As I said before, there is no such thing as autism

The word is a label for what are likely several different conditions, that have different symptoms and different causes. None of them, however, is caused by or related to vaccination or acetaminophen. Robert Kennedy Jr. has created a lot of irritation and pain because he apparently believes that the word refers exclusively to people with profound developmental disabilities. That is indeed what it originally meant -- although even back then it was probably not a singular phenomenon -- but it has since expanded to include a range of less severe disabilities, and even encompasses some people who don't necessarily qualify for the label of disability at all.

 

Scientists are starting to sort this out. Here's a Medscape report on a study recently published in Nature which parsed "autism" cases diagnosed early in childhood versus those diagnosed later and found that the two groups followed distinct developmental pathways and had different genetic profiles. (The diagnosis in both groups is highly heritable.) But, as researchers interviewed for the story tell us, we probably won't end up stopping at just two different phenomena. 

 

Uta Frith, PhD, emeritus professor of cognitive development, University College London, said the findings make her “hopeful that even more subgroups will come to light, and each will find an appropriate diagnostic label. It is time to realize that ‘autism’ has become a ragbag of different conditions. If there is talk about an ‘autism epidemic,’ a ‘cause of autism,’ or a ‘treatment for autism,’ the immediate question must be, which kind of autism?” said Frith.

 

Azeen Ghorayshi of the NYT recently discussed the history of the diagnosis. 

 

Once primarily limited to severely disabled people, autism began to be viewed as a spectrum that included far less impaired children and adults. Along the way, it also became an identity, embraced by college graduates and even by some of the world’s most successful people, like Elon Musk and Bill Gates.

That broadening of the diagnosis, autism experts believe, along with the increasing awareness of the disorder, is largely responsible for the steep rise in autism cases that Health Secretary Robert F. Kennedy Jr. has called “an epidemic” and has attributed to theories of causality that mainstream scientists reject, like vaccines and, more recently, Tylenol. . . .

Speaking of autistic children in the spring, Mr. Kennedy said, “These are kids who will never pay taxes, they’ll never hold a job, they’ll never play baseball, they’ll never write a poem, they’ll never go out on a date.”

 

This enraged people who have the diagnosis, or have a family member who does, to whom these words do not come close to applying. Advocates are now increasingly calling for the diagnosis to be split in two, e.g. "profound" vs. "non-profound." However, I quite sure, along with Dr. Frith, that while that might be a good practical step, it will only be the beginning. In fact, it's possible that some people with "non-profound" autism do indeed have a milder version of whatever is going on in some people with profound autism, while others have some entirely different etiology. We just don't know.

 

 

While it's heartening that we are seeing some progress in understanding the issue, or likely multiple issues, regarding autism, it is extremely disheartening that we have an ignorant, deluded, narcissistic crank in charge of our federal medical and public health functions.  The damage he is doing is indeed profound, and it will not easily be undone.