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Edge on Autism

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Autism's Mysterious Increase

December 15th 2008

Health/Medicine - Autism

Impaired social function, repetitive motion, circumscribed interests—these are common themes in a group of complex developmental disabilities known as Autism Spectrum Disorders or ASD.

Individuals with ASD refer to themselves as being “on the spectrum” as they exhibit symptoms, characteristics, and function spanning the wide range from being unable to communicate or care for themselves, to managing to fit into society despite their quirks.

Although recognizable in historical writings, autism is still a relatively recent diagnosis. New collections of behaviors and deficits are being recognized as part of the autism spectrum. The initial characterization of Asperger's Syndrome (one of three forms of ASD) occurred in 1944, and work continues on sensory integration disorder, and on the catch-all pervasive developmental disorder.

Why is the incidence of autism mushrooming? The Autism Society of America states, “Autism is growing at a startling rate of 10-17 percent per year. At this rate…the prevalence of autism could reach four million Americans in the next decade.” The steady upswing in the number of cases in the last 20 years has brought us to today's count of one in every 150 children being somewhere on the spectrum.

Many theories exist as to the causes of autism: the mercury preservatives thiomersal in vaccines, environmental contaminants, infection, and various forms of prenatal stress. It is believed there is a genetic component to ASD, but no specific genetic marker is known at this time. The exact mechanisms behind the changes to the brain are unknown, however the clumsiness and impaired social function seem tied to differences in mirror neurons, and the speech deficit has tantalizing links to other disorders that have been partially characterized via genetic inspection.

Mirror neurons, or "monkey see, monkey do" neurons, were first identified by chance in lab animals a decade ago. When monkeys were wired with EEG caps to observe brain function, researchers noted that if a subject animal was engaged in solving a puzzle, another monkey watching the process would have the same brain activity, despite the fact that it was sitting motionless. Further experiments were done, first on monkeys, then on humans, and it was learned that we have systems in our brain that allow us to judge another's mood and intent based on facial expression as well as the ability to mimic the physical actions we observe another performing. Having deficits in these areas, those with autism are often physically and socially clumsy.

A study entitled "A Functional Genetic Link Between Distinct Developmental Language Disorders," published in the November 2008 New England Journal of Medicine, describes a possible genetic explanation for some of the language deficits that autistics experience. Mutations in the FOXP2 gene can affect the CNTNAP2 gene, a massive stretch of DNA representing 1.5 percent of chromosome 7, resulting in speech deficits and deafness. No causal mechanism is described for the mutation, but knowing where the genetic change occurs is a large step forward in the search for the culprit.

The repetitive motion behaviors common to those on the spectrum are known as stimming. They are coping mechanisms. Sights, sounds, and smells that are of no consequence to the neurotypical person can be insufferable distractions to the autistic. Hand wringing, twirling, and other behaviors allow those on the spectrum to regain some sense of balance in a world that is too intense for them.

Less obvious to researchers are the sources of the circumscribed interests. Those on the autism spectrum often have a very deep interest in a highly specific area. The more functional leave behind stereotypes that autistics are not creative thinkers, and make industry-changing advances in their field. Autistic author and expert in livestock handling systems, Temple Grandin, is a quintessential example, publishing eight books that range from farm animal handling systems to an analytical exposition on social rules written in concert with fellow autistic Sean Barron.

Autistics face subtle differences at the physical level as well as the neurological. Digestive difficulties associated with a typical western diet are the norm, with wheat and milk proteins being the two primary suspects when trouble arises. Unlike the violent reaction to wheat protein experienced by those with celiac disease, the autistic may go well into middle age before noticing that gluten is a problem for them. Gluten and to a lesser degree casein, the protein found in milk, can be problematic both in the moment and over the long haul. The immediate effect of exposure to these proteins has been described as having a bad case of stomach flu and being treated with a moderate narcotic. The victim is left unable to drive for a day or more, and focusing on any intellectual task is challenging. If the problem is not identified early it makes itself known forcefully at around age fifty, when bowel resection surgery to repair the damage caused by years of inflammation can become necessary.

There is no cure for autism and many articulate autistics bristle at the idea that there is anything wrong with them, as the lack of acceptance by the neurotypical is their one significant problem in life. Some of those trending towards the more functional end of the spectrum choose medication in order to help them fit into society. Anti-anxiety prescriptions are a common treatment for the perpetual stage fright experienced in social situations, and anti-depressants comfort those who experience each day in the neurotypical world as a tight rope walk. Others find, often through trial and error, career paths that permit them to work from home, work independently, or otherwise limit social interaction on the job.

The internet has been a marvelous advance for those on the spectrum. Many web sites now provide health care and parenting information for those with autistic children. Social networking sites such as Wrong Planet are a locus for education, activism, and like-minded company. The virtual world Second Life has several groups formed by the autistic, and there are gathering places catering to those who find “first” life social interaction overwhelming.

Autism presents a heartbreaking puzzle for the parents of those who are profoundly affected, and an ongoing challenge for those who are able to communicate but are still in some way obviously different from their peers. Research in prevention and methods for remediation are important, but understanding and respect for the unique value of those who are on the spectrum is a social change happening today—and one that is long overdue.

Neal Rauhauser is an analyst and consultant on energy and telecommunications. He is a member of the Stranded Wind Initiative and can be found at strandedwind.org.

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