Clinic Notes: Munchausen Syndrome by Proxy and Autism

On my website and in my clinic I recommend that parents of children with autism seek help from multiple professionals such as Speech Language Pathologists, Occupational Therapists, sometimes Physical Therapists, and Pediatric Neurologists in addition to the psychological services that I provide. And many parents follow my advice. Now I hear that some mothers of children with autism, so far none who come to my clinic, have been accused of Munchausen Syndrome by Proxy (MSBP). In MSBP mothers seek excessive medical care, sometimes for a disease they have caused or fabricated, and the multiple treatments may threaten or actually harm the child. Mothers accused of MSBP often have their children taken away from them by the court and now there is at least one case in court where a mother of a child with autism is being accused of MSBP and is in danger of having her child taken away from her. I guess no good deed goes unpunished.

Clinic Notes: Making Sense of Autism Research

As a clinician, who also does research into the etiology (causes) of autism, I am often overwhelmed by the explosion of research findings. Which findings are useful in diagnosis? Which findings are useful in revising treatment options? Which findings are useful in designing future studies? It is simply too much--too much data in too many places with no organization. I was thrilled to read about the National Institute of Health's (NIH) new autism database. The National Database for Autism Research (NDAR) that will have research findings in one place that can be accessed by clinicians and researchers. As I read further though I was less thrilled. The database will only contain data from NIH sponsored research and will not be operational until 2012. Oh well, one small step . . .

Clinic Notes: Asperger's and God

In last week's blog I discussed a teenager with Asperger's who had murdered a classmate after years of rejection by his peers. Now a big switch to a study that examined how Asperger's folks see purpose in their lives. People without Asperger's who believe in God saw His purpose behind many events in their lives. Similiarly, in terms of thinking, a group of atheists stated that things just happen there is no Devine intervention. This study supports the idea that children and adults on the Spectrum lack a "theory of mind" an ability to see or hypothesize what others are thinking.

Clinic Notes: Asperger's and Murder

Children with Asperger's have problems socially. Often they are isolated and friendless and cannot understand why. Theoretically, children with Asperger's lack a theory of mind. In other words they cannot hypothesize what others are thinking and therefore cannot adjust their behavior in social situations. Recently, a child with Asperger's who had been rejected all of his life commited murder. Children with Asperger's have obsessions and this child committed murder because of his obsession with Stephen Ling novels--one of which said that the 19th would be a day of doom. So on the 19th he took a kitchen knife to school and stabbed another student to death in the restroom. The jury did not buy his insanity defense. I see a number of Asperger's children in my clinic each week and have yet to see any that are violent. Interestingly, in the new DSM revision, which is the bible of psychiatry and psychology, Asperger's will be deleted and children with Asperger's will be diagnosed with high functioning Autism. In my next blog I will discuss Asperger's and belief in God.