Autism in America: Changing Times

Autism is considered a spectrum disorder, meaning that the symptoms are not unitary over both the grouping of affected people and the symptomatology. A developmental disorder that predominantly appears within the first three years of life and begins showing signs between 2 and 6 years, autism affects the ability of those with the disorder to communicate and interact with others. Treatment for autism is not a one size fits all, according to Dr. Cecelia McCarton, director of a school for autistic children in New York City. McCarton adds "[t]he sooner you start [treatment], the better off you are." ("Autism" Ranit) It is estimated that autism will cost between $3.5 and 5 million in a lifetime per person. With an estimated 1.5 million adults suspected of having autism, that equates to somewhere in the area of $600 trillion in total costs. As the number of cases of autism increases, the amount of money being dedicated to research and the cost to care for people with autism dramatically increases, more and more information is coming to light and treatment (traditional and modern) continues to change.

According to Pediatrics magazine, 1 percent of the population of children in the U.S. ages 3-17 have an autism spectrum disorder. (Pediatrics, survey.) This represents an estimated at 1 in 110 births in the United States (as of December 2009) according to a Center for Disease Control and Prevention. According to the Autism Speaks website, the majority (63% or 1 in 70) of cases are males. According to Andre T. Cavagnaro with California Health and Human Services Agency in a 2003 survey, it is the fastest-growing developmental disability in the US, with a 1,148% growth rate. (Autistic Spectrum Disorders, 2003.)

Autism symptoms break down into three categories (according to a Mayo Clinic study); social skills, language and behavior. These patterns of symptoms are common signs, although they present in a variety of ways in different groups. Within social skills, symptoms include: failure to respond to their names, poor eye contact, a resistance to cuddling, the appearance of being unaware of others' feelings, a preference to solitude - or self play, and an apparent indifference to listening. Among the language symptoms are: talking to other children at a later age than is generally prescribed, loss of previously used words or sentences, robotic or singsong speech patterns, inability to begin or continue conversations, a repetition of words or phrases without an apparent understanding of their meaning.

Behavior symptoms include: repetitive movement such as rocking or spinning (or hand-flapping), development of routines or rituals religiously adhered to, becoming disturbed at the slightest change to routines or rituals, constant movement, fascination of an object (such as a spinning top), an unusual sensitivity to light or touch or sound coupled with an obliviousness to pain. Severity of symptoms differ from patient to patient and may sometimes decline over time. Some older children with autism may even start to become engaged with other children and adults, but in nearly all cases, the acquisition of new knowledge comes slowly. Signs of autism vary between cases of severity, gender and environment. For disconnected parents or dysfunctional family situations, diagnosis may occur much later than is optimal.

There is no single accepted cause for autism that researchers are able to point to, but many theories have sprung up over the years. One such theory, presented by Dr. John Cannell of the Vitamin D Council, is a vitamin D deficiency. Over the past 20 years, between a lack of vitamin D intake and sun avoidance, the levels have been in serious decline. Also, Dr. Cannell links the belief that vitamin D reacts differently with estrogen and testosterone, leading to the increased rate of autism in males. Although not a cure, the implementation of proper dietary nutrition and exposure to natural light would seem a viable way to blunt the onset and / or severity of autistic disorders.

According to other researchers, a possible cause for the social deficiencies apparent in autistics disorders is a dysfunction in mirror neurons present in the frontal and parietal lobes, which are theorized to be responsible for the learning functions of repeating observed actions. Thus, the normal methodology of teaching at an early age, that of mimicry or observed learning, would be severely hampered by this dysfunction. If the mirror neurons are damaged, it would be imperative to both ensure early diagnosis and implementation of alternative learning methods as quickly as possible in the formative years.

Another possible cause for autism is the Thimersol connection. This is a form of industrialized mercury, which was used in vaccines and first used in 1931. According to independent studies by child psychologist Leo Kanner and Dr. Hans Asberger, autism was first diagnosed in the 1930's, with the oldest documented patient being born in 1931. The mercury form in Thimersol is ethylmercury, which converts to organic form when entering the body. But once it gets to the brain and enters the neurons, it irreversibly converts back to its inorganic form and bonds to the cells. But a recent study at the University of Washington and published by the National Institute of Environmental Health Sciences (Burbacher, et al) disputes the concentration of the ethylmercury in the brain as being responsible for autism. In a study of infant monkeys injected with vaccines containing Thimersol, they found that the ethylmercury cleared the system much sooner than believed, and that the bonding suspected being the damaging causes related to autism was not as predominantly present as previously thought.

Treatment of autism is as fluid and non-standard as the symptoms and causes, as there is no known "cure" for the disorder. Parents, care-givers and researchers have been confounded by conflict in the way treatment is recommended. But it is commonly accepted that early diagnoses and intervention is key to creating an effective treatment. A combination of classroom, home and clinical environments, as well as the amount of time and investment of educators, medical professionals and parents, makes the treatment of autism an extremely intense and comprehensive undertaking. As no single method of intervention is suited for every child or adult with autism, there are many variety of treatment options. Applied Behavioral Analysis is a scientific approach to understanding behavior and how it is affected by the environment. Pivotal Response Therapy is used to increase language, decrease disruptive behavior and increase social, communication and learning skills by focusing on pivotal factors that affect a wide range of behaviors. verbal Behavior Therapy, as outline by B. F. Skinner in his 1957 book Verbal Therapy, uses analysis as a basis for teaching language and shaping behavior. Floor time, based on the Developmental Individual Differences Relationship Model developed by Dr. Stanley Greenspan in the 1980's, is a manner of treatment where adults can help expand the child's learning experience by engaging them at their current level and then by using a six level model, helping the patient grow.

Other treatment options include Relationship Development Intervention, Training and Education of Autistic and Related Communication Handicapped Children (TEACCH), and Social Communication/ Emotional Regulation/ Transactional Support (SCERTS). Along with the treatment of the disorder, the medical side of the disorder must also be addressed. Diets, therapy (physical, speech and occupational) as well as a constant monitoring of any normal issues which could exasperate or interfere with ongoing treatment. And, as with the understanding of autism, its symptoms and causes, treatment continues to evolve. A recent advancement in software for the education and therapy of children with autism was developed by Karl Smith, whose own son was diagnosed with autism a few months after his first birthday. Smith founded the company Acceleration Educational Software (AES), which makes computer-based interactive training software that is "used in almost 1000 school systems nationwide and countless private homes." It is a program that is educational but uses the fundamental concept of game play to help offer a sense of accomplishment that greatly impacts behavior. ("Necessity" Edwards)

The prospect of a cure for autism is just a dream of parents and researchers everywhere at the current time. Education of the public, although greater today than ever before, is still complicated by conflicting information coming from government and private researchers as well as advocacy groups with varying agendas not always connected to what is best for the children and adults living with autism today. But not all is doom and gloom. New research is being conducted, new treatment is being developed on many different levels of medical and technical avenues and the public is being educated to the seriousness and complexity of this disorder. Until such time as a cure is found, or a consensus is reached on the causes at the very least, the dedication and efforts and love shared by the parents and professionals within the Autism community, and the understanding and compassion of the general public at large, will have to carry the estimated 1.5 million children and adults suffering from this disorder.

Works Cited

Burbacher, Thomas M., Shen, Danny D., et al. "Comparison of Blood and Brain Mercury Levels in Infant Monkeys Exposed to Methylmercury or Vaccines Containing Thimerosal". 21 April 2005. ehp Environmental Health Perspectives. Web. 15 April 2010. (http://ehp.niehs.nih.gov/docs/2005/7712/abstract.pdf)

Cavagnaro, Andre T. "Autistic Spectrum Disorders: Changes in the California Caseload, An Update June 1987 June 20007." California Health and Human Services Agency. State of California 2003 survey of developmental disabilities.

Cannell, Dr. John. "Vitamin D Theory of Autism." Vitamin D Council. Web. 14 April 2010. (http://www.vitamindcouncil.org/health/autism/vit-D-theory-autism.shtml)

Edwards, Pam. "Necessity - the father of invention." Columbia Star. 5 February 2010. Print.

Facts About Autism. Autism Speaks, Inc. Web. 14 April 2010. (http://www.autismspeaks.org/whatisit/facts.php)

Iacoboni, M., & Dapretto, M. (2006). The mirror neuron system and the consequences of its dysfunction. Nature Reviews Neuroscience, 7(12), 942-951. doi:10.1038/nrn2024. Pediatrics. 5 October 2009. (based on a National Children's Health Survey done with 78,000 parents in 2007.) Web. 3 April 2010.

Mayo Clinic Staff. Autism. Mayo Clinic. 31 May 2008. Web. 15 April 2010. (http://www.mayoclinic.com/health/autism/DS00348/DSECTION=symptoms)

Mishori, Ranit. "What do we know about autism?" Parade. 27 January 2008. Web. 14 April 2010. (http://www.parade.com/articles/editions/2008/edition_01-27-2008/Is_There_Hope_For_Autism)

"Prevalence of Autism Spectrum Disorders - Autism and Developmental Disabilities Monitoring Network, United States, 2006." Department of Health and Human Services, Centers for Disease Control and Prevention. Morbidity and Mortality Weekly Report, 18 December 2009.

Additional Sources

http://www.autismspeaks.org/whatisit/facts.php
http://www.autism-society.org/site/PageServer?pagename=about_whatis_factsstats
http://www.autismfacts.com/aboutus.php
http://www.parents.com/baby/health/autism/facts-about-autism/

(Author's note - symptomatology is a real word whose definition can be found online at http://www.thefreedictionary.com/symptomatology.)