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Let’s not go back to blaming parents

In the April 2020 article, “Early Media Exposure and Autism Spectrum Disorder: Heat and Light,” in JAMA Pediatrics, Dr. Christakis urges the USA to further investigate the association of early television viewing by infants with the uptick in autism. He ponders, “Whatever the underlying genomics of autism are, they cannot explain the increase because they have remained largely unchanged while the incidence has steadily risen. Hence it seems logical to think of environmental perturbations.” This author goes on to state that the prevalence of autism grew rapidly in the 1990s, as did television watching by infants. Regarding television watching, he offers that the content, the lights and sounds, the heat, the abrupt scene changes, the difficulty for infants to process media, and/or the decrease in interactions with caregivers might all contribute to autism. Certainly, infants learn through contact, imitation, reinforcement, and interactions that television cannot offer. Due to possible concerns regarding childhood development, obesity, and sleep interference, in 2018, the American Academy of Pediatrics (AAP) issued a statement that children should avoid digital media exposure until 18 to 24 months. The AAP offers “Media tips,” but notes, “Media and digital devices are an integral part of our world today.” [2] I agree with this statement, but not because I think early television exposure causes autism. Limiting television at a very young age for better health is prudent, but there’s a downside in claiming any cause of autism. The JAMA Pediatrics article implies by being better parents/caregivers and interacting more with our children we can prevent autism. The inferred message then is parental/caregiver blame for their children’s autism as a result of allowing their infants’ exposure to media. This line of reasoning regresses to the 1950s when Kanner blamed “refrigerator moms” for essentially causing autism in their children. Surely, infants’ exposure to media warrants investigation, and there may be an association of autistics being drawn to digital platforms, but it’s unlikely media exposure causes autism, especially as studies have shown proof of autism in utero. [3-4] Thus in most cases, autistics are born autistic --perhaps even wired to excel in an increasingly digital world.

1. Christakis DA. Early Media Exposure and Autism Spectrum Disorder: Heat and Light. JAMA Pediatr. 2020;174(7):640–641. doi:10.1001/jamapediatrics.2020.0659

2. American Academy of Pediatrics. Children and Media Tips from the American Academy of Pediatrics. May 2018. (online) https://www.aap.org/en-us/about-the-aap/aap-press-room/news-features-and-safety-tips/Pages/Children-and-Media-Tips.aspx

3. Bonnet-Brilhault F, Rajerison TA, Paillet C, et al. Autism is a prenatal disorder: Evidence from late gestation brain overgrowth. Autism Res. 2018;11(12):1635-1642. doi:10.1002/aur.2036

4. Prem S, Millonig JH, DiCicco-Bloom E. Dysregulation of Neurite Outgrowth and Cell Migration in Autism and Other Neurodevelopmental Disorders. Adv Neurobiol. 2020;25:109-153. doi:10.1007/978-3-030-45493-7_5

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