Wednesday, October 18, 2006

TV=autism? Not convinced...

Kristina's post today in Autismland about her take on the new research study that finds a link between autism & tv inspired me to actually read the paper. There's a link to the paper at notmercury's site (& his parody post is pretty neat, too) that downloads in pdf. I was a bit long-winded in my comment to this post, but this is just the sort of research that gets wide media exposure but does little (in my opinion) to help the autism community or truly elucidate the complexities of autism & life with autism. It causes great furor but to what end...? Here is what I commented at Kristina's site:

OK. I read the paper (not mercury has the link) & I really appreciate your well-thought-out refutation, Kristina. My main discomforts with the paper are that they contunually refer to autism "developing" in early childhood as if it's an established fact that this is how autism happens. I don't see any definitive proof anywhere that this "development" hypothesis has been proven & like you, we were aware of B's differences from infancy. Another part of the paper that your post clearly refutes is the part beginning on pg. 15 where they look at the "high risk" younger siblings of already-diagnosed children & how long it takes them to visually disengage from the tv screen, assuming that a longer disengagement time will predispose them for autism. As you have clearly stated, though, some autistic children don't visially engage the screen for very long at all- were they "lower risk" for autism by exhibiting that behaviour? Wouldn't it have been a good idea for these researchers to look at the actual tv-watching habits of autistic children? Interestingly, by the standards of this study, B is not autistic (they excluded kids with Aspergers, PDD-NOS & Rett's- see pg. 7) but he was & is a tv-watcher with very good visual engagement of the screen- I wonder how their narrow definition of autism affects their conclusions? I also have trouble with the part on pg. 23 where they go into the gender aspects of the study, which show that boys are more likely to watch tv & more likely to be autistic- as if these really correlate. It feels to me as though they have taken apples & oranges (defining only macintoshes as apples & excluding the rest of the varieties) & found that apples can become oranges under certain circumstances. This quote from pg. 27 sums up my discomfort with the conclusions of this paper nicely:

"One possibility for why the California data does not exhibit a positive correlation between precipitation and autism is that there is an omitted variables problem. That is, there could be another important variable that is correlated with television watching and also correlated with precipitation in the California data set in a manner that results in no significant relationship between autism and precipitation in our test of equation (4) using California data. "

California is their gold standard in this study because the reporting on autism rates is seen as more reliable & goes back farther than any other place in the US. But California does not support their hypothesis...? Another thing that gives me deep misgivings is that they are not able to directly prove the tv-autism link, but only through the mediator of precipitation. As I mentioned in an earlier comment, I know from my own research days that you can prove practically anything you want with statisitics,, depending on how you look at the data.

Bottom line for me is that I wish this study not only had a better basis in the science/medical realities of autism (since it is speculating on an "effect" from tv watching that produces physical changes in a young child) but had been able to give some useful information as to the mechanism for these possible changes to occur. Their conclusion is a lukewarm "we want to emphasise that young children should not watch tv- just in case". I know that the purpose of this study is not to assist people like me who are already raising children with autism (although by their standards B is not...) but the attention that this study has drawn in the media is way out of proportion to it's usefulness in my opinion. Sorry to go on for so long, Kristina...

One of the things that has helped our family in navigating the maze of suggested treatments & ways of approaching B's autism is that both my husband & I are trained in science & we can read a paper & understand the statistics (as well as anyone can, I suppose). We have been unconvinced & unimpressed by the "science" coming out of the curebie camp all along & have never felt that we had to try everything & anything to "help" B because it's obvious to us that a lot of what's out there is voodoo thinly disguised as science. When one of B's doctors makes a recommendation we research it before acting. I wish more parents could more easily navigate the mass of information, speculation, & opinion that we all face. I also wish that the media actually felt a responsibility to report news, rather than sensationalise hot topics that will get a lot of attention. Autism is hot news because if the fear it engenders, I'm afraid. I wish that we could get past fear & have a greater understanding of the realities (since every person affected by autism is different, as Kristina notes) of life with autism.


At 12:38 PM, Blogger Joseph said...

The autism fries guy also recommends that children should absolutely not eat fries, ever.

Assuming the TV study is serious (someone might want to email the authors) I think its results must be explained some way, regardless of the qualifications of the authors. (The Geiers are not epidemiologists, but I think it's still necessary to point out the flaws in their work).

I think the confound in this study is that states with higher precipitation are generally states with higher population density too. Save for Las Vegas, not many cities will be built in the dessert. Administrative autism prevalence is well known to be linked to degree of urbanization and/or population density. This is often also used to correlate autism with environmental pollution (or anything else that occurs more often in cities), as I argue here.

California is often found to be special, not just in this study. I think this is because it's a highly urbanized state and one of the top economies in the world.

Is it surprising that when everything about modernity and the economy exploded in the 1990s, autism rates also exploded? Not at all. Availability of information increased substantially, driven mostly by the internet, and the number of autism specialists increased substantially too. This coincidence of increasing rates of everything easily leads to false correlations, obviously.

Also, it would not be sufficient to determine if autistic children watch TV more often. They might, and that could still have nothing to do with causation.

BTW, a more plausible interpretation of the results is that spending time outdoors is protective.

At 2:47 PM, Blogger notmercury said...

Hi Lisa,
Thanks for linking to my blog. I realized that I misspelled television in the title. I fixed it without realizing that this would change the url so your link is now broken. Oops. Sorry about that. I guess that's what I get for learning how to spell with Sesame Street.

At 4:36 PM, Blogger Lisa/Jedi said...

I have fixed the link- thanks for the heads-up, nm!

At 9:00 PM, Blogger Kristina Chew said...

"Autism is hot news because of the fear it engenders:=" This sentence gets right to the core of things, to me. Autism is such a dreadful thing to happen to a child and a family that next thing you know, they'll correlate parents' computer use (blogging, emailing.....) with children becomeing autistic.....

Joseph, your point----"Is it surprising that when everything about modernity and the economy exploded in the 1990s, autism rates also exploded? Not at all": I am going to post about this soon (as in this weekend, I hope). The book I've done a few posts on (Unstrange Minds by Grinker) considers the increase in children diagnosed with autism in part by telling the history of the DSM and of psychiatry and psychoanalysis in this country. I am thinking that the TV/autism study will become one for the history books in the growing list of "causes of autism."


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