In 1859 Charles Dickens wrote the opening of The Tale of Two Cities. ”It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the season of Light, it was the season of Darkness…”
Now 167 years later most people would say the same thing about our present situation, politically, environmentally, and our health care systems. Both in 1859 and now, we simultaneously hold great progress and deep suffering, extreme wealth and absolute poverty, or high hopes and severe fears. In the “age of foolishness” our government has cancelled funding for much vital research.
Autism diagnosis is presently based on using established criteria that show a persistent problem in the areas of Social communication and interaction, Restrictive and repetitive behaviors, have an Early onset, and Functional impairment that cannot be explained by an intellectual disability or global developmental delay.
In the 1970’s twin studies confirmed that there was a strong role of genetics in the diagnosis of autism. The role of genetics in individuals with collections of behaviors placing them into the Autistic Spectrum can’t explain why 1 in 36 American children have autistic spectrum disorder or why that number has skyrocketed in such a short time.
Dr. Thomas Hartung in Environmental Health and Engineering says that it is hard to find the culprit on both sides, genetics and environment, that contribute to autism. All human traits are the result of interactions between genes and environment. A child carrying genes predisposing them to grow tall may still be short if they don’t receive proper nutrition. A child born with a metabolic disorder phenylketonuria (PKU) will have brain damage if they are fed phenylalanine (a normal essential amino acid in our environment). They will be normal if their diet regulates the amount of phenylalanine.
These are two examples of interactions between genes and the environment. Of course, it is not so simple. The challenge is to understand/identify the environmental risks and the genes that make a person susceptible to those risks. Environmental risks are air and water pollution, (67,000 plus newly invented chemicals (including plastics) in our water and air, some permanently), climate change, viruses, etc. To make it more complicated it is also necessary to know when exposure occurred. Was it before birth, to the mother, the father, or during pregnancy? Was it continual as in water or brief as in a mild cold?
Drs. Christine Ladd-Acosta and Heather Volk co-lead a groundbreaking, large scale research on autism spectrum disorder (ASD) and gene-environmental interactions. In the ”best of times”, it is still funded through 2027. With data from 18 ongoing population studies, they are investigating how certain genes interact with the environment to alter their function to cause autistic behaviors.
To be in the “age of wisdom” we must demand that there should be increased funding for such research and a strong EPA to protect our future children and help those who have altered behavior.
by Sally Robinson, MD Clinical Professor
Keeping Kids Healthy
Published 09/2026