MIND TRAPS: How Smart People Went so Wrong on Autism

The great irony of the internet is that while it opens each individual to a universe of information, it also unleashes a flood of misinformation. For every groundbreaking new scientific finding which gets disseminated, there’s a bogus diet theory, an unfounded medical scare, a viral hoax. When it comes to separating the wheat from the chaff, we’re largely on our own.

The perils of getting sucked into internet nonsense were vividly illustrated by erstwhile Playboy model Jenny McCarthy, whose long journey down a particularly tortuous rabbit hole of misinformation began with a Google search of the word “autism.” She told Oprah Winfrey how the process began after she diagnosed her young son as having the condition:

McCarthy: First thing I did-Google. I put in autism. And I started my research.
Winfrey: Thank God for Google.
McCarthy: I’m telling you.
Winfrey: Thank God for Google.
McCarthy: The University of Google is where I got my degree from…. And I put in autism and something came up that changed my life that led me on this road to recovery, which said autism-it was in the corner of the screen-is reversible and treatable. And I said, What?! That has to be an ad for a hocus pocus thing, because if autism is reversible and treatable, well, then it would be on Oprah.

The above dialogue is from the new book The Panic Virus, by Seth Mnookin, who goes on to describe the course of action that McCarthy took in response to her remarkable discovery:

The ad McCarthy saw was for a wheat- and dairy-free diet. Within weeks of putting Evan on this new regimen, McCarthy said, he’d doubled his language, his eye contact improved, he began smiling more, and he became more affectionate. “Once you detox them,” McCarthy said, “your kids are going to get better. You’re cleaning up their gut. You’re cleaning up their brain. There is a connection.”

When Winfrey asked McCarthy how she could be so certain that her conclusions were correct, she answered: “Mommy instinct… I know what’s going on in his body, so this is what makes sense to me.”

Unfortunately, McCarthy’s growing conviction that she understood the cause of her son’s behavioral problems eventually expanded to embrace the discredited theories of British former surgeon Andrew Wakefield, who published a study – now understood to be fraudulent – implying that childhood vaccines are a major cause of autism. McCarthy became a prominent figurehead in the movement to stop parents from vaccinating their children, which caused a significant drop in immunization levels and a number of documented deaths. Even now, with a vast amount of scientific evidence having been marshaled to prove the falsity of Wakefield’s claim, McCarthy continues to stand behind Wakefield. This past Monday, she wrote in a column for the Huffington Post:

I have never met stronger women than the moms of children with autism. Last week, this hoopla made us a little stronger, and even more determined to fight for the truth about what’s happening to our kids.

The anti-vaccine movement is not an isolated case. Rather, it is an example of a problem that is endemic in the public health sphere. Scientists and policy makers operate on the assumption that if the public is provided with the most up-to-date, scientifically verified information about their health, then they will be able to rationally weigh their options and make the correct choices. The reality is anything but. Millions of highly intelligent, well-educated consumers are continually being misled by erroneous information because they fall victim to a single simple error of logic.

Harvard historian of science Steven Shapin writes compellingly about this issue in a recent edition of the New York Academy of Sciences Magazine. In an article entitled “Who’s an Authority on Nutrition Science,” he identifies the problem with a word that many be unfamiliar to many: casuistry. This, in essence, is the preference for drawing inferences from a few particular cases rather than the more scientifically rigorous method of looking at large samples and testing hypotheses through statistical analysis. Writes Shapin:

Academic dietetic expertise treats human bodies in general and as populations. If you weigh this amount, or if you drink this amount, your chances of contracting or avoiding this or that dread disease is n per cent… This can be useful information, most especially for policymakers…. The problem, however, is that individual people tend to be interested in what is likely to happen to them.

This is something that people who sell a lot of books and DVDs understand. In the popular literature, Shapin writes,

… books are quite generally structured around particular cases. Indeed, they often are organized as a kind of counterpoint between the general and the populational, and stories about, say, Mrs. Finkelstein, a 49-year-old woman weighing 212 pounds, on the other.

In essence, the scientists and policymakers who deal with issues that have an enormous impact on the public well being – things like nutritional recommendations and the risk-benefit analysis of medical treatments – are speaking an entirely different language from the Jenny McCarthys of the world, who find their own experience of one child’s problem vastly more compelling than any number of peer-reviewed studies. And here I should emphasize that I do not think that Jenny McCarthy is a foolish woman. And that’s just the problem. Casuistry is a deeply intuitive approach to understanding the world that even the smartest people can easily fall into if they’re not forearmed. One highly intelligent friend of mine is a journalist specializing in health reporting; she recently surprised me by taking the side of raw milk activists who argue, contrary to any scientific evidence, that unpasteurized dairy products are healthier. “Why do I need double-blind studies,” she said, “when I have actual case studies?”

It’s not at all clear how to combat casuistic thinking. Simply compiling more data will not do the trick. Casuistry predominates among the public because it addresses the kinds of concerns that people have in the real world. Namely: how is this news going to affect me? Observes Shapin: “You cannot use better logic or more evidence to refute a different kind of concern.”

So what do we do? Ultimately, it would be fantastic if some day the educational system were to recognize the huge importance of logic in everyday life, and schools made basic logic and statistics a fundamental part of every American’s education. For the time being, a more practical solution would be for policy makers to recognize that they have a problem in getting their message across. It’s not enough to tell the public what’s true; you have to present the information compellingly, and in a relatable way. If casuistry is a fact of life, then perhaps it can be made to serve the truth.

How? Look at the way that the anti-vaccine movement lost steam. One of the most powerful strikes against their rhetoric was the news that 10 children had died in California from whooping cough, a disease that had virtually been wiped out before parents stopped giving their kids the vaccine. All at once, statistics and hypotheses were swept away by real, live, grieving, suffering people. The cost of Wakefield’s rhetoric was no longer notional; it was palpable. At last, in parents’ anguish, the flaw in a movement’s faulty logic revealed its true, terrible cost.