Wednesday, January 21, 2015

Autism: An Economic Time Bomb?

As spectrum youths become adults, the financial consequences could be severe. But could improving job outlooks for autistic adults be as simple as pressing an off button?


In 1989, Universal Pictures released a shameless, product-placement strewn motion picture titled “The Wizard.” Starring Fred Savage of “The Wonder Years” fame, the film was basically a 90-minute commercial for Nintendo, as the movie’s threadbare plot revolved largely around a bunch of kids in pursuit of a video game tournament championship.

In the movie, the control pad wunderkind is a young child with severe speech pattern abnormalities. He clings to an old lunch pail at all times, and has an obsessive interest in building blocks. In fact, the only time he breaks out of his dead-to-the-world demeanor is when he’s shoving quarters into “Double Dragon” arcade cabinets and marveling at the majesty of the Mattel Power Glove -- manufacturer’s suggested retail price, $74.99.

In hindsight, it’s obvious the character had a severe autism spectrum disorder, but being 1989 -- long before ASDs were fashionable -- hardly anyone who viewed the film picked up on it. Indeed, that year, the national autism rate was about 10 births per 10,000, a far, far cry from today’s astonishing rate of one-out-of-68 births.

Twenty years after “The Wizard” hit theaters, an Environmental Protection Agency report found 1988-1989 to be a “changepoint year” in global autism diagnoses. A year prior to that cohort set, the approximate worldwide autism spectrum disorder rate was 6-births-per-10,000. A year afterwards, the rate jumped up to about 24-births-per-10,000, and the number has been going up -- substantially -- every year since.

According to the EPA, the major uptick in autism prevalence could not be explained by “genetic mechanisms alone.” Rather, for an increase that sizable over such a short period of time, the authors of the report state “exogenous environmental factors” simply had to play some kind of role.

Interestingly enough, the 1988-1989 window was also a “changepoint year” for the video game industry as a whole. With global video game revenue laying low at a comparably paltry $4.5 billion in 1987, sales skyrocketed to nearly $14 billion a year afterward.

By 1993, global video game sales were approaching $30 billion annually. As fate would have it, that same year, the autism diagnosis rate in the U.S. reached 20 ASD births per 10,000 -- a doubling of diagnoses in just five years.

Autism prevalence rates hit 30-out-of-10,000 births in 1996. That coincided with the release of the Nintendo 64 and Sony Playstation, as global video game revenue surpassed $40 billion for the first time.

Looking at video game console sales figures and autism rates by year, the bar graphs become eerily similar. When the original Nintendo Entertainment System (NES) was released in 1985, the ASD diagnosis rate was locked at about one-in-2,500 births. By the time the NES successor, the Super Nintendo, hit U.S. shelves, that rate had jumped up to one-in-1,000. By the time the Playstation was on the market, the rate had leapt to one-in-500; with the release of the Playstation 2 in 2001, the rate had increased yet again, to one-in-250. When the Playstation 3 was released in 2006, the ASD rate had gone up to one-in-150.

Last year, a Neurology Now report made it clear that intensive video gaming indeed altered the wiring of young people’s brains, resulting in a surfeit of dopamine that, in the words of the author, “can almost shut prefrontal regions down.”

It’s not exactly a groundbreaking discovery, either. Going as far back as the early 1990s, researchers have concluded that video gaming overstimulates the parts of adolescent brains that govern spatial skills, resulting in the underdevelopment of regions that dictate sociability and emotional control.

Report after report finds children with ASD diagnoses tend to spend significantly more time in front of computer screens than their cohorts, with some researchers finding a direct correlation between intensive video game play and problem behaviors in youths with autism spectrum disorders. 

Demonstrating the pervasiveness of the issue, the American Psychiatric Association even vouched for “Internet Gaming Addiction” to be included as an actual mental health disorder in an addendum to the DSM-5, which is more or less the bible of clinical psychiatry.

Today, the global video game market is about $70 billion a year. That’s about ten times the amount of revenue generated by Abilify, the top-grossing pharmaceutical in the U.S., which, as fate would have it, is also one of the most commonly prescribed drugs for autistic individuals.

Despite the considerable amount of research indicating the clearly negative neurological impacts of intensive adolescent video game play, the manufacturers of the games with the highest density of ASD players have actually tried to spin things the other direction, claiming that their offerings are actually “educational” experiences. Sadly, this is a notion gaining traction with educators and parents across the nation, with the author of a Pacific Standard article, without the slightest tinge of irony, suggesting schools eschew genuine social interaction events, like dances, for "Minecraft parties.

I’m not even going to pretend that I know why ASD diagnoses have shot up so much over the last 30 years. Personally, I wouldn’t rule out anything as an explanation at this point, whether it’s additives in processed foods or stronger doses of antibiotics doled out be pediatricians. Maybe the real answer is the simplest, and the most cynical -- that more clinicians are just diagnosing kids so they can get kickbacks from the pharmaceutical companies. Not that they would ever think about exploiting children for their own financial gain or anything.

I find it inarguable, however, that electronic media producers and manufacturers have exploited the ASD demographic. Console makers and software providers specifically target the child and teen spectrum population, capitalizing on their tendencies to obsess and reward-seek. It’s a marketing strategy that’s kept Nintendo afloat for the better part of two decades, as their cash cow franchise “Pokemon” -- complete with its infantile, hyper-consumerist “Gotta’ Catch ‘Em All” mantra -- has sold more than 260 million copies since the mid 1990s. Interestingly, the creator of the series is a high-functioning autist himself, who said the franchise was heavily inspired by his compulsive childhood collecting.

So enmeshed in juvenile pop culture -- your “Star Wars” and your “My Little Pony” and the like -- one observer has noted that a growing number of adult autists can only communicate with others in “geek speak,” which is basically the context-less re-quoting of television dialogue and Internet memes. It’s Madison Avenue’s dream come true -- an entire fleet of ultra-consumers whom literally speak in a brand-dictated patois.

If you’re a software or hardware huckster, of course you’re going to go after the adult ASD crowd. Statistics indicate half of them don’t work, a majority are in-home dependents and they’re not getting married, having kids or generally interacting with society to any great degree. To video game marketers, they are the most enviable prize in the land -- eternal children, with all of the free-time in the world, with nothing to do but play, play, play, while their parents -- or other adult tax payers -- make a down payment on their next GameStop haul.

As a social issue, autism is quickly changing from a strict medical matter to cultural one, as proponents of  “neurodiversity” decry Applied Behavioral Analysis as barbaric and retroactively diagnose long-dead historical figures with the same spectrum disorders they share.

"The Holist Manifesto" -- something of a Magna Carta for the politicized ASD set -- states the political demand rather bluntly: “We are entitled to be different and learn and work differently.”

For the most part, the fledgling identity politics movements is concerned with educational access -- which, for sizable surcharges, many colleges are more than happy to provide.

Interestingly enough, there’s not a whole lot of talk within the movement about employee rights … and for good reason.

A 2013 report by the A.J. Drexel Institute found the economic outlook for young adults with autism -- this, being the cohorts born around the time of the “change point” noted by the EPA -- to be rather grim. According to their research, only one out of five ASD adults had full-time employment, with the average autistic full-timer making just $8 an hour. The same report found that more than half of autistic adults never had a job, of any variety, within eight years of exiting high school.

For all the talk we hear about the “school to prison pipeline,” it’s a bit surprising that hardly anyone ever brings up the “diploma to disability pipeline,” which is a much more ingrained -- if not wholly accepted -- aspect of the nation’s educational system.

Typing in the query “autistic adults income” in Google yields perhaps the most telling indicia for spectrumites over the age of 18 -- the entire first page is filled with tips on applying for social security benefits.

While data on the reproductive habits of autistic individuals is scarce, researcher Simon Baron-Cohen (who, to the best of my knowledge, isn’t related to Borat) believes assortative mating is likely to be a factor in the uptick in ASD diagnoses -- meaning, those with milder autistic traits tend to select partners with similar characteristics, which he believes results in offspring receiving a “double dose of autism genes and traits.”

The bulk of research, however, indicates adults with more pronounced spectrum disorders simply aren’t reproducing. A report in the Journal of Autism and Developmental Disorders from 2011 found that ASD adults were marrying at almost unfathomably lower rates than the general public, with singles representing 99 percent of subjects in one trial.

As today’s spectrum youth fall deeper into technological absorption, passive entertainment and machine-assisted communication, the dual casualties are sociability and independence.

This New York Times op-ed, about an autistic child whose only friend is an iPad, more or less proves the depersonalized, high-tech dystopia of the 2013 film “Her” has already become a reality. Worse than a culture sans social skills, we’re probably just a generation away from an entire subculture of youths who are incapable of any sort of communication without computer assistance.

Even worse, we’ve seemingly convinced ourselves that these kids can fulfill their pie in the sky multimedia and STEM fantasies without developing adequate social skills, that they can make it by just fine in life with severe communicative deficits.

We’re literally breeding an entire generation of children destined to never grow up, to never become adults capable of handling their own finances or even holding down steady employment.

The end result, I imagine, will be similar to Japan’s fate, where so many adults have withdrawn from society that there’s actually a name for them -- hikikomori, whose unproductive ranks are so high that some analysts have listed them as a primary factor for Japan’s ongoing recession.

That’s the autism problem no one is discussing -- the economic one.

How exactly are you supposed to support a high-demand consumer market when just a tenth of said consumers make more than minimum wage? How exactly is a national economy, comprised primarily of service industry jobs, supposed to sustain itself when the workforce has been told since birth that they’re too unsociable to find employment? What sort of labor market are we creating when our educational systems eschew soft skills for technological dependency, telling kids to abandon interpersonal communication for machine-aided isolation?

The media, entertainment, technology and even education sectors aren’t encouraging autistic adults to grow up and make a living of their own. Instead, they keep telling them it’s OK to sit around playing the same games they’ve been playing since they were children, that it’s OK to be forever coddled by their parents and that ceaseless consumption is more worthwhile than actual human interaction.

Regardless of the neurological roots of autism, we can’t be doing spectrum youth any good by permitting passive screen time over real social experiences. Nor are we setting ourselves up favorably in terms of workforce development; after all, when unproductive children turn into unproductive adults, it’s not just a burden on mom and dad -- indeed, it’s one shared by all of society.

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