Hello, and welcome back to The Autistic Writer. Thank you for dropping by. How are you feeling? Me, I’m tired. But I’m going to come back to the subject of tiredness in a later blog, very much through an autistic lens. This week, there’s another subject I want to discuss. And it was prompted by something I think of, with tongue firmly in cheek, as the Great Lithium Reveal. I can hardly believe I’m having to talk about this, but here we go once more into the murky depths of autism “research”…
The phrase, “correlation does not equal causation” is now so well-known that even people who have no interest in science, statistics, or skepticism are familiar with it. But still, so-called research continues to emerge that, no matter how much it’s dressed up, ultimately is correlation-spotting. Where autism is concerned, such bad science can be harmful. I should say something up front here: I consider myself a rational person, a deployer of rational skepticism, and a person who trusts the scientific method. If I’m criticising something that claims to be scientific research, it’s not because I’m anti-science; far from it. I’m so pro-science that I get really annoyed and frustrated by the pseudoscientific bullshit that permeates popular culture.
Bad science really is a thing. While good scientific method is responsible for the great strides our civilisation has made in medicine, physics, biology, chemistry and so on, we have to also be aware of science being done badly. The way I see it, having complete trust in something just because it claims to be scientific is as unwise as refusing to trust any science. So, why is some science being done badly? How can it be that someone can get into the field of scientific research and produce work that is wrong, misleading, or inaccurate? Surely, that would go against the whole reason for being a scientist, right? Well, unfortunately, human nature sometimes has bad outcomes…
Incompetence exists. So does moral weakness, fraud, and intellectual bias. When disgraced doctor Andrew Wakefield claimed, very publicly, that vaccines caused autism, his study on the subject was taken scientifically seriously, to begin with. Then some uncomfortable truths emerged. Those uncomfortable truths were that there was no scientific basis to his claim after all, and that financial fraud was involved. Wakefield was struck off the medical register as a result, but not before the vaccine scare he induced led to an uptick in deaths from measles. Even today, the anti-vaccine movement continues, showing that once bad science is out there, it’s almost impossible to eliminate from the public consciousness.
The Wakefield vaccine scandal is a great example of one type of bad science (fraudulent), although not the only one. But the longevity of its effects is remarkable. The main reason it caught hold of the public’s attention so intensely has to do with the fact that Wakefield chose autism as the MacGuffin for his scheme. If he had claimed, for example, that the common cold was caused by vaccines, or that acne is caused by vaccines, it’s unlikely the same dramatic effect would have been achieved. Autism, though… autism always catches the public’s imagination. This is largely because people are terrified by the thought of having children who are autistic.
The old mythology of refrigerator parents played a part in creating this public fear of autism; when parents were led to believe that they were the cause of their child’s autism, and that their kids might be taken away from them, you can imagine the terror this caused. The changeling trope of autistic children (the idea that autism somehow steals away a healthy child, leaving a deficient autistic changeling behind) has also stoked the fires of public fear and misunderstanding of autism. The work of so-called experts like Simon Baron-Cohen, which has often led to autistic people being viewed as less than fully human and incapable of human emotional responses, has maintained public fear, even though much of his work has been refuted by other experts in the field. And the grieving phenomenon (the idea that parents of autistic people should grieve for the non-autistic child they could have had) has caused huge damage to public perceptions of autistic people, suggesting, as it does, that a dead baby is better than an autistic baby.
The fact that the truth about autistic people is very different from the sickening lies I listed above simply doesn’t get through to the general public. The harmful myths and stereotypes about autism and autistic people continue to be circulated in our culture, perpetuating a pervading sense of fear of autism. This fear creates a market for treatments, therapies, interventions and fake cures, aimed at parents of autistic children and prospective parents who desperately don’t want to bring an autistic child into the world. No one should underestimate the financial pulling power of this cultural fear of autism. According to Fortune Business Insights, the global autism industry is worth almost 2 billion dollars, annually. The organisation Autism Speaks, which likes to sell itself as an autism charity, but which is responsible for much of the misinformation and fear-mongering about autism, turns over literally millions of dollars annually, and a lot of that money goes into autism research. Which brings us back to bad science.
There are a lot of excellent scientists and researchers out there. But human nature being what it is, and the lure of money being what it is, there is scope for things to go awry. If you’re a researcher in the field of autism, your job and livelihood literally depend on there being a market for your research – someone has to pay your salary, and fund your labs, your equipment, your research materials, your place of work, your experiments, and so on. Why is such money available, and for what purpose?
The truth is that most research into autism is looking for causes; why some people are born autistic and some not. Another big part of research is into treatments, therapies, and so on. The simple existence of these lines of research demonstrates a colossal lack of understanding of autism which is fuelled by public fear. The search for treatments or therapies for autism makes no sense when you understand autism is not an illness. And I’m not being controversial when I say autism is not an illness; I’m not peddling some fringe viewpoint; it is the prevailing scientific and medical view. There is also a prevailing and firmly verified view in science that autism is genetic; a naturally occurring neurological difference from the norm, whatever that is. So looking for treatments or causes should be a nonsense; you don’t treat something that isn’t an illness, and you wouldn’t waste resources searching for the causes of something the cause of which is already established. And yet here we are, with this nonsense research ongoing… thanks to public fear. Every new piece of research into supposed causes and treatments just adds more fuel to that fire.
Time and time again, research into causes of autism reports results in the form of “risk factors”, which are themselves simply correlations. Commonly reported risk factors include: being born to older parents, premature birth, maternal obesity, maternal diabetes, prenatal infections, exposure to pesticides, exposure to pollution… blah, blah, blah. These are all just correlations. Let me make this clear; a correlation by itself neither proves nor disproves causation.
The key to understanding how pointless these autism correlations are is that none of them have a scientifically proven mechanism showing causation. Even the work done on genetics fails to deliver; no science has found an “autism gene”, but it seems that every month or so, some new research finds yet another gene to add to the hundreds (yes, hundreds) already “implicated” (read: correlated) with autism. So, with all the above in mind, imagine my combined frustration and boredom when headlines were awash this week with yet another environmental correlation with autism. Yes, it was the Great Lithium Reveal. Grab your vomit bags, and we’ll talk about it.
First off, what is lithium? Personally, every time I see the word, I think of Star Trek and “dilithium crystals”. But forget that silliness. Lithium is a metallic element, which has various uses from batteries to treating bipolar disorder and alcohol addiction, among others. Lithium is naturally occurring, and there is rather a lot of it in the ocean. It can turn up in fresh water, and get into water supplies. Hence this huge scare headline at TheHill.com…
The article is prompted by a study carried out by the University of California, Los Angeles. And the data was from… Denmark. Why Denmark? Well, it seems the Danes are keeping some pretty detailed and extensive records. The data in question were civil records of levels of lithium in drinking water, and concurrent information on pregnancies and psychiatric disorders. You can read the actual study – rather than a panicky article about the study – by clicking here.
So, in the summary of the study, you will find this text:
“In this Danish nationwide population-based case-control study, the study team found that maternal exposure to higher levels of residential lithium in drinking water during pregnancy was associated with a moderate increase in ASD risk in the offspring.”
The heavy lifting in this assertion is being done by the words moderate and in particular, associated. This is just another word for correlation. I mentioned at the beginning of this blog how the phrase, correlation does not equal causation, has become increasingly well-known. So well-known, in fact, that whenever anyone points out a simple correlation being touted as a potential causation, they are often mocked and treated like anti-science fanatics. So why don’t we see if someone with a bit of scientific clout has anything to say on the matter?
Max Wiznitzer is a respected professor specialising in paediatrics and neurology, which of course includes autism. In the past, he has very sensibly debunked Andrew Wakefield’s vaccine nonsense, and has equally sensibly insisted that there is no increase in the incidence of autism, just an increase in diagnoses. He has also been somewhat misquoted as saying 10-15% of autism cases are genetic. This is a misrepresentation of what he actually said. The verbatim quote is: “In about 10-15% of the cases we can identify genetic causation.” In no way does this statement indicate 10-15% is the limit of genetic causation of autism; only that this was what had been discovered so far, as of 2009. Research has moved on swiftly since then. There is now no serious scientific doubt that autism is genetic. What, then, does Mr Wiznitzer have to say about the Great Lithium Reveal? Speaking to CNN, he said:
“It’s an interesting association, but causation is definitely not proven. We have to see if there’s a viable and biologically plausible mechanism by which a small amount of lithium in the water supply can somehow do this, yet pharmacologic dosing of lithium in women with bipolar disorder has not been reported to be causing increased risk of ASD.”
There are other causes for concern about this study. First of all, the study was intended to answer the question, taken from the paper’s summary, Is maternal prenatal exposure to lithium in drinking water associated with autism spectrum disorder (ASD) in offspring? In other words, the authors set out looking for this very specific correlation, and found what they were looking for. This is not great science. Anyone familiar with research methods knows that if you look long enough at the noise, sooner or later you’ll see a signal.
I’ve called the Great Lithium Reveal bad science, but it’s actually debatable whether it’s science at all. The study started by aiming at the specific conclusion they were looking for, found correlating data, and concluded there might be a small causal effect. This is not the scientific method. Where is the causal hypothesis? There is none, so how could the hypothesis be tested in the study? What quantifiable predictions are made? Where is the explanation for why the correlation is not present in other instances of lithium exposure, as Max Wiznitzer queried?
The Great Lithium Reveal isn’t just bad science… it’s pseudoscience. And it was a limited study based on a comparatively small and specific population. The only way to blow this nonsense completely out of the water would be a much larger study on multiple populations exposed to different concentrations of lithium over an extended period of time. Considering the delays and misses that occur with identifying people as autistic, such a study could take decades, and I feel safe predicting that the results would show the Great Lithium Reveal to be just statistical noise. But, sadly, the damage has already been done. Much like the way the current anti-vaccine movement is entangled with Andrew Wakefield’s autism fraud, the subject of lithium in drinking water will now be forever linked with autism causation in the public consciousness. I predict many badly informed expectant mothers rushing out to buy water filters.
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The reporting of the Great Lithium Reveal has been largely in the form of a scare. An increased risk of autism spectrum disorder from contaminated water is the general format and tone. Lithium is tricky stuff, and has been linked to some health issues, but it’s also present in all our bodies in small amounts. It’s part of our environment. No doubt many, many naturally occurring environmental phenomena could be correlated with autism. Strange, irrelevant correlations are a thing. There are websites devoted to them, such as TylerVigen.com/Spurious/Correlations. My favourite weird correlation is the way the numbers of deaths by falling into a swimming pool correlates closely with the number of films featuring Nicolas Cage. Another one my son painted out, in his words: “Rates of violent crime are correlated with sales of ice cream, but it doesn’t mean people go out, have a fight, followed by a celebratory ice cream. The hidden factor is the temperature.” I just hope the next report I see about lithium is about improving the performance and recyclability of batteries, because that’s really important for the environment.
That’s all for this week. Until next time, take care.
Darren
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Why Do I Write This Blog?
When I first found out I was autistic, I was a middle-aged adult and I knew nothing about autism. I quickly learned that there was a serious shortage of information and resources for adults in my situation. With this blog, I aim to inform about autism and autism-related issues as I learn, hopefully helping people who are on a similar journey of discovery. Like anyone who writes a blog, I want to reach as many readers as possible; if you like what I’m doing, please share it with your friends and followers. I will never hide this blog behind a paywall, but running the website does incur costs. If you would like to support, feel free to make a small contribution at BuyMeACoffee.Com.
You might also be interested in David Scothern’s blog, Mortgage Advisor on FIRE, which covers a range of topics including mental health issues and financial independence.
The Autistic Writer 
According to the internet, pretty much everything everywhere is correlated with autism. Speculation might cause lots of headline clicks, but it takes a lot more than that to find scientific truth.
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