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Tuesday, May 03, 2005

The Age of Autism: Educated Guesses


Washington, DC, May. 2 (UPI) -- There was something similarly strange about the children who caught Leo Kanner's attention starting in 1938. He called their behavior "autistic."

There also was something strangely similar about the families they came from.

"There is one other very interesting common denominator in the backgrounds of these children. They all come of highly intelligent families," child psychiatrist Kanner wrote at the end of his historic study of 11 children, published in 1943.

He ticked off the fathers' occupations: four psychiatrists, one "brilliant lawyer," one chemist and law school graduate, one plant pathologist, one professor of forestry, one ad copywriter with a law degree, one mining engineer and one businessman.

"All but three of the families," Kanner wrote, "are represented either in 'Who's Who in America' or in 'American Men of Science,' or both."

Among the first 100 cases Kanner saw, he reported they "almost invariably came from intelligent and sophisticated stock." Of the 100 fathers, 96 were high school grads and, of those, 74 were college grads -- almost twice today's percentage. They included:

--31 businessmen

--12 engineers

--11 physicians

--10 lawyers

--8 tradesmen

--5 chemists

--5 military officers

--3 with a Ph.D. in science

--2 with a Ph.D. in the humanities.

Why this amazing "intellect effect" in the parents of children whose only common traits were language delay and deficit, "extreme aloneness" and "a desire for the preservation of sameness?" Kanner said those traits were present from birth: "These children had never been there."

The topic is not much discussed these days, as researchers hunt genetic causes and debate whether autism rose tenfold during the 1990s. Yet, the effect was so striking -- and, it turns out, so short-lived -- that surely it is a clue to the roots and rise of autism, the subject of this ongoing series.

"It is not easy to evaluate the fact that all of our patients have come of highly intelligent parents," Kanner acknowledged.


--Brilliant people (read: brainiacs who were a little weird to start with) hook up with other brilliant people and produce autistic (read: very weird) children. Verdict: unproven, unable to explain more than a fraction of children now affected.

--So-called refrigerator moms and dads, who obsess over their careers and their academic abstractions, coldly ignoring their child's development. Verdict: a damaging and discredited idea.

--Parents with the most education and money were most likely to bring their children to a specialist like Kanner. Verdict: plausible.

--Autism started in this stratum of society. Verdict: plausible.

Let's discuss the two open verdicts.

Four of those first 11 fathers were psychiatrists, likely to realize early on that something was clinically wrong with their children -- and likely to know about Kanner, a renowned psychiatrist at The Johns Hopkins University in Baltimore.

Interesting, though, one of the first autistic children appears to have been identified, not by her psychiatrist father, but by a doctor at the institution where she lived. Kanner disapprovingly remarked she had been "dumped in a state school for the feebleminded." This suggests, counter-intuitively, her father's medical career might be a risk factor for autism, not the reason she was referred to Kanner.

Regardless, the whole approach feels dubious and has a whiff of paternalism -- only the really top-drawer crowd would notice their child had a bizarre problem and get to the right doctor. It also is significant that Kanner, a brilliant observer, did not dismiss the "intellect effect" that way, but continued to puzzle over it.

Another correlation, less noticed, involves the mothers: nine of the first 10 also graduated from college, including a writer, a physician, a psychologist and a history teacher.

The 1940 U.S. Census reported just 3.8 percent of all women over 25 had completed four years of college. Yet, 90 percent of these mothers graduated from college? That is at least as startling as the fathers' attainments.

Looked at this way, what really connects these first families, including the husbands and wives, is more precise and less bizarre than an "intellect effect."

It is a college education, particularly the remarkable fact of the women's degrees.

This education effect does a better job of reconciling Kanner's view -- that autism was "very rare" and differed "markedly and uniquely from anything reported so far" -- with the much higher current autism rate of 30 to 40 children out of every 10,000. It does so by defining the parents of these early autistic children by what they did (going to college) instead of who they were (brainiacs).

It does, however, raise an unpleasant prospect: Some outside factor, unique to that remarkably homogenous group at that time, could have triggered autism in their children -- and then spread.

There are some early signs of exactly that spread: The one pair of parents without college educations constitute the 11th of Kanner's original 11 families.

Their son, Charles, was born in 1938; the other 10 children were born earlier in the decade. Kanner described the father as "a high school graduate and a clothing merchant ... a self-made, gentle, calm and placid person." His mother, whose education also stopped with high school, "has a successful business record, theatrical booking office in New York, (and is) of remarkable equanimity." (Say good night, weirdo-brainiac-refrigerator-mom theories.)

Look again at the list above of Kanner's 100 fathers, a list that incorporates the super-educated dads from the original study. Starting with Charles' parents, college and whatever it might imply no longer was the common thread.

Ten out of 10 of the original fathers were college graduates, followed by 64 of the next 90 -- still impressive, but a much lower percentage, no longer connecting all the families. Four did not even graduate from high school and eight were described as tradesmen.

There was not one businessman among the first 10 fathers, but there were 31 in the next 90. There were four physicians in the first 10, but just seven more in the next 90.

Demographics are always tricky to decipher, and it is easy to make too much of too little, but at some point all sorts of families began having autistic kids, and that ominous pattern may well be visible in the first 100 cases.

What were the conceivable risk factors for autism among the college-educated men and women of the 1920s and early 1930s and did they spread? We will pursue that in future columns.


Next: Clues from Kanner's kids.


This article is the third of seven in a series UPI published earlier this year.


The Age of Autism aims to be interactive with readers and will take heed of comment, criticism and suggestions. E-mail: dolmsted@upi.com

Posted by Becca

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