Tuesday, May 10, 2011

Should Grinker and Co's Flawed South Korean Autism Study be Taken Seriously?

The newly reported autism study from South Korea with its "shocking" 1 in 38 autism rates figure doesn't make much sense. As reported in the Boston Globe:

"Roy Richard Grinker, a cultural anthropologist at George Washington University who worked on the study, said his own child with autism would probably function very well in such a system.

"Many kids with autism who are doing well can adapt to that highly structured situation," he said.

So, what does this finding mean for the United States?

Not necessarily much, according to several researchers who were not involved in the study. They praised the study generally, but pointed out flaws and assumptions that raise questions about whether there really are so many kids with autism in South Korea -- and by extension, in the United States.

Dr. Isaac S. Kohane, a professor of pediatrics at Children’s Hospital Boston and Harvard Medical School, said he thinks the researchers may have taken their estimations too far by assuming that the rate of autism was the same among the nearly 700 families who declined followup assessments for their children, as among the ones who agreed. Wouldn’t a parent worried about a child be more likely to participate than one with no concerns? Without this assumption, Kohane says the researchers would have found roughly the same 1 in 100 prevalence we see in the United States.

Also, the definition of "autism" is so squishy today that it’s very hard to draw the line between autistic and non-autistic, he and other researchers said."

I am the father of a low functioning son with Autistic Disorder and I am not a fan of Roy Richard Grinker's involvement in defining autism and autism prevalence estimates. Grinker is the father of a high functioning child with Asperger's who favors the New Autism Spectrum Disorder definitions of the DSM-5.

I don't know why an anthropologist with strong biases was involved in an autism prevalence study in South Korea. I am not surprised though if a Grinker involved study found higher rates of autism ... particularly if the autistic persons found to have been missed were very high functioning.

Regardless, Dr. Kohane a professor of pediatrics at Children’s Hospital Boston and Harvard Medical School has pointed out some serious flaws and assumptions involved in the study. Hopefully other serious professionals will examine the study and consider Dr. Kohane's comments before promoting the 1 in 38 study from Grinker and Co.


Usethebrains Godgiveyou said...

I swear I don't know why I keep coming back to your blog. It's like a part of me just woke up to what is going on. I love my son as much as you love yours. But I'll be damned if I'm going to medicalize him into a serious label for a very mild disability. I see kids like him using it as an excuse, or brilliant kids seeing themselves as disabled. A fire has been lit in my heart.

Anyhow: my thoughts on the study.

Autism: 1 in 4…Give it, ah, about…Well, hell…anyone a mathmetician around here? What was it, 4 in 10,000 about 20 years ago? As it becomes more lucrative, it becomes more common;

Let’s see… 1 out of 38 = .026
4 out of 10,000 = .0004

That an increase of 6500%

The stock market went from about 3,000 in that time, to about 12,000 today. That’s only an increase of 400%

Autism is a lucrative business!!!!

Hope y’all can afford to send your kids to college on our kids backs!

Over at Autismo, they see me as the Village Idiot. Whatever...takes one to know one, I guess.

Unknown said...

r.b. the higher a blogger or commentator is ranked at Autismo Hub the more it indicates that person shares the Neurodiversity autism is not reallllly a disorder views of the AH owners, conversely the more criticism you receive or the lower your ranking the more it indicates a reality based approach to autism

Usethebrains Godgiveyou said...

That would explain a lot...

Anonymous said...

Follow the money. Here's where I see the biggest problems: Professional define the problem (Dx), and define the solutions/interventions - makes practice SOOO much easier!Somewhere in the midst of all this easy-practice, easy billing (DSM) nonsense is the opportunity to miss the reality presented by the "subject," and the necessity of tailoring an approach to the specific needs and abilities of the individual. Practice suffers, but productivity - evidenced by numbers treated- and billing efficiencies, go through the roof.

For insight into the failings of the APA, read anything by Thomas Szazs. Then there are the gazillions of studies showing how inappropriate a capitalist model is for the delivery of health care. . .or, indeed, social services in general - or you can skip directly to the history of the AMA, and their slow but steady acquisition of control of school accreditation, requirements for licensure, requirement for membership, etc, etc. How about this: after La Leche had been around for a while, the professionals created the position of "lactation consultant" - ok, rant over.

jonathan said...

Actually it is misleading for you to imply that this is largely Grinker's study. The lead author (among many authors) in this study is Young Shin Kim and Grinker was in reality one of the most minor authors, though his name appears on the study.

I do agree with you that the study was flawed in the sense that it had some serious limitations if not outright shoddy methodology. The results of this study also seem to at least somewhat support your posts about the percentage of persons with autism, excluding asperger's and PDD NOS with intellectual disabilities.

You can read more about my take on this study in my latest post on autism's gadfly. Shameless plug, I know.

HL Doherty said...

Jonathan I didn't imply or misrepresent anything about Grinker's role in the study. I don't even know why he was involved in the study as an anthropologist? My commentary was based largely on the Boston Globe article which quoted Grinker and which quoted a criticism of the study by Dr. Kohane a professor of pediatrics at Children’s Hospital Boston and Harvard Medical School .