(c)
2007 Dow Jones & Company, Inc. Reproduced with permission of
copyright owner. Further reproduction or distribution is prohibited
without permission. In the spring of 2005, Cornell University
economist Michael Waldman noticed a strange correlation in Washington,
Oregon and California. The more it rained or snowed, the more likely
children were to be diagnosed with autism. To most people, the
observation would have been little more than a riddle. But it soon led
Prof. Waldman to conclude that something children do more during rain
or snow -- perhaps watching television -- must influence autism. Last
October, Cornell announced the resulting paper in a news release
headlined, "Early childhood TV viewing may trigger autism, data
analysis suggests." Prof. Waldman's willingness to hazard an
opinion on a delicate matter of science reflects the growing ambition
of economists -- and also their growing hubris, in the view of critics.
Academic economists are increasingly venturing beyond their traditional
stomping ground, a wanderlust that has produced some powerful results
but also has raised concerns about whether they're sometimes going too
far. Ami Klin, director of the autism program at the Yale Child
Study Center, says Prof. Waldman needlessly wounded families by
advertising an unpublished paper that lacks support from clinical
studies of actual children. "Whenever there is a fad in autism, what
people unfortunately fail to see is how parents suffer," says Dr. Klin.
"The moment you start to use economics to study the cause of autism, I
think you've crossed a boundary." Prof. Waldman, who thinks
television restriction may have helped rescue his own son from autism,
says many noneconomists don't understand the methods he used. His paper
recommends that parents keep young children away from television until
more rigorous studies can be done. "I've gotten a lot of nasty emails,"
he says. "But if people aren't following up on this, it's a crime." Such
debates are likely to grow as economists delve into issues in
education, politics, history and even epidemiology. Prof. Waldman's use
of precipitation illustrates one of the tools that has emboldened them:
the instrumental variable, a statistical method that, by introducing
some random or natural influence, helps economists sort out questions
of cause and effect. Using the technique, they can create "natural
experiments" that seek to approximate the rigor of randomized trials --
the traditional gold standard of medical research. Instrumental
variables have helped prominent researchers shed light on sensitive
topics. Joshua Angrist of the Massachusetts Institute of Technology has
studied the cost of war, the University of Chicago's Steven Levitt has
examined the effect of adding police on crime, and Harvard's Caroline
Hoxby has studied school performance. Their work has played an
important role in public-policy debates. But as enthusiasm for
the approach has grown, so too have questions. One concern: When
economists use one variable as a proxy for another -- rainfall patterns
instead of TV viewing, for example -- it's not always clear what the
results actually measure. Also, the experiments on their own offer
little insight into why one thing affects another. "There's a
saying that ignorance is bliss," says James Heckman, an economics
professor at the University of Chicago who won a Nobel Prize in 2000
for his work on statistical methods. "I think that characterizes a lot
of the enthusiasm for these instruments." Says MIT economist Jerry
Hausman, "If your instruments aren't perfect, you could go seriously
wrong." By suggesting that something within parents' control
could be triggering autism, Prof. Waldman has reopened old wounds in
the realm of autism research, which is littered with debunked theories
linking the disorder to the family environment. "This is junk
science," says Alison Singer, parent of an autistic child and senior
vice president of Autism Speaks, a nonprofit founded by former NBC
Universal Chief Executive Bob Wright. "Autism is a genetic disorder.
The only thing the parents do wrong is they have bad genes." The
term "autism" describes a spectrum of diagnoses with symptoms that may
include impaired language skills, difficulty understanding social cues,
and an obsession with routine or repetitive actions. The Centers for
Disease Control and Prevention estimate that as many as one in 150
children in certain parts of the U.S. have some form of autism. Studies
in recent decades have shown the proportion of children with autism
growing, though researchers aren't sure the disorder has actually
become more prevalent. Greater awareness, broadening definitions of the
disorder and the availability of special-education programs may have
made parents more likely to get their children diagnosed. Over
the years, attempts to understand the affliction have been tough on
parents. One of the earliest, the "refrigerator mother" theory, blamed
autism on a lack of maternal affection. Popularized by celebrity
psychologist Bruno Bettelheim, the theory survived from the 1940s until
the late 1960s, virtually demonizing mothers of autistic children until
more-careful studies failed to support the idea. More recently, a scare
about measles vaccinations stirred anxiety, but large studies have
shown no link to autism. Most researchers now recognize that
heredity plays a central role in autism, and they are making progress
in identifying the genes responsible. They're also looking into the
possibility of interaction with environmental factors, both in the womb
and after birth. Some experts think that in reaction to the
discredited theories the pendulum has swung too far away from the
family. "The discussion of the role of the family, and social
interaction within the family, is virtually taboo," says Anna
Baumgaertel, a developmental-behavioral pediatrician at the Children's
Hospital of Philadelphia. She says some of her autistic patients have
been heavy video and TV watchers since birth -- a factor she thinks
"may lead to autistic behavior in susceptible children, because it
interferes with the development of 'live' auditory, visual, and social
experience." Prof. Waldman, a recognized expert in the field of
applied microeconomics, doesn't pretend to be an authority on autism.
He became engrossed in the subject in the fall of 2003, when his
2-year- old son, David, was identified as having an autism-spectrum
disorder. Hoping to eliminate any potential triggers, Prof. Waldman
supplemented the recommended therapy with a sharp reduction in
television watching. His son had started watching more TV in the summer
before the diagnosis, after a baby sister was born. Prof. Waldman
says his son improved within six months and today has fully recovered
-- a surprising result, given that autism is typically a lifetime
affliction. "When I saw the rapid progress, which was certainly not
what anyone had been predicting, I became very curious as to whether
television watching might have played a role in the onset of the
disorder," he says. He tried to get medical researchers interested in
the idea, to no avail. In late 2004, he decided to look into the
subject himself, ultimately putting together a research team with
Cornell health economist Sean Nicholson and Nodir Adilov, a professor
of economics at Indiana University-Purdue University in Fort Wayne. In
principle, the best way to figure out whether television triggers
autism would be to do what medical researchers do: randomly select a
group of susceptible babies at birth to refrain from television, then
compare their autism rate to a similar control group that watched
normal amounts of TV. If the abstaining group proved less likely to
develop autism, that would point to TV as a culprit. Economists
usually have neither the money nor the access to children needed to
perform that kind of experiment. More broadly, randomized trials seldom
lend themselves to studying economic questions, particularly the more
traditional ones. It would be unfair to randomly subject some people to
a higher tax rate just to see how it affects their spending. Instead,
economists look for instruments -- natural forces or government
policies that do the random selection for them. First developed in the
1920s, the technique helps them separate cause and effect. Establishing
whether A causes B can be difficult, because often it could go either
way. If television watching were shown to be unusually prevalent among
autistic children, it could mean either that television makes them
autistic or that something about being autistic makes them more
interested in TV. The ideal instrument is a variable that is
correlated with A but has no direct effect of its own on B. It should
also have no connection to other factors that might cause B. If data in
a study nonetheless show that the instrumental variable is linked to B,
it suggests that A must be contributing to B. Take a question
Prof. Angrist of MIT sought to answer: Did service during the Vietnam
War have a negative effect on people's future earnings? It wouldn't be
enough to say that people who served ended up poorer. Perhaps a lack of
opportunities in the civilian world made them more likely to enlist in
the first place. As an instrumental variable, Prof. Angrist chose
the draft lottery, which made some people more likely than others to
serve in the Vietnam-era military, but didn't have any connection to
their initial circumstances. On average, white men whose low lottery
numbers made them draft-eligible had much lower earnings many years
later. (The data on nonwhites were inconclusive.) In a seminal 1990
paper, Prof. Angrist concluded that conscription had a detrimental
effect on future earnings. "Economic research is becoming more
empirical and in some ways more like clinical research in medicine,"
says Prof. Angrist. "I think it's a wonderful thing. It's a sign of the
extent to which economics has become more of a science and less of an
exercise in formal abstraction like philosophy or mathematics." Chicago's
Prof. Levitt tackled police staffing and crime. That's an issue where
cause and effect are hard to disentangle because cities with many
criminals are likely to have more police, but that doesn't mean an
excess of officers causes crime. Prof. Levitt took advantage of the
fact that mayors and governors tend to put more police on the streets
in election years. Using election cycles, he concluded in a 1997 paper
that adding police reduces violent crime. Prof. Waldman and his
colleagues had such studies in mind when they approached autism and TV.
By putting together weather data and government time-use studies, they
found that children tended to spend more time in front of the
television when it rained or snowed. Precipitation became the group's
instrumental variable, because it randomly selected some children to
watch more TV than others. The researchers looked at detailed
precipitation and autism data from Washington, Oregon and California --
states where rain and snowfall tend to vary a lot. They found that
children who grew up during periods of unusually high precipitation
proved more likely to be diagnosed with autism. A second instrument for
TV-watching, the percentage of households that subscribe to cable,
produced a similar result. Prof. Waldman's group concluded that
TV-watching could be a cause of autism. Criticism quickly arose,
illustrating some of the perils of the economists' approach. For one,
instruments are often too blunt. As Prof. Waldman concedes,
precipitation could be linked to a lot of factors other than
TV-watching -- such as household mold -- that could be imagined to
trigger autism. At best, his data reflect the effect of television on
those children who changed their habits because of rain or snow, not on
those who did it for other reasons such as a desire to watch
educational shows. "It is just too much of a stretch to tie this
to television- watching," says Joseph Piven, director of the
Neurodevelopmental Disorders Research Center at the University of North
Carolina. "Why not tie it to carrying umbrellas?" Also, Prof.
Waldman's findings do nothing to explain the mechanism by which
television would influence autism, a gap that instrumental variables
are inherently unable to fill. That's one reason many autism
researchers think he shouldn't have publicized his results or made
recommendations to parents. "I think this is irresponsible," says Dr.
Klin of Yale. "We should not provide clinical advice unless there is
scientific evidence to substantiate it." To those who wonder
about the autistic children who never watched TV or who had clear
problems before they started watching, Prof. Waldman responds that his
hypothesis isn't meant to be all-inclusive. "Even if we are correct,
there are likely other triggers and possibly some children become
autistic even in the absence of any trigger," he says. David
Card, a professor at the University of California, Berkeley, who has
done influential work on the minimum wage, fears that the fascination
with the instrumental-variables technique "leads to interest in topics
that economists are not particularly well-trained to study." Those
who favor the method say it's just one tool among many -- all of which
have flaws -- and is intended to help fill in the picture. Prof.
Angrist, for example, readily acknowledges his Vietnam study applies
only to those whom the draft forced to serve in the military, not to
those who signed up voluntarily, and needs to be looked at in tandem
with other work on the economic effects of military service. Harvard
economist Jeffrey Miron has started a project to test Prof. Waldman's
methods and results. Prof. Waldman welcomes the scrutiny, saying he
hopes his work will also provoke autism researchers to conduct clinical
trials. "Obviously this is an unusual thing for an economist to
be looking at," says Prof. Waldman. "Maybe I was overconfident. We'll
see."
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