Autism and TV

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Rey responds to the latest nutso theory connecting autism and some randomly-selected phenomenon that has increased during the time period autism has increased. This time it's television. Someone needs to write a serious-sounding article claiming that not being Amish causes autism, using reasoning exactly parallel to that found in this kind of argument. The numbers are there for that just as much as they're there for vaccines, television, and eating bread. I'm sure someone out there will see it as a moral imperative that we all become Amish immediately in order to protect our children. It's sad to see Al Mohler involved with perpetuating this kind of nonsense.

I think my first thought at a real demonstration of a correlation, even aside from the alternative explanations raised by Rey, was that the causation is almost certainly the other way around if a connection is genuine. Has it even occurred to them that autistic kids are going to be watching more TV than neurotypical kids? After all, they don't have the interest or ability to develop the kinds of relationships that most kids want to develop, and the kinds of activities most kids engage in will therefore be both difficult and unattractive to them. They appreciate the bright colors and musical elements of programming for young children, since they stimulate the senses very well. They take to things like Sesame Street that offer very repetitive number and letter learning. Why isn't it obvious to anyone who knows much about autism that kids who are already autistic are going to be watching more TV? Never mind that parents of autistic kids will generally have a harder time keeping them within boundaries in order to do housework or other things during the day and will thus consider TV a very nice way to help lower the need for overstimulation from getting into cupboards, emptying silverware onto the floor, coloring on walls, dumping bins of toys, and so on. All kids do some of that, but autistic kids seem to want to do it 24-7 unless they have a distraction. That distraction can't always be an adult, since even full-time parents can't devote 100% of their time to kids, never mind to more than one kid when each would need 100% attention to prevent disaster. The fact is that TV calms them down, and thus parents will be motivated to have them stimulated in that way rather than in truly dangerous ways like what they're naturally inclined to do without the understanding danger that other kids naturally develop much earlier.

7 Comments

From early on, the only few things that would calm my autistic cousin down was the television and a pencil (which was just giving him a vehicle to repeat the cycle). My aunt opted for the former. Back when the research on the vaccines came out she blamed herself for getting him vaccinated when he was young--so did a couple in my church (who had a boy with autism). This, no doubt, will have my aunt and that couple wondering once again if they did something wrong.

One of the most foul things about some of the research into the causes of autism is that people run with half baked theories that end up with parents blaming themselves for someting that they really have no control over. A lot of this stuff, especially what people say about vaccines causing autism, is no better than experts back in the day telling mothers that they caused their children's autism by being cold to them.

Parableman: The problem here is that kids are being exposed to TV at a highly sensitive time in their development. When autism finally manifests itself around the age of three, the damage is already done. This study doesn't even address the possible effects on children who are being put in front of the TV to control their autistic behavior -- as they are past the developmental stage that seems to be the most vulnerable. The study is saying that it is possible that watching TV at 0-3 years of age could possibly trigger autism due to a vulnerability in some children's development at that time. The American Academy of Pediatrics has recommended NO TV for kids before the age of 2 for several years now. I think this is a precaution worth taking -- considering all the harmful effects of TV and now possibly this connection. In my opinion, it doesn't hurt children at all if they don't watch ANY TV, especially if they are doing other things that are creative and healthy.

Tamara, you're assuming that there's any connection to begin with, which is what I think is bunk. I haven't seen anyone specify what damage is caused by TV, why that and that alone could be causing it, and so on. The biggest difficulty is showing that it's not the genetic cause that's already been so clearly established, with more TV watching as simply an effect of a condition that's already there. Does the study disprove that? Since that's the most plausible explanation given the already clear genetic cause, how is it supposed to be good science to assume that that's not what's going on? Instead they'd rather engage in this kind of fear-mongering. That strikes me as thoroughly immoral.

As for the general arguments against TV, there are some good reasons to limit kids' access to TV, particular at early ages. But those aren't arguments against any TV, despite what the AAP has said. Kids can engage in creative activities and watch TV, all in the same day. How's that for thinking outside the box?

Furthermore, you've ignored my other point. If you've got two autistic kids still in diapers and a baby, and you're the only one spending most of the day at home, it's going to be completely exhausting trying to act the way a parent of an only child without autism can act. You can set your kid to do something and not worry if they'll destroy everything in the house while you're washing dishes. You can leave them alone for a few minutes and not expect to find the contents of their diapers spread all over all the books that have been taken off the bookcase. You can try to pay some bills without worrying if they've gone out the front door to go lie down in the middle of a busy road. When our kids watch Veggie Tales, they usually sit and watch it. If the TV is off, sometimes they do more creative things, but whether it's good for them to be doing creative things depends on how much attention the adults around them can be paying them at the moment.

And do you know what? Child #3, the one exposed to the most TV as a baby due to the difficulties with Child #1 and Child #2, isn't autistic. It's possible that TV might slightly increase the symptoms of an already-autistic child the same way plenty of other things might, but I don't think we have any clue at this point which ones of those things reliably might do so and which just happen to be correlated with other things that do. Either way, it doesn't cause autism, or every kid who watches TV would be autistic. It's just bad headlining to put it that way.

I probably see more autistic children and hear their stories than most people because I conduct history and physical assessments on autistic children coming in to our school district special education preschool program. I write their medical heath care plans and follow these children throughout the school years. As you can imagine, I am very aware of the challenge of autism for all who are involved. As far as the study goes, I think you should read it carefully and completely rather than make generalizations about it. It isn't saying that television causes autism, but that it may hinder a stage of development between the ages of 0-3 that could lead or contribute to autism. The study doesn't rule out heredity or any other possible factor. It does seem to point to a likely link between television and autism for some children, and we don't have any way of knowing who those "some children" might be until autism manifests itself -- usually between the ages of 2-3 years of age. Just as all people don't have seizures when playing video games, some do, and playing a video game will trigger it. If the child never played the video game, no one would ever know he had that type of seizure. Heredity very likely plays a part in the whole autism scenario, as do other factors. At any rate, I will use my influence and education to promote and teach that NO TV is the American Academy of Pediatrics' recommendation for children between the ages of 0-2. At this age, infants/toddlers are not able to destroy the house or even get out of the house under reasonable supervision. They simply don't have the motor skills. And ALL children at this age need supervision, not just special needs children. People were able to control their children before the advent of television, and I suspect they can do it now just as well. I believe there is good evidence to support the fact that TV is neurologically harmful to children from age 0-2, and too much TV is socially harmful to ALL ages. Parents need to wake up and take this seriously, as seriously as keeping babies and toddlers away from other more obvious dangers. Just because the damage from television isn't obvious and immediate doesn't mean it doesn't exist. We must be open-minded and flexible to all research and theory if we are to ever find a solution to the autism crisis. And, may I add that seriously limiting television is definitely "thinking out of the box," and away from the box! One will be harmed far more by television than by the lack thereof.

I wasn't talking about the two-year-old destroying the house or escaping. I was talking about the older siblings doing that. And you just try keeping her away from the TV when her brothers are watching their Veggie Tales.

I also made it extremely clear that I don't think there's nothing to the claim that TV can be harmful, and I don't think it's a bad idea to try to hold back to some degree on how much TV children watch. That's not my issue with this. My issue is that they're making speculative claims that they haven't supported, they're then going on to say things about those claims that even the original speculative conclusion doesn't support, and then people are trotting it around as an even stronger conclusion as a result.

The paper provocatively advertizes itself as if it is about whether TV causes autism. The title of the paper is "Does Television Cause Autism?" It's true that they more carefully state the results they came up with (at times, anyway), but that's not the message a title like this sends. All the study shows (given some inferences that I don't think are yet established) is that TV watching is consistent with being a trigger for autism. They even state this in the last sentence of the abstract. But the immediate sentence before that has the kind of wild speculation that their evidence does not show. It flat-out says that their tests show that the growth of cable TV caused the increase in autism. That's not what their tests show. That is completely irresponsible and amounts to nothing more than the kind of junk science that links autism with vaccinations or pollution, which they in this paper rightly reject as unestablished. I'm really not sure this study is any better.

As I've argued above, the numbers they're showing can very easily be explained in an opposite manner, that the rise in autism is what causes higher TV use in those family, even before the family knew the kid was autistic (and the paper itself presents an explanation for why this might be but amazingly refuses to mention that alternative conclusion until much, much later in the paper and then only to dismiss it because of the precipitation connection, about which see my comment further down).

They controlled for several factors, including income, but they didn't control for occupation of parents (which there is some evidence has a connection, e.g. the nerd factor in silicon valley).

There's also the issue of assuming that autism is triggered at some time between ages 0 and 3, when I think it's far more likely that whatever triggers it comes in at birth or before. The formation of the brain is the most likely time, but certain events such as lack of oxygen to the brain at birth might also serve as triggers.

I'm not even convinced yet that it's not 100% genetic without environmental triggers. Have they found identical twins with one of the twins autistic and the other not? If so, then it's not likely to be purely genetic. But then it might also be genetically caused but environmentally prevented, instead of being genetically potentialized and environmentally triggered. I'm not sure why either of those is a superior explanation to the other. But if they haven't found identical twins where one is autistic and the other not, then I'm not sure we even have reason to assume there are triggers to begin with. Couldn't it just be genetics? I haven't heard of anything showing otherwise, but maybe there is evidence out there.

There are several other problems. The timing of the increase in autism in California corresponds almost exactly to the growth of the Silicon Valley computer industry, where the nerd factor has been offered as an explanation for increases in autism in that area. When you've got people who are borderline or undiagnosed Asperger's marrying others who are borderline or undiagnosed Asperger's, it would be nothing short of miraculous not to see an increase in autistic children.

There's also the ADHD issue. (1) They assume there is something to the ADHD stuff. I'm not sure I buy that this is anything other than active kids who aren't as disciplined. (2) They acknowledge that the ADHD may be causing the greater instances of TV watching rather than the other way around, but they don't acknowledge the same possibility with autism.

As for the precipitation factor, it looks as if they're finding one factor, correlating it with another, and then correlating the second with a third, eventually using that to connect the first and third. This leaves a lot of room for mistakes in reasoning. The discussions here and here give some of the reasons why. Tyler Cowen suggests that the areas with higher rainfall in the study also happen to be the areas with a more diverse population and thus more chance of autistic factors being present in the gene pool. He also notes that the precipitation differences in California don't match up at all to the autism frequency. Also, it turns out that the correlation between precipitation and autism is stronger than the correlation between TV-watching and autism, which is really strange if TV is the trigger. A commenter mentions the connection between precipitation and vitamin D, which together with the connection between vitamin D and brain development presents at least as plausible a potential trigger as TV-watching. One commenter at the Freakonomics post points out that this has a difference of an average of 15 minutes of TV watching a day accounting for something like 40% of the cases of autism. That seems really implausible, because the variability of TV watching within each area should leave the differences between areas coming out as less significant than the average would tell you.

Then there's Steven Levitt's supposition: "My theory: when it rains a lot, parents watch more TV, see more shows about autism, and this leads them to seek out a diagnosis of autism for their kids. They have the same kids, it is just that TV makes them believe that their kids are autistic." I'd tend to doubt that this explains the whole story, but I wouldn't doubt that it's part of it. The increase of autism diagnoses is at least partially because parents are more willing to seek a diagnosis, doctors are more willing to give it, and so many disorders are now becoming lumped under that heading that they won't even speak of it as a disorder but as a spectrum of disorders, some of which aren't very closely related to each other. Since autism diagnoses skyrocketed right after the DSM manual added an entry for autism, you also have to factor that in. There are also several mentions of the fact that they are comparing data from different states without factoring in that different states have different means of keeping track of information, especially in the earlier years that make a lot of difference in this study.

The paper has not been published also, which means it has yet to stand up to peer review. I'd be interested to see what in the paper survives that process. I'll give them points for creative thinking, and their attempt to counter the reverse causation possibility with the precipitation element is a nice try. I just don't think it ultimately works.

This will be my last comment here, as I am serving on the state's Autism Information Council. We educate parents on the information that is available for them about autism and the help that is available through the school system and other entities. I've appreciated reading the various posts and comments of people throughout the nation on this and other sites, and have found it interesting to see what people are thinking and talking about as far as autism is concerned. I stand by the medical recommendation that children between 0-2 years of age not watch ANY television, for various reasons, including the one that suggests it might contribute to autism and other behavioral problems. I believe it is neurologically damaging to children of this age. I will continue to discourage my patients and their families in the use of TV as a babysitter or child control method. As I said before, people were able to control their children before the advent of TV, and there is no reason that they can't do it now. (Unless TV has spawned uncontrollable children -- which would support the study in question). TV is not necessary to sustain life, as some would have us believe. It is necessary to sustain the fat wallets of business people.

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