The Increase in Social Media and Autism - Coincidence or Causal?

Over the last 4 decades, the number of children diagnosed with autism and related disorders has grown at an astonishing rate.  In the 1970s and 1980s, about one out of every 2,000 children was estimated to have autism.  In the year 2,000, with a broader definition and better diagnosis, the CDC estimated that one in 150 8-year-olds in the U.S. has an autism spectrum disorder, or ASD.  

Since that time, prevalence rates have increased 10 - 17% annually.  By 2012, the ASD estimate had risen to 1 in 68 8-year-olds.  “There is no established explanation for this increase.” 

Autism/ASD is mental disorder caused by variations in the brain’s development.  These disorders are characterized by difficulties in social interaction, verbal and nonverbal communications, and repetitive behaviors.  More specifically, children with autism demonstrate either “deficits in social-emotional reciprocity, deficits in nonverbal communicative behaviors, and deficits in developing, maintaining, and understanding relationships.”

I became interested in this issue because a close friend of mine has custody of a grandchild who has ASD.  Recently my friend asked me, because I had written the book, Raising a Happy Child, if I had any ideas on what might help his interactions with the child.  Knowing very little about the disorder, I did some quick research which uncovered the information conveyed above.

What do we know about the cause of autism/ASD?  Prior to the 70s, autism was thought to be caused by bad parenting, “unloving mothers.”  That theory has been thoroughly debunked. 

Instead, research has shown that a number of genes are connected with autism.  Further, a number of environmental factors before and during birth, that influence early brain development and thus increase the risk, have been identified.  They include advanced parental age, maternal illness, extreme prematurity, very low birth weight, and certain difficulties during birth involving periods of oxygen deprivation.  Also, mothers exposed to high levels of pesticides and air pollution may be at greater risk of having an autistic child.

Clearly, the factors identified by science to-date could not even begin to explain this rapid increase in the rate of autism/ASD.  In looking briefly at several recent symposia on the subject, no new ideas were identified.  There was just hope in identifying “modifiable risk factors” as we better understand why the prevalence of ASD has increased.

When I first read the definition of autism noted above, I had a “duh” moment.  The definition, with the possible exception of repetitive behaviors, almost exactly tracks what researchers are finding is the negative result of compulsive use of modern technology … the internet, computer games, smart phones, social media.  

We’ve all seen the phenomenon.   Whether on the subway, in the theater, on the street … people of all ages, not just the young but older Americans as well, seem unable or unwilling to be disconnected from their technology tool, their new umbilical cord, for an unnecessary moment.  It has become an addictive behavior. 

I knew from research I had done when writing my book that “stress in the womb can affect a baby's temperament and neurobehavioral development. ‘Who you are and what you’re like when you are pregnant will affect who that baby is,’ says Janet DiPietro, a developmental psychologist at Johns Hopkins University. ‘Women's psychological functioning during pregnancy – their anxiety level, stress, personality -- ultimately affects the temperament of their babies. It has to ... the baby is awash in all the chemicals produced by the mom.’” So it certainly seemed possible that an obsessive compulsive social media addiction would have an impact.

After I had done my initial research, I responded to my friend and indicated my hunch that the appearance of the new technology and its compulsive use during pregnancy probably has a strong correlation with the increase in ASD prevalence.  He responded by telling me that, interestingly, the ASD boy’s mother had been a compulsive computer gamer, including during pregnancy, and also didn’t take very good care of herself.  The boy is also a compulsive gamer.

With that single confirmation, I decided to delve deeper into the existing research.  The new definition and diagnostic criteria for ASD was developed in the early 1990s.  It’s probably reasonable to assume that the difference between the estimated prevalence prior to the broadened criteria for ASD diagnosis and post are mostly due to the new criteria as well as greater awareness.

However, in the period since ASD was defined, the criteria has been constant and the awareness consistently high.  So what accounts for the rapid increase since that time?

If one looks more closely at the CDC prevalence estimates, one sees a pretty stable figure prior to 1996 births, 1 in 150.  This finding is almost identical with a British study done during the early 90s.  Between 1996 and 2004 births, however, the prevalence increased to 1 in 68 children.  

More recent CDC data are not available (the report on 8-year-olds in 2012, thus born in 2004, was issued in 2016).  However a report from a 2015 government survey of parents found that 1 in 45 children, age 3  - 17, have been diagnosed with ASD.  Since the source of the data is different, though, one can’t conclude that the prevalence has increased further.  It may indicate an increase or it may indicate that the CDC data source is not as accurate and that the earlier prevalence rates were actually higher.  Either way, it’s not good.

During this period of rapid ASD prevalence growth, commercial internet and social media use took off (in the late 1990s).  We know from Pew Research data that during this period, ending in 2005, usage rose from 0 - 7%; during that same period the prevalence of autism doubled.  

Since then internet and media usage has grown exponentially.  The Pew study found that between 2005 and 2013, usage by adults increased from 7% to 62%.  The increase leveled off after that and the last reading was 65% in 2015.  This survey, however, did not measure frequency or duration of use, which from observation appears to have increased significantly.

If I’m on the right track, the scary question is what the set of CDC data will look like from children born in 2010 or later, given this huge increase in social media and internet use.  That data unfortunately won't be available until 2022 on the current schedule.

And there’s one more point.  The current research assumes that all factors impacting ASD development cease the moment one is born.  It considers no post-birth environmental factors.  Yet research has shown that a child’s brain continues significant structural development at least until age 3, with further development continuing until adolescence.  

It’s a very common sight these days to see even 2-3 year-olds staring at their little screens, watching a program or game while in their strollers, accompanying their parents at a restaurant, or elsewhere.  It’s becoming the new pacifier.  I cannot but think that it will have an impact on autism prevalence.

I cannot go any further with this line of reasoning from the available data.  However, I think that the connection, being both evident and sufficiently strong, points to the need for the CDC, or other appropriate federal agency, to gather information on the computer/social media habits of mothers during pregnancy.  And that data needs to include not just how many sites she visits (as was the case with the Pew data), but the frequency and duration of her visits.  Since it does not appear that such data would be able to be retrieved through the CDC’s ADDM data gathering system, a survey would most likely have to be employed.  Data on toddlers’/young children’s exposure to computer games/programs also need to be gathered.

Testing my hypothesis is of upmost importance.  I would even say urgent, given the ubiquitous nature of obsessive social media use prevalent today in our society.  If indeed more children are being born with ASD due to this risk factor, then every pregnant woman needs to be given a health advisory to stay off social media during her pregnancy.  This should be treated no differently than advice given to pregnant women to avoid other harmful behavior, whether it’s smoking, taking drugs, or eating fish from contaminated rivers.  And the use of devices by toddlers should be restricted.

If my hypothesis is correct but left unaddressed, this development could have more impact on the future health and vitality of our country than almost any problem we are currently facing.

For Being So Smart, Man Sure Has Made a Mess of Things

In his ceaseless quest for “progress,” man is creating an environment which is ever more inhospitable to man.  Many would call this statement an oxymoron.  The general wisdom is that progress makes our lives better, as embodied by the old DuPort slogan, “Better living through chemistry.”

Unfortunately the general wisdom, while in part undeniably true, has come at a terrible price for mankind.  The environment which sustains us and gives us life as well as our very humanity are being seriously compromised, possibly irreparably.  Let me count the ways - some much discussed, some less so.

Probably the most discussed way in which progress is creating a world inhospitable to man is the destruction of the environment.  The industrial revolution and the adoption of the automobile as the primary and preferred mode of transportation, combined with the rate of population growth and the emergence of newly-middle class populations particularly in China and India, have resulted in an exponential growth in the use of fossil fuels over the past century, especially in recent decades.  

From 1910 to the present, fossil fuel use has increased from a base of 1,000 to 11,000.  In the last 50 years alone, its use has increased almost 300%.  And while coal, the dirtiest of the fossil fuels, does have a much smaller share of the total energy market today, what is rarely pointed out is that the actual amount of coal used world-wide is more now than ever; a 200+% increase since 1965.  

This increase in fossil fuel use is causing a change in the climate/weather parameters that man has depended upon to support his way of life for millennia.  (See my post, “Climate Disorder = Global Upheaval.”)   We are probably already past the tipping point.  The efforts of the international community to reduce carbon emissions may, if successful, slow the process, but it will not stop the process.  The news from scientists is always the same, “We didn’t think it would happen this quickly.”  But it has and continues to.

Beyond the use of fossil fuels, our use of chemicals in every conceivable product is causing mostly unknown damage to man.  Yes, a small number of chemicals have been studied and shown to be dangerous, and they have been taken off the market.   And there has been improvement, along certain parameters, in air and water quality under the Clean Air Act and the Clean Water Act. 

But vast numbers of chemicals have been released into the air, soil and water, and absorbed by our bodies, that have not been studied at all.  We simply have no idea what impact they will have.  We do know that illnesses, such as cancer, exist now in unheard of numbers and there is speculation that the air we breathe, the water we drink, etc. is the cause for this increase is disease prevalence.  But there is no proof.  

However, a rational person looking at the plethora of chemicals in our bodies, the air, the soil, and water would say that the most reasonable assumption is that these chemicals will have a negative impact on us.  How could they not, given the intricacy of the functioning of the environment and the human body.  And that they therefore should not be allowed unless proven to be safe.  Rather than the other way around, which is how we have operated.  The dictum of criminal law, “innocent until proven guilty,” has no place in this context.

Then there is the issue of technology.  Several decades ago, the development of new technology was touted as the harbinger of more leisure time, a shorter work week.  Instead,  just the opposite has happened.  With each new technological advancement, making it possible to do things more quickly or be available at all times, our lives have become more burdened.  Certainly people in white collar jobs work harder now than they ever did with less time for leisure and for family.  For many blue collar workers, technological progress has brought unemployment as their jobs have been eliminated by increasing automation. 

But there is a darker side to the impact of technology resulting from the use of smartphones and tablets in combination with the development of social media.  It’s obvious in just looking around that most people are connected to their electronic screens every moment when they are not otherwise occupied, and often even when they are.  Whether they’re in a restaurant with friends or family, standing in the subway, walking down a street, or even in the theater … there, those electronics don’t get turned off till the last possible second, and as soon as the lights come up, they are turned on again.

Numerous articles have been written stating that the use of social media has become an addiction and that the social skills of people, especially the young, who are obsessively absorbed with their electronics have been negatively impacted.  Their interpersonal skills have been weakened.  They shy away from real relationships and instead see their social media “friends” as relationships.  They are removed from whatever they are doing, they aren’t really there.   This so closely tracks the definition of autism that I recently wrote a post, “The Increase in Social Media and Autism - Coincidence or Causal?”  But few people seem to be paying attention to this threat.

Another topic that is rarely discussed is the impact of the automobile and tourism on our lives.  For centuries we have made our homes in cities, towns, and villages.  These were vibrant places … even the smallest village … with life and human interaction typically centered around the local grocery/general store or stores, sitting on porches and chatting with passersby, or otherwise being part of a community. 

Now tourism and the automobile have created a double whammy that has rendered almost every place, with the exception of the largest cities, either a perversion or shell of their former selves.  In the decades following WWII, many cities and towns suffered economically.  Those that could turned to tourism as a way to pour fresh blood into the local economy.  But due to the increased use of credit cards and the marketing prowess of the internet, tourism has in the last decade become an all-devouring monster for many communities.  

Yes, it brings in people and dollars, stores are no longer empty, but the cost to the lives of the people who live there has been great.  Whether it’s Charleston, Savannah, or Asheville, to name just a few, towns are now overrun with tourists.  And these are not mostly tourists who have a love of history, who want to savor the charms of the past.  It’s hard to know what drives them, but mostly they seem to be out for fun and a few minutes of enrichment.  With hordes of such tourists, who seem to have no respect for the place they are visiting, the beauty and pace of life that was, is no more.

Other cities and towns, who continued to prosper and grow after WWII, developed suburbs in response to population growth and the availability of the automobile.  With the new residential development came shopping malls filled not with local stores but chains. 

As a result of this growth, and people’s love of driving, even people who still live in cities or towns started driving out to the suburbs to do their shopping because they wanted name brands/chains.  And the stores in the new malls were larger, had a greater selection of merchandise, often at lower cost, than the smaller stores that existed in town.  So not only did many people with disposable incomes move out of the cities, but those that remained stopped shopping there.   

And so slowly, the small local stores that had been the hub of life in the cities/towns went out of business.  I experienced this first hand in my home town of Reading, PA.  When I was growing up in the 50s and on into the 60s, downtown Reading was a vibrant place.  That’s where people went to shop.  You knew and talked to the store owners, sales personnel, the butcher, etc.  But by the 80s, the suburbs and shopping malls had grown so much that downtown Reading collapsed.  It was no more.  Literally.  Now it has been turned into an office center.  

And this is not just an American experience.  A recent article in The New York Times noted that the same phenomenon has happened in France where many of the older cities/towns are filled with shuttered shops as people flock to the outskirts to shop in the new shopping malls.

So the progress offered by the freedom of the automobile together with that offered by the use of credit cards has resulted in a catastrophe for many cities and towns.  They are devoid of the life that they used to have.  The new suburbs are also devoid of this quality of life.  They aren’t towns in the old sense of the word; there is no commercial nucleus around which the towns exist and function.  It’s all sprawl.  Everything is totally car dependent … you can’t walk anywhere in post-WWII suburbs.  There is no community.

And so people’s lives have changed, and not for the better.  As an example of poetic justice, the technology of the internet is now threatening those very shopping malls as more and more people are shopping online; it’s convenient.  

In the largest cities, you do still have vibrant neighborhoods.  They have not been impacted by tourism or the automobile.  But here, community life has been drastically altered both by technology and the chase after the almighty dollar.  Everyone is so focused on their electronics and making money, on improving their status in life, that they have little time or energy for other people, even often their own family.  Yes, people still get together to have fun.  And parents and children cross paths at home.  But that seems to be all that it is.  There’s no energy for a deeper investment or interest in others.  

This is not nostalgia.  This is an assessment of how our interaction with each other, our sense of community (beyond rooting for the local sports franchise), has diminished.  And with that we have lost something very important as human beings.  We have created an atmosphere that is barely fit for human life.  For to be human is to interact with others, face to face on a personal level. 

So what does mankind have to show for all the “progress” we’ve made in the past few centuries, especially the last one?  We certainly have more wealth.  We have more creature comforts, a higher standard of living.  Household chores have been made easier.  Illnesses have been cured and people live longer.   These are not minor achievements. 

But in this Faustian bargain, we have set in motion an upheaval in our environmental habitat that will have major but unknown consequences for our lives and well-being.  We have polluted the air, soil, and water around us, as well as our bodies, with a multitude of chemicals, again with unknown but unquestionable consequence for our health.  We have each year created new technological advances, and yet our lives grow harder and the sap of human life is drained from us.  And the ubiquitous automobile together with credit-driven tourism has resulted in the demise of our cities, towns, and villages as places where humanity thrives.

In this post, I have discussed these issues from a very human-centric perspective.  Yet we ignore at our own peril the impact that our “progress” has had on the animals and plants with whom we share this planet and on whom we depend in so many ways for our survival.

I’ve written several posts on how we might find our way back to a more meaningful life.  (For example, see “Healing Our Nation, Healing Ourselves.”)  But given human dynamics, it seems highly unlikely that we will change direction barring some huge catastrophe which makes everyone stop and reassess our way of living.

The Increase in Social Media and Autism - Coincidence or Causal?

Over the last 4 decades, the number of children diagnosed with autism and related disorders has grown at an astonishing rate.  In the 1970s and 1980s, about one out of every 2,000 children was estimated to have autism.  In the year 2,000, with a broader definition and better diagnosis, the CDC estimated that one in 150 8-year-olds in the U.S. has an autism spectrum disorder, or ASD.  

Since that time, prevalence rates have increased 10 - 17% annually.  By 2012, the ASD estimate had risen to 1 in 68 8-year-olds.  “There is no established explanation for this increase.” 

Autism/ASD is mental disorder caused by variations in the brain’s development.  These disorders are characterized by difficulties in social interaction, verbal and nonverbal communications, and repetitive behaviors.  More specifically, children with autism demonstrate either “deficits in social-emotional reciprocity, deficits in nonverbal communicative behaviors, and deficits in developing, maintaining, and understanding relationships.”

I became interested in this issue because a close friend of mine has custody of a grandchild who has ASD.  Recently my friend asked me, because I had written the book, Raising a Happy Child, if I had any ideas on what might help his interactions with the child.  Knowing very little about the disorder, I did some quick research which uncovered the information conveyed above.

What do we know about the cause of autism/ASD?  Prior to the 70s, autism was thought to be caused by bad parenting, “unloving mothers.”  That theory has been thoroughly debunked. 

Instead, research has shown that a number of genes are connected with autism.  Further, a number of environmental factors before and during birth, that influence early brain development and thus increase the risk, have been identified.  They include advanced parental age, maternal illness, extreme prematurity, very low birth weight, and certain difficulties during birth involving periods of oxygen deprivation.  Also, mothers exposed to high levels of pesticides and air pollution may be at greater risk of having an autistic child.

Clearly, the factors identified by science to-date could not even begin to explain this rapid increase in the rate of autism/ASD.  In looking briefly at several recent symposia on the subject, no new ideas were identified.  There was just hope in identifying “modifiable risk factors” as we better understand why the prevalence of ASD has increased.

When I first read the definition of autism noted above, I had a “duh” moment.  The definition, with the possible exception of repetitive behaviors, almost exactly tracks what researchers are finding is the negative result of compulsive use of modern technology … the internet, computer games, smart phones, social media.  

We’ve all seen the phenomenon.   Whether on the subway, in the theater, on the street … people of all ages, not just the young but older Americans as well, seem unable or unwilling to be disconnected from their technology tool, their new umbilical cord, for an unnecessary moment.  It has become an addictive behavior. 

I knew from research I had done when writing my book that “stress in the womb can affect a baby's temperament and neurobehavioral development. ‘Who you are and what you’re like when you are pregnant will affect who that baby is,’ says Janet DiPietro, a developmental psychologist at Johns Hopkins University. ‘Women's psychological functioning during pregnancy – their anxiety level, stress, personality -- ultimately affects the temperament of their babies. It has to ... the baby is awash in all the chemicals produced by the mom.’” Source: http://www.medicinenet.com/script/main/art.asp?articlekey=51730&page=3.  So it certainly seemed possible that an obsessive compulsive social media addiction would have an impact.

After I had done my initial research, I responded to my friend and indicated my hunch that the appearance of the new technology and its compulsive use during pregnancy probably has a strong correlation with the increase in ASD prevalence.  He responded by telling me that, interestingly, the ASD boy’s mother had been a compulsive computer gamer, including during pregnancy, and also didn’t take very good care of herself.  The boy is also a compulsive gamer.

With that single confirmation, I decided to delve deeper into the existing research.  The new definition and diagnostic criteria for ASD was developed in the early 1990s.  It’s probably reasonable to assume that the difference between the estimated prevalence prior to the broadened criteria for ASD diagnosis and post are mostly due to the new criteria as well as greater awareness.

However, in the period since ASD was defined, the criteria has been constant and the awareness consistently high.  So what accounts for the rapid increase since that time?

If one looks more closely at the CDC prevalence estimates, one sees a pretty stable figure prior to 1996 births, 1 in 150.  This finding is almost identical with a British study done during the early 90s.  Between 1996 and 2004 births, however, the prevalence increased to 1 in 68 children.  

More recent CDC data are not available (the report on 8-year-olds in 2012, thus born in 2004, was issued in 2016).  However a report from a 2015 government survey of parents found that 1 in 45 children, age 3  - 17, have been diagnosed with ASD.  Since the source of the data is different, though, one can’t conclude that the prevalence has increased further.  It may indicate an increase or it may indicate that the CDC data source is not as accurate and that the earlier prevalence rates were actually higher.  Either way, it’s not good.

During this period of rapid ASD prevalence growth, commercial internet and social media use took off (in the late 1990s) and grew exponentially.  A Pew Research study found that between 2005 and 2013, the use of social media by adults increased from 7% to 62%.  Since then the increase has leveled off and the last reading was 65% in 2015.  This survey, however, did not measure frequency or duration of use, which from observation appears to have increased significantly.

While the Pew data start where the CDC data leave off, we nevertheless know from it that between the late 1990s when social media started to 2005, the usage rose from 0 - 7%.  A huge percentage increase.  If I’m on the right track, the scary question is what the set of CDC data will look like from children born after 2010.

And there’s one more point.  The current research assumes that all factors impacting ASD development cease the moment one is born.  It considers no post-birth environmental factors.  Yet research has shown that a child’s brain continues significant structural development at least until age 3, with further development continuing until adolescence.  

It’s a very common sight these days to see even 2-3 year-olds staring at their little screens, watching a program or game while in their strollers, accompanying their parents at a restaurant, or elsewhere.  It’s becoming the new pacifier.  I cannot but think that it will have an impact on autism prevalence.

I cannot go any further with this line of reasoning from the available data.  However, I think that the connection, being both evident and sufficiently strong, points to the need for the CDC, or other appropriate federal agency, to gather information on the computer/social media habits of mothers during pregnancy.  And that data needs to include not just how many sites she visits (as was the case with the Pew data), but the frequency and duration of her visits.  Since it does not appear that such data would be able to be retrieved through the CDC’s ADDM data gathering system, a survey would most likely have to be employed.  Data on toddlers’/young children’s exposure to computer games/programs also need to be gathered.

Testing my hypothesis is of upmost importance.  I would even say urgent, given the ubiquitous nature of obsessive social media use prevalent today in our society.  If indeed more children are being born with ASD due to this risk factor, then every pregnant woman needs to be given a health advisory to stay off social media during her pregnancy.  This should be treated no differently than advice given to pregnant women to avoid other harmful behavior, whether it’s smoking, taking drugs, or eating fish from contaminated rivers.  And the use of devices by toddlers should be restricted.

If my hypothesis is correct but left unaddressed, this development could have more impact on the future health and vitality of our country than almost any problem we are currently facing.