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TV Really Might Cause Autism
Alien54 writes "Cornell University researchers are reporting what appears to be a statistically significant relationship between autism rates and television watching by children under the age of 3. The researchers studied autism incidence in California, Oregon, Pennsylvania, and Washington state. They found that as cable television became common in California and Pennsylvania beginning around 1980, childhood autism rose more in the counties that had cable than in the counties that did not. They further found that in all the Western states, the more time toddlers spent in front of the television, the more likely they were to exhibit symptoms of autism disorders. The Cornell study represents a potential bombshell in the autism debate."
What about internet use, with sites such as youtube, will that cause autism as well?
Well, cable television was becoming more prevalent, yes, but wasn't detection of autism and recognition of its status as a disorder also becoming more acknoledged?
Oh, and exactly what debate is there about autism? I think I missed something here.
~ C.
Everyone, let's say this together. Come on, I want everyone to join in. Let's all yell it at the top of our lungs until the media hears us. Ready? Here we go:
CORRELATION DOES NOT EQUAL CAUSATION!
CORRELATION DOES NOT EQUAL CAUSATION!
CORRELATION DOES NOT EQUAL CAUSATION!
Now stop reporting on every correlation between disease X and social variable Y as though it were somehow equivalent to a randomized double-blind study on the effects of Y on X. Thank you.
I call bullshit.
That is, it is entirely possible (and plausible) that a correlation exists. However I'd interpret it in the reverse way. That is, the study shows just that children born with autism are more likely to spend time watching TV (knowing the features of autism, this is entirely possible).
Moreover, the existence of a correlation does not show necessarily a cause-effect relationship. Do you remember Lisa Simpson showing Homer a rock that protected from tigers?
This kind of papers are what my collegues call "scientific pornography" -papers thrown up just to stir up controversy, but based on very fragile assumptions and with a few data inflated as much as possible. Quite a common occurrence, sadly, these days.
-- Patent no.123456: A way to personalize
Perhaps the problem is not Television, but rather, the quality of the shows catching children's interests. I highly doubt educational tv is causing autism. The content on channels like nickelodeon, disny, and even MTV is highly lacking. The method of constantly changing frames and displaying lots or colors does keep someone watching, but it makes it hard to concentrate. Could this be the cause?
Could there POSSIBLY be other factors at work?
How about the increased understanding of and accurate diagnosis of autism and autism-related disorders around that time?
How about the repetitive nature of television programming, especially kids shows, appealing to autistics as a source of consistency and comfort?
How about the fact that the places getting cable were also the places getting elevated concentrations of geeks, who seem to have genetic quirks that have this tendancy to result in autism-like disorders? Could that POSSIBLY have ANYTHING to do with a rise in autism in Washington, _Oregon_, and *CALIFORNIA*?
Sitting your child in front of a talking box all day instead of having a real human taking care of them impairs their ability to communicate? Who would have thunk it?
:)
Though I am no expert in child behavior or learning styles, from what I have heard/seem most all children learn by observing. If most of their attention is devoted to passive entertainment (Television), they are observing a system in which they do not get to interact or communicate within.
Though I don't want to pull a Jack Thompson here and blame the tech for all of today's problems, I also think television is at least partially responsible for many of the behavioral "conditions" faced by today's children (mainly ADD). I don't deny the existence of ADD as a valid condition, however it is my belief that it's a learned trait rather than a naturally occuring condition and that television helps it along quite a bit. Maybe I am way off base here (Dammit Jim, I'm an engineer not a Children's psychologist!) however I think that reducing the amount of time kids spend in front of the bewb tube can only be a good thing, even if it only means they have to spend more time with their folks.
I gave up on TV years ago
No, you didn't. You still watch TV, you just use different hardware. This has some advantages (fewer ads, less 'TV network' crap), but it's still TV.
NO!
A solid background in statistics is required to launch a bombshell like this. It is likely that these authors have that background.
Furthermore, economists (which one of the authors would seem to be based on his affiliation) are well trained in methods of robustly detecting effects in non-experimental data (such as this); whereas medical researchers are typically more involved with experimental data. Experimental data is much easier to deal with than non-experimental data. Indeed, one could argue that these sorts of studies are more likely to be carried out properly by economists trained in dealing with this sort of data.
The important aspect of this is that there was a natural experiment carried out where some counties received cable television and others didn't. Provided the counties that received cable television did so for essentially random reasons, this data is the equivalent of a randomised experimental trial. As such, the standard argument that correlation does not prove causation is much weaker. There might well be a third factor at work here, but hold those knee-jerk reactions. One needs to be a good statistician to detect these correlations - medical researchers can work out the reasons later.
Okay, that's a little petty, but here's a real difference - people without TVs choose what to watch, when to watch it. People with TVs so often just sit down in front of it and then vegitate, accepting whatever crap is shovelled to them. I'm sure there are plenty of people out there (yourself included?) who will then jump up and shout "But I only turn it on when there's something I really want to watch!" The difference is that people without TVs choose to watch less - they are generally more selective. Speaking for myself, I have a lot of fun times with my wife and daughter - playing games, reading books, talking. I kind of feel sorry for people who miss out on that sort of thing because "There's something really good on TV".
Oh arse
Before anybody starts jeering stupidly and making wise about this subject, perhaps people should read this article from Scientific American: http://www.sciam.com/article.cfm?chanID=sa006&colI D=1&articleID=000B7F38-893D-152E-88E283414B7F0000
Now for some of the usual comments people tend to spew out:
Correlation is not causation
This is true - but correlation indicates that there MAY BE a causation. Thus, when things are strongly correlated and there are other reasons to suspect a causal connection, it is well worth researching further.
Increased awareness
Perhaps 'increased awareness' of autism means that we discover more cases that were not previously recognised? Perhaps, but I don't think it is very likely. Full-blown autism is not something you overlook. It is a serious disorder that in most cases means lifelong disability, and it is unlike any other psychiatric disorder. The increased awareness, I suspect, mostly means that now we spot more of the milder cases, but it is not my impression that this is what this research is about.
So why is it that people on this list are hostile to the idea that maybe TV can contribute to the emergence of autism? My guess is that this is because people on the list tend to be heavy consumers of passive entertainment, like TV and computer games; you don't want to hear that it may be bad for you.
If you have read the article I referred to above, you will know that autism probably has a lot to do with the development of 'mirror neurons' in the brain; a neural system that makes us able to imitate what other people do. Like all neural systems, the mirror neurons need to be trained, and TV is probably not a very good role model for that, at least not if you are already weak in this area. So it is actually quite reasonable to suspect that watching too much TV at an early age may contribute to the development of autism.
This idea that all one needs to understand is statistics in order to comment on a scientific discipline is incorrect. Analysis of statistics is important, but in order to draw conclusions from them, one really has to understand the field they are being made in. It is a common issue with economists who tend to view the numbers as the be all and end all without understanding where they have come from and what the greater issues at play around the numbers might be.
That's such an idiotic assumption that it essentially destroys the research on its own. Genuine randomness is incredibly important is selecting participants for any sort of psychological experiment, and I can think of a number of reasons off the top of head why there would be a correlation between the availability of cable TV and incidence of autism.For example, increased wealth makes cable TV a viable business to set up, but also allows parents to pay to have autistic children treated resulting an increased number of reported cases. Alternately, cable TV may only be launched in areas with a certain level of technological uptake.
There's also a theory that autism rates increase when technologically minded people start gathering together at workplaces (therefore breeding, therefore passing on (and concentrating) their autistic-related genes). There's another potential explanation for the correlation.
This is certainly not a study that psychologists would credit as being worthwhile, which highlights why people should have some idea why they're talking about before dropping bombshells like this.
CORRELATION DOES NOT EQUAL CAUSATION!
I think that the study itself really drives this point home. If you read the actual paper (PDF file) a major part of their case is:
1) When the weather is lousy, children watch more television
2) Places with a lot of rain and snow have more autistic children
I'd imagine that when the weather is bad, children also are more likely to use umbrellas. Therefore, by their logic, umbrellas cause autism.
PVRs remove this problem of course... A 3 year old might have difficulty even with Tivo though.
There's a growing trend of sitting the child in the front of a childrens channel then forgetting about them.. the TV becomes the babysitter. That's the key to the problem - the parent isn't interacting with the child.. in fact its only social contact is through wierd blokes in brightly coloured bird costumes who sing a lot..
In Canada we have warning labels on cigarette packs. Big warning labels. Cigarettes cause cancer, etc. So, naturally, some dollar store entrepreneur creates fake warning labels.
;-)
... it's obviously not a perfect analogy, but I've been debugging way too long to care]
e -against-the-mighty-machines-day-9-of-no-tv.
Anyway, when I was a stereotypical angry young philosophy student, I thought it would be fun to make my own fake warning labels to put on my cigarette packs. So, who did I turn to? Hume, of course.
So, my cigarette packs had a big warning: "Correlation Does Not Imply Causation" on them. I thought it was a good joke, by philosophy joke standards anyway.
Now, I knew perfectly well that in this case even though it did not imply it, it was in fact true. Of course cigarretes caused cancer. In many cases correlation is, um, correlated with causation. But I was 18 so I didn't care; I thought it was funny.
What a joke.
So, the point is: correlation is a start. If there is a correlation, you should look for ways to establish whether causation exists or not.
Now, you usually cannot do real proper experiments on humans with smoking (starting with a large random set of non-smokers, making half of them smoke their entire lives, and seeing how many of each group died of cancer). The ethics boards at the university wouldn't approve
So, do you just give up and say "thank you for smoking" or "well, we'll never prove anything according to David Hume then". No, you don't. There are statistical tools like factor analysis which let people smarter than me figure out how much of A is (probably) caused by B, etc.
Anyway, I have a 2 year old son now, and stuff I thought was funny at 18 is certainly not funny anymore over a decade later. I quit smoking. I certainly wouldn't give my son a cigarette, ever.
However, if there is a strong correlation between TV and autism, I have to wonder whether I am in effect doing something similar. What if further anaylsis proves (as much as you can prove anything) that it is indeed a cause?
What would I have done??
[yeah, yeah, there's a mountain of evidence in one of the cases vs. one study in another
"Correlation Does Not Imply Causation" does not mean act insanely. You have only ever seen gravity by correlation, but you still believe in it. (Yes you do. Wipe that smirk off your face.)
Now, coincidentally, I also cancelled cable TV after reading Gregg Easterbrook's original Slate article. Obligatory blog whoring: I blogged about it at http://peterarmstrong.com/articles/2006/10/08/rag
Do I think there is conclusive, Hume-would-be-proud proof that TV causes autism. No.
Do I think that TV is good for young children?
Would I give my 2 year old son a cigarette?
As a pediatrician trained in child development (and the parent of an autistic teenager), I've got a strong interest and background in this, and I can tell you quite plainly that the paper is crap.
This is a spectacularly good example of really stupid statistical games. I only skimmed it (Acrobat Reader blew up on me as I tried to save it, and I'll get another copy later), but these people did the following amazing things:
1. Accept as fact that autism itself is increasing (as opposed to the diagnosis of autism). This is possible, but contentious and somewhat controversial. I'll spare you the full story, but the general opinion is that while the disorder is more common than it once was, changes in diagnosis (and benefits for diagnosis) make it hard to do more than guess at the actual rate of increase.
2. Consider de novo a hypothesis "that early childhood television watching is an important trigger for the onset of autism." They do note that nobody else has bothered to consider this, but don't spend much time wondering why. Apparently, they're special. Perhaps because nobody has measured this in a useful manner? They do admit this, but they find a solution!
3. Because there are no good numbers for early television watching, they use precipitation as a proxy for television watching. Apparently, if it rains, you're likely inside with the tube on. They do show a strong positive correlation between rainfall and autism. Yep, that's right - rain causes autism.
4. But wait - it can't be the rain, it has to be the television! That's what we started trying to prove, anyway, so it's important to stay focused. They try it another way: they consider the availability of cable. They show that autism correlates with the availability of cable. No, really, it does. Of course, diagnosis of a LOT of chronic developmental syndromes increases with affluence, because of the increased availability of medical care and the reduction in "grab-bag" diagnoses like "mental retardation". But still, it must be the cable.
5. Having neatly done all the "proof" they require, they then proceed to tear the numbers apart and "prove" that 40% of autism in California is triggered by early television watching, while only 17% is triggered in PA. Why, we don't know, but it appears that rain, or cable, or maybe just TV is more powerful in CA than in PA. Or something like that.
I don't have time for a complete fisking right now, but I may do it later. Aside from the basic methodologic errors (confusing correlation with causation, adopting a highly questionable proxy indicator without validating it, and spending almost no time ruling out confounding factors or tainted data), there remain the dozens of smaller tactical problems that should have sidelined this turkey. I assume the peer reviewers, if there are any, were on drugs.
This paper will be a bombshell, all right. I'll use it over and over again as I explain to medical students and colleagues that you don't have to have much in the way of actual brains to write a scientific paper. Or, as I said about another paper in journal club once, "the font is nice, and I like the layout of the tables. It's a shame the actual science is such garbage."
I think it's easy to blame TV's for "creating autism" or whatever, but think about it: You have a screaming child that, regardless of what you do as a parent, is never EVER soothed by ANYTHING. This child won't talk, at least coherently. This child only eats 20% of what you put in front of him or her, and won't stop crying when in the shower, bath, bed, school, store, car... After 20 straight hours of screams you set them in front of the TV............hear that? Peace and quiet!
I think the fact that the TV is something that Autistic individuals can relate to IS NOT EVEN CLOSE to the same as the TV being responsible for it! Try living with someone who's Autistic, you'd be amazed at the variance in attitude between "TV Time" and "life."
TV causes autism? I doubt it.
An article in Slate yesterday argued that TV watching causes autism. The Slate article is based on research done by Cornell economists Michael Waldman, Sean Nicholson, and Nodir Adilov. You can download the academic working paper here.
The paper gives some theories why TV and autism might be linked, but the more interesting part of the paper is the data analysis. The researchers are trying to find a "natural experiment" that shifts around TV watching, but otherwise has no impact on whether a child is diagnosed as autistic. Rainfall is one of the things they use. In places where it rains a lot, kids watch more TV. Maybe rainfall doesn't affect autism in any other way. This is a creative approach, although it suffers from the weakness (which they acknowledge in the paper), that rainfall changes other things, like how much time you spend indoors doing other things besides watching TV. They also use the arrival of cable TV in an area. This approach is potentially stronger, although it would be better if they used availability of cable TV, rather than the number of people who actually subscribe.
These are intriguing approaches, but personally I did not find the empirical evidence in the paper very compelling.
The rainfall evidence is based off of three states: Washington, Oregon, and California. It rains a lot in some parts of these states, but not others. There is more autism in the parts of the states where it rains more. The problem is that it rains on the coast of Oregon and Washington, and in Northern California. But there are a million other differences between the coast of Washington and the Eastern part of the state, and between Northern and Southern California. The researchers also look at how much rain there was when you were between the ages of 0-2, controlling for your county. This is more promising. The impact of rain gets smaller, but it is the most convincing evidence in the paper.
The data analysis of cable TV is limited to California and Pennsylvania and also finds positive results. The difficulty with the cable TV analsyis is that there is an incredibly strong positive trend in autism. The cable TV data are basically on an upward trend. The regression analysis is going to have a very hard time sorting out between a steady rise in cable TV penetration and the time trend. In the current version they only include a linear time trend, which is an extrememly powerful predictor. My guess is that if they generalize their specification to allow for non-linear time trends, the cable TV result will disappear.
The authors have done some interesting work, but the nature of the problem makes it a really hard one to answer convincingly. For instance, you might think that Oregon and California should have similar autism rates. Nope, Oregon's rate is four times higher. That sort of gap is almost certainly due to differences in what is called autism in the official data in one state versus the other. The increasing time trend is also heavily influenced by what is labeled autism. When the outcome of interest is measured so poorly, it is hard to know what the analysis is really picking up--differences in the underlying symptoms or just in the reporting of them.
The more I thought about it, the more it seemed to me that there might be a causal link between rainfall, TV, and autism, but not the one suggested by the paper.
My theory: when it rains a lot, parents watch more TV, see more shows about autism, and this leads them to seek out a diagnosis of autism for their kids. They have the same kids, it is just that TV makes them believe that their kids are autistic.
I don't mean to sound overly negative on this research. I applaud the authors for asking a daring hypothesis and gathering data to try to test it. My gut, though, tells me that this is a result which will not stand up to scrutiny.
from http://www.freakonomics.com/blog/
Mission-creep in the psychiatric-industrial complex has caused the expansion of many syndromes to encompass more and more people, because the more people you can diagnose as having a disease, the more money the psychiatric-pharmaceutical industry can make.
/. readers would gladly be diagnosed as autistic by the psychiatric-pharmaceutical industry, I suspect.
It used to be that the term "autism" was reserved for severely impaired kids. Now its definition has been expanded to include anybody on the slightly geeky side.
Most
We must be alert to the danger that public policy could become captive to a scientific-technological elite. - Eisenhower
I currently watch one - two NFL football games per week in season, and between two and three hours (minus PVR ad-skip time of 20% or so) per week year-round, mostly shows my wife wants to watch and I watch with her to be sociable.
Put it this way: I have a small TV in my office that I haven't had on in the last two years except during a few major news events.
Years ago, when I had my limo *and* wrote freelance, people asked me how I managed to keep such a hectic schedule. The answer was simple: I didn't watch TV at all during that period, so I had four more hours of work time per day then the average American without sacrificing any other activities.
- Robin
Unbelievable. As if knowing what's on TV is an important part of a healthy social life.
The idea here is that his children were actually socializing and focused on meaningful, fulfilling life activities, rather than spending time staring at the blinking lights. So what if some of their social time was a bit awkward? All kids run into awkward social situations. The TV-free kids were probably better prepared to deal with it because they spent more time being social than their peers in the first place.
I do not have a signature
Yes, the old "It was easy enough for me, too bad you got a bad roll of the dice... but that doesn't mean that you shouldn't suffer continually for it." Sorry, but as a parent of an ADHD child who's been a neverending non-stop ball of energy since birth, ah, sometimes you just have to grasp any lifeline you can get. If some TV calms him down for a while letting the parents take a break in order to recharge rather than dropping from exhaustion, well, I -- having experienced that life -- can't criticize them too harshly. I notice you didn't mention your having offered to take their child off their hands for a few hours a week. You know walk in their shoes and all that. And it would give them a break as well. No, much more productive to "pull no punches" giving them advice and lay a guilt trip on them by thrusting this preliminary and controvertial report in their faces. As if they didn't have enough trouble.
TV did not make my son ADHD. Yes, he probably watches more TV then many of his peers, but it is also obvious that he's been different from birth. And while sometimes he does "zone" out while watching, he's also just as likely to be bouncing off the walls (well, actually the couch and chairs) or assembling legos with new and wonderful creations.
Gawd, I hate the smug, oh, so superior attitude of some people.
"Does anybody really think that the rates of autism really doubled in this time period. Isn't it far more likely that the rate of diagnosis simply went up. What would cause parents to become aware of this unusual condition called autism? Maybe they saw a segment about it on TV?"
No. I read some studies on this a few years ago and that was ruled out. Better testing was assumed to be the cause of some huge spikes in CA among geeks who had children (cue "geek disease" headlines) but was ruled out.
I have seen some powerful correlations with the introduction of mercury-using vaccines in countries like China, and correlations with being downwind of coal-fired power plants that release mercury. And I have seen studies refuting this.
Whatever the cause, it is real, and the increase it is there.
1. First the timing of more cable with the increased diagnosis of autism may be a coincidence. For a one-or-two year-olds, cable doesn't mean more to watch. There's almost no programming for that age, unless there is a round-the-clock Teletubies channel I've not heard about.
2. They may be confusing cause and effect. I worked with austistic children. They're not stimulated by contact with other people like ordinary children, but they are often attracted by repetitive patterns of light of the sort a small child might find on TV. As a result, the parents might have been more likely to put them in front of a TV as a pacifier.( And that might have even made the child's autistic tendencies worse.) In such a case, TV was not so much the cause as a diagnostic sign.
I'll see if the authors deal with those problems in their paper. It's hard to believe that they don't.
And TV addicts shouldn't get all in a dither about this. At most, this just means that parents shouldn't put little baby Johnny down in front of a TV. It's not going to turn a 22=year-old into an austitic.
--Mike Perry, author of Untangling Tolkien
Much as I think TV is suitable only for folks with water on the brain, it's important to remember that a statistical correlation (which is what this is) does not mean that TV causes autism, or that autism causes TV. It's easy to imagine a scenario in which autistic children simply watch more TV because one of the main symptoms of the disorder is difficulty interacting with others. That said, it is a fascinating bit of data, and one that means we better find out what staring at TVs _does_ cause (if anything) before there's nobody left with a normal brain to do it.