instead it makes you want to cry. Where has the integrity gone in autism science?
      Mark F. Blaxill Cambridge MA
      References:

1. Dolnick, Edward, "Madness on the Couch" (New York, Simon and Schuster, 1998).
2. 2. Gillberg C, Wing L. Acta Psychiatr Scand 1999 Jun;99(6):399-406. Autism: not an extremely rare disorder
3. 3. Baron-Cohen, Simon,  "Have the airplane and the computer changed the architecture of the mind? And is that why autism is on the increase?" reprinted in FEAT DAILY NEWSLETTER, January 17, 2002. 
4. 4. .Baron-Cohen S, Cox A, Baird G, et al. Br J Psychiatry 1996;168:158-163, Psychological markers in the detection of autism in infancy in a large population
5. 5. Baird G, Charman T, Baron-Cohen S, Cox A, Swettenham J, Wheelwright S, Drew A. J Am Acad Child Adolesc Psychiatry 2000 Jun;39(6):694-702. A screening instrument for autism at 18 months of age: a 6-year follow-up study.
6. 6. Treffert DA. Arch Gen Psychiatry 1970 May;22(5):431-8. Epidemiology of infantile autism.
7. 7. Hoshino Y, Kumashiro H, Yashima Y, Tachibana R, Watanabe M, Folia Psychiatr Neurol Jpn 1982;36(2):115-24, The epidemiological study of autism in Fukushima-ken.
8. 8. Ritvo ER, Freeman BJ, Pingree C, Mason-Brothers A, Jorde L, Jenson WR, McMahon, WM, Petersen PB, Mo A, Ritvo A. Am J Psychiatry 1989 Feb;146(2):194-9. The UCLA-University of Utah epidemiologic survey of autism: prevalence.
9. 9. Lotter V. J Child Psychol Psychiatry 1978 Jul;19(3):231-44. Childhood autism in africa.
10. 10. Tao KT. J Autism Dev Disord 1987 Jun;17(2):289-96. Infantile autism in China.
11. 11. Dhadphale M, Lukwago MG, Gajjar M. Indian J Pediatr 1982 Jan-Feb;49(396):145-8. Infantile autism in Kenya.  

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