[Lia]

What Do We Know About Autism?

By Dr. Ranit Mishori, PARADE Magazine

As a child, I learned how autism turns a world upside down. In our house, it was my little brother who was diagnosed at 3. In the search for a treatment, parents will go to any lengths. I saw that with my parents, and I see it now as a practicing physician. Much has changed in the field of autism, but the need for parents to make decisions in a bewildering terrain has hardly changed at all.

A diagnosis of autism usually rests on three distinctive symptoms: difficulty with social interaction, problems with verbal and nonverbal communication, and repetitive actions or obsessive interests. These behaviors can range from mild to disabling.

Parents may first notice that something is wrong when their child fails to babble or point by age 1 or to speak by 16 months. Some autistic children don’t smile or make eye contact. Others seem to be hearing impaired or do not know how to play with toys. There also are cases in which a child who appears to be making normal developmental progress abruptly loses language or social skills.

Is Autism an Epidemic?
Until the 1940s, there was no autism—in the sense that it was an unrecognized condition. In 1988, when Dustin Hoffman’s Rain Man brought a version of autism to life on film, many of us first heard about it—as an odd, almost-fascinating disorder which was also, apparently, rare.

Fast-forward to today. Autism is front-page news. Celebrities talk about it, Congress ponies up millions for research, and the numbers are startling: One in every 150 American kids has some form of autism, says the Centers for Disease Control. The last 15 years in particular have seen diagnoses rates soar. “It is the fastest-growing developmental disability in the U.S.,” says Dr. Andrew Zimmerman, director of medical research at the Kennedy Krieger Institute Center for Autism and Related Disorders in Baltimore.

No one really knows why the numbers are so high. But there are many theories. The most commonly accepted one centers on how we define and recognize autism. “There has been an expansion in the criteria,” explains Dr. Cecelia McCarton, the director of a school for autistic children in New York City, echoing the majority of mainstream experts.

A broader definition means that there are simply more ways to be considered autistic than in the past. At the same time, parents, teachers and doctors are paying more attention to the symptoms—which tends to lead to higher numbers of diagnoses.

But changes in how children are labeled and diagnosed alone “cannot explain the rise,” says Dr. Zimmerman. Other theories rest on maternal, obstetric or environmental factors that perhaps trigger an innate tendency. “Anything from autoimmune disorders to chemicals in the environment may be involved,” adds Zimmerman. He notes that researchers have been pursuing all of these theories to varying degrees, “but science has not yet pointed us to any concrete answers.” An important study released this month suggests that a genetic flaw that occurs around conception may sharply increase the risk that a child will develop autism.

More than perhaps any brain disorder in history, autism has ignited heated arguments among parents and professionals.

What Is the Best Treatment?

There currently is no single definitive treatment for autism. “One size fits all” does not work. But starting early does. These days, children as young as 1 are being evaluated and treated. “The sooner you start, the better off you are,” says Dr. McCarton. Early intervention works, she explains, because of the malleability of the brain in very young children—that is, its ability to grow and develop when stimulated.

Today, most school-based programs rely on behavioral therapy to stimulate development. The treatment aims to reinforce appropriate behaviors while discouraging the inappropriate. Typically, a child is required to perform over and over a task that autism makes difficult—say, buttoning a shirt—with rewards such as stickers or candy for performing the task correctly. This approach, practiced in different variations and sometimes customized to the individual child, helps some autistic children make eye contact, increase spoken vocabulary and master basic life skills.

Lisa Goring of Manhasset, N.Y., got her son Andrew early-intervention services at age 2. “When we started, Andrew threw tantrums that made it impossible for us as a family to go anywhere,” recalls Goring. “At first we felt lost. But after we found a program, he learned how to speak. Once he was able to communicate, his world opened up.” Andrew made such good progress that he was able to enter mainstream kindergarten. He’s now in sixth grade. Though not at the level of his peers, Andrew functions well with one-on-one support provided by his school district.

While behavioral programs claim a scientific basis, the reality is that it is difficult to test their effectiveness or even to compare one type of behavioral treatment with another. Still, these therapies win general endorsement by most professionals and many public school districts (though insurance companies generally refuse to pay for them).

Do Vaccines Cause Autism?
Most doctors and researchers answer a clear “no” to this question. But the controversy remains alive in the media and among parent-advocacy groups.

Parents in these groups have reported a sudden and dramatic social disconnect—including loss of language—in children who previously seemed to be developing normally. The change occurred soon after the children were given the first dose of the MMR vaccine (to prevent against measles, mumps and rubella), typically at around 12-15 months. These parents adamantly believe that their children’s autism was caused by something in the MMR vaccine or in combination with other vaccines containing the mercury-based preservative thimerosal. They insist that the timing of the onset of autistic symptoms is not a coincidence.

While some physicians and scientists support the vaccine-autism link, the overwhelming majority of medical professionals and mainstream medical organizations maintain that vaccines do not cause autism. This is the position of the Institute of Medicine (IOM), National Academy of Sciences, CDC, American Academy of Pediatrics and NIH. After reviewing the research, the IOM concluded that the evidence “did not support an association between autism and the MMR vaccine.”


In fact, even autistic children who never received the MMR vaccine first show symptoms at around the same age as those who are vaccinated.

Is There Hope?
Parents of autistic children should not despair. “Many kids do very well and adapt to their situation,” says Dr. Lee Marcus, clinical director of the pioneering TEACCH program in Chapel Hill, N.C. Since the 1960s, the program—now mandated in North Carolina—has been combining behavioral and developmental therapies, with parents as co-therapists.
“There can be progress and optimism about the future. Society is more accepting. Many people do a good job teaching kids with autism.”

Indeed, the road ahead for people with autism depends on the attitudes of the rest of us and our willingness to create opportunities for jobs, for education and for inclusion. “We know our son will always have challenges,” says Lisa Goring, “but we feel very fortunate that we found people who understood how to teach him. He’s different, but his friends absolutely accept him. He has a community.”

Source

[magosienne]

thanks for that article. i disagree a bit about the last sentences. in France there is simply not enough staff to handle these kids. so my little cousin who is severely autistic stays at home with my aunt when she's not working, and it's so exhausting for her and my uncle. they also have lost many friends who won't come over to their house anymore, i believe my parents are one of the few people who still go there. and of course, with so few teachers, my cousin's autism is still at the same level, if not worse.

[Lia]

I see - the reality on the text is from USA - i imagine that here the things aren't like USA as well.

[Ricci]

Thanks for the post .. I have a feeling its the shots we are supposed to give our babies (Vaccine) that may be causing some of it

Until the 1940s, there was no autism—

[Lia]

Originally Posted by Ricci

Thanks for the post .. I have a feeling its the shots we are supposed to give our babies (Vaccine) that may be causing some of it

Vaccines exist since the beginning of XX century (the small pox one being the oldest). If the 40's were the culprit, we'd have to blame antibiotics, that only became really available at that era.

Thanks for the input, Labrat!

[beaglette]

I agree with the vaccination "theory". I'm not sure I am sold on what the correlation is but I do believe there is one. That is one reason I DO NOT vaccinate my children. They say "well, the risk of vaccination, if there is one, is far less than a child getting chicken pox". I had a horrible, miserable, horrible case of chicken pox as a child and I didn't die and nothing atrocious happened to me (besides the physical suffering at the time). If my children get chicken pox, it's not the end of the world. Now, if they contract something like polio, then there's a bigger problem than them merely contracting polio.

I also think that *previously* autism was wayyy over-diagnosed. In my experience in "special ed" classes, many children were given that diagnosis when they couldn't figure out what else is wrong. It kind of became a catch-all phrase. Your child can't talk? Obviously autism. Your child likes to spin around? Obviously autism. Your child stares into space? Obviously austism. Hopefully that trend is diminishing and correct diagnosis are being made. Because without *correct* diagnosis, there will never be a fully effective widespread treatment or research that would amount to more than a hill of beans.

Ok, that's my rant

Warmly,

Brandi

[Lia]

I don't believe because i live on a place where kids are massively vaccinated (see, i live on a poor country - here vaccination is a MUST , on USA there's not that problem, and it's not a big deal because you almost don't have infectious diseases) and it doesn't seems that here it's THAT common , as USA.

I believe more in the overdiagnoses and in the tendency of everything being medicated - an active child isn't considered just active anymore, he/she has to have ADHD and be medicated.

And also, there's the fact that psychiatry itself only began to really develop after the 60's - before that, there were no efficient drugs, and people with mental illness were just labeled as 'crazy' and institutionalized - and 'treated' with things like lobotomy and eletric shocks - which could be effective, but on most of cases were uneffective and hurtful.

So, there were no such thing as autism = the kid was just weird or cucko.

PS> here we don't have on the public system (which means for free) the chicken pox vaccine - we have:

The polio one (the sabin, not the salk);
Measles, mumps and rubella;
Hep b
BCG (which is controversial, but it's still kinda useful)
Diphteria, Tetanus, Pertussis and Haemophilus influenzae type B - caused meningitis
Yellow Fever - we recently had some outbursts of that disease again on another state
And against diarrhea induced by Rotavirus

I had 2 friends who had rotavirus (as adults) and they told me it's the worst thing you can ever have - you spend 1 week puking and having diarrhea at the same time - for an adult, it's just a PITA, but for a kid it can mean his/her life *because of dehydration*;

[reesesilverstar]

Wow...

Wow....

I've often heard of autism, and I'm so guilty of not finding out more about it. You guys, thank you for posting this. Now I'm more aware, and now I realize that I need to be more concerned about topics like this.

Thank you

[beaglette]

My daughter had rotovirus on her 1st birthday last year. She was miserable. She lost weight and she did get dehyrated fast.

Having said all of that, however, if there would have been a vaccine for it, I *still* would have not allowed her to have it. Even after all the projectile vomiting on *me*, the smelly diarrhea and her misery-- it's a short-lived thing and, yes, children *can* die from it but, frankly, if and otherwise healthy child contracts rotovirus and dies, well, IMO someone wasn't doing their job (a parent being pro-active, a doctor, etc. etc.) Again, the latter sentence is a generality and IS MY OPINION (obviously, I'm writing it :P).

I think there are some things that over-diagnosed. ADHD is a good one. Many children need a good spanking or some good discipline-- NOT MEDICATION. And yes, I advocate spanking- NOT abuse-- SPANKING, quite a difference. And no, I'm not interested in debating someone who doesn't advocate spanking :P To each his or her own!

Warmly,

Brandi

[Lia]

Originally Posted by beaglette

My daughter had rotovirus on her 1st birthday last year. She was miserable. She lost weight and she did get dehyrated fast.

Having said all of that, however, if there would have been a vaccine for it, I *still* would have not allowed her to have it. Even after all the projectile vomiting on *me*, the smelly diarrhea and her misery-- it's a short-lived thing and, yes, children *can* die from it but, frankly, if and otherwise healthy child contracts rotovirus and dies, well, IMO someone wasn't doing their job (a parent being pro-active, a doctor, etc. etc.) Again, the latter sentence is a generality and IS MY OPINION (obviously, I'm writing it :P).

I think there are some things that over-diagnosed. ADHD is a good one. Many children need a good spanking or some good discipline-- NOT MEDICATION. And yes, I advocate spanking- NOT abuse-- SPANKING, quite a difference. And no, I'm not interested in debating someone who doesn't advocate spanking :P To each his or her own!

Warmly,

Brandi

Don't worry - you don't live in the same conditions as i do. Being a 'doctor ' (i'm still a med student) on a poor country (i live in Brazil , mind you), it's easy to see why a kid would die from rotavirus. Imagine this very common scene here:

Single mom, lives in a poor neighborhood (without proper conditions like sewage system and things like that), has 5 kids - the older being 10, the younger being 5 months. She has to go to work , leaves the house at 7 am. Leaves the 5 kids in charge of the 10 year old - she already leaves the food ready for the kids - flour based foods and maybe milk.

The younger gets rotavirus - let's say it's a girl. Baby girl starts to puke and have diarrhea. She's already malnourished (almost on kwaishiorkor levels). Big bro calls the mom at 1 pm to tell that baby girl is sick - mom says she can't arrive before 5 pm . She arrives at home at 7 , gets the baby girl and go to the local ER.

Arriving there (after 2 hours on the bus), she takes 4 hours to be seen by a doc. We already have this girl with diarrhea and extremely puke for more than 12 hours without being able to drink nothing, and she's already malnourished

Doc asks for the baby girl to be admitted on a hospital... But there's no beds. And she waits for more 12 hours... just with an IV of saline.

And so the story goes on...

What i want to tell with this little story - here the vaccination saves lifes because of our poverty. If it was a wealthy kid , the mom would take as soon as possible the kid to a private hospital, the kid would be treated and would easily survive, since she's previously healthy. But for a poor kid, the vaccination can be the difference between life and death

[beaglette]

Originally Posted by Lia

Don't worry - you don't live in the same conditions as i do. Being a 'doctor ' (i'm still a med student) on a poor country (i live in Brazil , mind you), it's easy to see why a kid would die from rotavirus. Imagine this very common scene here:

I totally understand what you are saying. I adopted my two oldest children from overseas and they lived in a filthy orphanage until I brought them home. There was a little boy quarantined from the rest of the class due to some illness and he was in a room all by himself. I LOVE children and I couldn't stand the thought of him being in that room by himself all day long (and he was). So, I decided to go in there and love on him- hug, kiss and talk to him. He loved it as did I! I contracted whatever it was that he had and ended up with spinal meningitis upon returning home. I was hospitalized and almost didn't pull through that one.

I don't want you to think I was debating the merits or lack thereof for you, in your country. I was just speaking for me, living in the US and the risks of autism or otherwise vs. my children getting sick from not having a vaccine.

I totally understand your perspective and, as everything, it's always a personal choice.

Warmly,

Brandi

[magosienne]

that's really interesting to read, i realise vaccines can be really useful.
but to link a vaccine and autism, i'm not sure. i got all my vaccines as a kid, but the others like the flu or hep B, no. because it didn't feel like it was absolutely necessary, and there was also the scandal about the hep B vaccine and people getting multiple sclerosis after (i read there was no link proven between the two).

[PerfectMistake]

I have a cousin with a pretty heavy case of it.

It's so hard for the family sometimes, but we still love him the same

[beaglette]

There is soooo much we don't know about medicine and the human body and how things affect us.

The thing is, they will say "there is no correlation between such and such" and, maybe the appropriate component of such and such wasn't studied?

Things also react differently with different people, hence the reason for such a wide variety of the same type of medications. My husband swears by herbs. They have *zero* effect on me, as much as I wish they did. Why? who knows? Is it the placebo effect on him? Well, sometimes I think yes but I have no clue.

I do think there is a correlation between autism and vaccinations. Far too many children have suddenly changed after vaccinations. Now, the thing I'm puzzled about is what component, exactly, is the culprit. And, what genetic component is within the children affected that reacts with the component in the immunization and causes autism to develop? I think we'll have the answers to that *someday* because people are becoming more pro-active in their approach to their health and the health of their children, at least in the US.

Warmly,

Brandi

[Barbette]

Lia, good article, I would like to add this article, I read this a while ago and it made me smile; ABC News: Autism Breakthrough: Girl's Writings Provide 'Remarkable Insight' on Disorder

Originally Posted by beaglette

There is soooo much we don't know about medicine and the human body and how things affect us......

..........I do think there is a correlation between autism and vaccinations. Far too many children have suddenly changed after vaccinations. Now, the thing I'm puzzled about is what component, exactly, is the culprit. And, what genetic component is within the children affected that reacts with the component in the immunization and causes autism to develop? I think we'll have the answers to that *someday* because people are becoming more pro-active in their approach to their health and the health of their children, at least in the US.

Warmly,

Brandi

I think that if there is a link between vaccinations and autism it is also due to a genetic component in the children. It's pretty obvious that there is a genetic link to autism....it's actually been proven now (only they still are far from fully understanding it). I know it runs in my family....I happen to have honor of being the first girl who inherited it.....it goes back a few generations....it's not something new to my family.....I know most of them weren't vaccinated. My father wasn't and he still developed autism. I was and I did......

Originally Posted by Babette Pardoux

Lia, good article, I would like to add this article, I read this a while ago and it made me smile; ABC News: Autism Breakthrough: Girl's Writings Provide 'Remarkable Insight' on Disorder

Her autism is way more severe than mine is, but I can really understand what she's saying. I feel that way too. Sometimes I just want to tell people..."I'm not a freak, I can't help it." My autism is pretty mild, but I still have meltdowns, I don't always make eye contact and I always talk to myself out loud.....luckly, I'm in a line of work where it's not uncommon for people to talk walk around talking to themselves all day.....

[jdepp_84]

THanks for posting My former boss's child is autistic, although now he is 30, he's married and has a good life. Its a bit hard for him to understand certain things, but he's getting through. This is why she decided to go into family therapy, so she could try and give her son the best of care she could.