Wednesday, 22 October 2014

Autism, parental concerns and socioeconomic status

I'd like to think that there are some rather important messages to be taken from the paper by Xiang Sun and colleagues [1] on level of parental concern, socioeconomic status (SES) and risk of autism. Not only did the authors conclude that: "a higher SES was not associated with the risk of having ASC [autism spectrum conditions]" they also found that: "No child met ASC criteria where parents expressed no concerns".
Do you prefer "fashion victim" or "ensembly challenged"?

SES - including variables such as family income, parental educational attainment(s) and parental occupation(s) - has been something of a talking point in autism research down the years and the rather mixed messages which have come out of the research literature on SES and offspring autism risk (see here). The growing appreciation that children of those positioned in a higher SES bracket don't seem to be at any significantly greater risk of autism is something rather important as per other evidence, for example, noted by Fujiwara [2]. Whether this means previous contrary findings were in error or that there has been some shift in the factors linked to the onset of contemporary autism is unknown at this time.

Some of my first thoughts on the Sun SES findings were in relation to all the discussions about offspring autism potentially being associated with certain types of parental occupational choices [3]. Indeed, considering that the Sun study was both carried out in and originated from Cambridge (UK) and included Prof. Simon Baron-Cohen on the authorship team, it is coincidental that the findings could be construed as counter to such occupational links with autism (assuming that Physicists, Engineers and Mathematicians would be described as higher SES jobs).

Of course I'm not saying the research on any relationship between offspring autism and parental occupation choice is all bunk; the paper from Windham and colleagues [4] and other evidence is too strong to negate (including that of occupational exposures potentially being involved). Merely that there may be much more to see than just a spectrum of 'talent' genes overlapping with autism risk genes [5] when it comes to receipt of a diagnosis on the very wide autism spectrum. Oh, and assuming you believe talent is all in the genes...

The other finding from Sun et al discussing parental concern and potential diagnosis of autism in offspring also carries quite a bit of potential importance. Regular readers of this blog might already have picked up my respect for parents and carers as active agents both in terms of picking up the signs and symptoms of autism in their loved ones (see here) and also detecting and reporting other important comorbidity (see here). I see the Sun findings - "No child met ASC criteria where parents expressed no concerns" - as corroborating parents and caregivers as doing what they do best: knowing their own child. I might also suggest that the discussions on increasing autism rates solely being down to better awareness and greater diagnostic vigilance are not seemingly backed up by the Sun findings if we assume parental concerns represent the starting point of the diagnostic journey into autism.

Some music to close. Gershon Kingsley and Popcorn.

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[1] Sun X. et al. Parental concerns, socioeconomic status, and the risk of autism spectrum conditions in a population-based study. Res Dev Disabil. 2014 Sep 25;35(12):3678-3688.

[2] Fujiwara T. Socioeconomic status and the risk of suspected autism spectrum disorders among 18-month-old toddlers in Japan: a population-based study. J Autism Dev Disord. 2014 Jun;44(6):1323-31.

[3] Baron-Cohen S. Does Autism Occur More Often in Families of Physicists, Engineers, and Mathematicians? Autism. 1998; 2: 296-301.

[4] Windham GC. et al. Autism spectrum disorders in relation to parental occupation in technical fields. Autism Res. 2009 Aug;2(4):183-91.

[5] Baron-Cohen S. Autism and the technical mind: children of scientists and engineers may inherit genes that not only confer intellectual talents but also predispose them to autism. Sci Am. 2012 Nov;307(5):72-5.

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ResearchBlogging.org Sun, X., Allison, C., Auyeung, B., Baron-Cohen, S., & Brayne, C. (2014). Parental concerns, socioeconomic status, and the risk of autism spectrum conditions in a population-based study Research in Developmental Disabilities, 35 (12), 3678-3688 DOI: 10.1016/j.ridd.2014.07.037