Saturday, 5 March 2011

Kill your television

It happened again. There I was happily sipping my cup of tepid tea (as we English have been known to do) and browsing the web on a pleasant Saturday afternoon when gasp, a headline emerges from the internet ether - 1 in 60 kids suffer from autism spectrum disorder. Who, where, what and when are the questions that immediately sprung to mind.

Not so long ago I blogged about a media release discussing whether rates of autism are epidemic or not. My main beef with the previous article was the use of a message ('no autism epidemic') without any means of corroborating the accuracy of the statement (i.e. a link to some published research). A quick gander through this latest offering posted on-line in The Times of India regarding the rates of autism in India - the press coverage can be viewed here - stirred similar feelings to that of the last offering.

Scrolling down the article, we find the information is communicated by a Paediatrician attached to a Medical facility based in Chennai, India. If true, not only is it potentially in direct conflict with the previous press release of 'no autism epidemic' statement but perhaps more importantly it is an absolutely astounding prevalence rate, particularly if also applied to the gender ratio gap in autism.

Looking through the article however there is unfortunately no link to any published research; in fact no indication of how this figure was arrived at or whether the report is based on anything other than an opinion. Granted, I understand that there is always some journalistic 'flair' involved in any story, including as a catchy headline. But should this really be an excuse to print without corroborating evidence?

There have already been a few comments posted against this story on the on-line source. Interestingly up to this point, no one has commented on the source of the 1 in 60 figure; most people are finding a little bit of a problem with the explanation: 'excessive television watching' leading to a failure to interact with family members as a cause of autism. I will come back to this shortly.

Suffice to say that having conducted a search of the published literature available on prevalence rates of autism in India, at the moment I cannot find any published reference corroborating the 1 in 60 figure. In fact I can't seem to find anything approximating a current estimated prevalence rate for autism in India, aside from a comment in a paper from 2010 about a plan to start looking at the epidemiology which at the moment remains just that, a plan.

Anyway, back to the comment about TV causing autism. Mmm, where to start, where to start. Well, first there is the old adage of correlation not implying causation. I have discussed this issue in a previous post and so won't dwell on it too much. The literature on TV and autism covers quite a lot of ground, mainly from the point of using television for things like social skills training. A recent study from Thailand has also looked at TV viewing habits for children with autism compared with controls and concluded that TV viewing for children with autism started earlier, lasted longer in duration and interestingly, included more adult programmes (I assume this means more documentaries et al rather than the other 'adult' content). How far this is applicable to a non-Thailand population remains to be seen.

The question of whether TV causes autism has been asked by previous authors so is not a new question. Then, as now, the main issues coming up against any 'universal' effect of TV is the question; does TV 'cause' autism or are children with autism more likely to watch TV as a result of their autism?

I try to stay impartial on this blog, letting the evidence speak (obviously with the caveat that science is about probability not absolutes). On this matter I am leaning towards the latter position suggestive that autism is a predisposer to increased TV viewing rather than TV being a 'causer'.

I know that there is a body of research suggestive that too much TV can be bad for child development and one cannot discount that this may produce some effect alongside the 'sedentary lifestyle' aspect. But like all things, there are two sides to every story. Many of the TV programmes for younger children over the years (covering the same time period as the increase in cases of autism?) are geared to improve various aspects of child development. If not why are the BBC for example, investing so heavily in CBeebies and programmes like Something Special and Waybuloo and their drive towards 'better' psychological health and development?

More research is perhaps needed in this area, specifically into whether TV has any contribution to autism given the dyadic interaction required between 'man and machine'. But perhaps also such research should be conducted without the demonising undertones that have blighted our relationship with our favourite gogglebox and without the sweeping statements about TV causing autism.