What does not cause autism?

There are a lot of misconceptions around autism. Very often parents are blamed, or parents go ahead and blame themselves for the child’s autism. They may think that their parenting is responsible for the child’s autism or in the Indian context, they are likely to blame it on themselves and their bad ‘karma.’ This blame and guilt often push the parents into denial about the child’s autism or into depression believing there is something wrong with themselves. All of this is unnecessary and is only likely to waste precious time that can be better spent on working with children.

Similarly, some parents believe that the child’s autism is not really autism, but a set of mild symptoms caused either by too much screen time, or due to lack of social interaction in nuclear families, or because the child has spent time around other children who have autism. Under this belief and the fear of the burden of autism, parents again waste precious time trying to take temporary measures like sending the child to a school to increase social interaction, leaving the children with grandparents, sending them to preschool etc.

As we understand, autism research is still young, and we do not have a complete understanding of what exactly causes autism. As of now, what is clear is that a combination of several factors (genetics, parental age at the time of conception, other environmental factors- link to “what causes autism”) may cause autism and we have some clarity on what does not cause autism. The following are some factors that were identified as “causes of autism” earlier but have been ruled out through thorough research.

Bad parenting

It was once believed that “refrigerator mothers” meaning cold, uncaring, and emotionally unavailable mothers caused autism in children. Later, by the early 1970s, this cause was studied further, and the theory of refrigerator mothers was disproved.

Vaccines

One of the most prevalent myths among causes of autism is that vaccines, especially the Measle, Mumps, and Rubella (MMR) and the mercury containing vaccines cause autism. This claim has been investigated thoroughly and no link between vaccines and autism has been found. See @sec-vaccines for more.

Screen time

It has been noticed that some children develop autism-like symptoms due to increased screen exposure before 3 years of age. Some studies suggest that increased screen time is associated with melanopsin-expressing neurons and decreasing gamma-aminobutyric acid (GABA) neurotransmitter, and thus results in deviant behavior, decreased cognitive, and language development. This has been termed virtual autism.

While the symptoms are similar, and virtual autism may be diagnosed as autism, these are two different conditions. Autism spectrum disorder (ASD) is a neurodevelopmental condition with genetic links and is thus present lifelong. On the other hand, virtual autism has a definite cause, which is excessive screen exposure at an early age/ Intensive Early Screen Exposure and unlike ASD, can be reversed if intervened at the right time and with the right corrective measures.

There is no evidence that the autism spectrum disorder is caused by excessive screen time.

For children on the spectrum, social interaction is a difficulty. They do not intuitively know how to socialize appropriately and may not always have a pleasant experience socializing. However, this is a symptom of autism and not a cause. Children on the spectrum retain their autism, irrespective of the social exposure they get in childhood.

Social exposure may desensitize them to social situations but will not take away the autism from them. Thus, lack of social interaction may deprive the child from learning appropriate social skills but does not necessarily cause their autism.

Interaction with people on the spectrum

Some of us believe that if a child is spending time with a child on the spectrum, they may catch autism. But autism does not work like the flu. As we have discussed before, autism is neurodevelopmental and has genetic links. If a child is getting a diagnosis, it is because the child has always had autism. It may be diagnosed late due to various other factors (denial from parents, symptoms being masked etc.) Your child is not diagnosed with autism because he/she was spending time with another child who has autism.

In summary, some popular beliefs, or apprehensions about the cause of autism have been conclusively proved to be wrong and an awareness of these can help parents focus their time and energy on more useful approaches to dealing with their children’s autism.

Timeline of Various Causes of Autism

1949 - Kanner proclaims his theory that autism is caused by "refrigerator mother", a term used to describe parents who are cold and detached.

1964 - Refrigerator mother theory challenged with possible neurological factors (Rimland)

1967 - Refrigerator mother theory reinforced through the “Empty Fortress” book

1977 - First study of twins and autism- Genetics as important risk factor

1998 - Andrew Wakefield claims MMR Vaccine triggers autism

2010 - Andrew Wakefield’s paper retracted, barred from practicing medicine, and loses medical license.

Autism research continues and so far, scientists have identified around 100 different genes and certain environmental factors that could contribute to the possibility of autism.

What causes autism?