Is Asperger Syndrome nature or nurture?

The mind's of young children are shaped by the environment that they grow up in, and this shaping extends to conventions, social norms, and expectations of society.

It's something to do with the pattern of how the neurons interconnect.

Therefore if children are pushed too hard academically at a young age at the expense of social development, then the neurons will interconnect in a particular way. Conversely, if children are subject to more social development at a young age at the expense of academic development, then the neurons will interconnect in a different way.

Grandin's The Autistic Brain clearly points to our brains being hard wired differently, although that could be the effects of nurture as in other disorders.

Interesting, so this opens up the question for me of diagnostics and classification variations across cultures and causes - which is slightly off topic but this is where my train of thought is taking me. 

I catch your idea that autistic traits are a response to (caused by?) rapid cultural change and changing societal expectations (smaller families, less connections, more economic-career orientated outlook, lack of socialisation) and India would be model of that. If there's evidence in those areas (including outside of India) I'm open to reading it, although at the moment I'm leaning to the gene-environment interaction rather than environment being the sole explanatory cause. Difficult to unpick as this is the area that, frustratingly, needs more research. 

I'm new to this area so my understanding of the history, diagnosis, risks and etiology of ASC isn't that comprehensive. I'd need to do some more reading to contribute meaningfully to the exchange.

I'll check in with the thread again though - I've picked up some good reading on the way. 

I'm not an expert but If I only had one word to use for the causes of it, majoritively speaking, it would have to be - Fear. 

In medical circles, stress or trauma are the preferred terms for categorisation. Inter-generational fear. Conscious or unconscious though I would say mostly unconscious. Fear passed on from generation to generation through Inter-Environmental & Genetic means resulting in Neurodiversity. 

In my observations, fear can be expressed in many different ways from extreme timidness at one end of the spectrum to extreme anger or violence at the other end. I don't think it starts or ends with ASD. It is much wider. Much wider, and how often do we hear nowadays of the links between stress ( fear ) and disease ? 

If I only had 4 words to describe the causes in the grand scheme of things they would be - The way we live. 

I shall have a look though the links to see if there is anything useful...

I am most interested in AS rather than tradition or Kanner type autism. Roughly defined by:

1. No speech or language delay.

2. The individual is around or above what is expected from them academically for their age in the main school subjects.

3. Their deficiencies are social - like struggling to read people, lack of empathy etc.

As I have stated before,  India is a country that has undergone revolutionary changes in its society and economy over the past 25 years, whereas western countries have only been evolutionary in comparison.

Another question is whether ASD, and the proportion of different variants of the condition, varies much between people of different religions in India?

Information about home educated children with ASD in India is very hard to come by. However, parents push children academically so it's probably safe to say that most will be reluctant to home school a kid with AS who is average to above average academic ability.

Something to also take into account is that between Independence Day and the early 1990s, India was a significantly closed society. It operated as a lightweight form of the Soviet Union that allowed small scale private enterprise and the practising of religion, but otherwise the State dominated the economy and heavily restricted trade with the outside world. This had an effect on limiting knowledge about developments in psychiatry and mental health outside of India.

AS became known about in English speaking countries shortly after India opened up to the world.

There's quite a few papers, The (undated!) reference I found was about 160 articles (National Centre for Autism India) http://www.autism-india.org/research.php which also has a brief history of how the condition has been recognised and studied http://www.autism-india.org/history-autism-india.php

Reading University looked at the prevalence of autism in India in 2017. https://www.reading.ac.uk/news-archive/press-releases/pr727389.html I've only skim read it so I don't t think it fully addresses your question of increase in diagnosed cases.

One I found really interesting was one in 2017 suggesting a low prevalence of autism in schools https://www.spectrumnews.org/news/school-survey-india-reveals-low-autism-prevalence/ but linked this with the possibility that around 20% of children do not attend school (Unicef puts this at 30%) - those who do not attend are the most marginalised - my guess is that children with autism would fall into this group.

Reading your observations the suggestion is that autism is triggered by socio-cultural factors over biological/genetic ones. From my (very brief) wander in the literature socio-cultural factors have been studied in the context of diagnostics and adaptive behaviour (ability to adjust to the environment). 

The challenge is that autism is diagnosed through a behavioural observations -so there's no physiological test in diagnosis. However there are researchers out there pushing to understand the interaction in gene-environment interactions https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3513682/ 

There' was a large study examining the causation of autism across 5 countries in 2019, didn't include India sadly, but it may still be of interest, and suggested 80% of autism traits were due to heritage https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2737582?resultClick=1 although again the authors note "The contributions of gene-environment interactions or correlations between genes and environment to ASD risk are important unanswered questions". 

I think you have a point in social/cultural factors - although personally I would hesitate to attribute these as explanatory ones over genetics. Based on the quick look I had at the research I think there's interplay at work between genetics and environment but the what and how still needs to be understood.

Speaking anecdotally I wonder how much of my experience is down to environmental factors - I have those occasions where I'm wary of diagnosis based on behavioural observation or self-report (I think I naturally have a preference to objective physical measures). My father was undiagnosed autistic and I wasn't raised in the most social or supportive of environments so a lot of my strategies for everyday living were maladaptive. But then did that exacerbate my autistic traits or cause them? I'm leaning towards the former. Biographical material, and I appreciate the limitations of these, from Temple Grandin and Sean Barron indicate how expressions of their traits were curtailed with parental support but they also recognise that they still process and interpret information, especially in the social-relational sphere, very differently from other people. 

I'd love a clear cut answer - but then I also read Michael Blastland's excellent book "The Hidden Half". He's not a scientist - he's a journalist. His point was that when science begins to think it understands things there's a whole load of hidden factors which can introduce variation and put the kybosh on received wisdom from research.

It's an excellent question though- thank you for posing it 

mael said:

The fact that African heritage means less asd ,could easily be down to  genetics

African Americans (as in the descendents of slaves) and more recent immigrants from Africa (along with American born descendents) are culturally very different people with different lifestyles and different aspirations and outlooks on life. The African immigrants are a diverse collection of people rather than a single community.

As a result of these differences, African Americans and African immigrants (along with American born descendents) tend not to get on well with each other.

I'm a twin - my brother is NT.

Ethan said:

As for increasing prevalence it's not a phenomenon specific to India - and is a question that's been pinged at various times over the last couple of decades.

Take into account that India has changed, along wth the lifestyle of its children, more than any nation in western Europe or North America.

India in 1995

Families were larger – 4 to 6 children were common.

People didn't move around very much. It was the norm to live in the same community where your parents, and grandparents lived, along with the parents and grandparents of your classmates at school.

Extended families tended to live in the same community. It was quite common for children to have no relatives living elsewhere in India even if they had relatives living abroad.

A significantly higher proportion of the population lived in villages in rural areas than today.

Children grew up in neighbourhoods where the vast majority of the children were local.

Society was more laid back. Parents tended not to push their children hard with academics but instead just wanted them to go with the flow at school.

School was less academic than it is today. Children with tutors at home were perceived to be slow learners and behind academically.

Parents didn't push their children hard into careers. They were happier for them to have a basic job.

Children used to play out and engage in sports and social activities regularly. Parents encouraged them to do so.

Televisions were ubiquitous but digital devices were rare. If children wanted to play a video game then they would use a public arcade machine – and meet other children in the process.

India today

Families are smaller (more so in urban areas) – 2 or 3 children are common.

Millions of people have moved hundreds of miles from where they were born, and started new lives in new places.

Longstanding communities and extended families in towns and villages have been broken up by people moving here there and everywhere.

The population has become much more urban as people move from villages to cities in pursuit of careers.

Children now grow up in neighbourhoods and attend schools with lots children who are complete strangers.

Society has become career driven whereas in the past parents were happy for their children to have a basic job.

Parents obsess over grades and qualifications, so push their children to excel in academics whilst social activities and having fun are sidelined.

Children with tutors at home have them in order to achieve the best grades so they can go to the top universities.

STEM subjects are most highly regarded by employers, so parents emphasise excellence in them over humanities.

Children don't play out and engage in sports and social activities anywhere as much as they used to, and more often than not their leisure time involves being glued to digital devices at home for long periods.

Has there even been much official research into ASD in India?

Hmmm, I was persuaded it was genetic, but now I'm reading a Freudian perspective on it, The Protective Shell in Children and Adults I'm more persuaded it MIGHT be that nature creates the pre-conditions that are then triggered by early life experience. So maybe the increase is due to changes in neonatal experiences although the genes were always there. The descriptions in the book really resonate with me and the four people I know well with AS all experienced the early neonatal experiences she discusses.

Im also minded by the huge amount of Sanatorium, or Mental Hospitals, that we had in the west, and infanticide rates that we don't admit to.

I'm one of four and the only one with significant traits although my brother has plenty, my sister has some and my other brother is ND in other ways which I suspect are related. Improved Diagnosis led to me being labelled otherwise it'd never have been spotted. My dad,s clearly AS but undiagnosed and unspotted although everyone could list his traits. My grandad was labelled as disabled but clearly AS and struggling. I'm very conscious that the therapy turn in society in the 60s means we look for the causes for difference and for cures. Previous generations didn't but accepted difference or locked them up if it was too much. Affluence has brought therapy culture to India, there's a chance it hasn't influenced Afro-Americans to the same extent and ASs go unseen there.

It's really hard to distinguish cultural affects from genetic ones, and easy for scientific studies to miss culture as an explanatory factor. Lots of studies got undermined by studying twins that were separated at birth and raised in different environments. This seemingly pointed to genetics as a factor for many conditions until someone pointed out they'd all experienced separation from their birth mother and adoption and this is what explained the observations, ie nurture. This doesn't undermine all twin studies, just many.

But yes, I'm curious to know why I am this way, even though it won't change anything for me.

I think autism is 100% genetic - but the impact on the child and their ability to function is mostly down to their environment.   Their position on the spectrum can be pushed one way or the other by either calm, careful, nurturing parents and a nice home life compared to a crazy, chaotic random parents with no structure and no logical rules.    

It's obvious that 'normal kids would do better in the first example too but I think the early years and the puberty years are the most damaging for auties if their support is inadequate.

I was reading something a couple of weeks ago saying the 'ultra male' brain was a necessity in the old days - men with low empathy to be able to think logically and be able to kill - whether it be defending the village or despatching animals for food.    Fir this reason, I don't believe we are a 'throwback', I think we are a natural part of the human race - just like different hair or eye or skin colour.       The only problem with today's society is we don't fit with in with its heavy bias to socialising and communication - we fit better in a simpler, probably more rural environment..

Hi my understanding would be nature 100 % .The fact that African heritage means less asd ,could easily be down to  genetics eg certain neandethal genes are  rarly found in people with african  heritage.  But 50% of europeans carry them ,I think they are just more visible now .

in my fathers generation there where 2 ,not visible just slighlty different but found there place in the world ,in my generation 4 iknow of with 1 being visible [brother went to special school].next generation at least 6 and 4 very visable.probably 2 more will as they get older and start school, And then in the next gen the first grand child already showing signs 

The world seems to want conformity ,there used to be an understanding that people were all different ,

Usually I'd be writing a huge spiel on this but my guess is nature exacerbated to some degree by nurture (genes and environment thrash it out together and the resulting cocktail of life experience bubbles over after a combination of risk factors fizzle with varying degrees over time). I wonder how much of the impact of my quirks would have been mediated had my upbringing been different. 

As for increasing prevalence it's not a phenomenon specific to India - and is a question that's been pinged at various times over the last couple of decades.

Suggestions, as you've mentioned, have included:

Change in diagnostic criteria and/or over-diagnosis 

Environmental factors (the paper I read linked this to birth trauma - premature and/or low weight birth babies)

Change in research methodologies in estimating prevalence

Cultural awareness and recognition

There's a paper here https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4520794/ which explores some of the options - I'd imagine access to and willingness to engage with diagnostic services is another as an explanatory factor as why prevalence varies across cultures. 

It's a really interesting question though- I'd happily dig through more of the research if I'd the time - to weigh up some of his observations.  

Aspergers is complicated but research is consistently showing that Aspergers is not down to social conditioning.