Friday, November 04, 2011

"Bad news"

I went to what's probably the nation's best-known math-and-science high school, went to college "where fun comes to die," and am now living in a tiny, closed-off community primarily for mathematicians and scientists. I have been to numerous "apartment parties" where I was one of very few guests or the only guest. I have pained many an interlocutor by forcing them into ten seconds of small talk. So of course when Arts and Letters Daily linked, I read this Nature article about science-types and the autism spectrum (pull quote, from a scientist: "'I do think that when these geeks marry each other, that's bad news for the offspring.'") with interest.

Most of the time, when one thinks about the high-achieving couple's offspring, one thinks about regression to the mean. Or in layman's terms, the possibility that two former supernerds will produce a popular, well-adjusted B or C student. Amy Chua did her part to make it socially acceptable for parents to treat this outcome as one to be avoided at all costs, perhaps by trying to create a striving-immigrant atmosphere right there in your own UMC native-born household; the more typical writing on the subject is a thinly-veiled lament, a parent saying how wonderful it is to have a kid who's so athletic and outgoing, but who, alas, will never go Ivy.

But one does also think about another possibility, one that also may result in no-Ivy-for-junior, but that's a great deal more upsetting, namely that the kid will inherit an extra dose of awkward, minus whichever talents might lead to success as a computer-programmer or whatever. I'll confess that it does not take Borat's cousin to tell me that this possibility exists (see above), but it stands to reason that this of all issues is one that someone would be looking into quantitatively.

I have precisely one million thoughts on this (watch as I reveal my humanities-person-ness in my use of numbers), but the one I'll put in this post is that I wonder how much of the propagation of spectruminess (or whichever medically-recognized subset thereof) goes not through two-math-person couples, but through mothers who seem neurotypical and have no diagnosis otherwise but are... grown-up Darias, basically, who over the course of their lives have learned not to seem all that out-there. I have a zillion tons of anecdata, but nothing, alas, quantitative.

6 comments:

Dan O. said...

While there may be biases in diagnoses or differences in social conditioning, I don't believe those would explain the over 4:1 male to female ratio for ASD diagnoses. It seems likely the case that genes that cause autism get passed through the the female line (on the assumption that males who are more likely to express these genes are likely to have fewer children).

The age of parents also takes up a lot of the variance, as mentioned in the Nature article. There are so many genetic, developmental, and environmental factors that may contribute to that. So, speculating about explanations seem pointless.

The only clear moral from any of this is that getting genetic and prenatal counselling is a really good idea.

Research, and counseling led my wife and I to have our kids sooner than would have been financially convenient. I also got tested for Tay-Sachs (something everyone of Ashkenazi, Cajun, or Quebecois descent should probably do). There's some ASD in my wife's family. But there's other diseases/disorders in mine, such as Schizophrenia and Down Syndrome. (I hypothesize that the promiscuity with which I make lexical associations is an expression of schizophrenia-related genes. So, I blame my genetic makeup for others' reasonable failure to understand me. ) Also, there are fraternal twins in my wife's family, and the chance of twins increases with age of the mother.

Our 2 year old daughter is healthy, sweet, diminutive, obsessive, bookish, loves gymnastics, and is (inexplicably) blonde with brown eyes. (We call her a little lion. She says, "I'm not a lion, I'm a panda bear.")

We've got a son coming, God willing, in two months. I'm more anxious about that than I was about having a daughter (my wife isn't). Almost all of the congenital and developmental conditions that have expressed in our families have expressed in males.

Phoebe said...

Dan,

Two months, wow, congrats!

Now, the rest...

The reason for the "too brilliant to bathe" tag is that there's a vast difference between how it goes in early childhood for boys who are a bit odd and for their female equivalents. Boys may be bullied by some peers, yet celebrated by teachers, parents, and other peers for being budding Einsteins, whereas girls... will have to get with the program and care about seeming and looking "normal." By "have to" I mean there's no viable alternative - obviously a severely autistic girl will not morph into head cheerleader. But borderline cases will shift one way or the other according to gender, and I don't see why that wouldn't account for much if not all of the gender disparity.

(That's not even getting into the imperfect process of diagnosing such disorders - do quiet, awkward girls even come in for testing?)

Boys, but not girls, get positive along with negative reinforcement for being (to put it in crude terms) geeky. If this does, years down the line, mean that more boys get a diagnosis that is, let's remember, not some kind of binary, blood-test-proves-is-or-isn't sort of thing, should we be shocked? It's already known, apparently, that girls who are honest-to-goodness on the spectrum find ways to compensate and "pass" - wouldn't it stand to reason that many more girls and women pass so well that the only relic of being on this spectrum (as opposed to just a bit more shy/nerdy than most) is early-child memories of learning how to adapt, and that there's no diagnosis or close anywhere in their medical history?

Dan O. said...

Phoebe,

I appreciate the thanks, but I'm not touching the money yet, so to speak.

A couple of things:

I'm familiar with this general kind of debate. I used to think that differences in diagnoses of clinical depression was explained by gender bias (women are 3 times more likely to be diagnosed with CD). Men are similarly 3-4 times more likely to be diagnosed with substance abuse disorders. Seemed too much a coincidence. It turns out not. The symptoms just present so differently. Whether this is because men and women are essentially different or because of the way gender is socially constructed and conditioned is irrelevant to the elements of the disorders, as operationally defined in the DSM.

As such, there is no claim that autism, or ASD (even more so), is a natural kind, rather than a stereotypical cluster or symptoms collected together because of convenience and commonality among diagnoses and treatment.

And so, it is as it is, or - rather - it is as the DSM says it is. Insofar as girls present in such a way that they can function, whether this presentation is the result of detrimental social pressure or not, they simply don't present with ASD as often. Because if they don't present with the symptoms in a way that limits their ability to function, they don't have the disorder. Autism, like all psychopathological disorders, is operationally defined.

Your discussion is abstract in the sense of confronting a general social issue. I'm much more worried about my kids. I'm not too concerned with a child having ASD and faking it as normal. As a dude who sought out treatment for dysthmia, I know how to deal with gender-based social stigma about psychopathology. Fuck it. (Real men, especially smart men, are, after all, bipolar.)

I'm much more worried about a child being autistic and being incapable of functioning in such a way that faking it isn't possible. I'd feel out of my depth.

When I grew up (born mid-70's), it wasn't okay to be a geeky guy. It certainly wasn't okay for me. So, I compensated. I never got shoved into lockers because I was on the wrestling team. Maybe I just wasn't smart enough to get by as a geek.

I wonder, what would you say about the schizophrenic spectrum? The ratio of male to female diagnoses is much lower (1.4:1). Still, I would expect that you would see a bias in that area for similar reasons. After all, social withdrawal, geeky oddness, poor hygiene, etc. are all symptoms of schizophrenia. Similar arguments should apply. No?

Would the effect be so great so that we can conclude that the prevalence of schizophrenic spectrum disorders is greater in women?

Phoebe said...

Dan,

"Because if they don't present with the symptoms in a way that limits their ability to function, they don't have the disorder. Autism, like all psychopathological disorders, is operationally defined."

Right. But my point is that this is all the more reason to think that if there is an autism gene/are autism genes, this could be getting passed down through mothers who, well, have it but hide it to the point that no one would know.

Phoebe said...

And, b/c I didn't address this - I know very little about schizophrenia. Aspergers, on the other hand, is these days a near-default assumed possibility, at least, when someone is a bit more awkward than just awkward.

Dan O. said...

Phoebe,

If what you mean is that there are lots of women faking it with some as yet undefined-by-APA parallel of Aspergers with similar genetic causes, I'm sure you're right. In fact, I bet that's also true of the less serious schizophreniform conditions. Just like I'd bet there's lots more dysthmic men running around than there are accounted for.

But for pervasive forms of autism, there's still a large majority of boys. 2:1 isn't 4.3:1. But 2:1 seems big enough difference to me.