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.

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.

How Faith in Consumerism/Technology Replaced Faith in God

A friend of mine said once that whenever anyone walked through the doors of our Buddhist temple, it was because they were suffering and they were seeking a path to end their suffering.  That is probably a statement that can be made of all religions.  

In the past, when true faith in God was high, most people looked to religion to ease their insecurity and if not end their suffering, at least give them faith that there was some larger reason for their suffering.  Belief in God trumped everything else. “The Lord works in mysterious ways”; if we mere mortals can’t understand why, it’s not in our place to ask.  Even when people were in dire circumstances or tragedy struck, their faith in God was not questioned, indeed could not be questioned because to question it would have left them bereft of spiritual support, alone and unprotected; instead their faith provided them with comfort.

Enter the modern age of capitalism and consumerism.  Just as Darwin’s theory of evolution was taking root in the public mind, creating fissures in the bedrock of faith in the Bible and in God (the Scopes Monkey trial was in 1925), and the scope of the terrors of WWI raised questions anew about God’s mysterious way, there rose in our midst a new preacher, the ad agencies who promised happiness and security through the acquisition of goods and wealth.  Shaken in their beliefs, people were open to a new way to end their suffering, a new faith, and thus were an easy target for the siren call of consumerism.

And so for most of the 20th century, although surveys in the U.S. consistently reported that the vast majority of people stated they believed in God, religious service attendance declined as did membership.  People were giving lip-service to a belief in God, most likely as a result of peer pressure, the desire to belong to the group.  Their actions spoke otherwise.

But although the masses bought in to consumerism and its promise of happiness, people found themselves still feeling insecure and alone.  Small wonder!  And so during the last decade or so, the siren call of the new technology and social media found an avid audience.  If you observe people on the street, in restaurants, in any public setting, it would appear that most people have been fully taken in by the illusion of connectedness, of multitudes of friends, that the new technology provides.  Their faith in this illusion is so strong because it seems directly to answer their deepest longing.  Indeed the only word to describe their constant attachment to their electronics is “addiction.”   How sad.

At about the same time, though, a slight change in this shift of allegiance away from God could be observed.  Some people, mainly among the young, were feeling the effects of having no spiritual support.  They had grown up in an era in which they were not exposed to true faith.  So, unlike their parents, their faith wasn’t shaken, it never existed; there was just emptiness.  While they didn’t reject consumerism and technology, they were looking for something deeper to end their suffering and insecurity.

On the Protestant stage, numerous mega-churches … orthodox in the sense of preaching the inviolability of the Bible as the word of God … began preaching that God wants you to be rich.  That together with their emotional enticements … being born again and having a “personal relationship with Christ” … and “relevant” formatting resulted in soaring membership and attendance.  An odd marriage of convenience.

On the Jewish front, there has also been a large increase in the Orthodox community, both the more liberal Modern Orthodox and the ultra-Orthodox.  Without, however, the accommodation to modern culture seen in the Protestant mega-churches. 

But these changes in the Protestant and Jewish communities are small blips in the overall decline in religiosity as measured by attendance and membership.  The false idols of Consumerism/Technology still hold the greatest sway in our modern culture.  And so the vast majority of people, bereft of any sense of their spirituality, are left feeling alone and insecure behind a facade of connectedness at the same time as their ability to find some security through consuming, illusory though it may be, is impacted by falling real wages.

One can only hope that another false idol doesn’t appear on the scene to lead a weakened people astray and that instead a true source of spirituality, accessible to modern man, makes its presence felt and awakens people to their true self … to the God, Buddha, Higher Power, or whatever one calls it within them.