Is It Autism? The Line is Getting Blurry
Autism diagnoses are on the rise worldwide. In the U.S., the prevalence of autism has increased from 0.05 percent in 1966 to more than 2 percent today. In Quebec, the reported prevalence is close to 2 percent, and according to a paper issued by the province’s public health department, the prevalence in Montérégie has increased by 24% annually since 2000.
However, Dr. Laurent Mottron, a psychology professor from the Université de Montréal, has serious reservations about these numbers.
After researching autism data, he and his team found that the differences between people diagnosed with autism and the rest of the population is actually shrinking.
Their findings are published in the journal JAMA Psychiatry.
Mottron worked with an international research team from France, Denmark and Montreal to review 11 large analyses published between 1966 and 2019, with data drawn from nearly 23,000 people with autism.
The analyses reveal that individuals with autism and those in the general population show significant differences in seven areas: emotion recognition, theory of mind (ability to understand that other people have their own intentions), cognitive flexibility (ability to transition from one task to another), activity planning, inhibition, evoked responses (the nervous system’s response to sensory stimulation) and brain volume.
Together, these measurements cover the basic psychological and neurological components of autism.
The team examined the “effect size” — the size of the differences observed between people with autism and those without it — and compared its progression over the years.
They found that, in each of the seven areas, the measurable differences between people with autism and those without it has decreased over the past 50 years. In fact, a statistically significant dilution in effect size (ranging from 45% to 80%) was noted in five of these seven areas.
The only two measurements that didn’t show significant dilution were inhibition and cognitive flexibility.
“This means that, across all disciplines, the people with or without autism who are being included in studies are increasingly similar,” said Mottron.
“If this trend holds, the objective difference between people with autism and the general population will disappear in less than 10 years. The definition of autism may get too blurry to be meaningful — trivializing the condition — because we are increasingly applying the diagnosis to people whose differences from the general population are less pronounced.”
To verify that the trend was unique to autism, the team also studied data on similar areas from schizophrenia studies. They found that the prevalence of schizophrenia has stayed the same and the difference between people with schizophrenia and those without it is increasing.
The diagnostic guidelines for autism haven’t changed over the years, so this wasn’t the cause. Instead, Mottron believes that what has changed are diagnostic practices.
“Three of the criteria for an autism diagnosis are related to sociability,” he said. “Fifty years ago, one sign of autism was a lack of apparent interest in others. Nowadays, it’s simply having fewer friends than others. Interest in others can be measured in various ways, such as making eye contact. But shyness, not autism, can prevent some people from looking at others.”
To complicate matters, the term “autism” has fallen out of favor, replaced by “autism spectrum disorder,” a sign that there’s a new belief that there are various forms of the condition. This has prompted some people to question whether autism exists at all.
“And yet, autism is a distinct condition,” says Mottron. “Our study shows that changes in diagnostic practices, which have led to a false increase in prevalence, are what’s fuelling theories that autism doesn’t really exist.”
Even though Mottron recognizes that there is a continuum between people with autism and those without it, he believes that such a continuum could result from the juxtaposition of natural categories.
“Autism is a natural category at one end of the socialization continuum. And we need to focus on this extreme if want to make progress,” he said.
In his opinion, autism studies include too many participants who aren’t sufficiently different from people without autism.
In contrast to the prevailing scientific belief, Mottron thinks that including more subjects in studies on autism, as it is currently defined, lowers the odds of discovering new things about the mechanisms of the disorder. No major discoveries have been made in this field in the last 10 years.
Source: Université de Montréal
Pedersen, T. (2019). Is It Autism? The Line is Getting Blurry. Psych Central. Retrieved on July 10, 2020, from https://psychcentral.com/news/2019/08/22/is-it-autism-the-line-is-getting-blurry/149655.html