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Post No.: 0719vaccination


Furrywisepuppy says:


The cause of autism does not appear to be ‘refrigerator parenting’ i.e. uncaring, emotionally-distant or absentee parents. Parenting style can certainly help an autistic child cope better in this world, but it isn’t the root cause of autistic behaviour. Based on twin studies, the predominant reason appears to be biological and genetic. But rather than a single gene, there are multiple genes associated with a diagnosis of autism. This usually means that environmental risk and protective factors also play a role within complex gene-environment interactions – but there’s far more to environmental factors than just parenting.


As with most developmental disorders/difficulties, variability in diagnosis can be explained by both genetic and environmental factors. Someone might have a genetic predisposition, which is then triggered by something(s) in the environment – although nobody yet knows what that something(s) might be with autism spectrum disorder? Estimates for the heritability of ASD are quite variable across studies, but all suggest that it’s not 100% genetic, even for those studies that suggest that genetics plays a large role. So which environmental factor(s) matter?


Well we can categorically conclude that – after all the subsequent research conducted in this area since the media scare – various epidemiological studies have found no association between the measles, mumps and rubella (MMR) vaccine and autism.


Brain scans of 6 and 12-month old babies suggest that the potential signs of autism begin well before children reach the age of MMR vaccination anyway, and before any behavioural symptoms emerge. Possible environmental risk factors might involve those present in early (the first trimester of) pregnancy i.e. before mothers-to-be might even know they’re pregnant (perhaps certain pesticides, contagious infections, medications, stresses?) – where no single cause alone seems likely.


Research does suggest that autistic children are more likely to have experienced childhood adversity or trauma – but it can be difficult to disentangle what are causes and what are effects. We can have people who look like they present with similar symptoms/features to autism purely through living in a certain kind of environment (e.g. the stereotypy exhibited by orphans who experienced extreme deprivation or a lack of social interaction or communication in under-funded orphanages in the past), but this won’t necessarily mean they’re all autistic. Researchers have yet to find a unified psychological theory that explains all things in all people who are on the spectrum.


Autism is genetically mediated and has a tendency to run in families, yet it isn’t heritable in a predictable way. The development of prenatal screening for the genetic markers of autism has raised ethical debates too – some are concerned that it’ll lead to abortions and the negative eugenics of something considered a ‘difference’ rather than an inherent ‘problem’. Besides, too little is currently understood about the complexities of the multiple genes associated with autism and the way these interact with the environment, hence such tests will likely be unreliable.


This ethical conundrum already exists when parents screen for Down syndrome. Some argue that if an autistic child-to-be will face challenges in this world then it’d overall reduce total harm to abort them. Isn’t it moral to prevent suffering? Others argue that these difficulties aren’t insurmountable and we should change the world to accommodate autistic people – and neurodiversity in general – better, and prevent any suffering this way.


Most parents of autistic children aren’t looking for a ‘cure’ for their children and love them as they are, yet many of them would like their children to have special support that ‘neurotypical’ children don’t need (e.g. mentors at school), and this funding will therefore need to come from somewhere if not from the parents themselves – and if this will be public funding then this will take funding away from elsewhere in the public healthcare and/or education system (i.e. other (innocent) lives will be affected because no decision in this world happens in a vacuum). But a diversity of minds can lead to greater creativity and problem-solving in organisations and thus economies, including those who are details-focused, pattern-seekers, generalists, those who say they prefer to think visually, verbally, etc.. Most autistic people, relatively speaking, aren’t socially confident hence they may not be great at selling themselves or passing traditional job interviews – but society will miss plenty of talent if we judge them by their weaknesses, not strengths… or abort them before they’re even born. We need to capitalise on the boons of neurodiversity. Woof!


…Exploring the topic of vaccination fears for a moment – reasons why some parents choose not to vaccinate their children include the belief they do more harm than good (that the diseases to be inoculated against aren’t that serious or can be fended off by a child’s natural defences and that vaccination can cause something like autism); being swayed by anti-vax conspiracy theories; religious reasons; and political reasons in some countries or cultures (e.g. a distrust of external interventions and medicines due to a history of unethical experiments conducted on their communities).


There could also be a generalised distrust of big pharmaceutical companies. It’s absolutely healthy to be sceptical where there are potential conflicts of interest in scientific research, but not all studies into the efficacies of vaccination are funded by ‘Big Pharma’ or stakeholders who have a financial interest in a (competitor’s) product or hold a particular steadfast political affiliation. And in this case, independently-funded studies and independent scientists have concluded that MMR vaccination is safe. Well nothing in life is 100% safe – including what you’re going to eat for dinner – but it’s safe and the potential benefits of vaccination far outweigh the potential costs; unless a qualified medical professional has identified a specific contraindication with you.


Another reason is the view that individuals should have the right to control what happens to their own bodies. Yet parents choose everything for their babies’ bodies – from what they feed them and how to bed them, to even ultimately deciding on their very existence without their consent. Parents by nature and logic force many decisions upon their children, and must do so in most cases for a child’s benefit. A child is too young to comprehend certain decisions for themselves and many decisions cannot be safely deferred until they’re old enough to personally understand them; like whether or not to take a vaccine. Although independence is vital – responsible parents cannot just let a child be free to do whatever they want and for them to only independently learn from their own decisions, actions and their consequences (e.g. to let a child play with matches if he/she wants and to learn from his/her own mistakes!) Some lessons from personal experience will come too late, hence why social services would have a dim view of this ‘parental method’.


So it’s more sensible to teach and support, and to enforce some rules and decisions and restrict some choices. It’s a balancing act between giving/expecting others to take responsibility and taking responsibility for the impact of our own choices (both acts of commission and omission) upon others (e.g. as parents to our furry pups, as citizens to our fellow citizens, as custodians of the planet to future generations of life) i.e. sometimes the argument that ‘everyone should take responsibility for their own outcomes’ is used as an excuse to abandon or deny our own responsibilities towards others because of the belief that ‘other people’s outcomes are always completely their own fault, never partly ours’. The instruction of taking individual responsibility is too frequently (ironically) used to abdicate our own responsibilities towards the lives of other individuals in this highly-interconnected world where our own decisions and actions don’t just affect ourselves.


In any case, parents have the ultimate responsibility to decide for their children many important things that may affect them for the rest of their lives. But should this mean parents should be allowed to make irrational decisions for their children, like denying them thoroughly-tested vaccines?


…Returning to the specific subject of ASD – when a condition is diagnosed, such as ASD, what often happens is that other people will assume that everything a person experiences, does or finds challenging is because of that condition (‘diagnostic overshadowing’). As an analogy, some yoghurt mixed with mashed berries might taste too sour for you. Someone mentions to you that this brand of yoghurt is more sour than most others. So you assume that the high sourness is because of the yoghurt. But this might overshadow the possibility of considering other reasons for the sourness, such as the berries (also) weren’t ripe enough.


So one diagnosis can overshadow the consideration that something else may additionally, or instead, be going on for that individual. And this is more likely with something like autism. Those who are diagnosed with autism later in life are often first diagnosed, or misdiagnosed, with other conditions with apparently similar symptoms. This misdiagnosis might be due to pervasive autism stereotypes – white boys fit the ‘autistic stereotype’ more than girls for instance, hence girls with the same symptoms aren’t referred as often, or diagnosed as autistic by medical professionals as often even when they are referred.


Someone could be diagnosed with OCD but they’re also autistic – but they might never be recognised as autistic because their autistic differences are seen as part of their OCD symptoms. Consequently, they mightn’t receive support for their autism.


When people with ADHD are interested in something, they can focus on it extensively, and so on the surface this can appear like ASD. (Repetitive behaviours and interests were covered in Post No.: 0708.) However, when someone with ADHD isn’t interested in something, their attention will be a problem. Some people with ADHD are very competitive and like to win at things too. ADHD does commonly co-occur with ASD but they’re not the same condition. (So note that any medications for the ADHD won’t be for the ASD, thus appropriate strategies will still need to be in place to treat the challenges presented by the autism.)


Diagnostic overshadowing can mean that someone with an intellectual disability and/or autism might bang their head against the wall, and other people might assume that this is normal for someone with IDD or ASD. Thus they’ll fail to consider whether they might also be in pain and depressed, or something else?


Intellectual and developmental disabilities (IDDs) are also known as learning disabilities in the UK. The diagnosis of IDD is based on having a significant impairment in intellectual ability (usually an IQ test score of <70); having these issues present before 18 years old; and having a significant need for support in everyday life (e.g. around self-care or social skills and communication). The cause isn’t known for a large portion of those with IDD but in the majority of cases they have a genetic basis, whether due to inheritance, translocations or mutations. But there can be social factors, like poor nutrition or alcohol overuse during pregnancy. Issues with delivery that lead to oxygen starvation can result in intellectual disabilities. A lack of iodine is a major issue for the developing brain. Infections like rubella or meningitis can be impacting on a baby too (so get those vaccinations!) If an infant misses or is delayed in reaching certain developmental milestones (e.g. reaching out, sitting, crawling, walking) then we might check if there’s a diagnosis.


People with intellectual disabilities will typically experience issues with learning and acquiring skills. You might hear that some are said to have a ‘mild’ or ‘profound’ level of learning disability, and this is usually based on their IQ score. IQ tests are a blunt way to measure the inherent intellectual abilities of people though since social factors are also pertinent.


For instance, someone who struggles to learn and acquire skills may subsequently receive fewer opportunities in life, which reinforces their social deprivation, and thus personal struggles. These kinds of entwined interactions are what we need to consider in order to make a fair assessment of a person’s outcomes in life.




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