observer of times

– Toby Rogers

The lift I take twice a week to visit my physio’s gym also serves a five-star hotel. So I get to observe its wealthy clientele at close range. One day a mother and daughter got off at my floor by mistake. As they waited for the lift to return, the girl, who looked about seven, kept hitting the button. Her mother explained that only one lift was working and someone had taken it. ‘But I’m more important!’ yelled the girl, kicking the lift door, and her mother, with her little gold-sandalled feet. Her mother begged to differ. ‘But I’m more important!’ howled the girl, going berserk. When the lift doors opened she charged in headfirst.

Once upon a time, it went without saying that such displays came down to parenting. But that mother came across as caring, while her daughter’s vehemence and self-absorption seemed extreme. Only later did I recall the sons of former neighbours, who’d played ball for hours every day. I’d seen those autistic boys many times and they’d never acknowledged my presence. Was that obstinate little girl on the spectrum?

Intrigued by the top-down push for autism awareness, I recently watched the Netflix comedy-drama series Atypical. About an autistic teen, it contrasts examples of neurodivergent dysfunction with neurotypical cruelty, hypocrisy and stupidity. What message does the show send? Eighteen-year-old Sam, the main character, is relatable. Capable enough to keep a job and risk dating, yet different enough to suffer and unwittingly discomfit others, he falls between extremes on the spectrum, like world-renowned celebrities or adults who need full-time care. The criteria for autism have broadened. Meanwhile, autism rates have soared.

Nearly twenty years ago, on a narrow boardwalk, a boy slammed headlong into me. His aged male minder, jogging behind him, yelled ‘Are you okay?’ but they ran off before I could say no. Later, X-rays showed the force of impact had snapped my left pinkie. The encounter lasted less than a minute, yet I assumed the boy was autistic: he reminded me of three kids in a special class at my primary school. They, too, had often seemed blind to their surroundings and deaf to adult guidance. And that was what I’d thought autism was. While you didn’t get punished for running off or violence, you sure got shunned and ostracised.

Since then, psychiatry has moved the goalposts. And after release of the DSM-5 in 2013, diagnosis rates rose steeply. Today, autistic people can be climate activists, tech moguls, award-winning authors or leading comedians. And whether high- or low-needs, its diagnosis gives aggressive or socially tone-deaf recipients a get out of jail free card. Hence, resentful ableists have drawn flak for suggesting the label can entitle its bearer to special treatment.

I used to think antivaxxers who blamed vaccines for autism were wackos. Autism was rare, or so it appeared, during my childhood, yet we’d all been immunised. And since no-one caught diphtheria, tetanus, whooping cough or polio, vaccines seemed safe and effective and I paid them no mind for decades.

Then along came Covid and, on its heels, the mass advent of leaky vaccines, which could wreak more havoc than the virus they were meant to defeat. Yet not until the social divide between the vaxxed and us outcasts yawned wide did I begin to tune in to the discourse on vaccines and autism. Okay, the Covid jab didn’t prevent infection, but hey, it had been rushed to market. What could you expect? Then I learned that kids today receive lots of injections. And whether all those shots cause autism or not, the explosion in diagnoses reflects growing medicalisation of diverse human experience and behaviour, which conveniently negates parental guilt and responsibility. It’s as if the work of parenting – communally shared before ‘progress’ confined it to the nuclear family – is being usurped by medical experts.

And experts can err. Take the GP who once warned me, based on a report I hadn’t received, to avoid all sources of Vitamin D: my body was ‘making its own’. By the time I read the caveat below the too-high score – the test was ‘not useful for detecting Vitamin D deficiency, as level may be normal or even elevated as a result of secondary hyperparathyroidism’ – taking my GP’s advice had caused osteoporosis. But that’s small potatoes. My partner’s sister has spent nine years now in a wheelchair because experts who couldn’t identify her illness kept her in an ICU bed until her leg muscles wasted. They didn’t take her history on admission, nor ever, yet would’ve pulled her plug if we’d let them. She was suffering from an overdose of Vitamin D her GP had prescribed. And if doctors often harm the body, good luck healing the psyche. Not that the two can be usefully disentwined. That autism shares traits with, e.g., ADHD, OCD, anxiety and depression greatly complicates diagnosis. And it can often be comorbid not just with those, but epilepsy, insomnia, anorexia, gastrointestinal disorders and more.

According to the orthodox narrative, the exact causes of autism aren’t known. It runs in families often enough to confirm a genetic component, yet is thought to be complex and multifactorial (experts hide behind big words). And as its incidence rises along with many more DSM-5-endorsed disorders, this narrative spares parents the shame that might put them off seeking help, and effectively absolves everyone of blame all the way up to Pharma execs.

While vaccines might promise protection for some with autoimmune conditions, and an autism diagnosis can attract support, scapegoating of antivaxxers or TEDx paeans to ASD tend to distract from bigger issues. Three standard screening questionnaires I’ve tried show that I ‘may benefit from a clinical autism assessment’. Signs include ‘feeling highly sensitive to the environment’. Will more folk tick that box as cities get more toxic? Symptoms common to severe cases – self-harm, disconnection etc. – are escalating in the general populace.

Some autism awareness guides, like those on trans kids, can smack of recruitment, as if advocates of inclusiveness have got their priorities skewed – unless you choose to celebrate autism as your identity. More fascinating is what its prevalence means for society en masse. Genetics and epigenetics receive most funding for research on causes, and though results remain inconclusive, authorities shout from the rooftops that the vaccine myth has been debunked. Doth the system protest too much? Which needn’t mean the main culprit is vaccines; merely that dissing a simplistic theory creates a diversion as the scientific shift towards interpreting neurodivergence as ‘natural variations in brain development’ normalises warning signs of terminal societal decline, so as not to unduly disrupt business as usual.