Recently, I heard the latter portions of the radio version of a play, “Lucy” by Damien Atkins, relating to autism and produced by L.A. Theatre Works.  “Lucy” was originally performed and reviewed as long ago as November of 2007, but I was not aware of it until I encountered the production for radio about one week ago.  The plot revolves around a couple (Vivian and Gavin) with a daughter (Lucy) who is 13 years old and has a severe form of autism.  Of particular interest for the EMR readership is how Lucy’s mother, Vivian, views the relationship between the direction of human evolution and the prevalence of autism and the need for individuals with autism to receive therapy.

According to one review of the play (Siegel and Siegel, 2007), a key plot point that I missed in the earlier portion of the play was that after Lucy was born, Vivian gave her to Gavin, the father, to raise so that she could pursue her professional career as an anthropologist.  Of high relevance to the playwright’s apparent message as embodied by the play, Vivian is presented as both brilliant and socially awkward, i.e. similar in key respects to her daughter.

The plot moves forward by virtue of Gavin’s request that Vivian take Lucy for one year so that he can deal with personal matters that were either not specified or were alluded to before I began listening.  Based on two reviews of the play (Siegel and Siegel, 2007; Zinoman, 2007), the early scenes involving the relationship between mother and daughter portray Vivian as struggling to communicate with Lucy, who exhibits limited verbal ability.

Near the end of the play, when the mother plans to move to Africa for her work as an anthropologist, the father objects.  He also disagrees with the mother about the therapy that Lucy has been receiving. The father favors continued treatment but the mother objects.  In the ensuing argument between the parents, the mother suggests that Lucy is not merely fine as she is, but that she is actually more evolved than other children who do not have autism.  Although it is only implicit, the suggestion appears to be that individuals with autism-related attributes will be favored by natural selection.

After the end of the performance, the host for the radio program interviewed the eminent UCLA neurogeneticist Daniel Geschwind.  I have high respect for Dr. Geshwind’s research into the genetics of autism and have briefly corresponded with him some years ago.

Consequently, I was quite disappointed when Dr. Geschwind, while refusing to directly endorse Vivian’s highly dubious thesis that individuals with autism are evolutionarily superior to individuals who do not manifest the autistic profile, sort of obliquely granted this questionable idea some credibility.  Dr. Geshwind noted that when he has a serious writing project to complete, he prefers social isolation.  This observation, whatever Geschwind meant by it, could be interpreted by some to suggest that it can be advantageous to be “autistic” or “autistic-like” if, like Vivian, you aspire to major accomplishments.

Statements about the advantages of traits often linked to autism (such as intense focus on one or a few subjects of interest) have the potential to arouse strong responses from people with diverse interests, including those involved in what can be called the autism rights movement.  I am offering no definitive broad-based value judgment about attributes associated with autism because the net impact of any given trait can vary widely with circumstances intrinsic or extrinsic to an individual, affected or otherwise.  But I am wary of assertions about the overall superiority of autism-associated traits because I have previously seen how misleading they can be (Greenspan, 2010).

While some may praise the playwright, Damien Atkins, for posing such a provocative notion, it is only tenable in the absence of much insight into how evolution by natural selection operates.  Given the difficulties in social interaction associated with autism, it would not be expected that individuals affected by autism would on average have greater reproductive fitness or genetic success than individuals without autism.

Evidence consistent with the above expectation has been published (Power et al., 2013).  The study was based on a cohort of over two million individuals in Sweden who were born between 1950 and 1970.  For males affected with autism, the fertility ratio was decreased more than 70% compared to the general population.  In addition to the reduced reproductive fitness of affected males and females (fertility ratio decreased about 50%), their genetic success was probably also reduced since brothers of affected individuals had a modestly reduced fertility ratio (5-6% reduction from general population average) and sisters of affected individuals had a fertility ratio comparable to the general population average.

Another recent study suggests that parents of children with autism tend to have fewer children than parents who do not have children with autism (Hoffmann et al., 2014).  These results, in conjunction with those cited directly above, argue strongly against any notion that manifesting the behaviors associated with autism will provide an evolutionarily relevant advantage.

References

Siegel B, Siegel S. Sensational performances by Lisa Emery and Lucy DeVito highlight this rich new play that seamlessly combines science and theater. November 1, 2007.

http://www.theatermania.com/new-york-city-theater/reviews/11-2007/lucy_11967.html (last accessed on 10/10/14)

Zinoman J. An anthropologist evolves with help from her autistic child. November 2, 2007. http://www.nytimes.com/2007/11/02/theater/reviews/02lucy.html (last accessed on 10/09/14)

Power RA, Kyaga S, Uher R, MacCabe JH, Långström N, Landen M, McGuffin P, Lewis CM, Lichtenstein P, Svensson AC. Fecundity of patients with schizophrenia, autism, bipolar disorder, depression, anorexia nervosa, or substance abuse vs their unaffected siblings. JAMA Psychiatry. 2013 Jan;70(1):22-30. doi: 10.1001/jamapsychiatry.2013.268. PubMed PMID: 23147713.

Hoffmann TJ, Windham GC, Anderson M, Croen LA, Grether JK, Risch N. Evidence of reproductive stoppage in families with autism spectrum disorder: a large, population-based cohort study. JAMA Psychiatry. 2014 Aug;71(8):943-51. doi: 10.1001/jamapsychiatry.2014.420. PubMed PMID: 24942798.

Greenspan, N.S. Autism conceptualized:  “cloud vs. “spectrum.” The Huffington Post, May 25, 2010. http://www.huffingtonpost.com/neil-s-greenspan/autism-conceptualizing-au_b_586546.html (last accessed on 10/10/14)