Dispelling Myths About Autism
The boy continually flicks his hand while ignoring everything around him. He seems locked in his own world. He suffers from a condition called autism. A recent article in Pediatrics reported that about one in 91 children has autism spectrum disorder. Autism is more prevalent in boys than girls, with four times as many boys affected than girls. It usually shows up before a child turns 3. An autistic child may not speak or may simply mimic sounds. He may be prone to bizarre gestures and often rejects physical contact. The American Academy of Pediatrics recommends that all children should be screened for autism spectrum disorders (ASD) at 18 months and 24 months, regardless of whether there are any signs or concerns about a child's developmental progress
When psychiatrist Bryna Seigel, Ph.D., began working with autistic children, experts thought that mothers could cause autism by not giving their child enough hugs. She helped dispel this belief by showing that autism was a neurological condition.
Analysis and testing
Dr. Seigel is director of an autism clinic in San Francisco. Each year, she assesses children from hundreds of families. These assessments include intense analysis, observation, and testing. The experience is emotionally draining for her and the families.
"I don't think I'll ever become desensitized about telling parents that their child is autistic," Dr. Seigel says. "A diagnosis of autism can be like a living death, for a child may look normal but exist in a state of limbo."
As an undergraduate in the early 1970s, Dr. Seigel first worked with autistic children at a state hospital in Queens, N.Y. Most of her autistic patients came from impoverished, dysfunctional families. At the time, autism was considered a result of bad parenting.
Soon after, while working on an internship at the Elwyn Institute in suburban Philadelphia, she first noticed the remarkable similarity in many of the autistic children she had encountered, despite the vast differences in their socioeconomic background.
"As they were spinning in circles and looking at their fingers, I thought about how 'hard-wired' their actions were and realized that autism could be a neurological, not a psychological, disorder," Dr. Seigel says.
Dr. Seigel's beliefs were soon echoed by other child development experts, and by the 1980s, autism was classified as a neurological disorder.
Range of severity
Dr. Seigel stresses that autism surfaces in varying degrees of severity and lacks a concrete set of symptoms. Autistic children may develop unusual speech patterns, make little eye contact or flail their arms, but the most telling characteristic is what she calls a "learning disability of social contact."
She says that Hollywood's portrayal of autism in the movie Rain Man was accurate in its depiction of the character's bizarre social interactions, but off the mark by making him a math genius. In fact, she says, about 70 percent of autistic children also have some form of mental retardation.
Because autism is considered a brain disorder, young children usually are treated with 25 to 40 hours a week of intense behavioral therapy. The idea is to stimulate these children. They don't get the stimulation they need when they engage in endlessly repetitive behaviors or simply stare into space for hours.
Dr. Seigel developed a screening test to help people recognize signs of autism. The goal is to diagnose and begin treatment at an early age to improve the chances of autistic children achieving their potential.
Does that mean that children born with autism today will fare better than those born in 1950? "Absolutely," says Dr. Seigel. "It's very exciting. With early diagnosis and intensive treatment, some autistic children seem to have the capacity for brain remodeling [transferring functions from one part of their brain to another], much like a stroke patient."