What does the environment have to do with autism?

The search for autism’s causes is a daunting task — but researchers are investigating a variety of factors that might play a role.

Experts, however, attribute most of the upsurge to increased awareness, better access to services, and expanded criteria to diagnose the neurodevelopmental syndrome, which is characterized by restricted interests or behaviors and problems with communication and social interactions.

Autism is remarkably diverse, encompassing a wide spectrum of disabilities and gifts. “If you’ve met one child with autism,” parents and clinicians like to say, “you’ve met one child with autism.” That heterogeneity, which also includes a range of physical ailments, has made the search for autism’s causes a daunting task.

Casting a Wide Net

Multiple factors likely interact to cause any one child’s likelihood of developing autism. And though scientists agree that genetic and environmental factors both play a role, genetics research has far outpaced work on environmental links.

To scientists, environmental risks include anything beyond the genome. So far they’ve investigated a potential role for air pollution, pesticides, parental age, medical conditions including infection and diabetes, prenatal care, lifestyle factors like the mother’s diet, smoking and alcohol consumption, and time between pregnancies. Results from many of these studies have been mixed. Even when a study finds an association between an environmental factor and increased risk, it doesn’t imply causation, but suggests that factor might increase risk.

“There’s not a consistent evidence base yet,” says Croen.

Factors to Reduce Risk

Untangling the multiple ways that genes and environment might interact to contribute to autism has proven challenging. Genetic or epigenetic risks could lie with the child, the mother or possibly the father, all interacting in a dizzying array of combinations with exposure to environmental factors. And these interactions could go in two directions: Genetics could determine whether an exposure causes adverse effects, or an exposure could influence how the genes are expressed.

Epidemiologists hope that one day a technological breakthrough will allow them to read a person’s entire history of environmental exposures from biological specimens, just as they can determine a person’s genetic profile by genome sequencing. Until then, epidemiologists must settle for the messy tools of their trade. Still, Hertz-Picciotto remains hopeful that progress is on the horizon.

“I look back at things we’ve been studying for 20, 30, 40 years and, in some cases, there hasn’t been a whole lot more progress than we’ve had in the past 10,” she says. Hertz-Picciotto points to breast cancer researchers who now recognize that the changes leading to cancer likely start in childhood or puberty. “They’re trying to reconstruct things 30 years earlier. We’re just going back a few years.”

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