Is Every Cause of Autism a Definite Cause of Deafness?

Abstract

Everyone knows that autism is a primary brain disorder. This top-down theory seems so self-evident that it has proved impossible to get autismologists to engage with let, alone test, a radically different bottom up theory for which there is a large amount of evidence, namely that autism is a variant ear disorder (Gordon 1989). This means that every cause of autism is also a cause of deafness, any brain malfunction being secondary to sensory misspecification. Two recent papers provide a powerful comparison of these rival theories. Mankoski et al., (2006) provide clear evidence for autism being caused or aggravated by malaria, but totally ignore the fact that this was predicted by the otogenic theory, as is the case with their other implicated causes of autism (herpes, rubella, meningitis, mucopolysaccharidoses and cranial dysostoses) which also cause deafness (Gordon, 1991). One of their cases became autistic after Salmonella meningitis. Deafness is prominent after meningitis in African infants: of 19 survivors, 5 had se-quelae, 3 of whom were deaf (Molyneux et al., 2000). Not all causes of deafness may also cause autism, but there is a very long list of them that do (Gordon, 2007). So, does it include malaria, and is not the autism more plausibly explained by associated brain damage? Malaria is a common cause of deafness in Africa (Olu Ibekwe, 1998). Despite the strong co-morbidity between deafness and autism, most autists have normal pure tone audiograms (Hayes and Gordon, 1977). Hence any causal relationship is not with hypoacusis, but must be with hyperacusis or auditory fluctuation or distortion, as evident clinically and from many written accounts by autists. Itard (1821), who coined the word hyper(a)cousie, noted that this was often the first sign of progressive cochlear hypoacusis. There is a clear otological candidate for such an auditory syndrome, Meniere Spectrum Disorder, comprising the usual symptoms of Meniere's disease, but not chronic, obvious or progressive enough for a diagnosis of Meniere's disease in an otology clinic. The immediate trigger for this inner ear hyperirritability seems to be a drop in perilymph pressure from a fistula, low blood or spinal fluid pressure, weight loss, etc. (Gordon, 1983). In malaria, dehydration would be a clear trigger of such an endolymphatic hydrops. A doctor in Africa (Denti di Pirajno, 1956) gave an excellent description of his own sudden malarial Menieriform attacks: his knees turned to water; slight buzzing in his ears grew into deafening …