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Healthinmind/Mental Health Disorders/Infant, Child and Adolescent Disorders/Pervasive Developmental Disorders Autism is also sometimes called Early Infantile Autism, Kanner's Disorder, Kanner's Syndrome, Atypical Development, and Childhood Psychosis. Children later diagnosed as autistic were historically regarded as strange by their parents by the time they were 6 months old. Recently, onset at the age of 18 months has become twice as common as the earlier onset. Autistic children don't react normally to parents; social smiling and responsiveness to parents are missing, and the child remains a loner in his (three to four times as many boys as girls are autistic) own world. Communication skills are radically below normal; what speech there is may be echolalic (the child echoes what is said to him or her, rather than responding normally). Odd stereotyped motor movements and serious self-injurious behaviors are common. Many children are so inattentive to social cues that they are thought to be deaf until it is noted that they may be supersensitive to weak sounds. Most autistic children are mildly to severely retarded, but may show areas of exceptional skill (the so-called "autistic savant;" Dustin Hoffman in "Rain Man" portrayed a savant with a remarkable memory, but artistic skill may be the most frequent exceptional ability). Autistic children are often upset by any change in their physical surroundings or routines; change may bring on a temper tantrum. Extreme focus on useless routines, on parts of objects, or on a single sensory modality, is common. More controversy has swirled about Autism than about any other diagnosis. In the 1960s and for many years after that, the primary controversy was about the cause of autism. It has since been demonstrated that genes play a dominant, but not exclusive, role in the causation of autism; when one member of a pair of identical twins has autism, the other has it 75% of the time. Another long-standing controversy is about whether it is justifiable to use punishment to stop autistic children from injuring themselves. Head-banging is one very common example; autistic children may bang their heads against sharp corners because they apparently want to draw blood. They also may bite fingers, arms, or shoulders to the bone. Dr. Ivar Lovaas found that, contrary to intuition, punishment could be used to control or stop self-injury. Critics claim that the use of punishment is inhumane. A
third set of controversies concerns the effectiveness of various
therapies that have been claimed to help with autism; examples
include nutritional therapies and auditory integration training. A
fourth contentious issue concerns vaccinations. Some
researchers think that the combination shot for measles, mumps, and
rubella (MMR) can cause autism. Autism rates increased in the United
States following the introduction of MMR shots in 1978, and in the
United Kingdom following the introduction of the shots in 1988.
Others deny a connection, arguing that the apparent increases in
autism occurred because more disorders were diagnosed as autism
after those times. However, autism diagnosed soon after birth used
to be twice as common as autism with onset at about 18 months, when
MMR shots are given; now the reverse is true. That is consistent
with the belief that the increase could be related to the triple
vaccination. This uncertainty poses a problem for parents. They must decide whether to leave their children vulnerable to measles, mumps, and rubella, or possibly increase the probability that children will become autistic by getting them the shots. Some physicians think that there is less danger of autism if the vaccinations for measles, mumps, and rubella are given separately, with intervals between them. Parents should consult their physicians about inoculations and keep up with the latest thinking on the subject. Yet a fifth question is whether "facilitated communication" helps autistic children to communicate. Careful studies indicate that it seldom, if ever, works. The best source of information about both controversial and non-controversial issues, together with help for parents of autistic children, is available through the Autism Research Institute, a creation of Dr. Bernard Rimland. Dr. Rimland has an autistic son, has devoted about 40 years to the study of autism, authored the seminal book on autism, has the world's most complete set of materials on autism, and writes the Autism Research Review, a superbly written and always contemporary source of the latest information on autism. Dr. Rimland also served as the technical consultant on the movie, "Rain Man," and on April 6, 2000 testified at a hearing on Capitol Hill that autism might be linked to vaccinations. The Division for Developmental Psychology has recently become a clearinghouse for autism research and treatment, and should soon be providing valuable information and resources. Last updated 01/30/05 |
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