Clinic Notes: Autism and Timeout

Well it happened again. A child placed in a "seclusion room" or timeout room without supervision hanged himself. Timeout is an often used and mis-used procedure. When done properly it is very effective. When done improperly it is not effective and is some rare cases deadly. No child should be placed in a room alone without an responsible person observing the child all the time. On my website, www.aba4autism.com I give specific information for using timeout and when not to use time out. There needs to be rules enacted to regulate the use of timeout. Timeout does not need to be banned or abuse will increase.

Clinic Notes: The Cost of Autism

According to a recent Schafer Report article, over half a million families who have a child with autism are having financial problems. They pay more for autism treatment than parents of children who have other chronic diseases. I am not surprised. In my clinic I see this everyday. Children with autism need ABA, which insurance companies call "experimental" and do not want to pay for. School systems do not want to pay either even though ABA is the most effective treatment. Sending teachers to an ABA workshop is enough they tell parents. Of course, OT, SLP, and other therapies are also necessary and expensive. And these therapies may be needed for years. If we can start these therapies early we can mainstream many kids with autism and ultimately save money if these children can become self-supporting as many can. Hopefully, the new administration's health care plan will provide some relief to these families.

Autism and the Christmas Holidays

I am reposting this from a previous blog for the holidays
12-1-05
I have had many parents of children with autism or other neuropsychological disorders tell me that the Christmas holidays are an especially difficult time for them. Of course, any holiday can be difficult for any child with the changes in routine. But Christmas is usually the most difficult holiday for parents of children with autism or other neuropsychological disorders.
There are no sure-fire techniques to use with your child that will insure a "Martha Stewart Christmas." Families who have children with autism or other neuropsychological disorders have used the following 10 tips to make their Christmas better. And this year I'm adding a new suggestion to the list.
Several years ago Leigh Grannon and I did a study using pictures to increase social interactions in a child with autism. Children with autism are visual learners, and I have suggested to parents that they take pictures of what is going to happen at Christmas--the tree, the gifts, the relatives--and starting several weeks before Christmas show these pictures repeatedly to the child with autism. Tell a little story to the child while he/she is looking at the picture about how to behave, what's going to happen, and what the child can do if it is too much. Include your child in the pictures if possible. A picture of the child going to his room to escape the noise and confusion when he/she gets overloaded seems to help, too.
1. Try to keep your child in his or her usual routine as much as possible.
2. Sensory over stimulation—the lights, the sounds, the smells, the relatives touching your child--are the main culprits during the holidays. Eliminating or minimizing these culprits are your best bet.
3. Some families who have children with autism or other neuropsychological disorders wait until Christmas Eve to put up their tree and decorate.
4. Some families let their children with autism or other neuropsychological disorders do all of the decorating. Children with autism or other neuropsychological disorders may line up or stack decorations rather than decorate in the traditional way, but so what.
5. Rather than try to do the Christmas shopping with children with autism or other neuropsychological disorders in a crowded, noisy mall, many families shop by catalogue or online and let the child point to or circle the toys he/she wants. Websites, such as www.stars4kidz.com, offer a variety of toys for children with autism or other neuropsychological disorders. Just type "autism toys" in your search engine.
6. Tactile toys are often a better choice for children with autism or other neuropsychological disorders. Toys that make sounds or involve too much stimulation or are too complex may not cause an aversive reaction in the child. As mentioned above there are web sites that sell toys designed for children with autism or other neuropsychological disorders. Try ordering some of these toys and then let your child select the ones to play with as they are unwrapped.
7. Talk to relatives before they come over about the best way to behave with children with autism or other neuropsychological disorders. Have them read my article, “What Horses Tell Us About Autism,” which is available for free on the second page of my website.
8. Generally, kids with autism or other neuropsychological disorders do better in the morning than in the late afternoon or evening when they are tired. It may be better to schedule Christmas events at these times.
9. The parents of children with autism or other neuropsychological disorders need to relax themselves. Often the child with autism picks up on the parents’ stress and that is enough to ruin Christmas.
10. And last but not least, realize that you are probably not going to have a perfect food, perfect decorations, and perfect gifts. Christmas with children with autism or other neuropsychological disorders may not be traditional, but it can still have real meaning. (Sometimes I wonder if children with autism or other neuropsychological disorders know that Christmas has become too commercial.)
I wish you and your child the happiest of holidays.
Gary Brown, Ph.D Psychologist/HSP
(Thanks to the mothers of children with autism or other neuropsychological disorders who helped me with this post.)

Clinic Notes: Will We Ever Find the Cause of Autism

Recently, it was reported that a link between rainfall and autism had been found. Children who live in cold rainy areas such as the Pacific Northwest have a higher rate of autism. The author of the study theorizes that the rain keeps the children inside where they are exposed to more toxins, electromagnetic waves, etc. It is possible to find statistical correlations with the increasing rate of autism and anything else that has increased since the early 1990's. Normally, correlations give us a clue as where to conduct more controlled studies to establish causal relationships. The problem is that science has to be ethical. So obviously we could not randomly choose a group of children and raise them in a rainy environment to see if they developed more autism cases compared to a control group. One way out of this is to develop animal models of autism as is done with other diseases. But then another problem arises with animals because a prominent feature of autism is language which is not present in experimental animals. I expect that we will see numerous studies correlating autism with numerous other variables (we have published correlation studies in this area), but then we will have great difficulty in establishing causality.

Clinic Notes: Denis Leary on Autism

"Why We Suck: A Feel-Good Guide to Staying Fat, Loud, Lazy and Stupid," by actor Denis Leary is apparently not on the New York Times Best Seller List. What to do? How about a few stupid SAVAGE statements about autism that will make the news and get some free publicity. And I quote from Mr. Leary: "There is a huge boom in autism right now because inattentive mothers and competitive dads want an explanation for why their dumb-ass kids can't compete academically, so they throw money into the happy laps of shrinks . . . to get back diagnoses that help explain away the deficiencies of their junior morons. I don't give a [bleep] what these crackerjack whack jobs tell you - yer kid is NOT autistic. He's just stupid. Or lazy. Or both."
I sure hope sales don't increase!

Clinic Notes: Who Pays for ABA?

ABA is the treatment of choice for autism. But finding qualified ABA therapists, Board Certified Behavior Analyst (BCBA) and not someone who has been to a few ABA workshops, and paying for ABA are two roadblocks. Insurance companies argue that they should not pay because ABA is really more educational than medical and education is the responsibility of the public schools. Furthermore, the insurance companies argue that if they pay for ABA everyone's premiums will go up. Of course, the public schools make much the same argument--money and staff. Okay so who should pay? I know of wealthy families paying six figures a year for ABA and I know of families who cannot get any ABA. One point is who is going to pay when the kids are 21 and sitting in their parents living room with no place to go. And a parent has to stop working to stay home with their child with autism..

Clinic Notes: Mental Health Parity and ABA for Autism

Well today the Mental Health Parity bill passed in the House after decades of close votes. Oddly, the Mental Health Parity bill passed because it was linked to the 700 Billion Wall Street Bailout bill. The President says he will sign the bill. Mental Helath parity requires insurance companies to not discriminate in coverage for mental illness and physical illness. Okay this sounds great, but I'm wondering how autism will fare. Often when we seek pre authorization from insurance companies to cover services for a child diagnosed with autism we are told that we should submit to the insurance companies BHO (Behavioral Health Organization.) Some states have passed an autism equity act stating that autism is a neurological disorder and that if the insurance company's policy cover other neurological disorders it must pay for treatment for autism. (Some insurance companies will not pay for ABA because it is considered experimental despite the fact that the Surgeon General and NIMH recommend it as the treatment of choice.) So what, if anything, does the Mental Health Parity Bill do to ABA and autism coverage? Will BHO's disappear? Stay tuned.

Clinic Notes: NIH Cancels Autism Study

Chelation removes heavy metals from the body and is an effective treatment for lead poisoning. Many people believe that mercury in childhood vaccines causes autism so removing the mercury by chelation should be an effective treatment for autism. There are risks associated with chelation and the NIH decided that the risk of exposing children to chelation was unwarranted. Since many studies do not show a causal relationship between mercury and autism this was probably a wise move. Furthermore, the single case reports on chelation as an effective therapy are lacking. I have kids coming to my clinic who are undergoing chelation and I cannot see any improvement. I wish there was a quick fix for autism like chelation. I'd send all of my ABA patients.

Clinic Notes: Autism and Puberty and ABA

There is an old maxim in neuroscience, which states that anything that affects the normal brain affects the neurologically impaired brain to a greater extent. So usually fatigue, fever, injury, etc. will show up sooner and be more detrimental to a child with autism or other neurodevelopment disorders. Puberty, with its unleashing of hormones, is a difficult time for all children, but sometimes has a greater impact on children with autism. Longitudinal studies on children with autism find a setback in less than a forth of the children followed by recovery. In males I see an increase in aggression and in females difficulty in making decisions. I set up or re-initiate the ABA programs for compliance, which we run we often run with children with autism and related disorders when they first come into our clinic. In females I have found that birth control pills in addition to the compliance programs usually help.

Clinic Notes: Is Savage Right? Are Children with Autism Just Brats?

Nationally syndicated talk show host, Michael Savage said on his July 16 radio talk show "I'll tell you what autism is. In 99 percent of the cases, it's a brat who hasn't been told to cut the act out. That's what autism is. What do you mean they scream and they're silent? They don't have a father around to tell them, 'Don't act like a moron. You'll get nowhere in life. Stop acting like a putz. Straighten up. Act like a man. Don't sit there crying and screaming, idiot.' " Savage concluded, "If I behaved like a fool, my father called me a fool. And he said to me, 'Don't behave like a fool.' The worst thing he said -- 'Don't behave like a fool. Don't be anybody's dummy. Don't sound like an idiot. Don't act like a girl. Don't cry.' That's what I was raised with. That's what you should raise your children with. Stop with the sensitivity training. You're turning your son into a girl, and you're turning your nation into a nation of losers and beaten men. That's why we have the politicians we have."
Well, you can imagine the response of parents with children with autism and the autism support groups. Autism is a neurological disorder and there is impairment in communication, sensory processing, and other neurological processes. Children with autism need multiple services such as Applied Behavior Analysis (ABA), speech, Occupational Therapy, and often medication. Autism also has a genetic basis. Certainly autism is more than brat behavior; however, some children with autism are noncompliant and do not follow directions. Often in our clinic one of the first ABA programs we run is following directions. Sometimes this is related to autism and sometimes noncompliant brat like behavior. But even after these children are compliant and not tantruming there are many behavior left over that are related to autism and the usual parenting techniques do not work. Parents of children with autism who have heard Savage's remarks have all told me one thing. They would like Savage to spend a day with their child with autism.

Clinic Notes: The Children's Treatment Center for Autism or other Childhood Developmental Disorders

Go to http://www.childrenstreatmentcenter4autism.com and check out our new web page.

Clinic Notes: What does the Child with Autism See?

Most of the sensory information humans process is in the visual modality. And while children with autism often do not make eye contact it is assumed that most of the sensory issues in autism are in the auditory and tactile modality. This is most obvious when children with autism cover their ears in the presence of certain sounds or are tactile defensive refusing to wear certain fabrics or not liking to be touched. Problems in the visual modality are less apparent at times, but research has identified problems. For example, some anecdotal studies as well as empirical studies suggest that human faces are seen as either distorted or blank. Furthermore, children with autism seem to focus more on the mouth of the person speaking rather than the eyes. Some studies suggest that some children with autism have Prosopagnosia or face blindness, which cause social as well as other problems. Of course, these studies have an inferential component and I am still wondering what a child with autism really sees. I have planned a series of drawings that I hope can capture what I think the child with autism possibly sees.

Clinic Notes: Prosopagnosia (Face blindness), Autism, and Art Therapy

Prosopagnosia is a neurological condition where people have difficulty recognizing faces. The disorder may be genetic, caused by strokes, or head trauma. Children with autism or Asperger's may also have Prosopagnosia. Some studies have shown that children with autism and Prosopagnosia have less difficulty sometimes if faces are presented upside down. Other studies suggest that children with autism fixate on certain parts of a face and do not see the entire face. It as been suggested that one reason that children with autism have problems understanding emotions in other people is because of Prosopagnosia.
I remember when I was working in a head trauma clinic I encountered patients with Prosopagnosia and the only thing I could suggest was for everyone to wear name tags. Now I wonder if children with Prosopagnosia would profit from "art therapy" where they learned to draw faces. In my clinic we are in the process of identifying children with Prosopagnosia and starting art therapy.

Clinic Notes: Would it be Better to Know if Your Child Is Going to Have Autism?

Autism is usually not diagnosed until the second year of life when language begins to develop. There is some evidence that signs of autism are present much earlier and also that very early ABA intervention might even prevent the development of autism. So the hunt is on to develop a screening instrument for very young children. But some parents are up in arms. They are afraid that the idea that bad parenting will come back. I don't understand their concern. With any disease early detection is always better. So why not with autism?

ABA for Iraqi Child with Autism

I received the email below at my website and with permission reproduced it below. Parents worldwide have problems getting services. This Iraqi mother makes the most of her situation.
Dear Dr.Brown;
Thank you very much, I am really appreciate every single word I read from the ABA e-book, ABA course & Case History eBook. I was completely lost in this country. I am Iraqi dentist and live in United Arab Emirates. I did assessment for my son, age 3 years and 6 months, here by the only specialist in Dubai who had certificate in Autism from Birmingham in UK. She gave him diagnosis of Autism. I showed her a video which helped a lot in the assessment and she told me we will start our treatment with Resperidal. I was surprise by her treatment because she didn't start with any behavior management first to see if the child can be improve or not. I left her clinic and never went back. I visited few autism centers in UAE. They are just starting to give attention to Autism in this country and they gives the priority to the local people (UAE citizenship) and put the others on the waiting list for a years. So I have been dedicated my time searching and reading about Autism since I got the diagnosis trying to help my son. I made food intolerance test for him and the result shows that he should avoid Dairy and wheat product and some other foods also. I already start with him 3 months ago Casein Gluten free diet according to the research I saw from internet. This diet is really effective it improve his eye contact, he stop searching for hair to eat (pica), he start imitate , decrease in hyperactivity, improve in the relation with siblings. He has normal manual dexterity (eating by himself, walking, wearing his cloths with simple assistants). I engaged him in playing group (nursery for typical children ) and he is happy with that but no communication with other children. Before I read your course I start doing my best with him to start verbal communication (he has no words at all), so I start taking pictures for the different foods he eat, bath room, swing,.etc,every time I gave him a food I showed him the picture and tell him the name, after few days I start to show him the pictures especially the fruit that he likes to eat and every time he say the name I say bravo and give him that fruit as reinforcement (ex. if I showed him picture of grapes and he said grapes. I take him directly to the kitchen and give him grapes). It was very effective way and he has now 11 words so far. After I read your course I start with him ABA program. He refused riding bicycle and by using method of successive approximations (shaping);
1- I holding him and let him sit on the bike ( good boy, he will riding bicycle ) then as he stay few second sit ,I give him reinforcement ( I used mixed fruit sweet it is with out milk as he should avoid dairy ) .
2- I fixed his foots on the puddle and I stand in front of him and pulling the bike toward me by (saying come to me Hamza) his foots just pushed the puddles ,(good boy , riding bicycle. and give him reinforcement directly )
3- I stand little bit few steps away and call him (come to me), he push the puddles and once he touch me I give him the reinforcement directly, I never so him happy as he was that day (at that time I wish you Dr. brown be there so I can give you a kiss over your head, God please you).
4- After I that I increase the distant and the direction gradually .actually this improve this eye contact, follow the direction and compliant all at the same time.
Now I am working with caregiver in the nursery to make him stop the behavior excess (dangerous climbing).
I will answer all your quizzes and send it to you.

Sorry for the long email

Kindest Regards
I. H.
UAE

Clinic Notes: ABA for Grandmothers with Autism

When I came in the clinic this morning I checked the messages on the answering machine like I always do. The messages were the usual--parents wanting evaluations on their children--others with a diagnosis wanting treatment. Other messages were from school systems, doctors, speech language pathologists, and other agencies and professionals wanting information on children that I was seeing--nothing different. I thought. I returned as many calls as I could before my appointments started and ran into something different. A grandmother with several grandchildren requested an autism evaluation. I asked her how old her grandchildren were and she informed me that I didn't understand. The autism evaluation was not her grandchildren. The autism evaluation was for her. I apologized and asked her why she thought she had autism. It was because her grandchildren were acting different she said. She thought they might have autism and had got it from her. That's a backward way of looking at autism I thought to myself. Then I wondered if indeed this backward way of looking at autism was autistic behavior. And I wondered if anyone was doing ABA with grandmothers with autism.

Clinic Notes: Language and Autism

Language and speech problems are apparent in children with autism. Many children with autism only understand the literal aspects of language and not what is implied or metaphorical. For example, I was recently trying to get a new child diagnosed with autism to interact with me. I rolled a ball to him and said, "Roll it back". He picked up the ball, put it behind his head and let it roll down his back. I had not said, "Roll the ball back to me." The implied part of the sentence did not register. Idioms are another real problem. If I say to a child with autism, "It's raining cats and doges," they look at me like I'm crazy. One of the children I see with autism got mad at one of her relatives that she ad not seen in a while. The relative said, "You are growing like a weed." The child was insulted because she thought the relative was calling her a weed and did not get the metaphor.

Clinic Notes: Autism Week is Almost Over and There's Not Much to Celebrate

Forty years ago I saw a case or two of autism every couple of years. Now seventy to eighty percent of the children that I see each week have a diagnosis of autism. I have a long waiting list and most of the kids on my waiting list will also end up with an autism diagnosis. We do mainstream fifty percent of the children with autism that we see on a regular schedule and that's certainly something to celebrate. But I worry about the other fifty percent and the children that I see and the other children in the rural area where I practice that I don't see because of funding or other issues. Every Psychologists, Board Certified Behavior Analysts (BCBA), Speech Language Pathologists, Occupational Therapists, and Pediaric Numerologists I know tell the same story. Too many kids with autism and not enough providers. Parents of children with autism from all over the world email me at my website and complain about finding and paying for services. I feel like we are at war and our children are being taken from us in ever increasing numbers. And it is long past the time for mobilization. Hopefully, when autism week comes around next year there will be more to celebrate.

Additional Online Survey Question: Veins and Autism

We are conducting a survey on the potential causes of autism. We are analyzing data now from a larger study and hope to have the report completed by summer 2008. Currently, we have almost 3000 surveys. We have an additional issue we wish to explore concerning the presence of veins on the temples. We need mothers of normally developing children as well as those mothers with autism so we have a comparison group.
There are only 8 questions and will only take a couple of minutes to complete. By clicking on the submit button you are consenting to participating in this study. If you have any questions or concerns you can contact Dr. Angie MacKewn in the psychology department at the University of Tennessee at Martin at amackewn@utm.edu or 731-881-7370.
Thank you for taking the time to complete this brief survey.
If your child is normally developing thanks for participating so we can have a control group. Please go to http://www.aba4autism.com and click on the survey link. Thanks Dr. Brown

Twilight's Children:#1

Twilight's Children:
Research and Clinic Notes on ABA and Autism #1
Forward
The soft light that appears when the sun is still below the horizon, either at daybreak to sunrise or sunset to nightfall is defined as twilight. The children with autism that I treat in my clinic are like the twilight. With intensive therapy they are going to brighten like the earth brightens at sunrise, or unfortunately, as is sometimes the case with severe regressive autism or a failure to continue therapy, dim like the earth dims as night falls. What follows are some of my clinic and research notes on these extraordinary children whose numbers are now epidemic.

Introduction: A Short History of Autism

The history of autism is relativity short, unless you accept Bruno Beitleheim's suggestion that feral or wild children were really children with autism. He argues that feral children were abandoned autistic children. Since they couldn’t speak, it was assumed by the people who found them, that these kids were raised in the wild by animals. (For a case history and modern day examples of feral children see my eBook at http:www.aba4autism.com).
The history of autism starts in 1943, when an American psychiatrist named Leo Kanner published the first paper on autism. The word “autism” comes from the Greek word “autos” or “self” and Swiss psychiatrist Eugen Bleuler, first used the term in 1912. “Autistic thinking” did not involve outside reality, but only the individual’s inner thoughts or feelings. Bleuler thought schizophrenics were locked into this way of thinking. Kanner used the term autism to describe the extreme social disinterest he observed in a small sample of young children, and thought the disorder was congenital.
In 1944, paper published by Austrian psychiatrist Hans Asperger described a similar sample, which developed speech and functioned at a much higher level. The diagnostic label “Asperger’s Syndrome” was later coined for these children and added to DSM to go along with Kanner’s autism. Whether the kids Asperger observed were just high functioning autistic kids or a different syndrome is still debated. (At present we have a large-scale study underway, which will hopefully break down the Autism Spectrum into more definitive diagnoses.
Psychoanalyst Bruno blamed all the moms for autism. These so-called “refrigerator mothers,” who were emotionally cold and rejecting, caused a psychosis in their children which was similar to schizophrenia. (Actually, very few autistic children actually develop adult schizophrenia.) Unfortunately, mothers at the time not only had to deal with an autistic child, they also had to deal with their guilt.
Bad parenting does not cause autism. There is a genetic component to autism that is being investigated extensively. But genetics cannot be the whole story. Something else has to be involved either pre or post natal. The MMR vaccinations that children receive, viruses, allergies and food sensitivities, toxins and pollution in the environment, and dysfunctional immune systems are all being investigated as possible causes of autism. I expect that after more research is done--perhaps years more--that autism will be like cancer. Many types of autism and many causes of autism will be found. And of course, many treatments. Fortunately, autism is treatable now with ABA, speech therapy, occupational therapy, and a handful of medications.

Clinic Notes: Broken Promises in a Bottle

Broken promises in a bottle is not a lyric in a country song, but it could be a title to a bad country song that five year old Janie hears three or four times a week. Janie's mom is an alcoholic and former recreational drug user who has lost custody of her children. The court awarded custody to the grandparents. When mom calls every night she tells Janie that that she is going to come and get her the next day and take her to a movie, or the playground, or perhaps McDonalds for lunch. Janie gets excited and the next day waits patiently for her mom to pick her up. But mom never comes. Now Janie cries when she hangs up the phone after talking to her mother, because she knows that mom is going to not come the next day as she promised. Of course, Janie is learning to not trust people. Alcoholics and drug addicts are always going to leave causalities in their wake. Janie has a learning disability because her mom did drugs while she was pregnant and I had been doing ABA and behavior management for school problems. Her grandparents asked me if I could help. Social Stories are the only therapy that I know of that would be appropriate in a case like this. So I have been writing social stories on alcohol and drugs and broken promises and going over them with Janie. It's a lot for a five year old to take in. But Janie is not crying anymore.

Through the Looking Glass: ABA in Wonderland

A diagnosis of autism in a child can be horrible news for the family. Of course, after the diagnosis the physician or psychologist discusses the services the child will need to overcome autism and hopefully mainstream in the school system. According to the CDC and other government heath care agencies, as well as and most health care professionals now realize that Applied Behavior Analysis (ABA) is the treatment of choice. ABA will teach the child with autism to follow directions, not tantrum or be aggressive, and make it easier for speech, OT, teachers, and other professionals to work with these children. After getting a diagnosis of autism and information on services the real fun begins for parents. Usually, finding someone competent to do ABA with their child and how to pay becomes an issue. (Usually insurance companies say that ABA is experimental and will not pay.) ABA providers range from Psychologists with Ph.D's who are licensed Health Care Providers (HSP) to someone who has been to a few workshops. Board Certified Behavior Analyst (BCBA) hold Master's degrees and have specified graduate courses in ABA, a long supervised internship, and must pass a comprehensive national exam. In my view BCBA's hold the minimum qualifications. Of course there are not enough Psychologist and BCBA's around and the ones that are around are booked up and have long waiting lists. So many parents find themselves looking for ABA because it is the single most effective treatment for autism and wondering why it is not more widely available.

Clinic Notes: Prognosis for a Child with Autism

Every parent wants to know what the future holds for his or her child. And this is especially true for a child with a disability such as autism. What is the prognosis for a child with autism? Well years ago I remember reading articles asking what happens to children with autism when they become adults? Back then children with autism just seemed to disappear--absorbed into society in one-way or another. The stats were 1 in 2500, later 1 in 500. But now with 1 in 150 children with an autism diagnosis how will the picture look like when these kids are grown?
Last week one parent told me that a speech-language pathologist told her that her child had severe autism and would never amount to anything. This seemed to me a very cruel thing to say to a mother, but setting that aside how accurate was this prediction? I remember reading that 50% of children with autism also had mental retardation and 10% were savant. But I wonder about the accuracy of this statement because I know a lot of children with autism have performance deficits. In other words, they know the correct answer to a question, but choose to not give the correct answer for one reason or another. If 50% of children behave as if they have mental retardation what programs will be available for them after they leave the school system? (Group homes and sheltered workshops now have long waiting lists.) I have not seen this problem addressed by any candidate running for any office. Maybe children with autism will just be absorbed into society when they grow up like they were in the past. But I doubt it.

Clinic Notes: Does the Autism Apple Fall Far from the Tree?

When I have a new child come into the clinic, and I am taking a history, I ask the parents if anyone else in the family has an autism diagnosis. The answer is almost always no. But often, after weeks of therapy, one or both parents, after having learned more about autism, often state that they wonder if they have autism. (And sometimes after getting to know the parents I wonder too.) Parents of children with autism analyze their past development and either interpret or misinterpret some of their behavior as autistic. This seems to be especially true of certain high tech professions.
Much the same thing is true of other maladies such as bipolar disorder, depression, and alcoholism. But these disorders usually show up in adults and not children. So instead of parents seeing themselves as perhaps having the same autistic behaviors as their children, children, especially grown children, see (blame) their bipolar, depressive, alcoholic behaviors in their parents.