The Good, the Bad and the Mystery in Autism

From Dr. Sarita Freeman, Ph.D. Psychologist specializing in developmental disabilities: Although autism is a diagnosis and a “disorder” (whatever that means), it’s important not to consider it a “pathological condition.” In fact, some of those previously undiagnosed individuals that appear to have had behaviors consistent with a current dx of autism include geniuses, scientists, brilliant mathematicians, politicians, computer designers, etc., and are likely to have been responsible for the many technological advances and comforts that we non-autistic individuals now take for granted. This has been the most recent discussion and debate in the field related to the possibility of being able to identify autism in utero and what could happen as a result of the gradual genetic “weeding out” of these great minds. From my experience working with children and adults on the spectrum, they are very interesting individuals, their “take” on the world is unique, refreshing, and really can make you think. Do they struggle? Yes. Is that a reason to label them pathological? Hardly…most of them wouldn’t hurt a fly, and they would be the most loyal of friends you would could ever have if you allowed them into your circle. From my vantage point, if they get the appropriate interventions from early-on (the earlier the better), many can go to college and become contributing members of our society.
In terms of the autism dialogue: What we have learned about Autism over the last 15 years of research is that it is a neurobiological disorder. It is not an attachment disorder and is not related to being left at daycare. Although the rates in CA appear to be somewhat higher than in other places, there are other pockets in this country (New Jersey, for example), where rates are higher as well. But the most current statistics from the CDC of 1 in 150 are accurate throughout the world, and daycare is not utilized to the same degree worldwide. In addition to genetics, there is a great deal of ongoing research in the field looking at environmental triggers that may be unleashing a genetic predisposition in particular children.
Recent reports of an extremely high incidence of autism being diagnosed in children from Somali families living in the U.S. (1 in 14? but don’t quote me on that), has been fodder for the surge in research looking at environmental factors. Another recent set of studies have identified that exposure to higher levels of testosterone in utero may be responsible for at least some cases of autism. The genetic research thus far has shown that, in fact, autism is a highly heritable and genetic disorder. Identical twins have a significantly higher incidence of having autism spectrum disorders when one of the twins has it, than in the general population. Siblings of children with autism have a higher incidence of language delays and/or learning disabilities and/or autism. If you already have a child with autism, your risks of having another one are significantly higher than in the general population (I think it’s 25%, but again, don’t quote me on that). In interviewing the families of children or adults with a confirmed diagnosis of autism by an autism expert using gold standard methods, we find in most cases a strong history of other family members, including one of the individual’s parents, cousins, nieces, nephews, long lost uncles, etc., who either have had a confirmed dx of autism, or were always somewhat “off” and exhibited by observation, symptoms that could be consistent with ASD.
Although better diagnosis can account for some of the rise in cases, it’s not the only reason. That being said, it’s important to remember that previously we didn’t even consider the possibility that people who were “high functioning” (i.e., IQ within normal range) could be diagnosed with any kind of autism until Asperger’s Disorder appeared in the DSM-IV in 1994. So, the possibility that anyone could have a diagnosis of autism who did not present with behaviors that were at minimum consistent with what we saw in the movie Rain Man, did not exist until 1994.
If you’re really interested in learning about adults with autism spectrum disorders who are on the speakers circuit, google Temple Grandin, Stephen Shore, Jerry Newport, or go to http://www.autismhangout.com to hear podcasts where some of these people talk about their lives and experiences. Mozart and the Whale is a movie that was modeled after Jerry Newport and his wife, who both have autism. [Sarita Freedman, PhD, Licensed Psychologist, Adults and Children
Developmental Disabilities, 26540 Agoura Road, Suite 100, Calabasas, CA 91302, (818) 999-9330, sfreedmanphd@sbcglobal.net ]

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