Affluence and Autism: Cause and Effect? Or not?

Are affluent parents really more likely to have autistic kids?

Posted Aug 03, 2010

Have you seen this new University of Wisconsin study that correlates an increased prevalence of autism with greater household affluence?

This isn't the first study to reach that conclusion. But what does it mean? Many researchers dismiss research like this by saying wealthier people have more resources to get an autism diagnosis. They say more educated people are more likely to pick up subtle differences in their kids. And perhaps they're right.

Does that account for all the difference?

The incidence of autism combined with intellectual disability is not strongly (1.3 to 1) correlated with affluence. It's only the less severe forms of autism that are more common in wealthier homes. Is that because autism combined with ID is obvious, but the less severe condition is not?

Maybe . . . but maybe not . . .

Researchers note that intellectual disability by itself is inversely correlated with family affluence. That is, the more prosperous the family, the less likely they are to have an ID child. Knowing that, even a 1:3 to 1 correlation in the opposite direction may be suggestive of an unrecognized autism-affluence dynamic, even for the most severely affected kids.

The difference in non-intellectually-disabled kids is truly striking. For kids with autism, but without ID, there was almost a 3:1 ratio of autism in the highest socioeconomic group versus the lowest group. That's a pretty shocking ratio.

This study has some pretty profound implications.

If it's true that most of this 3:1 difference is due to more aware parents with better resources, then it follows that two out of three poor children with autism are going undiagnosed.

Sobering thought, isn't it?

Seen in that light, I find it hard to jump to the conclusion that we're failing to diagnose two out of three kids with higher functioning autism. I think the truth lies somewhere in the middle . . . there is some unknown reason that high functioning autism is associated with affluence, and we are still failing to diagnose a significant chunk of our less affluent population.

The researchers in this study seem to feel the same way.

This newest study attempts to address the question with some new methodologies. They looked at roughly half a million kids in a database compiled by the Centers for Disease Control, some of whom were diagnosed by doctors while others were diagnosed through schools. Some children had a pre-existing autism diagnosis, while others' records were evaluated as part of this study.

Here's the interesting thing:

No matter how you cut the study results, there is always a significant correlation between the incidence of autism and family affluence, even for kids who came into the study with no diagnosis. That sure suggests that there is some underlying reason that more affluent people are more likely to have autistic kids.

Do you remember Steve Silberman''s Geek Syndrome article from Wired Magazine, some years back? It looks like he had it right . . .

I had actually not thought about that story recently, but my son and Alex Plank interviewed Steve about that at this year's Autreat conference. You can see their videos of Steve here:

Why might affluent people tend to produce autistic kids? What do you think? Why might more affluent people be more likely to have kids who are "different?"

A significant percentage of our affluent population became financially successful by thinking differently. Some of those people invented new things. Others solved problems that defied solution. A few devised novel strategies to analyze markets. What do those people have in common? They think "differently."

Some people who think "differently" are just ordinary folks with a different thought every now and then. Others, however, are different all the time because their brains are different. Fifty years ago, such people were called eccentric. Today, more and more of those individuals are called autistic, or Asperger's.

It's an interesting thought . . . most adults with autism are not successful financially. They are disabled, and poor. Yet a significant percentage of highly successful people in engineering, analysis, and the sciences have autistic traits. Does a little bit of autism make you exceptionally successful, while a lot makes you exceptionally disabled?

I think so.

At the same time, our society has created institutions where geeky people with autistic traits congregate. Biotech companies. Electronic design firms. Research labs. Even Wall Street firms with their rooms full of mathematical savants. It should come as no surprise that males and females meet in those environments, and children result. To the extent that autism is genetic, we have created a unique environment for genetic reinforcement in those institutions.

What else is different, for affluent kids, and how might those differences lead to autism?

And what about the less affluent kids who are going undiagnosed? That is the less discussed but equally important finding of this research. How are we going to identify these kids so we can get them the help they need, and more important, where are we as a society going to get the money to pay for it with schools and autism service groups nationwide in a state of fiscal collapse?