AUTISM OLD RULES AND NEW RULES What everyone should know about Autism

WHAT IS AUTISM? According to Autism Speaks: “Autism spectrum disorder (ASD) and autism are both general terms for a group of complex disorders of brain development. These disorders are characterized, in varying degrees, by difficulties in social interaction, verbal and nonverbal communication and repetitive behaviors. They include autistic disorder, Rett syndrome, childhood disintegrative disorder, pervasive developmental disorder-not otherwise specified (PDD- NOS) and Asperger syndrome.”

COMING TO A CLASSROOM/NEIGHBORHOOD NEAR YOU:  1 in 88 American children are on the Autism spectrum  1 in 54 boys are on the Autism spectrum  1 in 252 girls are on the Autism spectrum  “By way of comparison, more children are diagnosed with autism each year than with juvenile diabetes, AIDS or cancer, combined.”

WHAT PEOPLE USED TO THINK ABOUT AUTISM  People who later would have been qualified under Autism were originally lumped with people who had Intellectual Disabilities/schizophrenia.  Many people thought the behavior of children was caused by parental neglect (mainly neglectful mothers.)  These children were then moved to foster homes, but behaviors didn’t change.  Then they tried to take these kids through the emotional development milestones they had missed when “neglected” but this didn’t work either.  One other theory was that kids who had this condition had a parent with the same condition but to a lesser degree. Again, this was because the parent was “neglectful.”

EARLY 1900’S Eugene Bleuler coined the word Autism (comes from the Greek word “Autos” or “self” to describe a group of schizophrenic symptoms.)

1940’S AND LEO KANNER Leo Kanner, a child psychologist from Berlin, “discovered” what we now call Autism in 1943, but reported he had seen cases since 1938 He wrote a paper in 1943 called Autistic Disturbances of Affective Contact, which documented his experiences with different children with Autism. Dr. Kanner thought Autism was something innate, and was ahead of his time in a need for biomarkers; many still thought the cause of Autism was neglect.

1940’S AND HANS ASPERGER Hans Asperger is said to have “discovered” Asperger's just after/around the same time, but his subjects had speech. He was a pediatrician and a psychiatrist; his work was not as widely known.

1950’S AND 1960’S  There was no mention of Autism in 1952 DSM, just “Schizophrenic Reaction.”  In the 1960’s is when professionals in the medical field started voicing that schizophrenia and Autism were not the same thing, as previously thought.  In the late 1960’s research was done into the way the brain functioned and how the process of brain development can go wrong pre-and post- natal started to show that Autism was a developmental disorder.  Treatments included: LSD, electroshock therapy, and behavioral (punishment) techniques.  In 1968, DSM-II still had no separate category for Autism; it still falls under Schizophrenia.

1970’S AND 1980’S  Researchers still had much to learn about Autism; not a lot of new information on the cause.  Switch from more invasive, cruel forms of therapy to behavior therapy and tightly controlled learning environments.  In 1987, Infantile Autism was included in the DSM for the first time.

2000’S/PRESENT  There have been many theories of what causes Autism over time: mercury, older parental age, genetics, something in the brain, genetic mutations (brains trying to develop too fast, vaccinations, etc.)

GENES AND MUTATIONS “Over the last five years, scientists have identified a number of rare gene changes, or mutations, associated with autism. Research has identified more than a hundred autism risk genes. In around 15 percent of cases, a specific genetic cause of a person’s autism can be identified. However, most cases involve a complex and variable combination of genetic risk and environmental factors that influence early brain development” –(Retrieved from AutismSpeaks.org)

POSSIBLE ENVIRONMENTAL FACTOR CONTRIBUTIONS Research is showing that in addition to gene mutations, some of the below environmental factors may increase a child’s risk for Autism:  Oxygen deprivation to babies’ brains  Older parent age at time of conception  Premature birth  Mother being sick during pregnancy  (These factors don’t cause Autism but can increase risk)

AUTISM AND THE BRAIN, PT.1 “According to an from Professor Deb Hudson, of SPU:” “Probably the biggest advances in the area of autism has been in brain research as it applies to the identification differentiating areas of the brain, genetics and DNA. The Autism Center at the UW has worked extensively with the functional magnetic resonance imaging (fMRI.) – (February 7, 2013)

AUTISM AND THE BRAIN, PT. 2 “Children with autism spectrum disorders (ASDs) have distinct differences in their brain that are not seen in children without ASDS. And while these differences don’t explain the cause of ASDs, they do explain some of the social differences, language issues, and motor skills difficulties that children with ASDs often display.” (Rosenblatt & Carbone, 2013, p.26). There may be: -Larger than normal head size (macrocephaly). -Brainstem abnormalities, neocortical malformations, abnormalities in the frontal and temporal lobes, abnormal maturation of the forebrain limbic system. -Technology, such as fMRI or Functional magnetic resonance imaging, studies have identified several neural systems consistently disrupted in autism, and abnormalities in regional size and amount of white matter.

TWIN STUDIES  Some researchers, such as those at the University of Washington, are studying twins who have Autism, and sets of twins where one of the twins has Autism to determine biological and behavioral traits of Autism.  In 2011, the largest Autism/Twin study was done. It found that when one identical twin develops Autism, the chance of the other twin developing the disorder is 70 percent... This is strong evidence that environmental factors are at play. –(Retrieved from Autismspeaks.org)

ABA: APPLIED BEHAVIOR ANALYSIS Current Treatments: While many treatments can currently take place for Autism, many people are starting to use ABA Therapy, which is a behavior treatment plan in which a positive reinforcement is paired with appropriate behavior, and the therapists/team work together to figure out “triggers” for students. For example, it might be noticed that when you stop music, Gigi screams. If a positive reinforcer of a Hershey's kiss has been identified, a teacher might pair this kiss if Gigi doesn’t scream when the music stops.

RE-CAP There have been many different thoughts and treatment plans on Autism over the years. Currently it appears that genetics are at play, with some environmental factors, and that brains in children with Autism are developing differently. ABA Therapy is an effective “treatment plan” for students with Autism.

REFERENCES Autism Resources. (n.d.) Autism faq – history. Retrieved from Autism Speaks. (n.d.) What is autism? Retrieved from Burns, M. S. (2012). New views into the science of educating children with autism. Phi Delta Kappan, 94(4), Courchesne, E., Townsend, J., Akshoomoff, N. A., Saitoh, O., Yeung-Courchesne, R., Lincoln, A. J., &... Lau, L. (1994). Impairment in shifting attention in autistic and cerebellar patients. Behavioral Neuroscience, 108(5), doi: / D. Hudson (personal communication, February 17, 2013) Grinker, R. R. (2007). Unstrange minds: Remapping the world of autism. New York, NY: Basic Books.

REFERENCES CONT. Huerta, M., Bishop, S.L., Duncan, A., Hus, V., & Lord, C. Application of DSM-5 criteria for autism spectrum disorder to three samples of children with DSM-IV diagnoses of pervasive developmental disorders. American Journal of Psychiatry 2012, 169(10), Rosenblatt, A. I., & Carbone, P. S. (Eds.). (2013). Autism spectrum disorders: What every parent needs to know. Elk Grove Village, IL: American Academy of Pediatrics. Sowell, E. R., & Bookheimer, S. Y. (2012). Promise for finding brain biomarkers among infants at high familial risk for developing autism spectrum disorders. American Journal of Psychiatry 2012, 169(6), doi: /appi.ajp University of Washington Autism Center (n.d.). Twin brain and behavior study. Retrieved from Waterhouse, L., Fein, D., & Modahl, C. (1996). Neurofunctional mechanisms in autism. Psychological Review, 103(3), doi: / X