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Sunday, September 10, 2017

Uncertainty Persists

Uncertainty is a major theme of The Politics of Autism. Here is how I start chapter 3:
If we can land a man on the moon, why can’t we cure autism? Frustrated parents may ask that question, remembering that when John F. Kennedy committed the United States to go to the moon, NASA scientists and engineers figured out how to get there. Ever since Neil Armstrong stepped off the lunar module in 1969, politicians have held up the Apollo project as a model for solving all kinds of problems. But autism is not rocket science. Contrary to the usual meaning of that expression, I hardly suggest that autism science is simple; rather, it is more puzzling than rocket science.
When the moon program was getting under way, there was consensus about the fundamental terms and facts. Although the engineering details were challenging, the basic math and physics behind the mission dated back to Isaac Newton. Autism is different. As we have already seen, it is a contested concept with many uncertainties. Just picture an Apollo program in which experts saw different kinds of moons in different parts of the sky and were not quite sure about the laws of motion.
Uncertainty underlies various ideas about what causes the condition.  Alexandra Ossola reports at CNBC:
"If you've met one person with autism, you've met one person with autism — everyone looks a little different," says Heather Volk, an assistant professor in the department of Mental Health at the Johns Hopkins Bloomberg School of Public Health.
Through careful epidemiological studies conducted on large populations, a number of scientists, including Craig Newschaffer at Drexel University and Peter Bearman at Columbia University, have been able to point to some factors that correlate to the risk of autism. Over the years, researchers have determined that childhood or prenatal exposure to toxic chemicals, such as pesticides ; hormone-disrupting phthalates (often found in plastics) and some found in air pollution, have played a role. Mothers who have bacterial or viral infections during pregnancy or those who are obese are also more likely to give birth to babies who are later diagnosed with autism.
It's important to note, however, that these are risk factors for autism, not causes — there's a correlation between these factors and autism, but researchers aren't quite sure of the mechanism that might make the disorder more likely to develop.
But even if a well-designed study uncovers a new risk factor, that has to be validated and replicated by other scientists. And so far, Volk says, researchers are not far enough down the road to come up with any interventions to treat or prevent autism based on those findings. There are some findings that, if reflected in policy, are generally beneficial, such as having cleaner air and making baby bottles that are BPA-free. "But we're not far enough to think about pharmacological interventions in pregnancy," Volk says.