07 May 2006

Time Magazine: New Insights into the Hidden World of Autism

On news stands tomorrow (8 May), Time Magazine's cover story (set of stories, really) looks at autism in some detail. Here is an excerpt from the main story, "Inside the Autistic Mind":

MORE THAN 60 YEARS AFTER AUTISM WAS first described by American psychiatrist Leo Kanner, there are still more questions than answers about this complex disorder.... But slowly, steadily, many myths about autism are falling away, as scientists get a better picture of what's going on in the bodies and brains of people with autism and as more of those who are profoundly affected are able to give voice to their experience. Among the surprises:
  • Autism is almost certainly, like cancer, many diseases with many distinct causes. It's well known that there's a wide range in the severity of symptoms--from profound disability to milder forms like Asperger syndrome, in which intellectual ability is generally high but social awareness is low. Indeed, doctors now prefer the term Autistic Spectrum Disorders (ASD). But scientists suspect there are also distinct subtypes, including an early-onset type and a regressive type that can strike as late as age 2.
  • Once thought to be mainly a disease of the cerebellum--a region in the back of the brain that integrates sensory and motor activity, autism is increasingly seen as a pervasive problem with the way the brain is wired. The distribution of white matter, the nerve fibers that link diverse parts of the brain, is abnormal, but it's not clear how much is the cause and how much the result of autism.
  • The immune system may play a critical role in the development of at least some types of autism. This suggests some new avenues of prevention and treatment.
  • Many classic symptoms of autism--spinning, head banging, endlessly repeating phrases--appear to be coping mechanisms rather than hard-wired behaviors. Other classic symptoms--a lack of emotion, an inability to love--can now be largely dismissed as artifacts of impaired communication. The same may be true of the supposedly high incidence of mental retardation.
  • The world of autism therapy continues to be bombarded by cure-of-the-day fads. But therapists are beginning to sort out the best ways to intervene. And while autism is generally a lifelong struggle, there are some reported cases in which kids who were identified as autistic and treated at an early age no longer exhibit symptoms.
On the topic of mercury/thimerosol:
At the Center for Children's Environmental Health and Disease Prevention at the University of California at Davis, toxicologist Isaac Pessah is studying hair, blood, urine and tissue samples from 700 families with autism. He's testing for 17 metals, traces of pesticides, opioids and other toxicants. In March Pessah caused a stir by releasing a study that showed that even the low level of mercury used in vaccines preserved with thimerosal, long a suspect in autism, can trigger irregularities in the immune-system cells--at least in the test tube. But he does not regard thimerosal (which has been removed from routine childhood vaccines) as anything like a smoking gun. "There's probably no one trigger that's causing autism from the environmental side," says Pessah, "and there's no one gene that's causing it."
Other stories in the set include:
The tale of two schools, the Alpine Learning Group in Paramus, NJ and Celebrate the Children in Stanhope, NJ, that apply two of the most common approaches to working with kids with autistic spectrum disorders, ABA and Floortime, respectively.

The Most Difficult Decision of My Life: A first-person column by TIME's Amy Lennard Goehner on her son's experience at a very unusual boarding school for autistic kids, called Boston Higashi.
I haven't had a chance to read all of it completely, but it looks like a lot of good information. It also looks like a lot of good controversy for discussion.

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