Introduction to a Circumstantial Case for the Causation of Autism

This document is an attempt to create a coherent theory of autism that can be discussed by persons interested in autism, that makes predictions about autistic behaviors that can be tested, and that acts as a logical construct that can guide caregivers, whether parents or professionals, in the decisions they make related to the care of autistic children and adults.

One of my challenges in getting people interested in this theory is my lack of credentials, largely meaning my lack of an educational degree in medicine or a related field that marks me as an 'expert'. It has been suggested to me by a well known autism researcher that if I want to have any impact upon beliefs about autism, I should go to medical school, select a very narrow aspect of my theory, spend 15 years testing that narrow area, and then publish in a medical journal. Only then can my ideas be integrated into the scientific debate on autism, and only in that narrow area I chose to specialize in. I considered that advice, and decided to go another way for the following reason: there are tens of thousands of bright researchers doing pretty much exactly that already, making very limited and slow progress in understanding autism. If I have anything important to say about autism, which I may not and that is fine, it is precisely and solely because I am taking a completely different path to gaining an understand about autism. This, of course, gets me right back to the issue with credentials - who am I to be preaching about the cause of autism when science clearly sees that no one understands it. The answer if there is one, I think, is that I have a different set of credentials, that are normally not viewed as valuable, than a researcher with a document telling the world they are a PHD. And I am not demeaning PHD's; my wife just finished hers in social work and it was an arduous process which required tremendous intelligence and dedication; and, it produced a fabulous researcher. I am just arguing a PHD is not the only potential set of credentials that is valuable. So, what are my credentials?

First, I am a person who is a little autistic. I am not disordered. No doctor would give me a diagnosis, and I am thankful for that. But, my brain is wired like people with autism. My skills tend to be their skills, my weaknesses theirs as well. This gives me a unique insight into autism that most researchers don't have. I can test things on myself and see what happens. I have a level of empathy associated with sharing a way of seeing the world, though this empathy is certainly limited by my lack of actually being disordered. Also, I have skills that are very helpful in solving complicated puzzles due to my association with autism. High functioning autistic individuals are notoriously strong puzzle workers and problem solvers. They are able to spot patterns and symmetries that other just miss. I have bult my real estate career around this enhanced competency (of course, there are lots of other tasks at which I am simply no good). I also have the obessiveness in areas of intellectual interest that you see among high functioning autistics. This obsessiveness keeps me on task far longer than most people. It causes me to enjoy reading 1,000 page textbooks on inflammation, psychological disorders, and many other topics. It keeps my mind constantly searching for alternatives and solutions. Nature built me to engage in this undertaking.

Second, my two careers, the law and real estate, both forced me to learn to think like a generalist, which is very rare in this society. In most lines of work, you make a lot more money specializing in an area, particularly in science and medicine. Specialists studiously ignore topics outside their specialty and are rewarded for this. I have been trained over the years to not be good at any particular task, but to be marginally competent at many. This results in a very different way of viewing the world, forcing me to understand the interrelatedness of many different fields of pursuit and many different areas of intellectual demand. To do my real estate job, I had to develop basic competencies in architecture, financial modeling, urban design, regional economic planning, tax and other areas of the law, tax incentives, politics, contracting and many other fields. In doing my law job, I was exposed to many diverse industries that I had to learn including medical recruiting, medical devices, shoulder mechanics, head trauma, car sales, the National Football League, patents, concrete saws, and many other areas. This exposure has produced a fearlessness in me that has allowed me the confidence necessary to go in, as a lay person, and gain a basic understanding of the fields necessary to understand autism including neurology, endocrinology, genetics, immunology, gastroenterology, psychology, sociology, and the human diet. Being a generalist has been crucial in the development of this theory.

Third, I am a guy with zero profit motive in putting this theory together. I am not under the sway of industry. I am not constrained by the scientific method and the rules of a university. I am not driven by fear. I am not pushing a supplement line. I am doing this because I think I have some knowledge that might help someone, because it is fun and stress relieving, and because I like to lecture at people (which my wonderful wife helps me monitor) because it is easier to lecture than engage in a real back and forth conversation. People have progressively gotten sick of my various interests over the years including urban sprawl, fighter planes, and global warming and I needed to come up with something else to lecture on.

Fourth, I don't care about being wrong; instead, I enthusiastically embrace screwing up and have done so in some really phenomenal ways. I have essentially no insecurity or esteem issues, and therefore no fear of judgment. And, it is in trying and screwing up that you learn some of the best lessons. This philosophy has been applied to this theory and has helped along its development. If I create a sub-hypothesis, and it turns out to have been foolish, I just let it go and move on. I have been down dozens of wrong paths, figured out they were wrong, learned somethng, and enhanced the theory as a result. I don't get invested in ideas and hold on to them stubbornly. In many ways, this is what separates me from many academics.

Fifth, and most importantly, I am trained in the methods of the law. I am not attempting to create a scientific proof of autism. That will be impossible for some years - the statistical models are just too limiting to pierce through the complicated causation. I am attempting to build a circumstantial case for the causation of autism, which is a very different matter. Let me give an example. If a legal team, detective and prosecutor, were assigned to investigate a murder, and three days into the investigation they determined there was no eye witness whose testimony could establish direct causation (I saw him stab her), they would not simply throw up their hands and declare the crime a mystery and move on to the next case. They would diligently piece together all the evidence they could and, if they deemed it sufficient, present that evidence to a jury in a hope they could convince the jury, under the standard of 'beyond a reasonable doubt', that he in fact did stab her despite the fact that no one saw it happen. They might have evidence that a witness saw the guy enter the house with a knife, that twenty seconds later they heard a scream, and that immediately thereafter the same guy ran out of the house carrying a bloody knife. This is not perfect proof, because there was no direct witness who saw the knife enter the body, but it is still a pretty good case to convict.

Prosecutors use all kinds of evidence to build circumstantial cases. They hire scientists to put together forensic evidence like DNA samples from hair, finger prints, and ballistics data. They scour the area of the crime looking for witnesses who might have seen something indirect, like a suspicious stranger lurking around. They check phone records, and flight times, and alibies. They look into motive and history, hiring psychologists and other experts to profile the parties involved. They use circumstance to make up for a lack of direct proof.

This is something science has a problem doing. For something to be scientific, for the most part, there needs to be a hypothesis, that is tested in a randomized study, which generates data, which data is analyzed by computer models to show statistical significance. The results of this analysis can then be published, positive or negative, to provide evidence on causation. When causation becomes complicated, and variables are added to the analysis, demonstration of statistical significance becomes harder and harder. At some point in time, scientists, working within this paradigm, may have to throw their arms up in  the air and say 'we just don't know how this works'. Frankly, they are prohibited from doing what I am doing. As one researcher told me, my approach is just not scientific. It is a grand unified theory that is not testable empirically and therefore not conventionally scientific, and I agree. That does not mean it is not valuable and that it is not possible using logic to evaluate its worth and contribute to the body of knowledge about autism.

I think I have built a strong circumstantial case that neurological excitatory imbalance and the human stress response are co-involved at the core of autism. I think I have put the causal pathways, what causes what and how the feedback loops work, together pretty well. I am pretty sure that my commentary on how modern society is causing an increase in incidence is largely right; nothing else makes sense. However, I am sure there is stuff in my theory that is plain wrong. I am sure there are other elements, for instance exactly how chronic inflammation influences autism, that are just missing. And, it will likely take years to really flesh out this theory, which is clunky and overly complex at times. However, as a generalist committed to linking new ideas and facts together, I will hopefully work with others to refine my theory over time. This is a work in progress.



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