Dr. Gabor Maté on Prenatal Stress and the Rise in Childhood Diagnoses
Autism now shows up roughly 30 times more often than it did a few decades ago. Some of that could be overdiagnosis; I won't rule it out. But there's an equally good chance that a real portion of the increase comes down to children being genuinely more troubled. The reason traces back to the mothers. Pregnant women today carry more stress, more distress, and more isolation, and they're treated as less important than they ought to be and than they once were. The pressures that weigh on families land on women, and from there they reach the infant. That interference with a child's health and development can start before birth.
A large body of research points to this. Women who lived through a hurricane, or who went through the trauma of 9/11, carried elevated levels of stress hormones afterward. A year later, their children showed higher stress hormone levels too.
Erik asked whether any of this is accepted in medicine, whether clinicians weigh it when they diagnose a child, or whether it stays outside the evaluation entirely.
The people diagnosing and treating these kids mostly have no idea what I'm describing, because they never look in that direction. Medical training skips the science altogether. So if the question is whether it's accepted, I'd say that scientifically it isn't even a matter of debate. Nobody who actually studies it doubts it. We can take a pregnant lab animal, a rat or a monkey, apply stress in a controlled way, and predict what will happen to the adult that offspring becomes. From human studies we also know how stress alters a woman's hormones. The science holds no controversy. The problem is clinical: none of it is understood, folded in, or even considered in everyday practice.
Because of that gap, doctors treat a child's difficulties as isolated biological problems, something to be corrected mostly with medication. They miss that a child's physiology, from conception forward, is a response to the surrounding world. If the trouble sits in the environment, and it does not start inside the child, then the sensible move is to examine the setting the child is growing up in rather than trying to repair the brain with pharmacology that is shaky at best. Those drugs can help at times, yes, and they can also cause terrible side effects.
An environmental view would pull back and take in the whole picture. The medical profession hasn't adopted that view, and it's nowhere close, even with the evidence sitting there in print. The distance between what the science shows and what happens in the clinic is enormous.