In America in 1970 one child in 14,000 was reckoned to be autistic. The current estimate is one in 68—or one in 42 among boys. Similarly high numbers can be found in other rich countries: a study in South Korea found that one in 38 children was affected. Autism is a brain condition associated with poor social skills. It has a wide spectrum of symptoms, from obsessive behavior to hypersensitivity to sound, light or other sensory stimulation, the severity of which ranges from mild to life-blighting. The range of consequences is also wide. At one end, the autism of a computer scientist may be barely noticeable; at the other, a quarter of autistic children do not speak.
Autism is a condition that defies simple generalizations. Except one: the potential of far too many autistic people is being squandered. Although around half of those with autism are of average intelligence or above, they do far worse than they should at school and at work. In France, almost 90% of autistic children attend primary school, but only 1% make it to high school. Figures from America, which works harder to include autistic pupils, suggest that less than half graduate from high school. In Britain, only 12% of higher-functioning autistic adults work full time. Globally, the United Nations reckons that 80% of those with autism are not in the workforce.
These numbers represent a tragic human toll, as millions of people live idle and isolated outside the world of work. Loving parents and siblings struggle to know how to help. Autism imposes hefty economic costs, reducing economic growth and swelling disability rolls. One American study suggests those costs could be as high as 2% of GDP. Fortunately, this need not be the case. Evidence, particularly from advanced economies, suggests there are plenty of things, from earlier screening to greater assistance with finding jobs, that could transform the lives of many autistic people.
Early screening is essential. There is no definitive test for autism. It can be diagnosed only by observing behavior. Most babies learn by watching their parents smile, hug, eat and bicker; autistic children often fixate on inanimate objects or play with their toys in an oddly repetitive way. Relying on diagnosis by observation makes the statistics around autism slippery: one reason the condition’s incidence has risen in recent decades is that doctors have changed the way they detect it. Yet there is little doubt that early diagnosis and intervention can help autistic children’s brains develop better. If parents fill in a detailed questionnaire about what their children can and can’t do, doctors can usually spot the symptoms by the age of two. Speech therapy and other intensive treatments can help an autistic toddler cope and encourage learning and interaction at an age when the brain is at its most plastic. A study in 2013 in Washington State found that, though costly, such early coaching paid for itself within eight years by reducing the need for extra help in school. Alas, the average age of diagnosis in the rich world is three and a half.
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