Earmarks Are Good: The Case of Staten Island

In The Politics of Autism, I discuss the congressional role in the issue.

Dr. Gracelyn Santos at The Staten Island Advance:

Congresswoman Nicole Malliotakis has announced she helped secure $500,000 for the Eden II School for Autistic Children as part of the federal government’s appropriations process.

Eden II will use the funds to renovate an existing building to expand day habilitation services for adults with autism.

“For nearly 50 years, Eden II Programs have gone above and beyond to support people with autism by helping them achieve their full potential through a number of educational, residential, and day habilitation programs,” Malliotakis said. “Serving more than 500 individuals across the New York City and Long Island communities, Eden II has become a leader in helping participants and their families overcome many of the challenges associated with Autism Spectrum Disorder

DeSantis, Lapado, and Antivaxxers

 In The Politics of Autism, I analyze the discredited notion that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.   And among those diseases could be COVID-19.

Unfortunately, Republican politicians and conservative media figures are increasingly joining up with the anti-vaxxers.   Even before COVID, they were fighting vaccine mandates and other public health measures. 

John Kennedy at USA Today:

Days after Gov. Ron DeSantis opened his second term with a combative speech blasting federal COVID-19 policies as based “more on ideology and politics than on sound science,” Florida’s surgeon general was a guest on a podcast called Liberty Lockdown.

“Isn’t it a beautiful day to be unvaccinated? It feels so good,” host Clint Russell said before starting into his conversation with Dr. Joseph Ladapo, the state’s top doctor who also is a tenured faculty member at the University of Florida.

With DeSantis expected in coming months to formally launch his bid for the 2024 Republican presidential nomination, Ladapo is emerging as a central player in the governor’s outreach to vaccine skeptics and opponents who now form a stunningly large part of the GOP’s national voter base.

...

The Liberty Lockdown appearance was the doctor’s latest on podcasts which attract a sizable segment of conservative followers.

Weeks earlier, in a First Class Fatherhood podcast airing Nov. 30, Ladapo urged listeners to rely on “intuition,” when it came to following medical or scientific advice.
...

Ladapo also appeared on right-wing podcasts in the weeks leading up to the November election that DeSantis won by 19% over Democrat Charlie Crist, the largest victory margin in a Florida governor’s race in 40 years.

He disputed widely accepted views of masking and vaccines on shows hosted by Dr. Sherri Tenpenny, an Ohio physician who promotes false claims about COVID-19 shots and wrongly says childhood vaccines cause autism.

Ladapo also appeared on X22 Report, a far-right podcast known for sharing QAnon-related conspiracies and misinformation. He also was on the podcast of conspiracy theorist Stew Peters, who has touted a wide range of false claims about the 2020 election, COVID-19 and more.

Good News on Disability Employment

 In The Politics of Autism, I discuss the employment of adults with autism and other developmental disabilities.

From the Kessler Foundation:

The year 2022 was a remarkable and historic time for the employment of people with disabilities. That’s according to today’s National Trends in Disability Employment (nTIDE) 2022 Year-End Special Edition, issued by Kessler Foundation and the University of New Hampshire’s Institute on Disability (UNH-IOD), based on data from the U.S. Bureau of Labor Statistics(BLS) Jobs Reports.

Employment trends in 2022 built upon the 2021 recovery from the pandemic recession—where people with disabilities reached beyond pre-COVID-19 levels and even pre-Great Recession levels. These trends are in stark contrast to those of their working counterparts without disabilities who have not yet reached pre-pandemic levels.

The average monthly employment-to-population ratio for people with disabilities (ages 16-64) increased from 31.3 percent in 2021 to 34.8 percent in 2022, which was also higher than the 29.1 percent recorded in 2020 (during the height of the pandemic) and 30.9 percent recorded in 2019 (prior to the pandemic).

In contrast, for people without disabilities (ages 16-64), the employment-to-population ratio increased from 72.5 percent in 2021 to 74.4 percent in 2022, which was higher than the 70.0 percent recorded in 2020 but not above the 74.6 percent in 2019. The employment-to-population ratio, a key indicator, reflects the percentage of people who are working relative to the total population (the number of people working divided by the number of people in the total population multiplied by 100).

Diagnosing Adults

In The Politics of Autism, I write:

Many analyses of autism speak as if it were only a childhood ailment and assume that parents are the main stakeholders. But most children with autism grow up to be adults with autism, and they suffer uniquely high levels of social isolation. Almost 40 percent of youth with an autism spectrum disorder never get together with friends, and 50 percent of never receive phone calls from friends. These figures are higher than for peers with intellectual disability, emotional disturbance, or learning disability. When school ends, many adults with autism have grim prospects. Though evidence is sparse, it seems that most do not find full-time jobs. Compared with other people their age, they have higher rates of depression, anxiety, bipolar disorder, and suicide attempts.

From the 2023 IACC Draft Strategic Plan: 

[A]ncreasing numbers of adults are presenting to clinics for first-time diagnoses of ASD, and recent studies suggest that many adults with ASD may be unidentified and living in the community without appropriate supports84,85. Many autistic individuals diagnosed as adults report being misdiagnosed with other mental health conditions initially, such as borderline personality disorder, generalized anxiety, or mood disorders such as depression or bipolar disorder86, 87 . These misdiagnoses may result in being overmedicated or being subjected to unnecessary medical treatments. Others report receiving care for mental health conditions such as eating disorders while displaying traits of autism that were unrecognized or ignored by healthcare providers88. Thus, there is a need to improve diagnostic tools that are specific for adults. There is also a need to practitioner training to recognize traits of autism in adults.

84. Brugha TS, McManus S, Bankart J, et al. Epidemiology of autism spectrum disorders in adults in the community in England. Arch Gen Psychiatry 2011;68:459-65.
85. Croen LA, Zerbo O, Qian Y, et al. The health status of adults on the autism spectrum. Autism 2015;19:814-23.
86. Lupindo BM, Maw A, Shabalala N. Late diagnosis of autism: exploring experiences of males diagnosed with autism in adulthood. Curr Psychol 2022:1-17.
87. Rødgaard EM, Jensen K, Miskowiak KW, et al. Childhood diagnoses in individuals identified as autistics in adulthood. Mol Autism 2021;12:73.
88. Bargiela S, Steward R, Mandy W. The Experiences of Late-diagnosed Women with Autism Spectrum Conditions: An Investigation of the Female Autism Phenotype. J Autism Dev Disord2016;46:3281-94.

Burbank's Mayor is Autistic

In The Politics of Autism, I write:  "Support from the general public will be an important political asset for autistic people. Another will be their sheer numbers, since a larger population of identified autistic adults will mean more autistic voters and activists."  Previous posts have discussed autistic officeholders and political candidates in California,  New York, Georgia, Texas, and Wisconsin.

In Burbank, California, the City Council chooses one of its members as mayor.  (An appointed city manager is responsible for day-to-day administration.)  Last month, the Council chose  Konstantine Anthony, who now has a very important distinction

Just wanted to remind everyone that this week the United States appointed its first openly Autistic mayor, @KonstantineinCA! pic.twitter.com/n4cdq5RhgM

— 🌟Autistic Voices United (El:Head Writer) (@autismsupsoc) December 24, 2022

From the City of Burbank:

Konstantine Anthony grew up in the small suburban town of Castro Valley, just outside of Oakland, CA. He spent his middle school years in rural Iowa and studied film at San Francisco State University with a diverse group of students from all over the world. In 2004, he moved to Burbank and became a union actor in film and television.

With 20 years of experience in improv comedy, Konstantine has appeared in numerous television shows and movies. That experience, and a passion for social justice, made running for office in the Media Capital a natural next step. On his second run for Burbank City Council, he won a seat with a record-setting 17,529 votes. In doing so, he also became the first openly autistic elected official west of the Mississippi.

In a 2020 interview, he said:  "My advocacy for disability rights stems from my autism diagnosis and witnessing the discrimination my fellow disabled Americans experience every day."

Coordination

In The Politics of Autism, I discuss the policy paradoxes of the issue.  I presented a paper titled "Autism and Accountability" at the 2020 Annual Meeting of the American Political Science Association.  

The abstract:

We expect policymakers to be accountable to the public for their handling of public issues. The case of autism presents fundamental difficulties. First, the boundaries of autism have shifted over the years, and they remain contested. Second, there are multiple publics with radically different views about the character of the issue. Third, there is no single “autism policy.” Instead, the issue spans multiple issue areas where responsibility is diffused and the connections between policy outputs and outcomes are difficult to establish. The paper ends with modest recommendations for improving our knowledge base.

Full text:  here: https://www.scribd.com/document/475658529/Autism-and-Accountability

From the 2023 IACC Draft Strategic Plan: 

Autism- and disability-related programs exist at numerous federal agencies to address a wide variety of issues ranging from health, research, disability services, justice, housing, employment, transportation, military needs, communication, and other diverse issues. Given the large size and distributed nature of federal activities, the U.S. Congress and federal agencies have also put in place several structures to coordinate federal activities around disabilities and, in some cases, autism specifically. These coordination structures foster interdepartmental and interagency communication and collaboration on issues that are essential to autism and disability-related federal activities.

The Interagency Autism Coordinating Committee (IACC) is a foundational part of the federal coordination structure for autism that was created under the Children’s Health Act of 2000 (Public Law106-310), reconstituted under the Combating Autism Act of 2006 (CAA; Public Law 109-416), and most recently reauthorized under the Autism Collaboration, Accountability, Research, Education, and Support (CARES) Act of 2019 (Public Law 116-60). It is the only autism-specific interagency federal advisory committee in the federal government. The Autism CARES Act of 2019 outlines requirements for the membership of the IACC, which includes officials representing an array of federal departments and agencies and public members who represent a variety of perspectives within the autism community. Collectively the committee provides advice to the HHS Secretary concerning issues related to autism and coordinates federal autism efforts. 

In 2014, Congress added a new component to the federal coordination structure by requiring in the Autism CARES Act of 2014 the designation of a National Autism Coordinator (NAC), “an existing official within the Department of Health and Human Services to oversee, in consultation with the Secretaries of Defense and Education, national ASD research, services, and support activities.” The duties of the NAC include coordinating and implementing federal autism research, services, and support activities, taking into account the IACC Strategic Plan, as well as ensuring that federal ASD efforts are not unnecessarily duplicative. The NAC accomplishes cross-agency and cross-departmental coordination in part through the activity of the Federal Interagency Workgroup on Autism (FIWA), an all-federal working group of representatives from multiple federal departments and agencies, most of which are also represented on the IACC. The NAC has led the development of several comprehensive reports to Congress on federal autism activities and other projects requiring cross-agency collaboration.

A third layer of interagency and intra-agency coordination is composed of a series of federal advisory committees and coordinating committees that work on specific issues related to autism and disabilities. At the National Institutes of Health (NIH), the NIH Autism Coordinating Committee coordinates NIH intra-agency efforts on autism research. Other advisory committees and agencies across the federal government that contribute to federal coordination on issues of relevance to autism and disabilities include:

• 2021-2023 IACC Strategic Plan for Autism Research, Services, and Policy Draft January 2023 11

• Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act Council (family caregiver issues)

• President’s Committee for People with Intellectual Disabilities (intellectual disabilities), theInteragency Committee on Disability Research (disability research) 

• Federal Partners in Transition (youth with disabilities)

• National Council on Disability (a federal agency for disability policy)

• Interdepartmental Serious Mental Illness Coordinating Committee (mental illnesses that may cooccur with autism)

• Federal Communications Commission Disability Advisory Committee (communication technology for people with disabilities)

• National Advisory Committee on Individuals with Disabilities and Disasters (disaster preparedness and response)

• Advisory Committee on Accessible Air Transportation - ACCESS Advisory Committee (disabilities and air transportation).

 Each of these advisory committees focuses on specific topics related to disabilities, which are informative to the efforts of the IACC to coordinate autism activities.

SCOTUS Case on IDEA and ADA

In The Politics of Autism, I write about special education and the Individuals with Disabilities Education Act. II also discuss the day-to-day challenges facing autistic people and their families. 

Amy Howe at SCOTUSblog:

The Supreme Court on Wednesday seemed ready to side with a deaf student who is seeking financial compensation from a Michigan school district that failed to provide him with a qualified sign-language interpreter.

The student, Miguel Perez, alleges that the school district violated the Americans with Disabilities Act. Lower courts threw out his lawsuit, ruling that a different federal law, the Individuals with Disabilities Education Act, required him to “exhaust” his claims against the district – that is, fully pursue them in administrative proceedings before going to federal court. During over an hour of debate on Wednesday, however, a majority of the justices seemed inclined to allow Perez’s lawsuit to go forward.

Representing Perez, lawyer Roman Martinez stressed that for over 12 years, the Sturgis Public Schools “neglected Miguel, denied him an education, and lied to his parents about the progress he was allegedly making in school.” That “shameful conduct,” Martinez said, “permanently stunted Miguel’s ability to communicate with the outside world.”

Perez initially brought claims under both the ADA and the IDEA through state administrative channels. An administrative judge threw out the ADA claim on the ground that he lacked authority to hear it, and Perez reached a settlement with the school district on the IDEA claim. Perez then tried to revive the ADA claim in federal court.

The school district now argues that Perez’s IDEA settlement “extinguishes” Perez’s right to seek financial compensation under the ADA, Martinez said. “But Congress,” he continued, “didn’t punish kids for saying yes to favorable IDEA settlements.”

Representing the Sturgis Public Schools, lawyer Shay Dvoretzky countered that the primary purpose of the IDEA is to ensure that all students receive the education to which they are entitled. The IDEA’s exhaustion requirement, Dvoretzky insisted, simply channels all claims through the administrative procedures first, rather than allowing parents to go straight to court.

From oral argument in Perez v. Sturgis Public Schools:

JUSTICE KAGAN: Well, I don't know that your view of how school districts are going to operate is always going to be true. As between the two, it strikes me that actually it's the parents that have the greater incentive to get the education fixed for their child. 

MR. DVORETZKY: I think that sometimes that -- 

JUSTICE KAGAN: This isn't litigation being run by a lot of rapacious lawyers, you know. This is litigation being run by parents who are trying to do right by their kids. 

IACC and Research Priorities

  In The Politics of Autism, I discuss the Inter-Agency Autism Coordinating Committee and research priorities.

The Interagency Autism Coordinating Committee has released a draft strategic plan.

Figure 1 shows the trend in funding for each of the Question areas over time. In 2008, the reported autism research funding for federal agencies and private organizations was $222.2 million and 745 projects. In 2020, funding for autism research among both federal and private funders totaled $409.2 million and spanned 1,536 research projects. Over the thirteen years, autism research showed a general upward trend in funding, increasing by 84% since 2008. However, not all Question areas have shown the same pattern of growth. Question 2 (Biology) is the research area that has shown by far the most dramatic increases in funding, peaking at $195.6 million in 2019. In 2020, research on genetic and environmental factors (Question 3) received the second largest amount of research dollars. Funding amounts for Question 3 started out relatively high in 2008, then dipped from 2011-2014, but have shown relative increases in recent years. Question 1 (Screening and Diagnosis), Question 5 (Services), and Question 7 (Infrastructure) have received largely consistent investments in research since 2008. Funding for Question 4 (Interventions) has also been fairly stable but has been on a slight downward trend in recent years. Research focused on lifespan (Question 6) has consistently received the lowest levels of funding but has shown encouraging growth over the past four years.

Using Strengths

In The Politics of Autism, I write:

Many analyses of autism speak as if it were only a childhood ailment and assume that parents are the main stakeholders. But most children with autism grow up to be adults with autism, and they suffer uniquely high levels of social isolation. Almost 40 percent of youth with an autism spectrum disorder never get together with friends, and 50 percent of never receive phone calls from friends. These figures are higher than for peers with intellectual disability, emotional disturbance, or learning disability. When school ends, many adults with autism have grim prospects. Though evidence is sparse, it seems that most do not find full-time jobs. Compared with other people their age, they have higher rates of depression, anxiety, bipolar disorder, and suicide attempts.

 At Autism, Emily C. Taylor and colleagues have an article titled "Psychological strengths and well-being: Strengths use predicts quality of life, well-being and mental health in autism."  The lay abstract:

It is often suggested that supporting autistic people to identify and use their strengths will lead to positive outcomes. However, little research has explored if this is true. To date, no research has explored whether autistic people already have knowledge of and use their strengths, nor whether increased strengths knowledge and use is linked to good outcomes, such as a better quality of life, well-being and improved mental health. Comparing large samples of autistic and non-autistic people, this study tested these unanswered questions. We found that autistic and non-autistic people reported similar strengths, but autistic people reported less knowledge and use of their strengths compared to non-autistic people. Importantly however, autistic people who reported using their strengths often had better quality of life, well-being and mental health than autistic people who reported using their strengths less frequently. We, therefore, propose that supporting autistic people to use their strengths more often may be a valuable way to boost well-being in this population.

Resarch Overlooks Physical Health Disparity

 In The Politics of Autism, I discuss the Inter-Agency Autism Coordinating Committee and research priorities.

From Vanderbilt University Medical Center,:

Physical health disparity conditions in autistic adults have not been the focus of any research funded by the U.S. National Institutes of Health (NIH) in the last four decades, an analysis of a federal database found.

Using the NIH Research Portfolio Online Reporting Tools Expenditures and Results (RePORTER) database to determine whether the NIH has funded any research related to physical health disparity conditions in autistic adults, T. A. Meridian McDonald, Ph.D., faculty research instructor in the Department of Neurology at Vanderbilt University Medical Center, used 30 separate searches to discover that "autism" is often used as a key term—not the target population.

Results of the study are published today in the Journal of Autism and Developmental Disorders.

Autistic adults are at greater risk of nearly every major chronic health condition, including obesity, diabetes, gastrointestinal and sleep disorders, and cardiovascular and immune conditions. These conditions contribute to increased pain and mortality experienced by autistic people as well as to decreased quality of life such as lower rates of employment and social inclusion.

"We don't know if treatments designed for the general population will work for autistic people," McDonald said. "Take cognitive behavioral therapy, the front-line treatment of insomnia, for example. This treatment is typically carried out in six to eight face-to-face provider-patient clinic sessions. During these sessions, the clinician provides a ton of information about how sleep works and how to do the treatment. The delivery of this information in these types of sessions may overtax many autistic people's information and social processing abilities."

It's key to understand how treatments work in different populations, accounting for social and physiological determinants of health, McDonald said. In the example of insomnia, the treatment often requires patients to change routines and habits, and that may be a serious challenge for autistic patients, she said.

McDonald used "autism," and "adult" coupled with one of 30 health disparity condition terms in the RePORTER, a repository of NIH-funded projects that is searchable with key terms. Searches surfaced numerous studies, which, upon analysis, often used "autism" in a project as a key term rather than a study designed to evaluate the prevalence or manifestation of disease or treatment in autistic people.

Research found only four studies that look at health conditions related to autistic adults, but none of the studies examined the treatment of physical health disparity conditions in autistic adults.

"Many of these studies are focused on the prevention of multiple health conditions. A study's goals might focus on the prevention of neurological conditions, such as stroke, epilepsy and autism. This type of study is not looking at the prevention of stroke in autistic people, who may have different risk factors or need specialized treatment options," said McDonald, lead author on "Mind the NIH-Funding Gap: Structural Discrimination in Physical Health-Related Research for Cognitively Able Autistic Adults."

"We need funding to test whether interventions are effective with autistic people. If treatments are not effective, then funded research is needed to adapt or develop interventions that are effective in treating physical health disparity conditions experienced by autistic adults," she said.

Both the U.S. Congress and the Interagency Autism Coordinating Committee identified co-occurring physical health conditions as a research priority and allocated funds for autism research to the NIH. Each of the 27 institutes that comprise the NIH have latitude in how it determines its research priorities.

The research in JADD describes several potential "nodes," or processes that contribute to the lack of studies focused on health disparities in autistic people, including designation of a "primary disease," which are often thought to be the cause of other conditions.

McDonald and colleagues note this assumption has not been tested in autism and "this designation [of primary disease] prevents researchers from testing whether co-occurring physical health conditions can be treated in autism."

Audrey Scudder, co-author and an autistic undergraduate student at Vanderbilt University and active member of both the McDonald's Spectrum for Life Lab and the Vanderbilt Autism & Neurodiversity Alliance, wants to prioritize advocacy for the autistic community as she pursues a research career.

"Many of my family members, friends and other fellow community members have expressed a need for health care that is accessible and effective for autistic people," Scudder said. "Addressing health disparities would greatly improve the quality of life of many autistic adults who struggle with finding care that treats their whole personhood. This study indicates that at this point in time there isn't enough research supporting what's effective in this population of adults."

Autistic adults have been left out of the recent shift to root out disparities in research, diagnosis and treatment, McDonald said.

"Moving forward I want the NIH to change funding policies to prioritize research on physical health disparity conditions in autistic adults. At the very least, they should not be excluded from review across agencies that fund physical health research," she said.


More information: T. A. Meridian McDonald et al, Mind the NIH-Funding Gap: Structural Discrimination in Physical Health–Related Research for Cognitively Able Autistic Adults, Journal of Autism and Developmental Disorders (2023). DOI: 10.1007/s10803-022-05856-w
Journal information: Journal of Autism and Developmental Disorders

Infinite

In The Politics of Autism, I discuss the day-to-day challenges facing autistic people and their families.

Joshua Pitney (aka "JP"), a sophomore at Pepperdine University, made this 7-minute narrative film.  It depicts an autistic student who come to accept his identity.

Yet Another Correlate: Where Forebears Lived

In The Politics of Autism, I discuss various ideas about what causes the condition. 

There is a very long and growing list of other correlates, risk factors, and possible causes that have been the subject of serious studies:

Inflammatory bowel disease;

Pesticides;

Air pollution and proximity to freeways;

Maternal thyroid issues;

Autoimmune disorders;

Induced labor;

Preterm birth;

Fever;  

Birth by cesarean section;

Anesthesia during cesarean sections;

Maternal and paternal obesity;

Maternal diabetes;

Maternal and paternal age;

Grandparental age;

Maternal post-traumatic stress disorder;

Maternal anorexia;

Smoking during pregnancy;

Cannabis use during pregnancy;

Antidepressant use during pregnancy;

Polycystic ovary syndrome;

Infant opioid withdrawal;

Zinc deficiency;

Sulfate deficiency;

Processed foods;

Maternal occupational exposure to solvents;

Congenital heart disease;

Insufficient placental allopregnanolone.

Estrogen in the womb;

Morning sickness;

Paternal family history;

Parental preterm birth;

Antiseizure meds

A release from the University of Utah:

When and where are often vital clues for epidemiologists, the medical detectives who help solve the underlying mysteries of disease. The technique dates back to at least 19th century London, where a physician named John Snow mapped cholera deaths and traced the source of the outbreak to a single well in the city. Once the well was closed, the epidemic ended.


Taking this idea to a new level, University of Utah Health scientists, using a unique combination of geographic and population data, recently concluded that when and where parents and grandparents of Utah children were born and raised could contribute to an increased risk of autism among their offspring.

The scientists think this new approach could be used to explore time and space aspects of any disease where family pedigree information is available.

The study, published in the International Journal of Health Geographics, is among the first to assess the influence of time and space (when and where) across generations on the increased risk of autism. In time, the researchers say, this finding could lead to the identification of environmental factors, such as exposure to pollutants, that could have disruptive effects on genetic information passed between generations.

"Looking back at families and where and when they lived helped us detect clusters of individuals who seem to have a higher subsequent risk of autism among their descendants," says James VanDerslice, an environmental epidemiologist in the Division of Public Health at U of U Health and senior author of the study. "Knowing that the parents and grandparents of these children with autism shared space and time brings us closer to understanding the environmental factors that might have influenced this health outcome."

Epidemiological studies across generations are difficult and time-consuming, says Rebecca Richards-Steed, the study's principal investigator and graduate student in the Department of Geography at University of Utah. In fact, most of these studies have been done in animals, which reproduce quickly and can be followed for several generations in a shorter time span than humans.

Using existing technology in a new way, VanDerslice and Richards-Steed circumvented this drawback by looking at existing data available for parents and grandparents to identify places and time periods that may be associated with risk factors that increased the risk of disease in subsequent generations.

The researchers used the Utah Registry of Autism and Developmental Disabilities, in conjunction with the Utah Population Database (UPDB), to identify parents and grandparents of children born between 1989 and 2014 who have autism.

Birth certificates, driver's license information, and census and medical records in the UPDB helped the scientists track when and where these individuals lived over time. The UPDB is one of the few databases worldwide to include this type of information.

For comparison, they randomly selected parents and grandparents of children in the UPDB database who were not diagnosed with autism. Names of the individuals were withheld from the researchers.

In all, VanDerslice and colleagues pinpointed where 7,900 parents and 31,600 grandparents were born and raised. They identified 20 key clusters, or groupings, scattered across the state. After analysis, 13 of the 20 clusters—nine among grandparents and four among parents—were associated with an elevated risk of autism in their children or grandchildren. In particular, descendants of paternal grandparents were about three times more likely to have autism than expected.

"What we were seeing fits in with current scientific understanding of how paternal genetics is key to evolutionary change and adaptation," Richards-Steed says. "So, it is quite possible in the case of autism that a signal, shaped in part by environmental experiences, is coming from the paternal lineage, which is being passed down through the family."

Seven clusters, all in rural areas, had a low risk of an association between autism and family lineage.

"We're really not sure why some rural areas seemed to have what might be called a protective effect," Richards-Steed says. "It's certainly possible that parents and grandparents living in urban areas had different environmental exposures or experiences."

"What we can say, based on our findings, is what we are being exposed to now is probably not just affecting us or even our children but maybe even our children's children."

Moving forward, the researchers will delve deeper into the factors, including lifestyle, that could help explain these results.

"Evidence shows our environment has a deterministic effect on our growth and development, which includes the germline cells we carry for the next generation," VanDerslice says. "Examining the shared space and time of our ancestors may give us clues about the environmental factors that may lead to biological changes that increase the risk of disease in future generations. "

The scientists think this new approach could be used to explore time and space aspects of other conditions where family pedigree information is available.

"This idea isn't limited to autism," Richards-Steed says. "It can be applied to any disease and could enhance our ability to understand how a confluence of genetic and environmental factors can have long-term health consequences for families."


More information: Rebecca Richards Steed et al, Evidence of transgenerational effects on autism spectrum disorder using multigenerational space-time cluster detection, International Journal of Health Geographics (2022). DOI: 10.1186/s12942-022-00313-4

Autistic Members of the IDF

In The Politics of Autism, I note that we need more study of how autistic people fare in other countries.

Joshua Zitser at Business Insider:

Each day, Sgt. I. scours the internet to find elusive intelligence that could help Israel fight its enemies.

He is a web specialist for an elite unit of the Israel Defense Forces, focused on open-source research that informs high-level decision-making and can even reach the prime minister's desk.

He is also autistic.

Sgt. I., like some 150 others, isn't in the IDF by chance. He signed up to serve through Ro'im Rachok, a first-of-its-kind program that places autistic people in the military to utilize their valuable skills.

Speaking to Insider from inside HaKirya, the sprawling headquarters of the IDF, he said he was able to cope with long, exhausting intelligence work better than many others and that he was most productive when given to-do lists.

He couldn't elaborate on the specifics of what he does. The IDF and Ro'im Rachok members spoke on the condition that Insider use initials or only their first names, citing the secrecy of their work.

A typical IDF open-source project might involve trawling social media and obscure sites for intel on everything from the effect of sanctions on the Iranian economy to the size of Hezbollah's arsenal.

An IDF minder sat in the meeting room throughout, ready to intervene if Sgt. I. accidentally divulged anything classified.

On occasion, Sgt. I. said, his daily work routine is interrupted by "stimming" — a behavior often associated with autism that can involve repeating words, sounds, or movements to cope with stress.

Sgt. I. tends to flap his hands when he's excited or overwhelmed. "It's an urge, like blinking," he said.

He'd always been taught in special-education settings, so he wasn't self-conscious about doing this before he joined the IDF and started working in an office alongside neurotypical soldiers. "So, yes, I've had to adapt," he said.