Monday, October 23, 2006

Happily Ever After--For Some, or Why TV Does Not Cause Autism

Does television cause autism? If “yes”, watch this rerun!

Does correlation imply causation? If “yes”, watch this rerun!

Today’s episode of “Why Television Does Not Cause Autism” opens with a fable. . . Once in a rocky land of farms and snow, there lived a dentist named Harry. His wife Borgny cradled their darling girl named Liv. Her parents loved her and played with her, and nothing seemed amiss with their beautiful babe. Liv learned to walk in an odd fashion, but never started talking. Liv’s little brother Dag, born three years later, fared far worse: he seemed alert and normal for a few months, but never even learned to sit. He stayed infantile for the rest of his tragically short life.

One doctor after another diagnosed both children as hopelessly mentally retarded. Since all the fairy godmothers had gone into retirement, the faithful mother took them to a non-physician healer, an herbalist, and even a visionary, but her efforts came to nought. The parents had suspected the strong musky odor of their children’s urine to be a clue, but nobody had any ideas.

The parents persisted in their quest and, through some family connections, found a doctor wise in the ways of chemistry. He had no answers, but, as a consolation, offered to test their children’s urine. The kindly doctor ran routine tests that got routine results. Then something magical happened. In test for ketones, the urine turned dark green and faded away. The color startled him for it should have turned red-brown.

The doctor spent the next few months testing over twenty liters of urine and began to recognize the footprints left by the suspect. He tested people in institutions throughout the land, and some tested positive for these footprints. Doctors from far away tested the urine of other affected children, but less than two percent showed the trail left by the villain who had stolen their intelligence. Through analysis of family history, they found the thief had appeared in generation after generations of affected families.

Harry’s and Borgny’s children were never cured. Dag died at the age of six. Heartbroken, they never had another child. It took another twenty years for other dedicated families and doctors to develop a special diet and screening tests to prevent this one cause of mental retardation in very small minority of children. They died knowing that their efforts led to the screening of nearly all children worldwide to lock-up that particular villain and protect developing brains from harm.

The story you have just read is true. The names were not changed to recognize the heroes. On December 6, 1962, a ceremony was held at a special dinner in Washington, D.C. for the Joseph P. Kennedy Jr. Foundation. In a moment the results of that dinner . . .

The kindly doctor received a glass statue of the winged seraphim, Raphael, the angel of science, healing and love, for “opening a new era in the study of mental retardation with his discovery of the disease phenylketonuria, or PKU.”

Cast:
Harry, Borgny, Liv, Dag . . . The Egeland Family of Norway
The Kindly Doctor . . . Dr. Asjørn Følling
The Magical Test . . . Ketone Test
The Villain . . . Phenylketonuria
The Past . . . Untreated Cases of PKU

Contrast this fable, both fabulous and true, to a recent study by two Cornell business professors asking Does Television Cause Autism? Autism does not have a cause, but, like mental retardation, it has multiple causes. Finding one cause of many will most likely come from teamwork between parents, doctors, and dedicated people working together. Finding causes of autism will be like peeling away layers of an onion. Finding one cause will take years of research and experimental statistics, not broad epidemiological studies. Some forms of autism will eventually be discovered and given a new name. Some will be preventable or manageable, but others may never have an answer.

I conducted an informal, non-scientific poll of my email list, Aut-2B-Home, to find out how listmates could have helped those researchers:
  • Some suspected satire because the study’s title seemed like a rerun of the refrigerator mother theory.
  • Television may attract autistic children because of its very nature: highly visual and repetitive. Perhaps the question ought to be, “Does autism cause television addiction?”
  • The study neglected other underlying factors: (1) parents of autistic children tend to be engineers, possibly the first to purchase VCRs, who live in areas on the cutting edge of technology and (2) many autistic children have asthma and allergies, which lessen in dry climates.
  • Television might have enabled children, formally classified nonverbal retarded, to learn language, upgrading their diagnosis to autism.
  • Some children showed no interest in television at an early age because of difficulties in shifting attention.
  • A few parents have seen a connection between television and either seizures or extremely negative behaviors.
I close with a quote from one of my statistics books:
Statisticians are often stunned by the over-zealous use of some particular statistical tool or methodology on the part of an experimenter, and we offer the following caveat. Experimenters, when you are doing “statistics,” do not forget what you know about your subject-matter field! Statistical techniques are most effective when combined with appropriate subject-matter knowledge.
(Statistics for Experimenters, 1978: pg. 14-15).

Stay tuned for the next installment of Tammy Glaser's special coverage of the link between autism and television . . .

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