The Nature Paper Rant & the Trouble with Hyping Autism Research
So earlier this week I went on a little bit of a twitter rant about a recently published and widely publicised letter to Nature. The study used MRI to collect structural brain images from 106 infants with an older ASD-sibling and 42 “low-risk” infants. The authors observed brain overgrowth in several parts of the cortex at very early ages (6 & 12 months) in the high-risk infant group. Furthermore, using this structural brain information, a machine learning algorithm was able to classify those infants who went on to diagnosed with autism at 24 months (15 in total) with around 80% accuracy.
Right I'm about to start a rant here brace yourselves...1/n https://t.co/7PMrIO4Nw5
— Robert (@neurofractal) February 15, 2017
I could give a detailed account of the merits of this paper (which are many), alongside a few technical critiques which might be of interest to students/academics in the field. But I’m not. That’s not what I was upset about. What concerned me was the process by which this information was reported to the general public and the effect this might have on autism support groups and parents more generally.
Let me start out with a couple of quotes:
“Brain scans can detect autism long before any symptoms start to emerge, say scientists” BBC News Website
“Scientists have successfully detected autism in babies using an MRI scan.” Daily Mail
Brilliant! We can all stop doing research because early ASD diagnosis has been solved. Apart from the fact that autism diagnosis was predicted in just 15 infants, there is no causative mechanism which links brain volume and autistic behaviour and the classification accuracy was 80% which is nowhere near high enough for effective clinical use. This is a classic case of seriously over-hyped science.
I get that reporting science to the general public is hard, especially with brain imaging and autism research. There are technical terms, statistical concepts and contradictory findings which are hard to convey. However, I think that people deserve a balanced view which appreciates the complexities of the field and emphasises how much work still needs to be done. Where are the phrases “may become part of autism diagnosis in future”, “promising early results”, “important first steps”? This black and white reporting has serious implications for discussions in autism support groups and the mind-set of parents. During my PhD, I have encountered parents who show me newspaper articles about over-hyped autism ‘cures’, ‘treatments’ and ‘diagnosis’, and hope that by getting a brain scan they can understand why their child has autism or get a faster diagnosis. In my opinion, the BBC and Daily Mail articles, and others like them, lead to this kind of all-or-nothing thinking within the autism community. It is irresponsible and frankly unethical to simplify and hype-up research findings in the hope that a few more people click your link. I was particularly angered by the BBC News Science headline “Autism detectable in brain long before symptoms appear” because the BBC is seen as such a reliable and impartial source of knowledge. I really hope that future articles on the site reporting on autism will use more appropriate language.
Let me finally offer my own mini write-up in the hope that at least some autism support groups and parents see the Nature letter in the correct context:
Autism is a complex neurological condition with no known ‘cause’. The prediction of an autism diagnosis or autism-related behaviours before 24 months is crucial because it allows families and clinicians to seek appropriate interventions at a critical time during development.
In the future, this may become possible through a careful combination of genetic information, brain scanning and behavioural assessment. Unfortunately, this is not possible at the present time. Our knowledge about the signs of autism before 24 months are poorly understood. There is a complex interplay between genetic and environment factors, and how this shapes the brain’s overall shape and functional working during development.
This is why the recent letter to Nature by Hazlett & colleagues linking brain volume with autism is important. It builds upon previous work linking atypical brain growth with autism using a larger number of people and data from very young infants. Furthermore, a machine learning algorithm showed that this overgrowth could be be predictive of autism diagnosis on an individual basis. The 80% classification rate is higher than previous work and would be exciting if replicated and extended using more data.
Ultimately studies like this one will help us to understand and predict autism before 24 months. But we aren’t there quite yet.
Some other useful readings:
The last paragraph of the article itself (wonder how many reporters read this?)
Twitter thread by @DrBrocktagon
NHS News Report
Guardian News Report
ITV News report








