April 16, 2014

Mail Bag: The Future of Society and Autism

This is an interesting question about autism and the future of society.

Mail Bag Joshua Kennon PenMr. Kennon,

With the rising rates of autism found in the general population, how do you think society will adapt to the cultural changes that will inevitably follow in the future as more people are born with the condition?  Do you think the increased prevalence will reduce the stigma for autistic people and their parents?

Please don’t publish my name.

We’ve talked about the evidence that autism is on the rise as a result of assortative mating patterns in certain sub-sets of humans, as evidenced by the vastly disproportionate rates of autistic children in parents who work in Silicon Valley.  This isn’t a new topic, by any means but, personally, I believe your question will not be relevant.

To borrow a phrase from finance, though far from a sure thing, the most probable indicator of future performance is past behavior.  I think you need a very compelling reason to believe that humans will behave differently under a comparable set of circumstances.  That is, generally speaking, any time you bet against human nature and conservation of one’s own resources by a mammal, you are going to have a bad time.  When viewed through that lens, I don’t think the hypothetical upon which your scenario is founded will ever come to fruition.  The reason is somewhat horrifying, but I can’t see a way in which it will be avoided under present laws.

Consider that as a result of advances in prenatal testing, 93 out of every 100 fetuses with Down Syndrom are aborted.  It cuts along all political, religious, racial, and economic lines.  No matter what you say, no matter what you believe, when your doctor informs you that your child has an almost certain probability of having Down Syndrome, the statistics show that there is a 93% probability you will terminate the pregnancy and a 7% chance you will decide to stick with it.  That is the cold, hard fact.  We can have deep discussions about whether that is good or evil, what that says about us as a civilization, what the implications are for the future of human evolution, and much more.  We cannot, however, argue that it is happening; that an overwhelming supermajority of individual citizens, when given free will, decide they are not willing to sign up for the challenges and rewards of such an experience.  It doesn’t matter if you are a raging pro-choice feminist living in a big city, or an evangelical pro-life crusader picketing abortion clinics.  The numbers show what you’ll actually do.

Though medicine is not quite fully there despite some major advances in this arena since 2011, it is close enough that relatively soon in the future, there will be prenatal screening for autism spectrum disorders.  Based on demonstrated behavior of people when acting in their own self interest, I think it is highly probable that once this is achieved, the incentive system currently in place, combined with human nature, will cause the autism birth rates to reflect those of Down Syndrome.  I have no reason to think that human nature has changed; what factors would cause this condition to be treated any other way?  It matters not what people say they value; it matters what they do.  On issues of reproduction, pregnancies of anything less than perfectly “normal” children are almost never allowed to result in a natural birth.

To put it bluntly, all evidence points to a future in which virtually all children with autism will be aborted once the condition can be accurately forecasted in the womb.  If you think otherwise, I believe you are deluding yourself because facing that reality is unpleasant.  We can have discussions about disabilities, social stigma, and coping strategies, but when push comes to shove, the data shows how people will behave.  Resource optimization is part of human nature and some people simply are not capable or willing of signing up for a lifetime of financial and emotional support to a disabled child.

It is unquestionably a form of eugenics.  The consequences of a smaller distribution of progeny as we homogenize the human genome is certainly going to be fascinating, though none of us will be around long enough to see it as the ramifications of this behavior will take thousands, if not tens of thousands, of years to unfold.

The only way to prevent such an outcome would be to somehow curtail the level of reproductive freedom currently permitted in the United States, which would result in significant backlash from certain segments of society even though this generation is the most pro-life in history (abortions have hit an all-time low, both in absolute number and relative to total pregnancies).  I think that is probably politically impossible.

In mental model terms, there is also an “operating leverage” effect in that it will only take a handful of parents choosing to abort such pregnancies before the economics are skewed even further against those who decide to give birth, increasing cost-per-patient and cost-per-student expense ratios, tilting the incentive system even further in favor of termination, causing a cascade effect.  As this author points out correctly:

There are, however, powerful economic forces arrayed against those with autism. Speech therapy, occupational therapy, physical therapy, play therapy, special education, are all essential services in the successful treatment of children with autism spectrum disorders. Over 95% of these costs are carried by school districts that are being bankrupted in the process. The cost is necessarily shifted to homeowners through property taxes. Parents must fight like lions every year in many school districts to maintain their child’s level of services. All too often, unscrupulous school officials mislead parents, wear others down, in the attempt to reduce services to children because of budgetary constraints.

If you know that there is no support in your local school district for your child’s needs and you are like most people, it’s probably going to influence your decision of whether to go to term or not.

I will leave it to you to determine whether you think this is a good or bad thing as that was not the question you posed; that way, you can come to your own conclusion without me influencing it one way or the other until you’ve had time to think about it.

Bottom line: There will be no young autistic community of which to speak, at least in the wealthy countries, 50 to 100 years from now.  Thus, to answer your question, society won’t adapt in any meaningful way as there will be no need.

  • joe pierson

    Silicon Valley is, by far, the most toxic area in the country (23 superfund sites), maybe that has something to do with the autism rates.

  • http://ianhfrancis.blogspot.com/ Ian Francis

    Ok, I have a more difficult question. Assuming you are right about people’s reaction to knowing the fetus growing inside them will be born with Autism (you are), do you think there would be the same reaction to discovering their child would be homosexual? (supposing some sort of test is devised)

    Homosexuality isn’t a disability, and is more and more widely accepted every year, but I can’t help but think, when push came to shove, many heterosexual couples would rather have heterosexual offspring. My gut feeling is, without some type of government intervention, you would see abortion rates at high levels, though likely much lower than the 93% abortion rate for Down Syndrome children.

    It makes me sick to think it, but the movie Gattaca is growing truer every day. Except in Gattaca, parents could choose the genes of the children they wanted to be born. In real life, we are exterminating the bad genes. Knowing that it is likely that modern medicine will be able to test for the presence of “unfavorable genes” long before it has the ability to pick and choose which genes to give to a child, I do not see a Gattaca-type scenario developing simply because we would have eradicated all the genes people didn’t want.

    Please tell me you see a mechanism that will stop this from happening, because at this moment, I cannot.

    • http://www.joshuakennon.com/ Joshua Kennon

      Excellent question. I’ve wondered about that, and I think there are two possible outcomes:

      1. Society doesn’t permit it because there is no medically relevant reason someone should be screened for sexual orientation, as we are on the verge of having it treated as a “suspect class” under legal precedent, something that would be almost instantaneous were a genetic cause discovered (I’ll be shocked if we don’t see that develop within the next decade given all the signs that have pointed that way and the fact that it fits all of the criteria traditionally applied throughout history). Thus, you’d have an interesting political affiliation between gay and pro-life activists who would pass laws making it illegal and unethical for doctors to even be permitted to administer the test given that there is no purpose to do it other than selective abortion. By putting the onus on physicians you bypass the public restrictions entirely as no doctor would risk his or her income and reputation to provide a test, and no laboratory would engage in such a test.

      Such a law would not work for conditions such as autism because signing up for a lifetime of challenge such as this would almost certainly be considered elective by the court system, which tends to go widely liberal when it comes to matters of reproductive freedom, whereas there are no negatives to having a child with a different sexual orientation.

      2. The courts and legislatures don’t get involved and sexual orientation screening is possible. In this case, there is no way to know what will happen. You might see the gay population decline substantially to the point of near eradication or you might very well have a marked increase in gay children as people self-selected offspring. Gay couples would probably be more likely to have gay children, and may even come to view it as a moral prerogative to ensure the propagation of their own kind. Certain demographics of straight women would insist on at least one gay son. It would probably balance itself out. In such a case, you’d probably see the same thing you do in India now for women – schools setup specifically for gay kids, laws designed to protect them, certain scholarship and benefit programs that were available only to them.

      In any event, reproductive ethics are interesting. Within our lifetime, the research being done in England will absolutely make it possible for two men to have a biological child together with no mother; we’ll see it before we retire, I’d bet money on it. That alone is going to make some people uncomfortable. (Personally, I think it is too damn bad because I believe that the right to have offspring is a “fundamental human right”, granted by either the virtue of being human or being created in the image of God, depending on your particular worldview. That means it cannot be taken away, except in the most extraordinary circumstances, along with the right to freedom of speech, freedom of assembly, freedom of the press, freedom of religion, freedom to marry, the right to bear arms, etc.)

      The biggest issue is going to be whether the rich and well educated are able to augment their children, creating a sort of super-race. There was a science fiction story written about that half a century ago … it’s name escapes me at the moment … but it was about a group of people designed so they didn’t need sleep. They ended up taking over the world, but the masses were so upset they ran them off the planet and into hiding.

      P.S. Consequence wise? If the worst happened and gays slowly declined out of the population, the world would look exactly like Oklahoma City; mud colored with far less music, art, dance, sculpture, literature, theater, and good food. From Pixar plot lines to the computer, none of it would exist were gays not around, so the world would be much less interesting. My guess is it has to do with integrating certain aspects of the male and female brain – there is a reason that certain legends in particular fields, like DaVinci, were gay. So generally speaking, life would begin to suck a lot more fifty years after the “Rainbow Holocaust” as I would call it.

      Think of how much history would have changed were gays not around … the United States may very well have lost World War II as Alan Turing wouldn’t have been born.

      Did you see the Tony’s opening with Neil Patrick Harris this weekend? If you haven’t Go watch it now. Stuff like this wouldn’t exist. It sounds so horrible living in such a dull world I’d probably start funding gay baby research. You get a gay, and you get a gay. I’d be like Oprah. Only handing out gay babies instead of cars.

      • Michael Starke

        Ken Jennings (of Jeopardy! fame) was on Wait Wait…Don’t Tell Me! a few weeks ago and predicted that the next big “bromance” would be between him and NPH. After that performance at the Tony’s, I think Ken will have to fight me for that honor…

        Seriously though, is it me or during that closeup, was NPH looking awfully gaunt… almost sickly?

        • http://www.joshuakennon.com/ Joshua Kennon

          I thought the same thing; did a double take. Compare it to this huge closeup. It could have been the makeup, though. Stage makeup for an event like the Tony’s is different from ordinary makeup. It looks horrible up close and being shot in high definition would have let you see pretty close to real life.

          On a related note, visit this page for a comparison of how celebrities look in their ordinary, real life and how they appear to the public. It’s crazy.

        • Michael Starke

          It seems that stage makeup tends to (insanely) over-emphasize cheekbones.

          (The following is a musing, as I really honestly know nothing about acting/production/etc.)

          I wonder if it’s not an intentional device in order to make facial expressions “readable” from farther distances, ie. the back of a theater. A mischievous smirk likely has to be “over-played” (unaided by makeup) to the point where something might be “lost in translation” when the production is staged.

          Either way, examined with modern video technology, and in closeup like that, it makes people look like Skeletor, with craniums that are disproportionately large as compared to jaws.

      • crabhooves

        The idea of gay people rallying together to ensure their survival is interesting. I’d love to see that happen, just to see what kind of new dynamics would emerge. Would there be a rift between gays born from straight parents and gays born from gay parents? How would gay culture change? Would it become more insular, would gay “ghettos” increase or decrease? Right now gay people have to find each other, we aren’t born into our own culture. But if that changed…mmm…the possibilities are so fascinating.

        • http://www.joshuakennon.com/ Joshua Kennon

          … if you had the possibility of gay people having biological children together and being able to self-select the sexual orientation of the off-spring so that they were also gay …

          I don’t know. I have to think about this. That could be wild. My first instinct is it would all but assure an entirely parallel society but then again, it could result in normalcy due to exposure and completely eradicate gay communities and cultures, just as there are no blond hair or freckle communities now.

          I’m going to have put this on the back burner and let it simmer for awhile. I cannot even remotely begin to picture what society would look like because you would have two huge competing mental models from human evolution: The first would be what we talked about during my trip to Epcot a couple of years ago, how people naturally assortatively self-select their peer group. The second would be social proof and the desire to integrate into and blend in with the broader society and civilization.

          It seems evident that were a parallel society to exist, the two forces would be working in tandem, but during the initial phase when it became possible, you’d have generations of people that came from straight families who would want to maintain contact with their friends and loved ones, which would make it very difficult for such a system to get enough momentum behind it to become a self-reinforcing cycle.

          My gut says social proof would win and we’d end up looking close to a Star Trek / Science Fiction -like society where romantic gender affinity was inconsequential. But I just don’t know. I don’t know.

          … you are going to make me go build strategy webs and decision trees to try to work this out because now it is going to be a thing until I can at least get a handle on the probabilities …