| The very nature of autism is not well understood and subject to great controversy.
In psychiatry, autism (called autistic disorder in the DSM) is considered a neurodevelopmental disorder that causes
marked problems with social relatedness, communication, interest, and behavior. It is considered to be one of the five types of
pervasive developmental disorders
(or autism spectrum disorders).
Many autistic people (and some non-autistic allies) in the autism rights movement do not see autism as a disorder but as a way of being. These autistic people
do not desire a cure for autism and see attempts to cure autism in the same light as an attempt to "cure" someone from any other
minority group.
Typical characteristics include great difficulty in communicating with others, inability to understand jokes or read between
the lines, and a somewhat unintentional lack of consideration for those outside of their 'sensory independence'; their
independent world.
Typically, autism spectrum disorders appear during the first three years of life. It is estimated that it occurs in
approximately 2 to 6 in 1,000 individuals, and is 4 times more prevalent in males than females. It is most prevalent in Caucasian
males, although it occurs in both genders and every race.
While certain (inconclusive) treatments for autism exist, it is widely considered that absolute cure from the psychiatric
condition is impossible since autism involves aspects of neurological brain structure determined very early in development.
History
The classification of autism did not occur until the middle of the twentieth century. In 1943, Dr. Leo Kanner of the Johns Hopkins Hospital studied a group of 11 children and introduced the label early
infantile autism. At the same time a German scientist, Dr. Hans
Asperger, described a different form of autism that became known as Asperger's syndrome — but the widespread recognition of Asperger's work was delayed by World War II in Germany.
Thus these two disorders were described and are today listed in the Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR
(fourth edition, text revision 1) as two of the five pervasive developmental disorders (PDD), more often referred to today as autism spectrum
disorders (ASD). All these disorders are characterized by varying degrees of difference in communication skills, social
interactions, and restricted, repetitive and stereotyped patterns of behavior.
Symptoms
Possible Indicators of Autism Spectrum Disorders:
- Does not babble, point, or make meaningful gestures by 1 year of age
- Does not speak one word by 16 months
- Does not combine two words by 2 years
- Does not respond to name
- Appears to be deaf or 'wanders'
Some other indicators:
- Lacks eye contact
- Does not seem to know how to play with toys in the usual manner
- Excessively lines up toys or other objects
- Is attached to one particular toy or object
- Does not smile (socially, but may smile during periods of self-stimulatory behavior)
- At times seems to be hearing-impaired
Social symptoms
From the start, typically developing infants are social beings. Early in life, they gaze at people, turn toward voices, grasp
a finger, and even smile. In contrast, most autistic children prefer objects to faces and seem to have tremendous difficulty
learning to engage in the give-and-take of everyday human interaction. Even in the first few months of life, many do not interact
and will avoid eye contact, seeming indifferent to other people.
Autistic children often appear to prefer being alone rather than in the company of others, may resist attention or passively
accept such things as hugs and cuddling without caring. Later, they seldom seek comfort or respond to parents' displays of anger
or affection in a typical way. Research has suggested that although autistic children are attached to their parents, their
expression of this attachment is unusual and difficult to interpret. Parents who looked forward to the joys of cuddling,
teaching, and playing with their child may feel crushed by this lack of the expected and typical attachment behavior.
Autistic children categorically lack 'theory of mind', meaning that they are incapable of behavior cited as exclusive to
higher primates such as adult gorillas, adult chimpanzees, adult bonbonos and children above the age of five. Without the ability
to interpret gestures and facial expressions, the social world may seem bewildering. To compound the problem, people on the
autism spectrum have difficulty seeing things from another person's perspective. Typical 5-year-olds understand that other people
have different knowledge, feelings, and intentions. An autistic person lacks this understanding, an inability that leaves them
unable to predict or understand other people's actions.
Although not universal, it is common for autistic people to have difficulty regulating their behavior. This can take the form
of "immature" behavior such as crying in class or verbal outbursts that seem inappropriate to those around them. The autistic
individual might also be disruptive and physically aggressive at times, making social relationships still more difficult. They
have a tendency to "lose control," particularly when they are in a strange or overwhelming environment, or when angry and
frustrated. They may at times break things, attack others, or hurt themselves. In their frustration, some bang their heads, pull
their hair, or bite their arms.
Imaginary friends
The social alienation of autistic and Asperger's people is so intense from childhood that many of them have imaginary friends as companionship. However, having an imaginary friend is
not necessarily a sign of autism and may be common in neurotypicals.
Communication difficulties
By age 3, typical children have passed predictable milestones on the path to learning language; one of the earliest is
babbling. By the first birthday, a typical toddler says words, turns when he hears his name, points when he wants a toy, and when
offered something distasteful, makes it clear that the answer is "no."
Speech development in autism takes a different developmental path than in neurotypical children. Some autistics remain mute throughout their lives, while being fully literate and able
to communicate in other ways — images, sign language, and typing are far more natural to them. Some infants who later show
signs of autism coo and babble during the first few months of life, but stop soon afterwards. Others may be delayed, developing
language as late as the teenage years. Still, inability to speak does not mean that autistics are unintelligent or unaware. Once
given appropriate accommodations, many will happily "talk" for hours, and can often be found in autism-focused chat rooms, discussion boards, or websites, or even using communication
devices at autism-community social events such as Autreat.
Those who do speak often use language in unusual ways, retaining features of
earlier stages of language development for long periods or throughout their lives. Some speak only single words, while others
repeat the same phrase over and over. Some repeat what they hear, a condition called echolalia. Sing-song repetitions in particular are a calming, joyous activity that many autistic adults engage
in. Many autistics have a strong tonal sense, and can often understand spoken language better if it is sung to them.
Some children may exhibit only slight delays in language, or even seem to have precocious language and unusually large
vocabularies, but have great difficulty in sustaining typical conversations. The "give and take" of conversation is hard for
them, although they often carry on a monologue on a favorite subject, giving no one else an opportunity to comment. When given
the chance to interact with other autistics, they comfortably do so in "parallel monologue" — taking turns expressing views
and information. Just as neurotypicals are not designed to understand autistic body languages, vocal tones, or phraseology,
autistics similarly have trouble with such things in neurotypicals. In particular, autistic language abilities tend to be highly
literal; neurotypicals often inappropriately attribute hidden "meaning" to what autistics say or expect the autistic to sense
such unstated meaning in their own words.
The body language of autistics can be difficult for neurotypicals to understand. Facial expressions, movements, and gestures
may be easily understood by some other autistics, but do not match those used by neurotypicals. Also, their tone of voice has a
much more subtle inflection in reflecting their feelings, and the neurotypical auditory system often cannot sense the fluctuations. What seems to NTs like a high-pitched, sing-song, or
flat, robot-like voice is common. Some children with relatively good language skills speak like little adults, rather than
utilizing the immature "kid-speak" that is common in their neurotypical peers.
Since neurotypicals are often unfamiliar with the autistic body
language, and since autistic natural language may not tend towards speech, autistic people often struggle to let others know
what they need. As anybody might do in such a situation, they may scream in frustration or resort to grabbing what they want.
While waiting for neurotypicals to learn to communicate with them, autistics do whatever they can to get through to them.
Communication difficulties may contribute to autistic people becoming anxious or depressed.
Repetitive behaviors
Although autistics usually appear physically normal and have good muscle control, unusual repetitive motions, known as
self-stimulation or "stimming," may set them apart. These behaviors might be extreme and highly apparent or more subtle. Some
children and older individuals spend a lot of time repeatedly flapping their arms or walking on their toes, others suddenly
freeze in position.
As children, they might spend hours lining up their cars and trains in a certain way,
rather than using them for pretend play. If someone accidentally moves one of these toys, the child may be tremendously upset.
Autistic children often need, and demand, absolute consistency in their environment. A slight change in any routine—in
mealtimes, dressing, taking a bath, or going to school at a certain time and by the same route—can be extremely
disturbing.
Repetitive behavior sometimes takes the form of a persistent, intense
preoccupation. For example, the child might be obsessed with learning all about vacuum cleaners, train schedules, or lighthouses.
Often they show great interest in numbers, symbols, or science topics.
Severity of symptoms
Autism presents in a wide degree, from those who are nearly dysfunctional and apparently mentally
retarded to those whose symptoms are mild or remedied enough to appear unexceptional (normal) to the general public. These
autistic persons are often classified as "nerds" by their peers.
"Low-" and "high-functioning"
In terms of both classification and therapy, autistic individuals are often divided into those with an IQ<80 referred to as having "low-functioning autism" (LFA),
while those with IQ>80 are referred to as having "high functioning autism" (HFA). Low and high functioning are more generally
applied to how well an individual can accomplish activities of daily living, rather than to IQ. The terms low- and
high-functioning are controversial and not all autistics accept these labels.
This discrepancy can lead to confusion among service providers who equate IQ with functioning and may refuse to serve high-IQ
autistic people who are severely compromised in their ability to perform daily living tasks, or may fail to recognize the
intellectual potential of many autistic people who are considered LFA. For example, some professionals refuse to recognize
autistics who can speak or write as being autistic at all, because they still think of autism as a communication disorder.
Asperger's and Kanner's syndrome
In one of the most common misrepresentations of autism, Kanner's syndrome is often described as classical autism, implying
low-functioning, while Asperger's syndrome is described as
a high-functioning form of autism.
In the current Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR),
the most significant difference between Autistic Disorder (Kanner's) and Asperger's syndrome is that a diagnosis of the former
includes the observation of "[d]elays or abnormal functioning in at least one of the following areas, with onset prior to age 3
years: (1) social interaction, (2) language as used in social communication, or (3) symbolic or imaginative play[,]" [1] (http://www.behavenet.com/capsules/disorders/autistic.htm) while in these areas a diagnosis of
Asperger's observes "no clinically significant delay." [2] (http://www.behavenet.com/capsules/disorders/asperger.htm)
The DSM makes no mention of level of intellectual functioning, but the fact that Asperger's autistics as a group tend to
perform better than those with Kanner's autism has fed the popular conception that Asperger's syndrome is synonymous with
"higher functioning autism," or that it is a lesser disorder than autism.
There is also a popular but not necessarily true conception that all autistic individuals with a high level of intellectual
functioning have Asperger's autism or that both types are merely geeks with a medical label
attached.
Autism has evolved in the public understanding, but the popular identification of autism with relatively severe cases as
accurately presented in Rain Man is an encouragement for relatives of family
members diagnosed in the autistic spectrum to speak of their loved ones as having Asperger's syndrome rather than autism.
As of 2003, psychiatric professionals have been considering redefining Asperger's autism and renaming it as Crypto
Sensitivity Syndrome.
Autism as a spectrum disorder
Another view of these disorders is that they are on a continuum known as autistic spectrum disorders. Another related continuum is Sensory Integration Dysfunction, which is
about how well we integrate the information we receive from our senses. Autism, Asperger's syndrome, and Sensory Integration
Dysfunction are all closely related and overlap.
Some high-achieving individuals are thought to have had some form of autism. However, this may be a favoured diagnosis due to
the high current visibility of autism in the popular press.
There are two main manifestations of classical autism, regressive autism and early infantile autism. Early infantile autism is present at birth while regressive autism begins at
approximately 18 months. There are also cases of children developing normally from birth but regressing around the age of 18
months, causing some degree of controversy as to when the neurological difference involved in autism truly began.
Rare autism spectrum disorders
Rett syndrome
Rett syndrome is relatively rare, affecting almost exclusively
females, one out of 10,000 to 15,000. After a period of normal development, sometime between 6 and 18 months, autism-like
symptoms begin to appear. The little girl's mental and social development regresses; she no longer responds to her parents and
pulls away from any social contact. If she has been talking, she stops; she cannot control her feet; she wrings her hands. Some
of the problems associated with Rett syndrome can be treated. Physical, occupational, and speech therapy can help with problems
of coordination, movement, and speech.
Scientists sponsored by the National Institute of Child Health and Human Development have discovered that a mutation in the
sequence of a single gene can cause Rett syndrome. This discovery may help doctors slow or stop the progress of the syndrome. It
may also lead to methods of screening for Rett syndrome, thus enabling
doctors to start treating these children much sooner, and improving the quality of life
these children experience.
Childhood disintegrative disorder
Very few children who have an autism spectrum disorder diagnosis meet the criteria for childhood disintegrative disorder (CDD).
An estimate based on four surveys of ASD found fewer than two children per 100,000 with ASD could be classified as having CDD.
This suggests that CDD is a very rare form of ASD. It has a strong male preponderance.** Symptoms may appear by age 2, but the
average age of onset is between 3 and 4 years. Until this time, the child has age-appropriate skills in communication and social
relationships. The long period of normal development before regression helps differentiate CDD from Rett syndrome.
*Rett syndrome. NIH Publication No. 01-4960. Rockville, MD: National Institute of Child Health and Human Development,
2001. Available at [3] (http://www.nichd.nih.gov/publications/pubskey.cfm?from=autism)
**Frombonne E. Prevalence of childhood disintegrative disorder. Autism, 2002; 6 (2): 149-157.
***Volkmar RM and Rutter M. Childhood disintegrative disorder: Results of the DSM-IV autism field trial. Journal of the
American Academy of Child and Adolescent Psychiatry, 1995; 34: 1092-1095.
Increase in diagnoses of autism
There has been an explosion worldwide in reported cases of autism over the last ten years. In the last decade, the population
of the United States has increased by 13%. There has been an increase in non-autism-related disabilities of 16%. The increase in
autism is 173%.
There has been considerable speculation as to why this might be, with no conclusive proof emerging around any theory.
Epidemiologists argue that the rise is either partly or entirely attributable to changes in diagnostic criteria,
reclassifications, public awareness, and the incentive to tap into federally mandated services.
A widely cited study from the M.I.N.D. Institute in California (Oct 17, 2002), concluded that the increase is real, even after those
complicating factors are accounted for (see reference in this section below).
Other researchers remain unconvinced (see references below), including Dr. Chris Johnson, a professor of pediatrics at the
University of Texas Health Sciences Center at San Antonio and co-chair of the American Academy of Pediatrics Autism Expert Panel,
who says, “There is a chance we’re seeing a true rise, but right now I don’t think anybody can answer that
question for sure.” (Newsweek reference below).
The answer to this question has significant ramifications on the direction of research, since a real increase would focus more
attention (and research funding) on the search for environmental factors, while a consensus for little or no real increase would
direct more attention to genetics.
- Wing L, Potter D. (2002) "The epidemiology of autistic spectrum disorders: is the prevalence rising?". Mental Retardation
and Developmental Disabilities Research Reviews 8 (3), 151–61. (abstract
(http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12216059&dopt=Abstract))
- Croen LA, Grether JK, Hoogstrate J, Selvin S. (2002 Jun) "The changing prevalence of autism in California". Journal of
Autism and Developmental Disorders 32 (3), 207-15. (abstract
(http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=12108622))
In 2001, Wired Magazine
published an interesting speculative article The Geek Syndrome (http://www.wired.com/wired/archive/9.12/aspergers_pr.html) exploring the surge in
apparent autism in Silicon Valley. This is only one example of the media's application of mental disease labels to what is
actually variant normal behavior. Shyness, lack of athletic ability or social skills, and intellectual interests, even when they
seem unusual to others, are not in themselves signs of autism or Asperger's syndrome.
Remediation of autistic behaviors
Remediation of the debilitating aspects of autism is hindered by widespread disagreement over its nature and causes, and by a
lack of recognized and effective therapies.
Dr. Bruno Bettelheim believed that autism was linked to trauma
in early childhood, and his work was highly influential for decades. Parents, and especially mothers, of autistics were blamed
for having caused their child's condition through the withholding of affection. Leo
Kanner, who first described autism (Autistic disturbances of affective contact, 1943) originated the "refrigerator mother" hypothesis, which held that autism was at least partly caused by a lack of
affection from the autistic child's mother. Although Kanner eventually renounced the concept and apologized publicly, Bettelheim
took the theory further. These theories did nothing to address the fact that having more than one autistic child in a family is
exceptional, not the rule. Treatments based on these theories failed to help autistic children.
Applied Behavior Analysis
A major breakthrough in the remediation of autistic behaviors came through work spearheaded by Ole Ivar Lovaas, who believed that success could be obtained by behavioral approaches.
- Lovaas' approaches—often referred to as Discrete Trial, Intensive Behavior Intervention, and Applied Behavior
Analysis—are some of the best known and most widely used in the field and focus on the development of attention, imitation,
receptive or expressive language, and pre-academic and self-help skills. Using a one-to-one therapist-child ratio and the
“antecedent-behavior-consequence” (ABC) model, interventions based on this work involve trials or tasks. Each
consists of (a) an antecedent, which is a directive or request for the child to perform an action; (b) a behavior, or response
from the child, which may be categorized as successful performance, noncompliance, or no response; and (c) a consequence, defined
as the reaction from the therapist, which ranges from strong positive reinforcement to a strong negative response,
“No!”(Autism Society of America, 2001).[4] (http://www.aann.org/ce/jnn04-02b.htm)
Lovaas' Applied Behavioral Analysis (ABA) methods were the first scientifically validated therapy for autism. Early
intervention, generally before school-age, is critical for children who would benefit from these programs.
The scientific validity of Lovaas's methods is questioned by many professionals as well as parents and autistics themselves,
however, who point out that true ABA is based around the use of aversives which
could be experienced by an autistic person as confusing and painful [5] (http://www.sentex.net/~nexus23/naa_aba.html). Nevertheless, some believe that ethical reasons
exist for applying Lovaas's techniques. Some behaviorist programs for autistics employ no aversives at all and do not attempt to
"extinguish" behaviors such as rocking or spinning which autistics use for calming purposes.
ABA may not be appropriate for every autistic or developmentally delayed child. ABA has come into widespread use only in the
last decade and the demand is outstripping the supply of committed and experienced service providers. As a result, parents of
children need to be extra vigilant in choosing appropriate treatments for their children and especially in choosing
providers, who may be inexperienced, use questionable methods or even deceive parents that they are competent to run an ABA or
any other program. Such problems have led to horror stories from some parents. [6] (http://users.1st.net/cibra/OpenLetter.htm)
[7] (http://users.1st.net/cibra/warningindex.htm)
Relationship Development Intervention
Relationship Development
Intervention (RDI) is a research-based treatment program developed by Dr. Steven E. Gutstein. Whereas ABA aims to teach
social skills directly, RDI focuses on building the "dynamic intelligence" that underlies the acquisition of those social skills
in neurotypical children. It also focuses on the building blocks of motivation by developing episodic memory (seen as impaired in
autism) and filling it with the child's own personal stories of competence and mastery. RDI emphasizes declarative (as opposed to
imperative) communication, and aims for an appropriate balance of verbal and non-verbal communication.
Dr. Gutstein claims that 70% of his patients improved their ADOS score within 18 months, which is unprecedented (it was
previously thought that improvement on the ADOS was impossible), and that a similar proportion are able to enter school without a
shadow teacher or other personal assistant.
Son-Rise
The Son-Rise program was developed by Barry Kaufman, who founded the Option Institute to promulgate his more general philosophy upon which the
Son-Rise program is partially based, and to provide training in this treatment approach. It is a home-based program with emphasis
on observing, accepting the child without judgement, and engaging the child in a non-coercive way. The Association for Science in Autism Treatment
(ASAT)maintains (http://www.asatonline.org) a Description of the Son-Rise Program (http://www.asatonline.org/about_autism/autism_info13.html).
Autism and computing
Computers can be an ideal environment for promoting communication, sociabilility, creativity, and playfulness for individuals
even at the extreme of the autistic spectrum. This is the opinion of the non-profit group Autism and Computing. They argue
that the central feature of autism is attention-tunneling, or monotropism. Computers would afford an easy way of joining
attention tunnels with minimal mutual discomfort, circumventing some of the most disabling features of autistic spectrum
disorders. The potential for computer use in treating autism would not just be educational but therapeutic. The group presents
both theory and practice on its website Autism and Computing (http://www.autismandcomputing.org.uk/NAS/index.htm).
Gluten free casein free diet
Dr. Karl Ludwig
Reichelt claims to have found peptides from casein and gluten that worsen the symptoms of autistic children. The peptides are casomorphines and gluten exorphines, which influence the brain. According to Dr. Reichelt, significant improvement has been seen in the
symptoms of autistic children on a diet that omits these peptides.
Autistic savants
The autistic savant phenomenon is sometimes seen in
autistic people. The term is used to describe a person who is autistic who has extreme talent in a certain area of study.
Although there is a common association between savants and autism (an association created by the 1988 film "Rain Man"), many autistic people are not savants. Calendar calculators and fast programming skills are the
most common form. Some famous examples are Daniel Tammet, the subject of the documentary
film The Brain Man [8] (http://www.guardian.co.uk/weekend/story/0,3605,1409903,00.html) and Kim Peek, the inspiration for Dustin Hoffman's
character in the film Rain Man.
Causes of autism theories
Brain testosterone theory
Simon Baron-Cohen's team at the Autism Research Centre
in Cambridge, UK, measured testosterone levels in the amniotic fluid of mothers while pregnant. This is presumed to reflect
levels in the babies themselves. The team found that the babies with higher fetal testosterone levels had a smaller vocabulary
and made eye contact less often when they were a year old.
His group has looked at the original 58 children again, at age four. The researchers found that the children with higher
testosterone in the womb are less developed socially, and the interests of boys are more restricted than girls. The results will
be published in the Journal of Child Psychology and Psychiatry (2004).
Baron-Cohen theorizes that high fetal testosterone levels push brain development towards an improved ability to see patterns
and analyse systems. Males supposedly tend to be better at these tasks than females. But the high levels are thought to inhibit
the development of communication and empathy, which are allegedly typical female skills. (New Scientist, 24 May 2003). There is
still no demonstrable evidence that testosterone levels affect brain development at all, let alone autism. Gender or
bio-determinism is a fashionable explanation for many human behaviours, but has been challenged by
other professionals (http://www.gender.org.uk/about/00_diffs.htm).
Vaccine theory
Research by Andrew
Wakefield in the UK, published in The Lancet in February 1998 suggested a possible link between autism and the MMR vaccine. This was very controversial. Subsequent studies failed to confirm the link, and some in fact
showed a lack of such a link. The original research has come under criticism, largely due to a conflict of interest on
Wakefield's part. In February 2004 The Lancet described the research as "entirely flawed" and said that it should never have been
published. Controversy continues, with Wakefield defending his integrity.
Critics with statistical skills have claimed that Andrew Wakefield was, and still is, severely incompetent in statistics and failed to recognize the
extreme bias of his sample among other obvious flaws. Wakefield's nonscientific study and its continuing circulation in autism
societies is sometimes depicted by the media as a "proof" no autism-vaccine connection exists and "it's 100% hype", a position
that wasn't proven either (even if most cases are not MMR or vaccine related).
Research in the US suggesting a similar link between autism and DPT
vaccine. It isn't however the large majority of autism that would come from vaccines, unlike early claims from Wakefield.
Brain trauma
Susan Bryson has said that some
autistics have evidence of trauma to the brain stem in early development, and that a small portion of the thalidomide victims have become autistic. The victims' limbs were normal unless
thalidomide use continued later in the pregnancy. The brain stem anomaly's most striking feature is inability to focus attention
away from a stimulus in a short time like neurotypicals, as demonstrated in a psychological test.
Neurology-skilled Aspies claim the inability to shift attention quickly interferes with the ability to read nonverbal language
where fast attention shifts are needed (such as eye language), suggesting that being nonverbal is not a primary feature of
autism. Strong and shiftless focus is however a benefit in some areas like science,
programming, and advanced mathematics. This is supported by the monotropism
hypothesis.
Dr. Bernard Rimland's
influential research and his book Infantile Autism (1967) argued that autism was not
caused by childhood trauma or abuse, but by damage to certain areas of the brain, particularly the reticular formation which
associates present sensory input with memories of past experiences. Dr. Rimland is a foremost advocate of the theory that autism
may be precipitated by mercury and heavy metal toxicity.[9] (http://www.curezone.com/art/read.asp?ID=79&db=2&C0=735) He also is prominent in
increasingly common claims of successful treatment of autism in children—particularly regarding improvements in ability to
comprehend the spoken word—with the gluten-free, casein-free diet and mercury chelation therapy.
Neurobiology-skilled Aspies have often claimed Dr. Bernard Rimland's methods cure heavy metal poisoning, but not autism. Curing heavy metal poisoning
when it is present is a worthy goal (it helps with IQ and other learning difficulties as well as general health), but claiming a
cure for autism is a misrepresentation. Heavy metal poisoning may be more common among autistics due to a severe metallothionein deficiency, but heavy metals don't cause autism. They might
make you more likely to get an autism diagnosis, though.
Adults with an autism spectrum disorder
Some autistic adults, especially those with high-functioning autism or with Asperger's syndrome, are able to work successfully
in mainstream jobs (though many are unemployed). Nevertheless, communication and social problems often cause difficulties in many
areas of life.
Many other autistics are capable of employment in sheltered workshops under the supervision of managers trained in working
with persons with disabilities. A nurturing environment at home, at school, and later in job training and at work, helps autistic
people continue to learn and to develop throughout their lives.
In the United States, the public schools' responsibility for providing services ends when the autistic person is in their 20s,
depending on each state. The family is then faced with the challenge of finding living arrangements and employment to match the
particular needs of their adult child, as well as the programs and facilities that can provide support services to achieve these
goals.
Biographies of autistic adults
Both Oliver Sacks and Torey Hayden have written about their autistic patients or pupils, respectively. Temple Grandin has also written about her own life as a person with autism.
Donna Williams in her books, including Autism: an inside-out
approach (ISBN 1-85302-387-6),
gives an interesting perspective on the experience of a person with autism and the degree to which recovery is possible. Many
other people who have autism have written books on the condition (and on other topics).
Proposed models of autism
The causes and origins of autism and Asperger's syndrome
are a source of continuing conjecture and debate. Amongst several competing theories are the underconnectivity theory (http://www.cmu.edu/PR/releases04/040727_autism.html) developed by cognitive scientists at
Carnegie Mellon University and the University of Pittsburgh, the Neanderthal
theory (http://www.rdos.net/eng/asperger.htm), the extreme male brain
theory by Simon Baron Cohen, the lack of theory of mind, and
the Preoperational-autism theory.
The extreme male brain theory
The idea of the extreme male brain theory is that people with autism are simply overly male. This would seem to explain why
autism strikes males more than females. It is believed that high testosterone levels during pregnency cause the brain to develop
differently. According to this theory, female brains tend more towards being empathetic and more socially oriented, whereas male
brains tend more towards being task oriented.
The Preoperational-Autism Theory
The Preoperational-Autism theory states that autistic people are those who get neurologically
stuck at the pre-operational stage of cognitive development, where much of information processing is at a wholistic-visual level
and largely musical and non-verbal. This also addresses the issue of the theory of mind where children at the pre-operational
stage of cognitive development have not attained decentralization from egocentrism.
The Neanderthal Theory
The Neanderthal
Theory is that autism and other psychiatric conditions evolved from interbreeding between Homo Sapiens and Neanderthals. This interbreeding is
believed to have caused genetic material from the Neanderthals to enter the Homo Sapiens genome. It is disputed whether such
interbreeding has occurred, however.
Monotropism
The monotropism hypothesis argues that the central feature of autism is
attention-tunneling, or monotropism. The hypothesis is founded on the model Mind as a
Dynamical System: Implications for Autism (http://www.autismandcomputing.org.uk/mind.htm). In this model of mind, the fundamental and
limited resource is mental attention. Mental events compete for and consume attention. In a polytropic mind, many interests are
aroused to a moderate degree. In a monotropic mind, few interests are very highly aroused. When many interests are aroused,
multiple complex behaviours emerge. When few interests are aroused, a few intensely motivated behaviours are engendered. From
monotropism hypothesis, autism results from different strategies of distributing attention in the brain.
Underconnectivity Theory
The underconnectivity theory indicates a deficiency in the coordination among brain areas (the
brain is known to be modular). With the aid of (fMRI), it was seen that white matter, which connects various areas of the brain like cables, has abnormalities in
people with autism.
The underconnectivity theory holds that autism is a system-wide brain disorder that limits the coordination and integration
among brain areas. This theory is parsimonious, in that it explains why autistic people are matured on certain dimensions eg:
visual information processing and logical analysis, and yet are socially and sometimes neuro-physiologically, significantly
younger than their chronological age. The underconnectivity theory can be regarded as monotropism in the brain.
Mindblindness theory
The analysis of autism as "mind blindness"—the inability to create models of other people's thoughts. The typical
example of this is "where does X look for the object they stored, but which was moved by Y"—see theory of mind. Not all autistics fit this pattern, however.
Other Theories
Other theories address the rise of autism in recent times. They suggests the rise of visual media and thereby the increasing
central role of visual information processing in the breakdown of language and the rise of autism.
Aspies for freedom
In August 2004, a Wiki was started at Aspiesforfreedom (http://www.aspiesforfreedom.com/pac/index.php/Main_Page) (or AFF). Its aim is to be an
Autism Encyclopedia, and indeed some content has been copied from
Wikipedia. One of the core differences, however, is that all articles are written
from an autistic point of view. Another difference is the room for personal experiences. Aspies For Freedom uses the same
Mediawiki software as Wikipedia.
See AFF's article on Autism (http://www.aspiesforfreedom.com/pac/index.php/Autism).
Major autism events
2002 was declared Autism Awareness Year in the United Kingdom
- this idea was initiated by Ivan and Charika Corea,
parents of an autistic child, Charin. Autism Awareness Year was led by the British Institute of Brain Injured Children, Disabilities Trust, National Autistic Society, Autism London and 800 organizations in
the United Kingdom. It had the personal backing of the British Prime Minister
Tony Blair and parliamentarians of all parties in the Palace of Westminster.
Autistic Pride Day, an initiative from Aspies For Freedom, is on 18
June each year, starting in 2005. It is to celebrate the positive side of being autistic and having Asperger's, to raise
awareness of issues relating to autism, and to seek acceptance for differences, with an aim to bring an end to discrimination. It is hoped that events will be held worldwide, such as
parades, marches, and parties.
External links
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