Wednesday, December 22, 2010

Geeks and Nerds

As we count down to the release of Paul Offit's latest book, I thought it would be a good time to briefly examine one of his pet theories regarding autism. 

Offit, who will embrace any hypothesis that deflects attention away from a possible link between vaccines and the disorder, has come up with the "autistics are really geeks" theory. 

ABC news reports him as saying:
People that we once called quirky or geeky or nerdy are now called autistic
and the evidence he presents to support this assertion? 
because when you give that label of say, autistic spectrum disorder, you allow that child then to qualify for services which otherwise they wouldn't be qualified to get."
That's it? The government services did it. I'm not even sure what government services would be of value to geeks and nerds.

In addition to an absence of evidence supporting his hypothesis, Offit's revelation seems to conflict with his belief that autism is a condition with a strong genetic component. On page 218 of Autism's False Prophets he states: 
The first clue to the cause of autism is that it's genetic. 
Since those traits thought of as "geeky" would be present in both child and parent, his genetic theory would seem to conflict with his geek theory since so many non-geeky parents have autistic children.

After all when I attend autism conferences, there’s nary a geek in the house. While parents of autistic children such as Dan Marino, Jenny McCarthy, John Travolta, Holly Robinson-Peete and Sylvester Stallone hardly seem like nerds

Additionally Geeks and nerds had geek and nerd friends and interacted with one another. Yet difficulty with social interaction is a key diagnostic feature of any autism spectrum disorder

Finally, anyone with even a cursory understanding of autism realizes there’s noting in the DSM that would cause one to conflate the two conditions

Diagnostic Criteria for Autistic Disorder

A. A total of six (or more) items from (1), (2), and (3), with at least two from (1), and one each from (2) and (3)
(1) qualitative impairment in social interaction, as manifested by at least two of the following:
(a) marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction
(b) failure to develop peer relationships appropriate to developmental level
(c) a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest)
(d) lack of social or emotional reciprocity
(2) qualitative impairments in communication as manifested by at least one of the following:
(a) delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
(b) in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
(c) stereotyped and repetitive use of language or idiosyncratic language
(d) lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level
(3) restricted repetitive and stereotyped patterns of behavior, interests and activities, as manifested by at least two of the following:
(a) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
(b) apparently inflexible adherence to specific, nonfunctional routines or rituals
(c) stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)
(d) persistent preoccupation with parts of objects
B. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years: (1) social interaction, (2) language as used in social communication, or (3) symbolic or imaginative play
C. The disturbance is not better accounted for by Rett's Disorder or Childhood Disintegrative Disorder.

Since there seems to be nothing remotely similar between an autism diagnosis and what we would think of as a geek or nerd, perhaps Offit, by "autism" means PDD NOS - which is a diagnosis falling under the autistic spectrum. Let's look at the diagnostic guidelines for PDD NOS then

This category should be used when there is a severe and pervasive impairment in the development of reciprocal social interaction or verbal and nonverbal communication skills or when stereotyped behavior, interests, and activities are present but the criteria are not met for a specific pervasive developmental disorder,

Admittedly, the above criteria is somewhat cryptic, but it's far from certain - or even plausible - that  "severe and pervasive impairment" is today's version of nerdiness.

Of course if autism was always present at current levels, todays expanded vaccine schedule could not have caused an increase that, in actuality, never occurred

So there we have it. The man who believes that vitamins are more dangerous than vaccines, that children can get 100,000 vaccinations on one day and that vaccines aren't very profitable; is trying to sell the idea that autism is really nothing new based on a self-contradictory theory apparently woven out of whole cloth. 

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