Autist's Corner: class

Showing posts with label class. Show all posts

Saturday, November 2, 2013

Jerk Tweets Sexist Remark, Prompts Me to Muse About the Meaning of "Freedom"

"Feminism is the radical notion that women are people" - Cheris Kramarae and Paula Treichler

It took a long time before this saying made any sense to me. Surely everyone knows that women are people, right? What else would they be? Space aliens? Robots? Very convincing holograms?

That was a joke --- I knew, even when I first heard the saying, that it was referring not to the tautology that female Homo sapiens are Homo sapiens, but to the philosophical concept of personhood. At the time, though, I couldn't imagine that anyone did not extend personhood fully to women, so the saying still struck me as bizarre.

Well, here is a wonderfully clear example of someone doing just that:

Tweet from Pax Dickinson saying "Women's suffrage and individual freedom are incompatible. How's that for an unpopular truth?" Image taken from the Public Shaming tumblr

This guy was, until recently, the Chief Technology Officer at Business Insider, a popular news website with an emphasis on business and technology (particularly information technology) news.

But I don't care so much about who the speaker is so much as I do about what he is saying: Women's suffrage and individual freedom are incompatible. What? People are freer when fewer of them can vote? How does that make any sense?

I would submit that it only makes sense when you assume that the "individuals" he's talking about are men. Women's freedom is compatible with women's suffrage --- see recent elections in which women's votes made the difference between a Republican rape philosopher and a more liberal (if not always pro-choice) Democrat.

Women's votes made the difference in 2012 in the Indiana U.S. Senate race between Richard Mourdock (the "pregnancy from rape is God's will" guy) and Joe Donnelly*, in the Connecticut Senate race between Linda McMahon and Chris Murphy**, in the Massachusetts Senate race between Scott Brown and Elizabeth Warren***, in the Ohio Senate race between Josh Mandel and Sherrod Brown****, in the Pennsylvania Senate race between Tom Smith and Bob Casey*****, and in the Virginia Senate race between George Allen and Tim Kaine.

Women's votes failed to make the difference in the Wisconsin Senate race between Tommy Thompson and Tammy Baldwin, and in the governor's races in Montana and Washington --- if only women had voted, the Democratic candidates would've won those races, but the Republicans' advantage among men was strong enough to carry them to victory anyway.

(It should be pointed out that, for the most part, abortion and other "women's issues" do not drive the gender gap in voting behavior --- there are much bigger differences between the sexes on whether to strengthen or cut back the welfare state and whether to pursue a hawkish or dovish foreign policy, according to Rutgers University's Center for American Women and Politics. The hard-right candidates that women voters rejected in 2012 espoused both extreme anti-abortion, anti-contraception positions and a desire to greatly diminish the welfare state, so it's hard to tell whether their anti-choice zealotry was the deciding factor in alienating women voters. But the fact remains that, if only men had voted, a lot more of those anti-choice zealots would be sitting in Congress today.)

So, besides being more likely to vote against candidates looking to curtail their reproductive freedoms, women also vote for candidates they think will strengthen the social safety net. What does that have to do with personal freedom?

Well, I think having a robust social safety net is critical for maximizing individual freedom: there are a lot more choices available to you if you don't have to worry about losing your home and being unable to feed yourself and your family if you lose your job. You're more free to blow the whistle if you think your employer is doing something unethical, to fight against what you see as unfair or exploitative working conditions, and to engage in political activism or commentary outside of work without being afraid that these things will cost you your job. You are also more free to leave a job for whatever reason. There's a reason FDR named "freedom from want" as one of his Four Freedoms, and why he used that word --- freedom --- instead of, say, "rights" or "entitlements" or "needs."

There's also a subset of welfare-undermining measures that serve only to criminalize poverty, to subject people needing government assistance to intrusive, degrading treatment and erode their freedom. Things that fall into this category are mandatory drug testing for welfare recipients, requiring welfare recipients to document that they spent a certain number of hours each week either working or engaging in approved job-seeking or job-preparatory activity, tying the amount of money a family receives to how well their children are doing in school, or requiring people applying for welfare to be fingerprinted.

People who favor such mean-spirited measures usually think there are legions of idlers living on welfare just because they don't want to work, and spending their benefits on luxury items.

(They are mistaken --- almost every form of public assistance that exists in the US is time-limited or situation-specific, like unemployment insurance (which expires after a certain number of weeks that varies by state), the program people are usually thinking of when they say "welfare" (which is officially called TANF: Temporary Assistance for Needy Families, which has, among many other limitation, a five-year lifetime cap on benefits), or WIC (which you can only get if you are pregnant, nursing, or have children younger than five years old). The one program that doesn't come with a predetermined expiration date is food stamps, which you can only get if you make 130% of the federal poverty rate or less, and which you can only use to buy food).

But whether or not the idlers exist, it's important to focus on the fact that these people --- the people who favor draconian measures to curb welfare fraud --- are more concerned with ferreting them out than with getting aid to those who need it, and subjecting those people to minimal state intrusion and hassle. That does not sound like a person who is concerned with human freedom; to me, that sounds a lot more like a person who cares little for people and a whole lot for pinching pennies.

There are some personal-freedom issues on which women tend to favor more restrictive policies than men do: according to this poll, women are less likely than men to support legalizing marijuana, to give just one example. But the conclusion one draws from that, taking into account everything I've said above, isn't that men are pro-freedom and women are anti-freedom; it's that most people favor at least some restrictions on individual freedoms, and that there are some differences between the sexes in terms of what should be allowed and what should be forbidden. The only way you arrive at "Women's suffrage is incompatible with individual freedom" is by defining "individual freedom" so selectively as to leave out any personal-freedom issue on which women are more liberal than men.

*Donnelly is pro-life, but unlike Mourdock he would allow an exception to a general ban on abortion for victims of forcible rape. He also voted for the Affordable Care Act and for the reauthorization of the Violence Against Women Act.

**McMahon supported the Blunt amendment, which would've allowed employers to opt out of providing insurance coverage for contraception. She also wanted to repeal the Affordable Care Act, which is slightly more popular among women than among men (i.e., for women it's almost a 50/50 split, while men are opposed by a slim majority).

***The biggest issue at stake in this race was obviously regulation and reform of the financial sector, which is not a "women's issue" but is, according to Rutgers University's Center for American Women and Politics, a greater priority with women voters than with men, though this poll shows huge majorities of both sexes favoring reform.

****Mandel seems to have campaigned on his opposition to the Affordable Care Act, and the fact that his opponent, Sen. Sherrod Brown, voted for it. Mandel also opposes abortion, same-sex marriage and including sexual orientation and gender identity in anti-discrimination laws.

*****Casey is pro-life, but unlike Smith he would allow an exception to a general ban on abortion for victims of rape or incest, or if the life of the mother is in danger. He voted for the Blunt amendment, but has also voted to protect Planned Parenthood's federal funding under Title X, and to rescind the Mexico City Policy (aka the "global gag rule" forbidding aid organizations from even referring people for abortion services). He also supported the Paycheck Fairness Act and introduced a bill to require colleges to do more to prevent (and track, and prosecute) sexual assault and domestic violence. Smith, as I mentioned, favors a total ban on abortion with no exceptions, and is one of the lesser-known Republican rape philosophers.

Wednesday, December 12, 2012

Autism Congressional Hearing Transcript: Opening Statement (2)

Right after Rep. Darrell Issa gave his opening statement, the Oversight Committee's ranking member, Rep. Elijah Cummings, gave a second opening statement.

Here's the video:

Transcript
_____________________________________________________________________________________________________________________

Thank you for that, Mr. Chairman, and I do thank you for holding today’s hearing. Before I get started I want to take special note, as you have already done, to our friend who is leaving, Mr. Burton. Over my seventeen years on this Committee, this has been an issue that he has constantly put forth and constantly made sure that we tried to address as best we could. Mr. Burton, I want to thank you for your vigilance and I want you to know that although you may be leaving the Congress, as the Chairman just said, we will continue the fight. And I know you will too.

Mr. Chairman, we have learned much about autism spectrum disorders over the past decade. Taxpayer-sponsored research has identified risk factors and evaluated therapies to assist with some symptoms. Physicians and parents now have a better understanding of the developmental signs and the symptoms, allowing for earlier detection, and educators have experience with new methods and approaches for assisting children with autism.

Congress has also acted to help individuals with autism and their families in significant ways. In 2010 we passed the Affordable Care Act, which contained significant new protections. Insurers may no longer discriminate against people based on pre-existing conditions. Insurers may no longer impose lifetime caps on health care coverage. New plans must include screening for autism without additional costs to the parents. And young people diagnosed with autism spectrum disorders may remain on their parents’ health insurance plans until they are 26 years old. These are real and significant protections that will improve the lives of millions of American families.

Even with this progress, there is still more to learn and there is still more to do. While autism affects all racial, socioeconomic and ethnic groups, some studies have shown that African-American, Hispanic and Asian children are less likely to receive an early diagnosis. These delayed diagnoses cause minority children to be further behind in development of language and motor skills. We must be vigilant in emphasizing earlier detection for all our children, as an early diagnosis can make a critical difference in the lifelong development of a child.

We must also continue to invest federal research dollars in new and evolving therapies to improve the lives of those with autism spectrum disorders. In my district we house the Kennedy Krieger Institute [link], an internationally recognized institution dedicated to improving the lives of individuals with developmental disorders. These institutions improve the quality of life, education, and continued development of those affected by autism spectrum disorders, and we must continue to support them.

Today’s hearing is an opportunity to examine what has been done about autism spectrum disorders to date and what more needs to be done in the future. There are many experts, individuals and groups who can help us in this effort. I want to take this moment to thank all of you for being here.

As the Chairman said, there are so many people who are interested in this issue, so many who wanted to speak, but I want to say to you what I said to Bob Wright of Autism Speaks a little earlier in the day: I thank you for caring about somebody other than your children and yourselves, because what you are doing here today is raising this issue so that other children, other than those, or other folks, other than those maybe in your own families, maybe your friends, will benefit in the future.

In other words, you are touching the future, and you are making it possible for those who are going through the autism spectrum disorders to have a better future. And so I thank you all for what you are doing, and as I said to Bob Wright, you must stay the course. One of the things that I’ve learned from being in Congress these seventeen years is that, in order for these causes to move forward, you have to keep banging the drum, and you must keep banging it louder and louder and presenting your case so that, after it’s all over, there’s high, as my mother would say, motion, commotion, emotion, and no results. I want you to be successful in what you’re doing. Life is short, and so what we must do is try and use our energy so that we can get the best possible results. And I am so glad the Chairman said what he said, about sticking with this, addressing it, and we encourage all of you to work with us as we move forward, and with that, Mr. Chairman, I thank you.

_______________________________________________________________________________________________________________________

(end transcript)

Rep. Cummings raises some important points: he's absolutely right that there are inequities in who gets diagnosed with autism, and in who has access* to the kinds of therapies, services and educational accommodations that can make an autistic person's life so much easier. He is absolutely right that these inequities are starkest along racial, ethnic and class lines.

He's also right to point out the gains autistic people and their families made with the passage of the Affordable Care Act.

Unlike Rep. Issa, Rep. Cummings seems to place the highest priority on identifying and providing services that improve actual, living autistic people's lives, as opposed to the more academic, theoretical research about what causes autism or what autism is at the molecular level.

I admit that I find the latter category of autism research more interesting, because I majored in biochemistry and I want to know about everything at the molecular level, but there's no question that the former category of research is more useful.

You can make the argument that scientific research shouldn't be funded solely based on its potential usefulness, or lack thereof, and I'd agree with you, but given that we're dealing with a limited amount of money that's supposed to cover pure research and applied research and actual provision of services, and that right now the bulk of the funding from both public and private sources goes to pure research, I'm okay with funneling some of that (public) money into the other two avenues. Private charities (looking at you, Autism Speaks!) would, of course, continue to be free to allocate grant funding however they see fit.

*As this article from the Los Angeles Times makes clear, these disparities persist even when services are supposed to be paid for by the state. In 2010, the California Department of Developmental Services spent $11,723 per child on white autistic children ages 3 to 6; on services for Asian children, they spent only slightly less: $11,063 per child. Black and Hispanic children fared the worst, with the state spending only $6,593 per child (just a little over half what they gave the white families!) on the former and $7,634 per child on the latter.

Monday, May 23, 2011

Autistic Woman Writes Terrible Column; Speculation About Her Capacity for Empathy Ensues

There's this woman, Penelope Trunk, who writes about climbing the corporate ladder on her blog, and in her book Brazen Careerist: The New Rules for Success. She's founded several startup companies, has worked in marketing and is now a full-time writer, focusing on career advice for young people.

She also has Asperger syndrome.

A few days ago, she wrote a column about Dominique Strauss-Kahn, the former head of the International Monetary Fund who is accused of sexually assaulting a hotel maid. In her column, Trunk advances the bizarre hypothesis that women who occupy the lowest rungs of the socioeconomic ladder, who work low-paying, menial jobs with no possibility of advancement, have greater freedom than higher-paid, professional women do to report sexual abuse by bosses, co-workers or clients.

Her notion is that someone working a low-paying job will not have the same incentive to hold onto that job that someone with a better job would have:

It has been clear for at least a decade that women who want to have a high-flying career should not report sexual harassment. I have written about this a zillion times, and before you argue with me, read the quotes from all the labor lawyers (representing plaintiffs) who agree.

The bottom line is that just about every woman who has entered the workplace has experienced sexual harassment, but the women who report it face retribution. ... [W]omen who complain about harassment generally lose their jobs in some convoluted but ultimately predictable way.
...
But, what about women who don't care if they get fired? Those women hold a lot of power in this equation.

It used to be that women with low-level jobs did not have the socioeconomic backing to stand up for themselves in the face of harassment. Today, women feel more empowered - even women in a low pay grade. And women across the economic spectrum can identify what crosses the line.

These women have nothing to lose when they report men who cross the line sexually. So the maid reported. And then, it turns out, all sorts of women in higher-up positions spoke up against Strauss-Kahn. The women wouldn't report the harassment on their own. They don't want to suffer retribution. But now there will be no retribution, so it's safe to come forward.

This is why men are going to focus harassment at the higher ranks of the corporate ladder. These are the women who have to keep their mouths shut if they want to keep climbing the ladder.

But God help the guy who harasses a woman with nothing to lose.

It's a great moment in history. Poor women are empowered to fight against lecherous men, and rich women can finally come out of the sexual-harassment closet because of it.

Matt Yglesias at Think Progress and Amanda Marcotte at Pandagon have both covered why this is astonishingly, massively wrong --- not just off, but actually the opposite of what's really true, which is that poorer women working menial jobs are more, not less, vulnerable to exploitation and abuse at work, and have fewer options for escaping or combating it. In believing otherwise, Trunk seems to have forgotten that, for some people, losing a job means not being able to pay rent, not having enough money to buy enough food, having to put off needed medical treatments or go without needed medications because they can't pay for them.

She also assumes that, if one quits a menial job, one can quickly and easily find another. This is just not true in an economy where almost one-tenth of all people in the U.S. are officially unemployed, and many more are working fewer hours than they'd like to. These low-wage service jobs are actually really competitive right now, since there are relatively few of them (since companies have mostly been weathering the Great Recession by laying off all the employees they could conceivably do without) and lots of people needing work.

There's a lot of other important stuff she leaves out, but I think the most important failing in her article is her assumption that women working low-paying jobs don't need those jobs. As a commenter on Pandagon noted, it's as if she's assuming that everyone has well-off relatives who can support them for a time, or has a trust fund or significant savings to fall back on. She doesn't seem to understand what poverty is.

Anyway, enough about Trunk. She's ignorant, naive and starry-eyed, and her good fortune and financial security have given her the (mistaken) impression that life is as easy for everyone as it has been for her.

Now, I want to talk about her critics.

It shouldn't surprise anyone reading this blog that commenters on both Pandagon and Yglesias's site have brought up her autism as a possible explanation for her failure to grasp basic economic and social realities.

From Pandagon:

Penelope Trunk's deal is that she has Asperger's and spends a great deal of time and energy figuring out the "rules" for social interaction. (Note: she is open about this and has written a great deal about it.) I got reading her because her perspective can bring some real insight into human interactions. But she can also get things dead, dead wrong.

If Ms. Trunk actually suffers from an illness which damages her ability to feel empathy, that both absolves her (partially) and leads to the next question --- why is she indistinguishable from the average conservative/libertarian?

My understanding is that while the inability to read nonverbal cues is quite acute, the practical effect of Asperger's also includes a lesser capacity for empathy, especially in relatively swift interactions.

From Yglesias's:

Trunk is wrong, obviously. But Asperger's Syndrome makes what she's trying to do here --- put herself in both DSK's and the maid's position and see who's right --- incredibly difficult. This isn't Tom Friedman telling us we gotta say "suck on that" to Iraq b/c he's a dick, this is someone with a legitimate medical condition exercising poor judgment by choosing to comment on something it's very hard for her to understand given that condition.

These comments are actually not representative of the threads in which they appear; these four comments are the only comments on both websites to blame Trunk's classism on her Asperger's diagnosis, and both threads also include other comments telling the quoted commenters that they are wrong to do so.

But it still depresses me that her diagnosis comes up at all in a discussion of why her article is wrong. One of the reasons it depresses me is because --- as the last comment I quote indicates --- it effectively bars all autistic people from participating* in discussions about workplace harassment. "Oh, you're autistic, you don't understand how normal people act." Because our "condition" prevents us from understanding other people, nothing we say about anything other people do --- even things they do to us --- has to be taken seriously. This is especially troubling when it's workplace (or school) harassment we're talking about, since autistic people are especially likely to be targeted for such harassment. (Indeed, we are often blamed for being bullied --- it's our own fault for being so weird, we're told as children.)

It also depresses me somewhat to see Trunk's excessive optimism about most people's ability to quit jobs at will, and find new jobs quickly and easily, attributed to her Asperger's rather than to her having a lot of resources at her disposal that she takes for granted, when most people with autism, when they can work, have terrible trouble finding jobs, and then holding on to those jobs for longer than a few weeks. If anything, we probably have a keener grasp than most people do of the risks inherent in quitting a job, because those risks are heightened for us.

I'd also like to point out, in two of those comments --- both written by the same person --- the use of autism as a metaphor for a self-serving political philosophy.

I've seen this once before, in an article on CommonDreams.org:

The language used in this passage --- citing "self-centered" behavior as the characteristic feature of autism, for example, or saying autistic people lack "linguistic, social, cultural or logical constraints to manage [our] lives" --- draws strong, if implicit, parallels between autism (a neurological condition) and selfishness (a moral quality).

These comments do a similar thing, with the "lack of empathy" that is so often cited as the core deficit of Asperger's syndrome. In the psychological literature on autism, the "empathy" being spoken of is usually cognitive --- we are unable to understand non-autistic people's behavior, feelings or states of mind, even though we are perfectly capable of caring about them. Yet, in the comment quoted above, the implication is that this lack of understanding also entails a lack of feeling for these incomprehensible others.

Autism is not a moral failing. Autistic people have moral failings, but they have them because they are people, not because they are autistic.

*Not in the literal sense of "You are not allowed to speak," but in the more nebulous sense of "You can speak, but if I know that you're autistic, I will attribute everything you say to your being autistic, and if any of it conflicts with what I think is true, or right, I will disregard whatever you say because your mind is diseased and mine is not."

Sunday, August 22, 2010

PLoS ONE: Children from Wealthier Families More Likely to Meet Criteria for an ASD

EXECUTIVE SUMMARY: A recent study shows that wealthier families are somewhat likelier than middle- and low-income families to have autistic children. The study compares surveillance data on a cohort of eight-year-old children in fourteen areas of the U.S. in 2002 and 2004 whom the CDC decided, based on school and medical records, met diagnostic criteria for ASDs with U.S. Census data from 2000 on eight-year-old children living in those same areas of the U.S. Statistical analyses were done on both groups' demographic data, which showed that the autistic children tended to come from somewhat better-off neighborhoods than the general population of eight-year-old children. Because of the study's use of public-school records, and its inclusion of a sizable group of never-before-diagnosed autistic children, its authors believe the association they found between higher socioeconomic status and higher rates of autism prevalence is not solely due to richer people's unfettered access to diagnostic services, but instead might also reflect some other factor that positively correlates with both autism and higher SES: the authors suggest both advanced parental age and excessive hygiene as potential candidates for this mystery factor.
___________________________________

This article in the Kansas City Star alerted me to a study published in PLoS ONE on July 12, giving the first indications I've seen that the conventional wisdom about autism and social class --- that autism is mainly a disorder of the upper classes --- might have more to it than just the simple fact that people with unfettered access to health care are a lot more likely than people without such access to get diagnosed with autism-spectrum conditions.

The way I had understood it, there was no big mystery there: people who can afford to see a doctor in non-emergency situations are going to get all sorts of things diagnosed at a higher rate than people who can't afford that kind of preventive care. In that framework, a higher rate of autism diagnoses among children from wealthy families says nothing about autism per se; it just serves as one more example of the huge inequality of access to health care here in the U.S.

The study I mentioned --- carried out by Dr. Maureen S. Durkin and her colleagues --- tries to address how much of the association between autism and higher socioeconomic status (which Durkin says shows up about half the time in the existing literature on the topic) is due to this gap in access to health care and how much may be due to other factors yet to be uncovered.

To try to include autistic children lacking formal diagnoses in their analysis, Durkin et al. relied on the CDC's Autism and Developmental Disabilities Monitoring Network, whose methodology is described here* on the CDC's website:

In 2000, CDC established the Autism and Developmental Disabilities Monitoring (ADDM) Network to track the prevalence and characteristics of ASDs in the United States. The ADDM Network is a multiple-source, active, population-based surveillance system that reviews developmental records at educational and health sources and employs a standardized case algorithm to identify ASD cases.

There is also a flowchart showing where they get their data from and how they decide which children are actually autistic; unfortunately, the flowchart is still pretty vague about which "educational and health sources" they use. It does mention that they use "multiple" of each, though.

So, in the years 2002 and 2004, the ADDM Network collected data on 407,578 (in 2002) and 172,335 (in 2004) eight-year-old children living in fourteen areas around the country: the northern half of Alabama; the central region of North Carolina; the Coastal and PeeDee regions of South Carolina; the entire states of Arkansas and West Virginia; parts of the cities of Denver, Colorado; Atlanta, Georgia; St. Louis, Missouri; and Salt Lake City, Utah; and the cities and surrounding areas of Phoenix, Arizona; Baltimore, Maryland; Newark, New Jersey; Philadelphia, Pennsylvania; and Milwaukee, Wisconsin**. Of these children, 2,685 met diagnostic criteria for an ASD in 2002; in 2004, the number was 1,376.

Durkin et al. took the data on all the children determined to be autistic --- minus the ones living in Utah and West Virginia, since those sites didn't provide enough information to determine socioeconomic status for the children living there --- and compared prevalence rates for ASDs across three socioeconomic "tertiles": high, middle and low socioeconomic status, as determined by three factors: 1) percentage of people in the area living above the poverty line, 2) percentage of adults 25 and over in the area who have at least a bachelor's degree, and 3) median household income for the area. They also compared those factors between the autistic children and the general population of eight-year-olds living in the same areas at the time of the 2000 census.

Compared with the general population of eight-year-olds living in the same areas, autistic eight-year-olds are somewhat less likely to live in "poverty areas," or areas defined in the 2000 census as having 20% or more of its families with children living on poverty-level incomes, with 16.8% of autistic children living in such areas and 25.8% of all children living in them.

Similar small-but-noticeable differences show up with respect to the other two factors, median household income and proportion of adults with college degrees. Among the general population, the median household income was $42,898; among families with autistic children, it was $50,114. Autistic children, on average, tended to live in census blocks where a larger proportion of adults 25 and older had bachelor's degrees; 30.3% had them compared with the general-population figure of 24.8%.

These differences kept showing up, even when the comparisons were set up differently: besides comparing autistic children with their (approximate) peers on measures of socioeconomic status, the researchers also compared autism prevalence rates across the three socioeconomic-status categories they'd created, and found that the richest group had the highest proportion of children meeting criteria for autism, the middle-income group had the second-highest, and the poorest group had the lowest. This pattern showed itself across all the racial categories included in the study, too.

Now, the question is, does the design of this study correct sufficiently for (well-established) class differences in access to specialized medical and educational services? Can its findings of autism prevalence increasing with socioeconomic status be taken at face value?

Part of the reasoning behind the authors' contention that at least part of the association between autism and wealth is real lies in their use of school-based, as well as clinic-based, documentation. Theoretically, all children in the U.S. going to public schools are going to be monitored by their teachers and screened for learning and developmental disabilities if they start to have problems with classwork, behavior or social interaction. But not all schools have the resources to make this sort of individualized attention a reality. It probably won't surprise you to hear that schools in districts where poor people live have less money than schools in districts where richer people live, and accordingly the poorer school districts are less likely to employ psychologists, paraprofessionals or even college-educated teachers. With less space and less staff, also, even very dedicated, insightful and observant teachers aren't able to give individual attention to every student they see struggling.

The U.S. educational system might be more equitable than its health-care system --- last I heard, public schools were still legally required to educate every student living in their districts --- but similar issues of accessibility plague both systems. Even if our educational system is technically socialized --- available for free to everyone, paid for with taxes --- there are still huge differences between the kind of education (including special education) you can get at a well-funded school in a primarily upper- or middle-class district and the kind of education you can get at a school in a poor district. The richer districts can levy additional taxes to give more money to their schools, and students going to those schools also pay student fees to cover equipment and activities.

All of this leads me to suspect that ascertainment bias can be just as big a factor in an educational setting as in a medical setting.

The study authors tackle this issue in their Discussion section:

An important limitation of this study was that the ADDM Network surveillance system relies on information for children who have access to diagnostic services for developmental disabilities. We could not rule out the possibility that the quantity and quality of evaluations and the information available for case ascertainment might have varied by SES. We looked for evidence of this by examining the number of evaluations per child with ASD recorded in the ADDM Network surveillance system, reasoning that if the higher prevalence of ASD among children of higher SES was due to increased access to diagnostic services, high SES might be associated with a higher number of diagnostic evaluations per child. However, we found no association between the number of evaluations per child and SES. We also examined the mean ages at diagnosis by SES and found that children of high SES received an ASD diagnosis at an average age of 58.0 months, 1.1 month earlier than those of middle SES (p = 0.2838) and 2.7 months earlier than those of low SES (p <>

The other important factor that somewhat mitigates the effect of differential access to the educational and medical professionals who can diagnose autism and provide autism-related services on this study's outcome is the inclusion of a subgroup within the group of autistic children they studied who had no prior diagnosis of autism; there were enough of these children (1,244) to do a separate statistical analysis of this group to determine whether the association between autism and socioeconomic status still holds up among children who had never been evaluated. The association did still stand: even among those children with no previous diagnoses of ASDs, the ratio of autism prevalence as determined by the CDC of low- to middle- to high-SES children was 0.78:1:1.09. (That is, the poorest children were somewhat less likely to be autistic than the middle-income children, who in turn were somewhat less likely to be autistic than the wealthiest children). It's worth pointing out that the ratio for children with previous ASD diagnoses is stronger in both directions, at 0.70:1:1.25.

While I'm not sure this study goes far enough to correct for huge systemic inequities in availability of services, those two findings --- that number of evaluations per child does not vary with SES, and that autism prevalence does vary with SES among never-diagnosed children --- introduces some doubt in my mind where there had been none before. Maybe there *is* more to this socioeconomic-status thing than just access to diagnostic services. I remain skeptical, but no longer absolutely convinced that ascertainment bias explains everything.

*A more complete description exists in this 2007 article in Pediatric and Perinatal Epidemiology, for which I cannot find the full text anywhere online for free.

**The list of fourteen areas applies to 2002; in 2004, only eight of those areas participated --- Alabama, Arizona, Georgia, Maryland, Missouri, North Carolina, South Carolina and Wisconsin. That's why the numbers are so much lower for 2004.

Durkin, M., Maenner, M., Meaney, F., Levy, S., DiGuiseppi, C., Nicholas, J., Kirby, R., Pinto-Martin, J., & Schieve, L. (2010). Socioeconomic Inequality in the Prevalence of Autism Spectrum Disorder: Evidence from a U.S. Cross-Sectional Study PLoS ONE, 5 (7) DOI: 10.1371/journal.pone.0011551

Tuesday, September 15, 2009

"The Next Step in Evolution"

(Cross-posted to Turner & Kowalski)

Over at John Elder Robison's blog, there's a two-part guest post on what it's like to be a woman with Asperger's. The guest blogger's name is Deborah McCarthy, and she is 49 years old, a vegan, an animal-rights activist, a Christian, and lives in Oregon.

While most of her writing just deals with her own experiences, particularly the differences she's identified between the way she thinks, feels, and perceives the world and the way most people do (and therefore often expect her to be that way, too), there are a couple of instances where she decides to make general pronouncements about things she really doesn't understand all that well. The statements she makes are inflammatory, hurtful (one more than the other, but neither is totally innocuous) and scientifically illiterate on a grand scale.

First, there's this:

Everybody says Asperger's' main symptom is a lack of empathy but I don't think that's true. Women exhibit differently from men. I'm sure conditioning has a lot to do with it but also women are predisposed from birth to be more empathic I think. I know I cry at the news very often. So I wanted to look at this and other characteristics to get clear on just what I can claim as mine and what just doesn't belong.

Empathy - I'm extremely empathic when it comes to the underdog, animals, children, the poor, the starving, etc. I have no sympathy whatsoever for the obese. Maybe that's from being bullied by my huge family members I don't know. Probably contributed. But for me it symbolizes greed and selfishness at the expense of another. After all, you don't get fat from veggies, you get fat from the flesh and mother's milk of another. Taking what doesn't belong to you. Taking more than your share. Taking more than giving. I have issues regarding fat. I admit it. Try not to hate me for it. I'm just being honest.

There are a lot of things wrong here, but since Sarah has already dealt with this part of the essay I will be brief, and stick to what is factually wrong with this paragraph, since Sarah focused on the failure of empathy involved. (Yes, I noticed the irony in such a massive display of bigotry cropping up as its author is trying to argue that autistics are fully capable of empathy. As they say at Shakesville, *lolsob*).

First: demographically speaking, poor women in America are much likelier than their richer counterparts to be obese. (The picture isn't as clear for men: some studies find that men of all classes are equally likely to be fat, while other studies find a relationship between low socioeconomic status and higher body weight that's significant, if not as pronounced as the corresponding trend among women). Second, it is possible to be fat and malnourished. We've all heard about how various systemic factors (agricultural subsidies making starchy, fatty, processed foods cheaper than produce and whole grains; lack of access to well-stocked grocery stores; lack of time to cook healthy meals, etc.) mean poorer people (who, as I mentioned, are fatter overall than richer people) tend to get a lot fewer nutrients out of their food, even when they're getting enough calories. There are also --- yes, even in the U.S. --- people so poor they can't always afford enough food. And, when bodies aren't getting enough energy, nutrients and raw materials (i.e., sugars, proteins, fats, starches), they start changing their metabolism to compensate for the scarcity. They become thriftier, hoarding more and more of the food they consume as fat.

As Kate Harding puts it:

Poor people are a lot more likely to go through cycles of eating too few calories followed by bingeing --- which, when it's known as "dieting," instead of "only being able to afford enough food sometimes" --- has indeed been shown to make people fatter in the long run.

You also cannot extrapolate whether someone is a meat-eater from their degree of fatness. There are fat vegans and vegetarians, and there are rail-thin omnivores. You can't look at someone's body and reliably predict what they eat. There are too many variables at work for there to be such a cut-and-dried relationship.

And attempting to judge a person's moral character by the shape of hir body? That belongs in the intellectual trash bin with all the earlier pseudosciences conceived along such lines.

Anyway, on to the second thing I found deeply problematic:

I, and others, don't feel that Asperger's is a disorder. I feel it is a neurological difference. You can SEE the difference on a brain scan. We are literally hard-wired differently than a neuro-typical person. (How many times have I said I'm just not wired that way!!) I believe we are a leap in evolution. Leaps like this occur in nature all the time. I believe a more childlike and pure sort of human is on the horizon. One that is less caveman-like and more angelic-like. More ethereal, less dense.

This idea --- that evolution is a linear progression from simple to complex, or primitive to advanced, "caveman" to "angel" --- is very common, but wrong.

The outcome of evolution is not any one species; it's biodiversity itself. It's change in populations over time. Individual variations arise, natural selection acts on them; organisms either propagate their genes or they do not. Intelligence, morality, free will --- or any other objective Good you might be tempted to see (human) evolution as trending toward --- doesn't enter into it.

Evolution is also not hierarchical. Every kind of creature that exists now is equally "evolved," and each constitutes an equally viable solution to the particular bio-engineering problems that shaped its unique evolutionary history.

In other words, there is no Great Chain of Being.

Finally, evolution is not a succession of different attempts to solve the same problem; it's a succession of solutions to a succession of problems. The natural environment is not static: climates shift, continents move, mountain ranges rise up and are worn down, natural barriers isolating potentially interbreeding populations from each other arise or disappear. The selective pressures that act on one generation won't be exactly the same as the pressures that will act on the next generation.

Here's a relatively simple explanation of what evolution is from my college introductory-biology textbook (Biology, Sixth Edition, by Neil A. Campbell and Jane B. Reece):

In the Darwinian view, the history of life is like a tree, with multiple branching and rebranching from a common trunk all the way to the tips of the youngest twigs, symbolic of currently living organisms. At each fork of the evolutionary tree is an ancestor common to all lines of evolution branching from that fork. Closely related species, such as the Asian elephant and the African elephant, are very similar because they share the same line of descent until a relatively recent divergence from a common ancestor. Most branches of evolution, even major ones, are dead ends; about 99% of all species that have ever lived are extinct.
...
We can summarize Darwin's main ideas as follows:
Natural selection is differential success in reproduction (unequal ability of individuals to survive and reproduce).
Natural selection occurs through an interaction between the environment and the variability inherent among the individual organisms making up a population.
The product of natural selection is the adaptation of populations of organisms to their environment.

Thus, there are as many outcomes of evolution as there are ecological niches to be filled.

I also like this image of a circular Tree of Life, in which all currently-extant taxa (er, categories of organisms, for the nonbiologists reading!) radiate out from the single hypothesized common ancestor of all. It conveys the never-ending, multifarious nature of evolution much better than any other drawing I've seen.

It will probably not strike regular readers of this blog as news that such a teleological, hierarchical view of evolution has acted as (pseudo-)scientific justification for race- and class-based oppression. This thread has been particularly noticeable in the history of racism: people of African descent have historically been seen as ape-like and "primitive" (i.e., less evolved, less civilized, certainly incapable of governing themselves without white people running the show for them!) by white people.

While I'm not really worried about autistic people oppressing neurotypicals --- we don't have the numbers or the political power or social privilege to do so systematically, although individual autistic chauvinists can, and do, loudly proclaim their neurological superiority on the Internet --- this kind of "Aspie-supremacist" rhetoric valorizing the Vulcan-like, superintelligent-but-socially-naive autistic person can further marginalize autistic people who don't fit that mold. If the autistic-rights movement embraces the "Aspie" to the exclusion of other autistic points of view, then other types of autistics will be right where they were before neurodiversity: voiceless and unnoticed.

Autist's Corner