Thursday, March 20, 2008

Twilight's Children:#1

Twilight's Children:
Research and Clinic Notes on ABA and Autism #1
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
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.

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