Autistic explosions abound

“Autism explosion”, declared The Australian’s headline on January 15. “Schools failing”. Journalist Rick Morton’s piece led with an alleged:

… crisis in schools that education systems are unable or willing to fix.

On January 16, the Weekend Australian featured a piece by Kate Legge headlined “The autism explosion in Australian schools”. The same outlet – Rick Morton again – referred to “the autism explosion” leaving “NDIS in disorder” in July 2015.

If you’ve got an eye-catching headline, why not get value out of it? And these are certainly eye-catching.

As bold, brash statements of a “problem” which we should be very concerned about indeed, they exemplify one of the flaws of science journalism in this country, and indeed globally – a quick Google search reveals that CBS News headlined a story The Autism Explosion in October 2007.

“Explosion” is an emotive term, guaranteed to command our attention. For that reason news editors love it, even if many of those readers who encounter it in the context of a public health issue will be alarmed by the impression given of a rapid, unexpected, exponential rise in a scary-sounding condition about which they may know very little.

It is indeed exactly the kind of usage which fuelled the MMR scare of the late 1990s and early 2000s (and which flares up from time to time even now). As readers of my piece on the amplification of irrational anxiety may recall, in the late 1990s an English doctor by the name of Andrew Wakefield asserted from subsequently discredited research evidence that the increase in autism diagnoses apparent even then was caused by the measles/mumps/rubella vaccine given to young children.

Following that false claim, given credence by news media all over the world for much longer than it deserved to be, millions of parents withdrew their children from the MMR vaccination program.

As a direct result, epidemics of measles – a disease thought tamed by medical science – have returned in many regions and countries of the world. Children have died, or been gravely harmed by the MMR/autism scare, and the news media must take some of the blame for that.

So to use terms such as “autism explosion” in 2016 is to invite reasonable scrutiny of editorial motives. What’s good for The Australian’s circulation and online traffic will not necessarily assist in the management of what is a complex public health management challenge.

Let me balance that criticism by noting that beneath the alarming headline there is, in both recent articles from The Australian, good journalism to be found. I don’t doubt the good intentions of the authors.

Legge’s piece is a moving account of how children with autistic spectrum disorders struggle to cope with bureaucratic systems such as public education, and how poorly resourced these services are.

Morton’s piece makes the key point, albeit deep down in paragraph 13, that the aforementioned “explosion” of autism is due to:

… a litany of factors including changing rules for how diagnoses work, the influence of tied funding to medical labels and, at the lower end of the spectrum, the pathologisation of quirkiness.

All true, and crucial to an understanding of how autism emerged into public awareness.

In addition, though – and journalists too rarely concede this – the rise of autistic spectrum disorder is a cultural phenomenon, linked to how the news media interact with and reinforce trends in other branches of the culture.

A condition that used to be invisible became visible for the first time in popular culture when Dustin Hoffman played an autistic savant in Rain Man. The concept of autism went mainstream after that, even achieving a certain cultural trendiness.

Documentaries were made about parenting autistic children, and about the “real” Rain Main – not the Hollywoodised version portrayed by Hoffman. Coverage of the condition in the news media exploded (if I may be naughty and appropriate The Australian’s language for a moment).

Ever since, doctors, parents, educators and others working with children (and the many adults who had hitherto been viewed as “a bit different” or “eccentric”) applied the label of autism – Asperger’s Syndrome being the most familiar and commonly diagnosed of the disorders on the spectrum – because it was available.

In short, autism has not “exploded”. It merely looks that way to the untrained observer of our news media.

The condition is real, and giving it a name brought relief to millions of families the world over, hitherto left to cope on their own. But there were, and are, misdiagnoses too, when worried parents or teachers choose to see what would once have been called “bad” or “difficult” behaviour as a medical condition, thereby making it easier to bear and, they hope, treat.

As a consequence of these complicated cultural trends, prevalence rose around the world, with remarkable consistency, to about 1% today. In Australia in 2003 there were 34,000 diagnoses of autistic spectrum disorder. In 2015 the figure was 230,000, according to the Australian Bureau of Statistics.

One wouldn’t expect the news media to ignore such a trend. But neither should they ignore their role in making a welcome advance in scientific knowledge about the communicative disorder we call autism into a “crisis”, and inflaming public anxieties.

Interestingly, the January 15 version of the piece, accessed on my iPad app, has a new headline in the web edition of January 16 – “Schools fail to cope with explosion in autism diagnoses”. This may be an attempt to turn the panic button down a little, since the “explosion” is now conceded to be in diagnoses rather than autism itself. If so, that’s a wise editorial judgement. Even if the e-word is still in there, it hits the eye with somewhat less violence than “Autism explosion”.

And the broader theme of the article is hugely important. Schools and other public services have a terrible record of supporting people with autism, and if The Australian’s coverage serves to make educators and governments deliver greater resources to those on the autistic spectrum, and those who work hard to support and help them achieve the very best that they can in life, that would be campaigning journalism at its most effective and worthwhile.

But in future, can we leave out the explosive media rhetoric and just get on with the journalism?