When Gibson Brown learned how to put on his socks, his mother was ecstatic. Watching her autistic son develop, she says, is a lot like "watching grass grow." Such a step was almost like an entire tree had shot from the earth.
Until, that is, she went over to her sister's house and watched, stunned, as her niece — younger than her own son — put on her socks, shoes and jacket in a snap.
"I think, 'Oh my gosh,'" Katrina Brown says, recalling her shattered enthusiasm.
For the parents of an autistic child, such comparisons can be dangerous. No one knows this better than the teachers at the Croyden Avenue School in Kalamazoo, Mich. Each day is filled with tiny steps and tons of repetition. Progress comes on many scales.
Croyden is also a rather unusual place in that it's a public school that offers one-on-one intensive counseling for autistic children. Done privately, such therapy could cost families up to $100,000 a year.
On a recent morning, Katrina Brown is filled with many hopes and fears as she drops her son off at Croyden.
"He will do smart things," she says. "He figures things out on his own. It's not that I expect an Einstein or whatever. It just makes me really worried when I see how far he still has to go."
The school is prepared for children facing a unique set of hurdles. The classroom is filled with nearly soundproof cubicles to minimize visual and verbal distractions. Children are encouraged to play before starting on work to get to know their environment.
Many of the children aren't talking when they arrive at school. The earlier they learn to speak — rather than use behaviors to convey what they want — the better, says Angela Telfer, the principal of the school.
"If you can imagine going though life not understanding what people are saying to you and not being able to communicate how you are feeling, it can be a really scary place," she says. "It almost seems like you are dropped in a foreign land."
Teachers focus on small steps and try to develop lesson plans that take into consideration each child's strengths, weaknesses, likes and dislikes.
Gibson, for example, is drawn to the toy train, so his teacher frequently uses this as a tool.
Katrina Brown is learning to accept that progress is relative.
"I am learning to just appreciate him for who he is and the miracle he is ... he's really had to work so hard. So when you think about it that way, he is doing pretty good."
Thursday, January 15, 2009
Autism Reveals Social Roots of Language
People with autism often struggle to learn language, and they also struggle with personal relationships.
Scientists say that's probably not a coincidence.
There's growing evidence that language depends as much on the brain circuits that help us navigate a cocktail party as those that conjugate verbs.
One of the people who believes that evidence is Temple Grandin. She teaches animal science at Colorado State University and has written several best-selling books. She's also autistic.
Grandin says it has taken her most of her life to reach the point where she can speak with other people in a way that sounds natural. She says that's because she's had to learn language without the social abilities most people have.
Grandin didn't begin speaking until she was 3 ½ years old. Her first words referred to things, not people, she says.
"I'd point at something that I wanted, you know like a piece of candy or whatever, and say, 'there,'" Grandin says.
She wasn't using language to reach out to her parents or to other children, the way most kids do, so she didn't have the same motivation to talk.
A Tool for Information, or Attention?
When Grandin finally did become interested in words, it was because they provided a way to get information, not attention.
"When I was in third grade, I had trouble with reading, so mother taught me how to read," she says. It opened up a world full of "so many interesting things," she recalls: "I used to like to get the World Book Encyclopedia and read it."
But the encyclopedia taught her little about using language to make friends. Even when she got to high school, chit-chat and gossip meant nothing to her.
She says that made her teenage years the worst part of her life. "Kids teased me, called me tape recorder because when I talked it was kind of like just using the same phrases."
She also kept talking, without letting other people respond.
Grandin and many others with autism have no problem with the mechanics of language, says Dr. V.S. Ramachandran, a neuroscientist at University of California, San Diego. But they don't understand what's really going on in many conversations.
"That's one of the hallmarks of autism," he says, "difficulty with social interaction, manifest both in spoken language and in just lack of empathy. The ability to understand other minds would be one way of describing it."
The Role of Mind Reading
Ramachandran says it's hard to use language if you don't have any idea what someone else is thinking and feeling.
That may seem obvious. But in the past, researchers have treated language as if it were primarily a system of rules. They assumed that people spoke because every human brain came pre-wired with a "universal grammar."
Now, a growing number of researchers, including Ramachandran, argue that the social and emotional aspects of language are at least as important as the rules for stringing words together.
Emotional Neurons
Ramachandran says one reason for the new thinking is a new understanding of the human brain. He says it's become clear that babies' brains are programmed to imitate.
"You stick your tongue out at a newborn baby, very often the newborn baby will stick its tongue out," he says.
Similarly, babies return smiles and often make sounds when someone speaks to them.
A few years ago, scientists found a biological explanation for this phenomenon: specialized brain cells called mirror neurons.
These neurons fire when you do things such as sticking your tongue out. They also fire when you watch someone else stick their tongue out.
And mirror neurons can reflect emotions as well as physical actions. Experiments show that some of the same cells that fire when we feel pain also fire when we see another person in pain.
But people with autism appear to have faulty mirror neurons. That may be why they have trouble putting themselves in someone else's shoes. And Ramachandran says without that ability, a lot of what you can accomplish with language disappears.
"You have to be aware of the effects that your words are having on the other person's mind," he says. Otherwise, how could we use words to manipulate other people?
Picking Up Non-Verbal Cues
Temple Grandin has learned to compensate for her difficulty.
Early in her career, she spoke to people on the phone instead of face to face. That way she didn't miss messages conveyed through eye contact or body language.
But even on the phone, people may not say what they mean. The phrase "I'm fine" sometimes means just the opposite.
So Grandin taught herself to listen very closely to a person's tone of voice.
"When I had a client that I thought might be angry with me, I'd call him up just so I could listen to his voice," she says. "If it had a certain little whine sound in it I'd go, 'Oh he's still angry with me.'"
Over time, Grandin has developed a catalogue of signals she uses to figure out what people are thinking. She checks to see if they are fidgeting during a lecture, or making eye contact during a conversation, or folding their arms during an argument -- emotional cues most of us register automatically.
"I always keep learning," Grandin says. "People ask for the single magic breakthrough. There isn't one. I keep learning every day how I think and feel is different. It's all through logic, trial and error, intellect."
Intellect can only take her so far, though. Grandin says she still has trouble with certain types of conversations.
"Just a couple of years ago I went out to dinner with some salesmen, and these people were absolutely totally social," she says. "They talked for three hours about sports-themed nothing. There was no informational content in what they were talking about. It was a lot of silly jokes about the color of medication and the color of different team mascots. It was boring for me."
Social Motivation for Language
The salesmen were using language as a way of bonding with one another -- not a way to share information. Scientists say this sort of behavior may explain how humans developed language in the first place.
Bonding is something most animals do. For example, apes bond by grooming each other. And one theory has it that early humans began to augment their grooming with affectionate gestures and sounds that eventually led to primitive language.
Ramachandran says there are some gaps in that hypothesis. Like how people got from grunts to grammar.
"The difficult part is to try to disentangle the notion that emotional empathy merely gives you motivation, a reason to talk to somebody, versus an absolutely critical role in the emergence of language," he says.
Ramachandran suspects it's the latter because empathy is what allows people to understand the intention behind an action or a phrase.
For example, he says, when we see someone reach for a peanut, empathy helps us decide if they intend to eat it, or throw it at us. And when we hear someone use a string of words, empathy tells us whether to take the words literally or figuratively.
Ramachandran says people who lack empathy also lack the ability to read another person's intentions -- whether physical or linguistic.
"Not only do they have problems understanding an action like reaching for a peanut," he says, "but also a metaphor like reaching for the stars."
Grandin doesn't use metaphors very often, even though she has mastered the mechanics of language. Grandin says she will never fully understand the social aspects of language, including other people's intentions. And that means language will never offer her more than a rough translation of what other people are trying to say.
Scientists say that's probably not a coincidence.
There's growing evidence that language depends as much on the brain circuits that help us navigate a cocktail party as those that conjugate verbs.
One of the people who believes that evidence is Temple Grandin. She teaches animal science at Colorado State University and has written several best-selling books. She's also autistic.
Grandin says it has taken her most of her life to reach the point where she can speak with other people in a way that sounds natural. She says that's because she's had to learn language without the social abilities most people have.
Grandin didn't begin speaking until she was 3 ½ years old. Her first words referred to things, not people, she says.
"I'd point at something that I wanted, you know like a piece of candy or whatever, and say, 'there,'" Grandin says.
She wasn't using language to reach out to her parents or to other children, the way most kids do, so she didn't have the same motivation to talk.
A Tool for Information, or Attention?
When Grandin finally did become interested in words, it was because they provided a way to get information, not attention.
"When I was in third grade, I had trouble with reading, so mother taught me how to read," she says. It opened up a world full of "so many interesting things," she recalls: "I used to like to get the World Book Encyclopedia and read it."
But the encyclopedia taught her little about using language to make friends. Even when she got to high school, chit-chat and gossip meant nothing to her.
She says that made her teenage years the worst part of her life. "Kids teased me, called me tape recorder because when I talked it was kind of like just using the same phrases."
She also kept talking, without letting other people respond.
Grandin and many others with autism have no problem with the mechanics of language, says Dr. V.S. Ramachandran, a neuroscientist at University of California, San Diego. But they don't understand what's really going on in many conversations.
"That's one of the hallmarks of autism," he says, "difficulty with social interaction, manifest both in spoken language and in just lack of empathy. The ability to understand other minds would be one way of describing it."
The Role of Mind Reading
Ramachandran says it's hard to use language if you don't have any idea what someone else is thinking and feeling.
That may seem obvious. But in the past, researchers have treated language as if it were primarily a system of rules. They assumed that people spoke because every human brain came pre-wired with a "universal grammar."
Now, a growing number of researchers, including Ramachandran, argue that the social and emotional aspects of language are at least as important as the rules for stringing words together.
Emotional Neurons
Ramachandran says one reason for the new thinking is a new understanding of the human brain. He says it's become clear that babies' brains are programmed to imitate.
"You stick your tongue out at a newborn baby, very often the newborn baby will stick its tongue out," he says.
Similarly, babies return smiles and often make sounds when someone speaks to them.
A few years ago, scientists found a biological explanation for this phenomenon: specialized brain cells called mirror neurons.
These neurons fire when you do things such as sticking your tongue out. They also fire when you watch someone else stick their tongue out.
And mirror neurons can reflect emotions as well as physical actions. Experiments show that some of the same cells that fire when we feel pain also fire when we see another person in pain.
But people with autism appear to have faulty mirror neurons. That may be why they have trouble putting themselves in someone else's shoes. And Ramachandran says without that ability, a lot of what you can accomplish with language disappears.
"You have to be aware of the effects that your words are having on the other person's mind," he says. Otherwise, how could we use words to manipulate other people?
Picking Up Non-Verbal Cues
Temple Grandin has learned to compensate for her difficulty.
Early in her career, she spoke to people on the phone instead of face to face. That way she didn't miss messages conveyed through eye contact or body language.
But even on the phone, people may not say what they mean. The phrase "I'm fine" sometimes means just the opposite.
So Grandin taught herself to listen very closely to a person's tone of voice.
"When I had a client that I thought might be angry with me, I'd call him up just so I could listen to his voice," she says. "If it had a certain little whine sound in it I'd go, 'Oh he's still angry with me.'"
Over time, Grandin has developed a catalogue of signals she uses to figure out what people are thinking. She checks to see if they are fidgeting during a lecture, or making eye contact during a conversation, or folding their arms during an argument -- emotional cues most of us register automatically.
"I always keep learning," Grandin says. "People ask for the single magic breakthrough. There isn't one. I keep learning every day how I think and feel is different. It's all through logic, trial and error, intellect."
Intellect can only take her so far, though. Grandin says she still has trouble with certain types of conversations.
"Just a couple of years ago I went out to dinner with some salesmen, and these people were absolutely totally social," she says. "They talked for three hours about sports-themed nothing. There was no informational content in what they were talking about. It was a lot of silly jokes about the color of medication and the color of different team mascots. It was boring for me."
Social Motivation for Language
The salesmen were using language as a way of bonding with one another -- not a way to share information. Scientists say this sort of behavior may explain how humans developed language in the first place.
Bonding is something most animals do. For example, apes bond by grooming each other. And one theory has it that early humans began to augment their grooming with affectionate gestures and sounds that eventually led to primitive language.
Ramachandran says there are some gaps in that hypothesis. Like how people got from grunts to grammar.
"The difficult part is to try to disentangle the notion that emotional empathy merely gives you motivation, a reason to talk to somebody, versus an absolutely critical role in the emergence of language," he says.
Ramachandran suspects it's the latter because empathy is what allows people to understand the intention behind an action or a phrase.
For example, he says, when we see someone reach for a peanut, empathy helps us decide if they intend to eat it, or throw it at us. And when we hear someone use a string of words, empathy tells us whether to take the words literally or figuratively.
Ramachandran says people who lack empathy also lack the ability to read another person's intentions -- whether physical or linguistic.
"Not only do they have problems understanding an action like reaching for a peanut," he says, "but also a metaphor like reaching for the stars."
Grandin doesn't use metaphors very often, even though she has mastered the mechanics of language. Grandin says she will never fully understand the social aspects of language, including other people's intentions. And that means language will never offer her more than a rough translation of what other people are trying to say.
Wednesday, January 14, 2009
Teen helps ‘parent' younger, autistic siblings
MINNEAPOLIS -- As a freshman in high school seeking volunteer hours, Abbey Davison applied to work one night a week with Lucy and Jacob Schneider, two Brooklyn Park, Minn., siblings with autism. She was prepared for tough questions, and tough questions she got: What did she know about autism? "Not much, but let's give it a try!" she said. What activities might she do with Lucy and Jacob, then 2 and 3? "Play outside when we could," she answered. "Color, work on social skills." Most important, why did Davison want to work with Lucy and Jacob? "I love kids!" she said.
She got the job. What she wasn't prepared for was the griller himself: Lucy and Jacob's older brother, Luke, then age 9.
"Luke had a questionnaire for me," Davison recalled with admiration. "He watches out for them, supports them, plays with them. They depend on him." Now 21 and studying occupational therapy at the College of St. Catherine, Davison remains close to the Schneider family, still going to the house weekly to help out. Her respect for Luke, who will be 15 in two weeks, has only grown. "It's different for a 14-year-old to be like that."
It's a new year so here's a new idea: a household without sibling rivalry. Luke Schneider simply doesn't have time for it.
Luke was 8 years old in 2002 when 2-year-old Jacob had tubes placed in his ears because he wasn't responding to the world around him. His parents, Mary and Steve, feared he was deaf. Instead, he was diagnosed with severe autism which was later changed to moderate. Mary recalls "so many people" encircling the family in their living room to explain the diagnosis. All she wanted to know was, "Will he ever say, 'I love you'? Will he graduate from high school?" Seven months later, 1-year-old Lucy also was diagnosed with autism. Luke remembers his parents telling him that "life was going to be different from now on," he said. "Their brains are a little different and they can't always understand what you're saying."
That helped Luke understand why his little brother didn't interact "normally" with him, running away, avoiding eye contact, not knowing that when someone says "Hi" to you, you say "Hi" back. But even early on there were victories. "I was so happy when he learned to play hide-and-seek with me," Luke said of Jacob. He learned how to help Lucy, too, finding her blanket, pouring her orange juice and making her peanut butter sandwiches. "They're like a couple of old people," Luke said. "You have to repeat yourself a lot."
ONLINE SCHOOL OFFERS FLEXIBILITY
Luke is a bit of an old soul himself. He is smart, polite, soft-spoken, a self-professed computer geek. He didn't care much for the "distractions" of a typical high school, which led him to enroll full time this year at Insight School of Minnesota, a fully accredited online high school administered by the Brooklyn Center School District. Luke attends school at the computer in his bedroom from about 9 a.m. to 4 p.m., pulling A's and B's in classes such as English Literature, Algebra One and World History.
His teachers describe him as responsible, disciplined and curious, a perfect candidate for online high school. Science teacher Angela Tingey advises the NASA club and said that Luke "knew the names of all the Mars rovers. He knew which one Phoenix was and that Phoenix had 'died,' or at least that they had lost contact. He knew everything about it. I said that he should be teaching the class."
The online option also allows him to help his parents when life doesn't go as planned, which happens more than occasionally.
She got the job. What she wasn't prepared for was the griller himself: Lucy and Jacob's older brother, Luke, then age 9.
"Luke had a questionnaire for me," Davison recalled with admiration. "He watches out for them, supports them, plays with them. They depend on him." Now 21 and studying occupational therapy at the College of St. Catherine, Davison remains close to the Schneider family, still going to the house weekly to help out. Her respect for Luke, who will be 15 in two weeks, has only grown. "It's different for a 14-year-old to be like that."
It's a new year so here's a new idea: a household without sibling rivalry. Luke Schneider simply doesn't have time for it.
Luke was 8 years old in 2002 when 2-year-old Jacob had tubes placed in his ears because he wasn't responding to the world around him. His parents, Mary and Steve, feared he was deaf. Instead, he was diagnosed with severe autism which was later changed to moderate. Mary recalls "so many people" encircling the family in their living room to explain the diagnosis. All she wanted to know was, "Will he ever say, 'I love you'? Will he graduate from high school?" Seven months later, 1-year-old Lucy also was diagnosed with autism. Luke remembers his parents telling him that "life was going to be different from now on," he said. "Their brains are a little different and they can't always understand what you're saying."
That helped Luke understand why his little brother didn't interact "normally" with him, running away, avoiding eye contact, not knowing that when someone says "Hi" to you, you say "Hi" back. But even early on there were victories. "I was so happy when he learned to play hide-and-seek with me," Luke said of Jacob. He learned how to help Lucy, too, finding her blanket, pouring her orange juice and making her peanut butter sandwiches. "They're like a couple of old people," Luke said. "You have to repeat yourself a lot."
ONLINE SCHOOL OFFERS FLEXIBILITY
Luke is a bit of an old soul himself. He is smart, polite, soft-spoken, a self-professed computer geek. He didn't care much for the "distractions" of a typical high school, which led him to enroll full time this year at Insight School of Minnesota, a fully accredited online high school administered by the Brooklyn Center School District. Luke attends school at the computer in his bedroom from about 9 a.m. to 4 p.m., pulling A's and B's in classes such as English Literature, Algebra One and World History.
His teachers describe him as responsible, disciplined and curious, a perfect candidate for online high school. Science teacher Angela Tingey advises the NASA club and said that Luke "knew the names of all the Mars rovers. He knew which one Phoenix was and that Phoenix had 'died,' or at least that they had lost contact. He knew everything about it. I said that he should be teaching the class."
The online option also allows him to help his parents when life doesn't go as planned, which happens more than occasionally.
Sunday, November 16, 2008
Troy, Mo., mom reaches out to help kids understand autism
Troy, Mo., mom reaches out to help kids understand autism
By Jessica Bock
ST. LOUIS POST-DISPATCH
11/16/2008
TROY, MO. — JoEllen Kessler had been in front of her son's class for only a few minutes when one of the second-graders asked, "How did Ryan get autism?"
"We don't know. No one knows, really," Kessler said.
Parents like Kessler still have lots of their own questions about autism. But what brought the stay-at-home mom, 41, into her son's classroom recently was the answers she has about Ryan.
Pushing aside her nerves, she spoke to the class fueled by hope that a little education about autism will go a long way with her son's classmates.
"You guys probably notice Ryan does odd things," Kessler told the class. "I'm here because I want to help all of you understand Ryan."
Chances are, kids these days are going to meet someone in their life with autism or a related disorder. Schools now know of more children with autism than ever before. In Missouri, the number of students with autism has increased from 934 about 10 years ago to more than 5,000 today.
Those increasing numbers of students with autism mean schools are challenged to develop plans for their education and train teachers and staff. Teaching the other students about autism can sometimes be an afterthought.
Like other children with autism, Ryan, 7, has trouble talking and other issues that can make it difficult to make friends.
That's why, after hearing about "The Autism Acceptance Book" for children by Ellen Sabin, Kessler decided to speak to her son's class at Boone Elementary. The book explains autism, and Kessler brought a copy with her to class.
School officials encouraged Kessler, who has since spoken to other classes at the school and has more presentations planned. Students see Ryan and other kids with autism each day in class,
at lunch and on the playground and know they are different, but they didn't really understand how.
"I think teachers in general are overwhelmed with responsibilities, and we don't always feel like we're the experts in everything," said Lisa Hamlett, a counselor at Boone. "Hearing it straight from Ryan's mom was really beneficial for everyone."
Kessler said it isn't easy. "But you're the mom. You're the advocate," she said.
Autism experts say what Kessler is doing is important and somewhat uncommon. Most parents don't feel comfortable enough to give a school presentation, said Staci Bowlen, a director with the Judevine Center for Autism, which offers support to children and adults with autism and their families throughout Missouri.
"There is such a need for this," she said. Children with autism often don't have the same social skills as others, and kids sometimes focus on those differences. They're curious, and hearing from a parent gives them the opportunity to ask questions, Bowlen said.
During her time with Ryan's class, Kessler brought one student to the front and asked the other students to make soft buzzing noises while she tickled the back of his neck. Then she asked him to try and answer a math question. The boy blinked a few times and stared back at the class, unable to respond.
"It was hard to concentrate, right? That's what Ryan feels every day in the classroom," Kessler said. "These things don't bother most people very much. But some people with autism feel their senses very, very strongly."
Those conditions are probably why Ryan will sometimes walk on tiptoe, stick out his tongue or tap too hard during a game of tag on the playground, Kessler explained to the kids.
Having Ryan in a class with children who understand that they can help is a great asset for Ryan's development, Kessler wrote in a note sent home to parents the day of her presentation. "The best tool for any child with autism is a strong support group."
Before she left, Kessler told them Ryan likes camping and four-wheeling, and she encouraged them to ask him to play.
Nodding her head, one girl said, "I'll ask him every day."
By Jessica Bock
ST. LOUIS POST-DISPATCH
11/16/2008
TROY, MO. — JoEllen Kessler had been in front of her son's class for only a few minutes when one of the second-graders asked, "How did Ryan get autism?"
"We don't know. No one knows, really," Kessler said.
Parents like Kessler still have lots of their own questions about autism. But what brought the stay-at-home mom, 41, into her son's classroom recently was the answers she has about Ryan.
Pushing aside her nerves, she spoke to the class fueled by hope that a little education about autism will go a long way with her son's classmates.
"You guys probably notice Ryan does odd things," Kessler told the class. "I'm here because I want to help all of you understand Ryan."
Chances are, kids these days are going to meet someone in their life with autism or a related disorder. Schools now know of more children with autism than ever before. In Missouri, the number of students with autism has increased from 934 about 10 years ago to more than 5,000 today.
Those increasing numbers of students with autism mean schools are challenged to develop plans for their education and train teachers and staff. Teaching the other students about autism can sometimes be an afterthought.
Like other children with autism, Ryan, 7, has trouble talking and other issues that can make it difficult to make friends.
That's why, after hearing about "The Autism Acceptance Book" for children by Ellen Sabin, Kessler decided to speak to her son's class at Boone Elementary. The book explains autism, and Kessler brought a copy with her to class.
School officials encouraged Kessler, who has since spoken to other classes at the school and has more presentations planned. Students see Ryan and other kids with autism each day in class,
at lunch and on the playground and know they are different, but they didn't really understand how.
"I think teachers in general are overwhelmed with responsibilities, and we don't always feel like we're the experts in everything," said Lisa Hamlett, a counselor at Boone. "Hearing it straight from Ryan's mom was really beneficial for everyone."
Kessler said it isn't easy. "But you're the mom. You're the advocate," she said.
Autism experts say what Kessler is doing is important and somewhat uncommon. Most parents don't feel comfortable enough to give a school presentation, said Staci Bowlen, a director with the Judevine Center for Autism, which offers support to children and adults with autism and their families throughout Missouri.
"There is such a need for this," she said. Children with autism often don't have the same social skills as others, and kids sometimes focus on those differences. They're curious, and hearing from a parent gives them the opportunity to ask questions, Bowlen said.
During her time with Ryan's class, Kessler brought one student to the front and asked the other students to make soft buzzing noises while she tickled the back of his neck. Then she asked him to try and answer a math question. The boy blinked a few times and stared back at the class, unable to respond.
"It was hard to concentrate, right? That's what Ryan feels every day in the classroom," Kessler said. "These things don't bother most people very much. But some people with autism feel their senses very, very strongly."
Those conditions are probably why Ryan will sometimes walk on tiptoe, stick out his tongue or tap too hard during a game of tag on the playground, Kessler explained to the kids.
Having Ryan in a class with children who understand that they can help is a great asset for Ryan's development, Kessler wrote in a note sent home to parents the day of her presentation. "The best tool for any child with autism is a strong support group."
Before she left, Kessler told them Ryan likes camping and four-wheeling, and she encouraged them to ask him to play.
Nodding her head, one girl said, "I'll ask him every day."
Friday, October 24, 2008
10 Myths About Autism
10 Myths About Autism
Experts Examine Misconceptions About Autism
By LARA SALAHI
ABC News Medical Unit
Oct. 23, 2008
As the number of Americans diagnosed with autism spectrum disorders climbs, so, too, does the number of questions surrounding this disorder. Namely, what is autism, and what is causing a rise in autism diagnoses among adults and children nationwide?
Amid these questions, television shows and magazines feature a barrage of stories and imagery -- families rallying for and against vaccines, debates between medical experts pointing to both genetic and environmental causes, and images of individuals diagnosed with autism who struggle to speak and function independently, while others can interact with others and are able to hold jobs. For many, these competing messages may make this already complex condition even more confusing.
Fortunately, doctors and researchers are learning more about the causes and characteristics of autism.
The following are answers to 10 common myths, that may help us better recognize the range of symptoms we call autism spectrum disorders.
Myth: Autism is an emotional or mental health disorder.
While physical or social behaviors of individuals with autism may suggest that they have a psychological disorder, autism is actually a biological illness that affects the brain's growth and development.
"In the case of autism, the parts of the brain that are most affected seem to impact three areas of functioning," said Michael Alessandri, executive director of the University of Miami's Center for Autism and Related Disabilities. "Social behavior, communication and restricted and repetitive rituals and routines are ways that the child or the adult with autism interact with the environment."
Although autism is now understood to be a neurodevelopmental disorder, Alessandri, an expert for ABCNews.com's OnCall+ Autism section, said autism can still be considered a complex disorder because its range of symptoms is so diverse.
"Scientists and clinicians now understand that autism is not a singular entity, but rather, a variety of syndromes that ... create the autism spectrum disorders," said Alessandri.
Myth: There is an autism epidemic.
The word "epidemic" often implies a sudden burst in the number of individuals within a fixed time who have, in this case, autism.
Although the CDC reports that one out of 150 children born have an autism spectrum disorder, some experts are quick to question whether a surge in autism cases is actually occurring. Some are more likely to link the upshot of numbers to the combination of a broader definition of autism, a wider spectrum, and an earlier diagnosis.
"The condition has not become more widespread, but there is more diagnosis of autism," said Dr. Bob Marion, director of Children's Evaluation and Rehabilitation Center at Albert Einstein College of Medicine in New York.
Sheila Wagner, assistant director of the Autism Center at Emory University in Atlanta, added that more awareness of symptoms has allowed more people to identify individuals who have autism.
"There's a lot of media exposure to autism, in television and movies," said Wagner. "This has made [autism] more recognizable in the lay population."
Myth: Autism can be cured.
Some parents may allude to a certain diet, medicine, or set of behavioral treatments that have cured their autistic children, where other parents may try the same mode of treatment and see no results. While there are treatments created to improve an autistic child's ability, there is no known cure for autism.
"We do know that with early intervention with younger children and Applied Behavioral Analysis, we can improve a child's functioning," said Marion.
Applied Behavior Analysis, or ABA, is one form of therapy for newly diagnosed children. It includes repeating behavioral activities to improve a child's social and physical functions.
According to Marion, there is no blanket treatment for autism, and it is up to the individual's doctor to assess what treatment will offer the best benefit for each autistic child.
In some cases, Marion said, behaviors, including eye contact, interaction with others and development of language skills, will significantly improve -- but the underlying biological disorder will not change.
"And that is definitely not a cure," he said.
Myth: Autism is the result of cold and unemotional parents.
In the 1940s, Austrian doctor Bruno Bettelheim theorized that autism was a result of parents, especially mothers, who did not love their children. Children in such situations would withdraw and become autistic, Bettelheim believed.
However, researchers have thawed the "refrigerator mother" theory. According to medical experts, a child's autism diagnosis has nothing to do with how the child is raised.
"We don't know if there are any things that a parent can do or not do, conclusively, will determine whether their child gets autism or not," said Dr. Daniel Geshwind, director of UCLA's neurogenetics program and center for autism research. "Most of the evidence right now points to there being a very strong genetic predisposition in most cases of autism, but not all."
Myth: Individuals with autism always have hidden or exceptional talents.
Stephen Wiltshire, 34, is best known as the human camera. He can replicate architectural designs and landscapes down to each blade of grass -- even if he is only given one opportunity to observe the area he is drawing. Wiltshire has reproduced panoramic scenes of Tokyo, Rome and London by memory after one short helicopter ride over each of the cities.
Wiltshire is an autistic savant. That is, he has extraordinary cognitive skills that allow him to recall details of designs, numbers and measurements that are normally considered too difficult to remember.
The concept of an autistic individual as a savant may have been popularized by Dustin Hoffman's character in the movie "Rain Man."
But while Marion acknowledges that there is a minority group of individuals with autism who have unusual islets of skills, savants are an unrealistic portrayal of the majority of individuals on the spectrum. He said most do not have talents or skills that distinguish themselves by extraordinary talents.
"There are strengths and weaknesses in every child," said Marion. "It's important for every child with autism to have a multidisciplinary evaluation by health professionals who have experience in assessing a child's skills and deficits, to come up with an educational plan that will benefit the child the most."
Myth: Repetitive or ritualistic behaviors should be stopped.
One of the classic indicators of autism is repetitive and ritualistic behaviors, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM IV), a physician's tool to diagnose autism.
While these behaviors -- which can include hand flapping, banging on walls or rocking back and forth -- may seem odd, they do have a purpose: they can be calming; they can feel good; and they may help the individual communicate with others, said Wagner.
Repetitive behaviors may only pose a problem if they begin interfering in family life or if they prevent those with autism from functioning independently, Wagner added.
However, according to Dr. Pauline Filipek, associate professor of pediatrics and neurology at the University of California, Irvine, a child may learn to outgrow repetitive behaviors.
"Often, as an individual gets older, they learn that such behaviors make them stand out in society, and they learn to miniaturize those behaviors," said Filipek.
Myth: Individuals with autism are unable to build social relationships.
"This is a generalization and needs to be individualized because the spectrum is so wide," said Marion.
In short, social relationships are possible for some individuals on the autism spectrum, but not for others on the most severe end of the spectrum, Marion said.
The DSM IV, which includes diagnosing guidelines for autism, lists "impairment in social interaction" as one indication that an individual can have an autism spectrum disorder. But not every child on the autism spectrum will have the same degree of difficulty connecting with others.
"At the most severe end of the spectrum, yes, that's true," said Marion. "But there is a multitude of children who have friends, and even some who do have close relationships."
Myth: Autistic individuals are a danger to society.
"It is a disservice to think that all people with autism are dangerous," said Wagner.
The idea rises from numerous news stories of individuals diagnosed with Asperger's syndrome, a high form of autism, who have been accused of burglary and, at times, murder.
However, if you look at the entire population of people on the autism spectrum, the number of people involved in crime is small, said Wagner. If someone with autism were to act out, it may be due to frustration or perhaps physical or emotional overstimulation, not necessarily malice, she said.
Experts Examine Misconceptions About Autism
By LARA SALAHI
ABC News Medical Unit
Oct. 23, 2008
As the number of Americans diagnosed with autism spectrum disorders climbs, so, too, does the number of questions surrounding this disorder. Namely, what is autism, and what is causing a rise in autism diagnoses among adults and children nationwide?
Amid these questions, television shows and magazines feature a barrage of stories and imagery -- families rallying for and against vaccines, debates between medical experts pointing to both genetic and environmental causes, and images of individuals diagnosed with autism who struggle to speak and function independently, while others can interact with others and are able to hold jobs. For many, these competing messages may make this already complex condition even more confusing.
Fortunately, doctors and researchers are learning more about the causes and characteristics of autism.
The following are answers to 10 common myths, that may help us better recognize the range of symptoms we call autism spectrum disorders.
Myth: Autism is an emotional or mental health disorder.
While physical or social behaviors of individuals with autism may suggest that they have a psychological disorder, autism is actually a biological illness that affects the brain's growth and development.
"In the case of autism, the parts of the brain that are most affected seem to impact three areas of functioning," said Michael Alessandri, executive director of the University of Miami's Center for Autism and Related Disabilities. "Social behavior, communication and restricted and repetitive rituals and routines are ways that the child or the adult with autism interact with the environment."
Although autism is now understood to be a neurodevelopmental disorder, Alessandri, an expert for ABCNews.com's OnCall+ Autism section, said autism can still be considered a complex disorder because its range of symptoms is so diverse.
"Scientists and clinicians now understand that autism is not a singular entity, but rather, a variety of syndromes that ... create the autism spectrum disorders," said Alessandri.
Myth: There is an autism epidemic.
The word "epidemic" often implies a sudden burst in the number of individuals within a fixed time who have, in this case, autism.
Although the CDC reports that one out of 150 children born have an autism spectrum disorder, some experts are quick to question whether a surge in autism cases is actually occurring. Some are more likely to link the upshot of numbers to the combination of a broader definition of autism, a wider spectrum, and an earlier diagnosis.
"The condition has not become more widespread, but there is more diagnosis of autism," said Dr. Bob Marion, director of Children's Evaluation and Rehabilitation Center at Albert Einstein College of Medicine in New York.
Sheila Wagner, assistant director of the Autism Center at Emory University in Atlanta, added that more awareness of symptoms has allowed more people to identify individuals who have autism.
"There's a lot of media exposure to autism, in television and movies," said Wagner. "This has made [autism] more recognizable in the lay population."
Myth: Autism can be cured.
Some parents may allude to a certain diet, medicine, or set of behavioral treatments that have cured their autistic children, where other parents may try the same mode of treatment and see no results. While there are treatments created to improve an autistic child's ability, there is no known cure for autism.
"We do know that with early intervention with younger children and Applied Behavioral Analysis, we can improve a child's functioning," said Marion.
Applied Behavior Analysis, or ABA, is one form of therapy for newly diagnosed children. It includes repeating behavioral activities to improve a child's social and physical functions.
According to Marion, there is no blanket treatment for autism, and it is up to the individual's doctor to assess what treatment will offer the best benefit for each autistic child.
In some cases, Marion said, behaviors, including eye contact, interaction with others and development of language skills, will significantly improve -- but the underlying biological disorder will not change.
"And that is definitely not a cure," he said.
Myth: Autism is the result of cold and unemotional parents.
In the 1940s, Austrian doctor Bruno Bettelheim theorized that autism was a result of parents, especially mothers, who did not love their children. Children in such situations would withdraw and become autistic, Bettelheim believed.
However, researchers have thawed the "refrigerator mother" theory. According to medical experts, a child's autism diagnosis has nothing to do with how the child is raised.
"We don't know if there are any things that a parent can do or not do, conclusively, will determine whether their child gets autism or not," said Dr. Daniel Geshwind, director of UCLA's neurogenetics program and center for autism research. "Most of the evidence right now points to there being a very strong genetic predisposition in most cases of autism, but not all."
Myth: Individuals with autism always have hidden or exceptional talents.
Stephen Wiltshire, 34, is best known as the human camera. He can replicate architectural designs and landscapes down to each blade of grass -- even if he is only given one opportunity to observe the area he is drawing. Wiltshire has reproduced panoramic scenes of Tokyo, Rome and London by memory after one short helicopter ride over each of the cities.
Wiltshire is an autistic savant. That is, he has extraordinary cognitive skills that allow him to recall details of designs, numbers and measurements that are normally considered too difficult to remember.
The concept of an autistic individual as a savant may have been popularized by Dustin Hoffman's character in the movie "Rain Man."
But while Marion acknowledges that there is a minority group of individuals with autism who have unusual islets of skills, savants are an unrealistic portrayal of the majority of individuals on the spectrum. He said most do not have talents or skills that distinguish themselves by extraordinary talents.
"There are strengths and weaknesses in every child," said Marion. "It's important for every child with autism to have a multidisciplinary evaluation by health professionals who have experience in assessing a child's skills and deficits, to come up with an educational plan that will benefit the child the most."
Myth: Repetitive or ritualistic behaviors should be stopped.
One of the classic indicators of autism is repetitive and ritualistic behaviors, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM IV), a physician's tool to diagnose autism.
While these behaviors -- which can include hand flapping, banging on walls or rocking back and forth -- may seem odd, they do have a purpose: they can be calming; they can feel good; and they may help the individual communicate with others, said Wagner.
Repetitive behaviors may only pose a problem if they begin interfering in family life or if they prevent those with autism from functioning independently, Wagner added.
However, according to Dr. Pauline Filipek, associate professor of pediatrics and neurology at the University of California, Irvine, a child may learn to outgrow repetitive behaviors.
"Often, as an individual gets older, they learn that such behaviors make them stand out in society, and they learn to miniaturize those behaviors," said Filipek.
Myth: Individuals with autism are unable to build social relationships.
"This is a generalization and needs to be individualized because the spectrum is so wide," said Marion.
In short, social relationships are possible for some individuals on the autism spectrum, but not for others on the most severe end of the spectrum, Marion said.
The DSM IV, which includes diagnosing guidelines for autism, lists "impairment in social interaction" as one indication that an individual can have an autism spectrum disorder. But not every child on the autism spectrum will have the same degree of difficulty connecting with others.
"At the most severe end of the spectrum, yes, that's true," said Marion. "But there is a multitude of children who have friends, and even some who do have close relationships."
Myth: Autistic individuals are a danger to society.
"It is a disservice to think that all people with autism are dangerous," said Wagner.
The idea rises from numerous news stories of individuals diagnosed with Asperger's syndrome, a high form of autism, who have been accused of burglary and, at times, murder.
However, if you look at the entire population of people on the autism spectrum, the number of people involved in crime is small, said Wagner. If someone with autism were to act out, it may be due to frustration or perhaps physical or emotional overstimulation, not necessarily malice, she said.
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