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I just read, for the umpteenth time, a statement that "the Amish don't vaccinate, and that's why there are no Amish people with autism." This statement draws, in part, from claims by Age of Autism writer Dan Olmsted - and, at least in this case, Mr. Olmsted is wrong.
I got my first inkling that this myth was, in fact, a myth, when I read this piece in the Combatting Autism from Within website:
The idea that the Amish do not vaccinate their children is untrue," says Dr. Kevin Strauss, MD, a pediatrician at the CSC. "We run a weekly vaccination clinic and it's very busy." He says Amish vaccinations rates are lower than the general population's, but younger Amish are more likely to be vaccinated than older generations.
Strauss also sees plenty of Amish children showing symptoms of autism. "Autism isn't a diagnosis - it's a description of behavior. We see autistic behaviors along with seizure disorders or mental retardation or a genetic disorder, where the autism is part of a more complicated clinical spectrum." Fragile X syndrome and Retts is also common among the clinic's patients.
Strauss said the clinic treats "syndromic autism", where autism as part of a more complicated clinical spectrum that can include mental retardation, chromosomal abnormalities, unusual facial features, and short stature, as well as Fragile X syndrome. "We see quite a few Amish children with Fragile X," he said.
...Strauss says he doesn't see "idiopathic autism" at the clinic, which he defines as children with average or above average IQs who display autistic behavior. "My personal experience is we don't see a lot of Amish children with idiopathic autism. It doesn't mean they don't exist, only that we aren't seeing them at the clinic."
He says a child in the general population is more likely to have autism detected early and to receive a diagnosis than an Amish child. "Amish child may not be referred to an MD or psychologist because the child is managed in the community, where they have special teachers," he says. "We know autism when we see it, but we don't go actively into the Amish community and screen for ASD."
Strauss adds that the Amish have a high prevalence of genetic risk factors and are protected from others. The low rate of idiopathic autism "might have more to do what genetic structure of population than lifestyle, environment or diet."
Just to check for myself, I called Strauss's clinic and chatted with a community liaison named Rebecca. Rebecca, who grew up among the Amish, confirms that about 70% of the Amish in Lancaster County do, indeed, vaccinate. She also confirms that the rate of autism seems to be lower among the Amish than among the general population. Of course, she didn't have a true explanation for this, though she said:
There's more of an acceptance [among the Amish] of people for being what they are, as they are. We certainly have children with difficulty learning - and there are special education facilities for children who have Downs, MR, and other issues. Most families have many children, a high rate of communication, no television; and it's important to be able to read. Communication is very, very important. I guess I have wondered whether the autism out there is due to lack of personal attention and communication to that child.
I found Rebecca's insights intriguing. To my mind, they argue for the notion that at least some of the huge rise in autism diagnoses may be linked as much to culture as to symptoms. What's more, in recent months I've come to realize that a great many of the therapies developed for autism really have just one thing in common: when done correctly, they involve a great deal of high quality 1:1 communication with the child.
The Amish do vaccinate. But in other ways they live very differently from the rest of us. I can't help but wonder whether they have a great deal to teach us relative to our children with autism.