What’s clear in the U.S. is that diagnoses of autism have increased tenfold over the last three decades; what’s unclear is why. Possible answers are many, including (of course) vaccination, which has been exculpated; a better ability of doctors and psychologists to diagnose autism, a change in the criteria for diagnosis (the DSM, for instance, expanded the criteria for “autism spectrum disorder”), unknown environmental causes like chemicals in the water or pesticides, and so on.
Steve Silberman’s new book, NeuroTribes: The Legacy of Autism and the Future of Neurodiversity, argues that the “epidemic” is due simply to changes in the diagnostic criteria (note: I haven’t read it, but am going on today’s New York Times review by Jennifer Senior). He excoriates the anti-vaxers who blame autism on shots, or on the mercury in those shots, and extensively recounts the history of autism, beginning with Hans Asperger‘s work in Vienna.
Senior finds faults in the book, including an overly-short treatment of the vaccination controversy and a tendency to give too much backstory on patients, but in the end gives the book a strong endorsement:
But carry on nonetheless. “NeuroTribes” is beautifully told, humanizing, important. It has earned its enthusiastic foreword from Oliver Sacks; it has found its place on the shelf next to “Far From the Tree,” Andrew Solomon’s landmark appreciation of neurological differences. At its heart is a plea for the world to make accommodations for those with autism, not the other way around, and for researchers and the public alike to focus on getting them the services they need. They are, to use Temple Grandin’s words, “different, not less.” Better yet, indispensable: inseparably tied to innovation, showing us there are other ways to think and work and live.
The most moving chapter, one that had me fitfully weeping throughout, is the penultimate one, which chronicles that miraculous moment 20 or so years ago when autistic adults finally began to find their own tribe after lifetimes of misdiagnoses and alienation. Silberman tells the simple story of an autistic woman named Donna Williams who had just written a memoir, visiting two compatriots she had never met. “Seeing the thrill that Williams got from the lights playing off a Coke can,” Silberman writes of one, “he later sent her a belt covered in red sequins from Kmart as a gift.”
It’s an apt metaphor for our culture’s evolving attitude toward autism: If the light bounces off something a little differently, it can be seen in a whole new way.
The first paragraph above is a bit confusing to me. The “neurodiversity” movement sees the variation in behavior and thinking as part of a normal spectrum, which may well be true for autism, but not for something like schizophrenia. And yes, of course people who are described as being “mildly autistic” or “have a touch of Asperger’s” are often those who are brilliant achievers in some area, and don’t seem to need “special treatment” at all. But there’s nothing controversial in what Silberman is saying here. Some of those on the “neurodiversity spectrum” do need help, for, regardless of whether and how people regard them as ill, they can’t function in society without special attention.
So who has ever doubted that “the world should make accommodations for those with autism”? For severe forms, at least, we don’t ask them to squeeze, without help, into the Procrustean bed of society.
The last two paragraphs are also uncontroversial; we should of course treat these people as humans with human dignity, and avoid stigmatizing them as “odd” or “sick” as far as we can. What I wonder, though is whether the extreme forms of autism, even if they’re the end of a spectrum, are to be celebrated as “diversity” rather than treated as an illness. Some, like Kay Redfield Jameson in her book Touched With Fire, argue that mental illness (she suffers from bipolar disorder) has salutary side effects, giving many cases of artists, writers, and scholars whose achievements, she claims, were promoted by their illness.
But the celebration of “neurodiversity” claim can go too far. As I wrote in a previous post on the neurodiversity movement,
I agree that there may be a spectrum for many mental conditions like depression, autism, and even bipolar disorder, and that the spectrum may even be continuous rather than a bimodal one having peaks at “normal” and “disordered”. After all, neurological conditions likely reflect a nexus of genetic causes—with cognitive and behavioral differences based on many genes—as well as environmental influences. Nevertheless, the important question is this: what do we do about those who suffer from things like bipolar disorder or autism? And I say “suffer from” deliberately, for doctors clearly see most such individuals as suffering because of their conditions. By accepting the condition as “normal”, or writing it off as simply one segment of a spectrum, neurodiversity advocates implicitly—and sometimes explicitly—deny that these conditions should be be cured.
I find that odd and even reprehensible. In the desire to see everyone as “normal”—as part of the rainbow of human diversity—this movement totally rejects the idea that some people are actually suffering and could benefit from treatment. Why else are there drugs for bipolar disorder, and why do parents desperately seek help—both medical and psychological—for children with autism?
The neurodiversity issue seems to me an extension of “identity politics”—which I’ll take here as the view that everyone is special and unique, and deserves to have their desires, abilities, and personality not only accepted, but celebrated. It’s the same mentality that has decided that, in school contests, everyone should get a prize so that nobody will be disappointed, or feel stigmatized or inferior. In the neurodiversity movement, not only should one not stigmatize “mental illnesses” (something I absolutely agree with, for these conditions are, like all disorders, determined by genes and environment), but we should accept them to the point that we shouldn’t even try to cure them.
But ask those who suffer, or who live with the sufferer, whether we should seek cures. Since conditions like autism, bipolar disorder, or schizophrenia must surely reflect neurological issues, they can in principle be cured or controlled. Bipolar disorder, for instance, can now be largely controlled with drugs, and believe me, those who have this issue want those drugs, despite their often unpleasant side effects. And which parent with an autistic child wouldn’t want that child to be helped or cured through some kind of intervention? The “facilitated communication” scam, in which people claimed to help autistic children “speak” by guiding their hands on a keyboard (the facilitators proved to be the ones doing the communicating), shows how desperate parents are to help such children.
In its desire to celebrate mental diversity, the neurodiversity movement in fact promotes suffering. Making sure that all children get prizes is one thing, and not terribly harmful, but denying children or adults cures for mental disorders is a different matter. That’s both thoughtless and horribly selfish, placing a misguided liberal ideology above the well being of the afflicted.
Or, as my doctor, Alex Lickerman, told me when I asked him about this movement, “The issue is not how far from normal you have to be to be considered as having a ‘disease’. The issue is how much of the way you are ‘built’ is causing you to suffer—and what do we do about it. . . The neurodiversity movement is utter nonsense. Ask those who have these problems whether or not, if a cure was offered, they would accept it.”
If we’re going to celebrate neurodiversity, then why not celebrate “health diversity”, and say that those who suffer from various illnesses should be held up as part of a continuous spectrum of wellness? Yes, of course nobody with chronic conditions and illnesses should be stigmatized or mistreated, but we should think twice before we argue for withholding cures, as many “neurodiversity” advocates do.
Now Silberman may not hold the “celebrate all differences” view of autism, and I hope he doesn’t. What interests me about the issue is the dramatic rise in cases of autism, and what we should do when it causes suffering. What interests me less is celebrating severe suffering as simply one tail of a distribution.
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I’ve seen that argument used many times as justification for not trying to cure these afflictions. That seems alarmingly cruel and self-absorbed…should we celebrate the suffering of these people just because the rest of us receive some transient benefit from it?
The tricky part is that some who are on the spectrum can make their own way in the world, but others will need support that ranges from counseling and some life assistance to constant care. Why anyone would want to ‘celebrate’ a kid who is locked in their own head and can barely communicate is beyond me.
It’s a tough call. The brother of a friend had been, as a child, rather severely autistic, isolataed behavior, head banging etc. By the time I knew him as an adult, he was mildly eccentric with a few unusual but harmless obsessions.
He was well aware of his ‘differences’, he observed that he had to view conversation as if it were a scripted dialog .. simple chi chat did not come naturally to him.
If you look at the famous cases of mentally ill artists, you’ll see that their mental illness eventually cut short their careers if not their lives. It’s like justifying drug abuse and alcoholism because so many great rock musicians partook without mentioning people like Janis Joplin or John Bonham who died young.
Additionally, one should point out all the great art produced in states of sobriety or by folks who are “neurotypical”. I’m extremely skeptical that drugs/alcohol/mental illness turned average joes into creative geniuses. The creativity was most probably already there.
There were some here who justified Christopher Hitchens’ borderline alcoholism by claiming that it helped make him what he was.
Hitchens did that himself. When asked if he would have lead a more abstemious life if he’d known it would kill him so young, he said he wouldn’t. The booze and ciggies was too important to his lifestyle.
But I much doubt whether Hitch would have claimed that his talents were boosted by drinking and smoking. He might have pointed out that they were part of his personality and without them he’d be a different person, but that’s not the same thing.
In one interview I remember he said he actually didn’t drink so much in later life as he did as a young radical. He claimed he lately drank about, I think it was, most but not all of a bottle of wine for dinner. Extras were, I guess, for parties, etc. Not what I would call an alcoholic (defn?) His reputation was from excess in his youth (who didn’t?). He did have enormous physical stamina – he could party and lecture steadily for several days at a time without sleep.
In the interview I recall, he seemed to me to be saying that the drinking and smoking were a necessary part of the interactions he had with other luminaries, without which the conversations he took part in would not have been as productive. Whether he was right about this is another thing of course.
Using it as a social facilitator? There probably is some validity in that.
That’s a different thing from claiming that drinking improved his faculties (which is analogous to the ‘autism-helps-talent’ claim*).
*I’m aware that may be oversimplifying the claim in question.
Yes, he didn’t suggest that it made him a better journalist, merely that the social interactions he had with many interesting people would not have been as fruitful without it. Certainly very different from the idea that mental illness is beneficial to creativity in some way.
Also the Grateful Dead’s very best album is the one they made when they were the most sober. American Beauty.
This IMO is true some of the time, but not universally so.
Vincent van Gogh was a great painter before mental illness started to affect him, even though his illness is sometimes romanticized as having somehow made his art greater (as in Don McLean’s song “Starry Night”). Nijinsky was a great choreographer before the onset of schizophrenia, and his illness definitely cut short his career. I suspect Sylvia Plath would have produced good poetry covering a much wider emotional range of feelings had she gotten a successful treatment for her depression.
During the first 20 years of his career, Paul Simon composed a very good body of songs about loneliness and alienation, his most famous song being probably “The Sounds of Silence”. However, IMO with the Graceland album, a new strong and self-reliant Paul Simon emerges. The latter is just as artistically appealing. The “Troubled Waters” persona couldn’t and didn’t last forever.
Some of Shelley’s poetry strikes me as a plea for sanity in a mad world.
Kay Jameson’s book cited above talks a lot about Virginia Woolf. The relation of illness to her art remains a subject of controversy. The romanticization of her as a “neurotic genius” is very argued against in the book “The Flight of the Mind: Virginia Woolf’s Art and Manic-Depressive Illness” by Thomas Caramagno. Notably, he sees her novels as being part of a quest for a cure!! (Oddly this book has an afterword by Kay Jameson, so the perspective of these two authors is evidently not 180 degrees at odds.)
A poet about whom this kind of sentiment was expressed more than once was William Blake, but many today believe that while he in some ways fit the profile of a schizophrenic, he nonetheless was not one.
There WAS a very amusing cartoon in the New Yorker years ago suggesting this sentiment, possibly the only three-panel cartoon in their history. Entitled “If they had Prozac in the 19th century”, Panel 1 showed Edgar Allan Poe petting a raven saying “Nice birdie”. Panel 2 showed Karl Marx sitting in the British Museum saying “I guess capitalism will eventually work out its kinks”. Panel 3 showed Friedrich Nietzsche outside a church saying “I really liked the sermon mother, especially the part about being good to weak people”.
Hilarious, but I’m not sure I agree with the message.
Ah. I see you already made this point. I agree.
I’m having difficulty finding a clear and authoritative definition of salutory.
I meant “salutary” and have changed it. Thanks.
I totally agree with you. I haven’t read the book, but I keep seeing comments about the book implying that autism is just another kind of normal.
I can’t believe anyone who has known families with children who suffer from extreme forms of autism could think this way.
To be clear I’m speaking exclusively of extreme forms. What he says about milder forms I don’t find groundbreaking or controversial.
I know someone who is bipolar and has been prescribed medications for it. She found the side effects unacceptable and turned to vegetarianism to treat the condition. After some time, she began to feel that that really wasn’t working. Not sure if she’s back on meds or just coping as best she can. There’s nothing salutary about her situation.
What I try to explain to people who ask is that the word autism most likely refers to a group of genetic diseases. This has turned out to be a very complex issue. Most of the case are probably influenced by multiple genes of small effect. This has made the problem very hard to unravel. I think it will happen, though, probably in the next decade or two.
If one does not want to label a mildly affected person who can function in society as having a disease, I don’t see why I could object, but there are patients who cannot function independently, and they should be so labeled so they can receive assistance.
This book will cause the anti-vaccine loons to howl. It will be fun to watch, but that link has been so thoroughly debunked that it is not worth discussing.
I have allergies. If you’d like to call that a disease, feel free. I’m mildly affected except when an insect stings me. I don’t feel stigmatized at all!
I wish brain disorders & diseases would stop being stigmatized. Lucky people who have the right DNA, upbringing, and early life experiences have no right to impugn the parents or patients as they do.
This is important to me, as I have a close family member with moderate Asperger’s. It was through this that I have learned that public schools today spend significant resources to assist kids with these conditions. It is now a routine and constant issue. They have full-time special counselors (who are very busy going from school to school in a district as there are not enough of them), quiet rooms (to help a kid who needs to re-group), and every teacher is aware and involved in the the pacing and sensory needs of each child. Just as an anecdote, for example, some desks will have a strip of velcro under the edge of a child’s desk. A child who is anxious can feel this with their fingers, and the sensory effect helps re-focus them into a calmer state. Very clever. Other kids need earplugs since the noise levels can cause a crisis for them.
This of course blends in with children with other disorders like ADHD, which schools must also deal with.
The *better* schools do this. Not all 🙁
That is true. I am in a very good district, and the counselors are stretched pretty thin as it is.
Can you go into more detail about the earplugs? I’m trying to picture it.
There are foam rubber earplugs that you can buy at any drugstore. They are good for anybody in other situations too, like loud concerts.
Do the other students have to wear them whenever the autistic child is in the classroom?
No, the earplugs give the autistic child a respite from noise. My autistic grandson and many children who are “on the spectrum” can become hysterical in noisy, chaotic situations. He has been in treatment for several years and is now better able to handle noise. But he still exhibits a number of abnormal behaviors like echolalia and repetitive movement. And he often ignores directions – frustrating for parents and teachers, and potentially hazardous for himself and others. One of the challenges of parenting such a child is distinguishing between willful disobedience and distraction / self-absorption.
Fascinating. It’s so interesting how low-tech some of the ameliorations can be.
50 years ago, children with severe autism were labeled “retarded” and sent to special “schools” to be warehoused. Children with Asperger’s were labeled “strange” and regularly bullied. They were saved by science, chess, or arty clubs in larger schools.
…and 50 years ago there were fewer children born to older fathers. I read somewhere (no citation, sorry) that autism is more common in children of older fathers.
The polio vaccine can be blamed for a lack of cripples parading around with withered legs and arms. Back in the day everyone knew someone who was crippled physically so there was less “ableism” back then. If we brought back polio there would be more empathy for people with invisible conditions!
p.s. Joni Mitchell is a polio survivor, and she developed her own method of guitar playing because it had affected her hands. So kudos for polio! And then there’s Itzakh Perlman, who plays violin concertos sitting down. What a great innovation, due solely to polio!
info on autism prevalence & age of father:
http://www.nature.com/news/fathers-bequeath-more-mutations-as-they-age-1.11247
Kong, A. et al. Nature 488, 471–475 (2012).
Sanders, S. J. et al. Nature 485, 237–241 (2012).
O’Roak, B. J. et al. Nature 485, 246–250 (2012).
Neale, B. M. et al. Nature 485, 242–245 (2012).
We don’t need to bring back polio. The War on Terror has taken up the slack and supplied us with more than enough crippled and maimed young people.
Not sure if “cure” is the best fit for discussions about mental illness. Reducing symptomatology may be the best one can hope for in refractory cases while trying to manage the emotional/behavioral loose ends. The neurodiversity motif is a way of euphemistically acknowledging (in an ingratiating manner) the ongoing limitations of modern psychiatry–despite mental healthcare’s desperate attempts to merge with clinical neuroscience.
I have a good friend and a nephew with Aspergers. My nephew, now in high school, has had a lot of support from both the public school system and special services, and he functions quite well.
My friend grew up in a household where neuro-atypicalness was seen as an absolute disaster and a reflection on parenting, so her differences were denied and she was often punished for misunderstandings. She’s learned to mostly function okay, but anyone who is close to her sees quickly that she’s just a bit different. As an adult, she’s had trouble keeping jobs because someone simply can’t stand to work with her and arranges her exit, or else a supervisor gets baffled and angry that she can’t “read between lines” and make “normal assumptions”, and turfs her out.
Currently, my friend has a supervisor who has training in psychology, and understands her predicament. As a result, he enables her to function very, very well in her current work environment. But to spend one’s life at the mercy of lucky breaks like that is very difficult.
And yet, if my friend were magically cured of her autism, how would that affect the rest of her cognition? Would that change the quirky, brilliant, enterprising, empathetic person that she is now? I don’t know.
But I do hope my nephew doesn’t suffer a similar fate.
“And which parent with an autistic child wouldn’t want that child to be helped or cured through some kind of intervention?”
Am I wrong in seeing a parallel between this and the parents who refuse to give a deaf child cochlear implants? Of course, these are usually deaf parents who want the child to “be like them.” I’ve always thought of this as horribly perverse, but many disagree. (In fact, it appears that children are being genetically pre-selected for deafness! See https://www.psychologytoday.com/blog/maybe-its-just-me/201102/selecting-deafness-in-children.)
And where do we draw the line? I’m sure that most on this list have argued strongly for the rights of gays, including the right to marry, and adopt, or to have children by whatever means suits them. But if it were possible to “push a button” and choose the orientation of one’s child, would it be wrong to look at the undeniable prejudice (including threat of death) that gays face, and choose for that child to be straight?
This leads to some really ugly thoughts. What if we could choose a child’s race? (Other than by the usual means of exercising choice of a mate.) Of course “not being white” isn’t a disease. But it’s undeniably linked statistically to being poorer, having more interactions with police and the prison system, and in particular having a shorter life span…which does bring us back around to the neurodiversity discussion.
Leaving autism aside for just a moment, I understand that there is also a significant movement in the deaf (and I use that word deliberately: I believe they use it to describe themselves and reject “hearing-impaired”) community to say that deafness is a condition to be celebrated, and that attempts to “integrate” into the hearing world (such as by hearing aids, lip-reading, and speech training) are inappropriate. This seems to me to be as misguided as the neurodiversity movement. Humans have a range of degrees of visual acuity also (my own vision was 20/200 before correction), and yet I have never heard of anyone urging that extreme myopia – or name your visual disability – is anything other than something to be treated if possible.
I believe you are correct on this. If the technology is there to give hearing to some who do not have it, how could it be better to not hear? The same for eyesight or smell.
Many older people go nearly deaf from damage over the years to hearing or loss associated with old age in general. It can be very difficult for the older person to function on their own after the hearing loss. Communication comes to an end and it is nearly as difficult as someone who suddenly goes blind.
I think it’s perhaps a mischaracterization to say that they regard the condition of deafness as something to be celebrated. Rather, it’s the unique language and culture of the deaf community that they value and wish to preserve.
So the analogy with visual impairment doesn’t really hold up; a better analogy would be with aboriginal peoples whose native languages and cultures are threatened with extinction by Western cultural imperialism.
I’m not saying that letting kids grow up deaf is the right answer. But I do understand where the impulse comes from, and I don’t think it helps to portray deaf people as moral monsters for wanting their kids to share their mother tongue.
Oliver Sacks’ Seeing Voices is a good intro to deaf culture.
“…I don’t think it helps to portray deaf people as moral monsters for wanting their kids to share their mother tongue.”
No, but that isn’t what they’re doing. At all. They’re “shar[ing] their mother tongue” to the EXCLUSION of all others. Which is monstrous.
Often families that have come to the U.S. from another culture have insisted that their children ONLY speak English, refusing to teach them (to cite just the most obvious example) Spanish. I know a LOT of second-generation Mexicans here who can’t speak Spanish worth a damn. That’s perverse (and really stupid) enough, but hardly a good analogy for the situation of forced deafness. That’s more like a Mexican family moving to the U.S. and forbidding their children to learn English…or any other language on the planet EXCEPT Spanish (or worse, Nahuatl or one of the Mixtec languages). In those cases, no one in their right minds would see the parents’ actions as anything but reprehensible.
My analogy was with aboriginal peoples, not immigrants. Deaf people didn’t “come to the U.S. from another culture” with the express intention of assimilating; they were born here and their culture has existed alongside hearing culture their whole lives. Historically there’s been no pressure for them to assimilate; deaf culture has been free to develop on it own.
Now they’re being told by hearing culture they have no choice but to assimilate, for the good of the children, that their reasons for resisting are irrelevant, and that failure to go along with this program is “reprehensible” and “monstrous”.
I just don’t think that’s a productive approach to solving a difficult ethical problem.
I haven’t read Steve Silberman’s book yet, but I found his TED talk moving and informative. I hope he’s not in the celebration camp, and I doubt that he is.
I would caution against assuming that autistic individuals who are brilliant achievers, or those with milder forms of autism, do not suffer disproportionately in ways that are invisible to even their closest caregivers. These individuals are often teased and/or punished, especially as children, for their inability to read and respond to social cues. There are therapies available to help these children once they are identified, but there is still a lot of work to be done in building community awareness. Interactions with law enforcement, for example, are particularly terrifying to parents raising a child with few or no visible traits of autism, who may be unable to distinguish between a single person who is asking for a response and background lights and noise.
Reblogged this on Nina's Soap Bubble Box.
There is a saying that I remember from somewhere that goes something like this, “People with mental illness are just like us only more so. “
Several child psychiatrists I know all attribute the increased incidence of autism spectrum disorders to better diagnostic criteria and mechanisms, i.e. they’d say it’s improved recognition of ASD manifestations, rather than an increased incidence per se. Physicians used to be reluctant to make a diagnosis in children under the age of 2 years, but that’s no longer the case, and many features of ASD can be recognized much earlier. One of the factors associated with an increased risk for ASD – low birth weight and prematurity – is often discussed in pediatrics journals (and there are a number of peer-reviewed studies documenting this), but I’ve not heard it mentioned by child psychiatrists.
I’d be interested to know whether Silberman mentions the ideas held by some child development specialists that overstimulation or inappropriate stimulation from electronic devices/media during infancy and toddlerhood might contribute to the increased incidence of ASD. I’m not willing to dismiss these ideas out of hand, actually, although some of them might arise from anti-technology woo, and it would be difficult to identify substantial populations of children raised in the absence of electronic media as controls for a meaningful study. It is true that the aforementioned preemie infant population is exposed to a lot more intrusive electronic crap in the NICU early in life.
Regarding the neurodiversity argument, some observations made by the father of the autistic child in the book/film “The Horse Boy” stick with me. At the beginning of the film, the boy spends a lot of time screaming and crying, doesn’t speak with his parents, and as the father says, “is isolated from his peers.” While it might be true that a few individuals choose to be socially isolated, I doubt that most people with ASD want to be perpetually isolated from their peers and family members because of social and communicative disabilities. Another point that’s made by the parents, during their trip to Mongolia, is that their son (who is beyond the usual age for potty-training) is not entirely in control of his bowels, which is a pretty common condition for older children and teens with ASD. That doesn’t seem like something that most people would want to put up with for the sake of neurodiversity.
Speaking about my current experience in Germany of working with autistic kids, I think it’s important that people at least encounter the idea that “it’s a part of diversity, not an illness”. I’ve often seen professionals treat it unthinkingly as an illness, with the implication that they are justified in attempting which ever treatment they currently favor. You don’t accept and illness, you try and treat it, and you are justified in ignoring a child’s wishes and even rights in order to “treat their illness”. Non-verbal children especially, get turned into guinea pigs for whatever the latest trend is — hugging therapy, freezing therapy, etc, and generally bossing them about.
A lot of these professionals look at me as if I’m talking gibberish when I talk about these children’s “rights”.
Of course, the extreme end of the spectrum is in effect indistinguishable from an illness, for all the difficulties it causes the sufferer. But therapy needs to recognize and build on their actual abilities and talents — not assume they’re they’re a blank slate that needs to be written on from scratch. (Like, instead of forcing them to learn a complex communication system suited to people with extremely low IQs, work on their already existing abilities to understand and respond to our verbal communication — the difference between questions/offers and commands, various ways of expressing the same idea, etc. And notice their responses and affirm these as communication.)
Oh, and seeing it as diversity would help protect parents and professionals from getting sucked into all the quack “cures” for autism.
And it helps parents overcome guilt feelings and blame for somehow “causing” it.
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There are a number of pitfalls we should avoid in talking about autism.
One is that it’s a mental illness. There’s plenty of evidence now that it’s not, but rather a personality condition caused by neurological changes arising during pregnancy, probably triggered by the coming together of several factors. A genetic predisposition doesn’t help, but neither does the mother suffering preeclampsia during pregnancy, or maybe other stimuli. The result is changes to the pre-frontal lobe of the brain. Almost literally the brain’s ‘wired up’ differently. There seems to be a correlation between the extent of the neurological damage and the severity of the symptoms.
If this is right (and it seems so) then autism can’t be cured. But its effects can often be lessened by techniques such as cognitive behavioural therapy.
Most people who have Asperger’s or High-Functioning Autism (known now in the US as mild autism)have never realised they have it. When they were young, no-one knew (the WHO did not accept the diagnosis until 1992, for instance; Lorna Wing didn’t describe and name it Asperger’s until 1981).
I was diagnosed at 56, following a stroke. It was an eye-opener. The explanatory power of knowing was huge. So many things going back to my childhood were were explicable by something more than just ‘eccentric personality’.
My own suspicion is that autism is a very old condition, and that in previous centuries any severely autistic person would have been seen as a lunatic (or at least as the ‘village idiot). Those with Asperger’s/HFA would have been found in monasteries, illustrating books, or perhaps they were stonemasons (or other craftspeople), or maybe farmers – absorbed in a skill that didn’t require them to mix. It was the early 20th century that sometimes labelled them schizophrenics.
That is, of course, if they were not Isaac Newton, or Einstein. Or Mozart. Or…
One wonders about ‘idiot savants’
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“Savant syndrome” really puzzles me too. I wonder what people with such a condition are like where there is (for example) no sophisticated arithmetic?
I agree with everything you said Jerry, with one caveat.
Yes, people with autism spectrum disorders should receive help. However, in my opinion, the “mainstream everyone” push has gone too far.
Many people close to me have to deal with this, personally, in schools.
Does it really make sense to put kids who scream at the top of their lungs all day (I’m not exaggerating) in with all the other children who would like to learn? Imagine having 5 kids like that in your classroom (of 30).
These kids need highly specialized help (all day). Regular classroom teachers are not trained for this; and most aren’t interested in becoming clinicians (good grief, they have enough mandates on them already!). The other kids are severely cheated — how can they learn? In one recent incident at my wife’s school, a child (primary grades) required 5 adults to get them under control. This doesn’t sound like some one who’s ready for mainstreaming.
Does it make sense for a child like this to have a full-time professional assigned to only them, all day, to keep things under control? Because that’s what it takes.
Generally, the mandates for things like mainstreaming come with grossly inadequate funding. What does that mean? No nurses in schools. No music. No art teacher. No librarian.
Some more sense needs to come back into the system.
This is why the free will discussion is so important–not necessarily the discussion between compatibilists and incompatibilists, but in the wider discussion between determinism and dualistic free will.
I suspect that much of the sentiment regarding not treating these mental issues arises from the same ingrained idea that causes people to think they “could have done otherwise.” The brain is viewed as a thing the mind controls rather than a thing that produces the mind. The most effective treatment for autism is applied behavior analysis and intervention starting at a young age. My wife has been in the field for a decade and a half; time and again the autistic children who best integrate into society are those with effective behavior programs. There are ways to modify behavior and they are all based on the assumption that behavior is deterministic. There is no ghost in the machine that allows those suffering with autism to simply fix themselves.
As a parent with an autistic child, I would welcome any additional level tolerance or societal acceptance that can be achieved. Not so I can use it as an excuse to defer treatment–I find such behavior as reprehensible as anyone on this message board–but because the world seems to be indifferent to kids/adults with this disorder (despite recent progress), and any move in the opposite direction would simply increase the chances for more of these kids to flourish.
My son has strengths, and we try to “celebrate” these, while acknowledging that his weaknesses have to be addressed in therapy and at home. One of the main problems is that, while you can mitigate some of the more extreme elements of the disorder through therapy and medication, there is no cure, and anyone born is going to have a much tougher time navigating the world successfully–which is why I believe it is essential for societal acceptance to increase.
Acceptance would help alleviate issues such as: discrimination with regards to child care; public schools who don’t currently make appropriate accommodations; expensive treatment that insurance isn’t required to cover; chronic bullying; employment discrimination for adults on the spectrum, etc. I simply marvel at what the gay rights movement is in the process of accomplishing with regard to similar problems it faces.
While I don’t agree with many of the more radical tenets of the neuro-diversity movement; from my perspective I just can’t see that society is dangerously close to accepting autism as form of normal–I think we have a long way to go before we reach that point.