The significance of being the smartest guy in the room is contingent on which room we're in — right?
Introducing a presser on autism (that wandered into other spaces along the way), the sitting U.S. president said:
/ So I've been waiting for this meeting for 20 years actually. And it's not that everything's 100% understood or known, but I think we've made a lot of strides.
I wish it was done a long time ago. Today we're delighted to be joined by America's top medical and public health professionals as we announce historic steps to confront the crisis of autism. Horrible, horrible crisis. I want to thank the man who brought this issue to the forefront of American politics, along with me.
And we actually met in my office. Is it like 20 years ago, Bobby? It's probably 20 years ago in New York. I was a developer, as you probably heard, and I always had very strong feelings about autism and how it happened and where it came from.
And uh he and I, I don't know the word got out and uh, I wouldn't say that people were very understanding of where we were, but it's turning out that we understood a lot more than a lot of people who studied it, we think.
And I say we think because I don't think they were really letting the public know what they knew. /
/ The meteoric rise in autism is among the most alarming public health developments in history. There's never been anything like this.Just a few decades ago, 1 in 10,000 children had autism. So that's not a long time and I've always heard, you know, they tell you, a few, but I think it's a lot less time than that. And, uh, it used to be 1 in 20,000; then 1 in 10,000. And I would say that's probably 18 years ago.And now it's 1 in 31. But in some areas it's much worse than that if you can believe it — 1 in 31. And I gave uh numbers yesterday, for boys it's 1 in 12.I was told that's in California where they have a. For some reason, a more severe problem.But whether it's 1 in 12 or 1 in 31, can you imagine that's down from 1 in 20,000 and 1 in 10,000.And now we're at the level of 1 in 12 in some cases for boys; 1 in 31 overall. So since 2000, autism rates have surged by much more than 400%. /
*Some* of this is vaguely, sort of, almost right; without being right at all when it's all mashed together.
You know, war-fighters used to enjoy their work a great deal more than they do now. Why? Because back in the day, nobody caught PTSD like they do now. Has Ken Burns uncovered even a single mention of PTSD in all those Civil War letters? No, he has not.
Did Erich Maria Remarque mention PTSD cases in All Quiet on the Western Front? No. None.
Where's the PTSD in Catch 22? It isn't there, because Joseph Heller knew better.
And what about Richard Hooker's MASH: A Novel About Three Army Doctors? If PTSD existed, those doctors never saw it.
Ditto Dog Soldiers (1974), Fields of Fire (1978), or Going After Cacciato (1978).
PTSD just isn't there ... not in WWI, WWII, Korea, Vietnam....
And then, in 1980, a whole bunch of people catch it all at once ... In 1979, nobody has PTSD; by the end of 1983, 830,000 Vietnam vets do.
An epidemic! Somebody should study it! What was different about Vietnam that a quarter of everybody who went and came back, came back with PTSD.
The answer is "nothing." Nothing was different. What was different was that researchers and mental health carers described it and gave it a comprehensive name: Post Traumatic Stress Disorder. And everybody who learned about that who knew even a little bit about U.S. history said, Oh ... shell shock ... battle fatigue ... Red Badge of Courage....
There's a general pattern in diagnosing diseases, disorders, conditions, syndromes, the lot: One case is a phenomenon; two cases are a coincidence; three cases start to look like maybe we should look around to see if there are more cases like these.
That's the pattern of measuring the prevalence of Autism Spectrum Disorder. The path of description and diagnostic criteria from 1943 to the present is a record of widening coverage, increasing clarity, and more nuanced understanding.
Borrowing a line from The changing faces of autism: The fluctuating international diagnostic criteria and the resulting inclusion and exclusion—A Norwegian perspective (2022):
/ The rates of diagnoses of autism have increased greatly. However, there is no reason to think there has been any change in occurrence over the last 70 years, suggesting rather an increase in our knowledge and awareness. /
That's what we need ... [A]n increase in our knowledge and awareness of what's known and understood and what's yet to be known, let alone understood.
Sources
https://www.youtube.com/watch?v=YinEMgW-0Uc
https://www.bbc.com/news/articles/cj07e3rjev2o
https://pmc.ncbi.nlm.nih.gov/articles/PMC3181586/
https://www.ptsd.va.gov/understand/what/history_ptsd.asp
https://www.ptsd.va.gov/professional/treat/essentials/history_ptsd.asp
https://www.cdc.gov/autism/about/index.html
https://pmc.ncbi.nlm.nih.gov/articles/PMC9365987/
https://pmc.ncbi.nlm.nih.gov/articles/PMC8531066/
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