Uneducated guess

Reading Kristina's blog this morning, as I do most mornings recently, my armchair theory of autism causation popped up in my mind again.

She quotes Kati Wright as saying:

Despite receiving high quality early intervention, my son lost every word, every skill he ever had within a year of his diagnosis. Christian lived in constant pain for the following two years with a destroyed immune system and endured bouts of severe colitis, pnuemonia, staph, strep and cellulitis, while hardly eating, barely sleeping, only screaming. Tens of thousands of parents are living this nightmare along with me. We are understandably angry at the glacial pace and narrow focus of autism research.

And I am struck by how different that sounds from MK's childhood which was all forward progress. It was different progress from the progress of his peers, but we never got the sense that he was going backwards, and other than the usual string of stomach bugs when he first went to daycare (which he was kind enough to share with his mother and father) he was never sick. I am convinced that MK has developed just as nature intended him to, a wonderful expression of the DNA he was born with.

When I think about this, I also think about childhood disintegrative disorder and about the Autism Twins blog and mitochondrial autism, which is apparently a condition in which insufficient mitochondrial function is at least a contributing factor to autism.

Autism is a name given to a cluster of behaviors and modalities of processing. It is tempting to assume that people who match up with this cluster of behaviors and modalities do so because they share some common neurocircuitry. I would go as far as to say that, if we could actually observe such things, some autistic people would probably be found to share at least some circuitry that would be distinguishable from neurotypical circuitry.

But I very much doubt that all people with an autism diagnosis would be found to have identical wiring, even if they shared very similar behaviors and modalities. That is because, in living things, similar variations can often have different causes. People jump up and down both when they've banged their thumb and when they've won the lottery. People get depressed because their serotonin production is too low, and because their serotonin reuptake is too high. People can be thin because they move around a great deal, or because they eat very little. Same appearances, different causes.

And seeing that the modalities and behaviors that were are talking about are anything but homogeneous in the first place (in fact, there is at least as much variety in the behavior of autistic people as there is in the behavior of NT people) the idea of homogeneous causation seems pretty unlikely.

If, then, there is probably more than one cause for autism, it seems fitting to me that there be more than one set of investigations going on. More importantly, if there is more than one cause for autism, then success in identifying or implicating one cause does not mean that that hypotheses involving other causes are invalidated by that success. It is possible for it to be true that autism is hereditary and part of normal genetic diversity and, at the same time, for it to be true that autism is caused by an immunological disorder during development of the brain. It wouldn't surprise me if there were a dozen or more causes, and probably hundreds or thousands if you count each combination of genetic variation as a separate cause.

That said, the real utility of having a term like "autism" has nothing to do with causation. The utility of the term is that it helps us get an idea of what we should do. We know that autistic people are often more happy and successful with certain types of support. We also know that support has been grossly inadequate (if not actively harmful) in the past. That should lead us to conclude that current support is unlikely to be optimal. So that is something that we could be working on. And that is the kind of research that would benefit just about everyone with autism.

So, in short, I think that people should go ahead and research whatever seems likely in terms of causes. There may even be some cases of autism that have causes that make them amenable to medical intervention. Other cases don't have a "cause" any more than blond hair has a "cause." It would be good to demonstrate that too. It's all good. In the meanwhile, no matter what the etiology, most autistic people can benefit from some support or accommodation. So, as and entirely separate issue from causation, and without splitting into camps depending on which cause seems most likely for the autism closest to our own lives, let be sure that the lion's share of the energy is spent on support and accommodation.