Autism

Stephen Black sblack at UBISHOPS.CA
Tue Mar 31 21:14:50 EST 1998


On Tue, 31 Mar 1998, Lesley Schimanski wrote:

> Can anyone give me details on the treatment of autistic children?  My
> cousin, age 2 1/2, has just been diagnosed as autistic.  Her parents
> have been directed towards thousands of dollars worth of treatments.  Is
> this worthwhile?  What are the symptoms of autism?  Any comments are
> helpful.
>     Lesley Schimanski
> 
> 
Dear Lesley:

Autism is such an enormous area it is difficult to know where to
start. If you have access to the World Wide Web, a search will turn up
a wide variety of on-line resources. Briefly, autism is a disorder
which begins very early. Its main features include: 

1) Impairment in social responsiveness. Autistic children do not form
social attachments, show little or no social responsiveness, do not
react to people or make eye contact, may have an aversion to physical
contact

2) Language is either absent or is not used for communication (for
example, they may only parrot what you say)

3) Show a variety of bizarre behaviours, such as ritualistic and
repetitive responses, may insist that nothing in their environment be
changed and will become upset if anything does, may form an attachment
to mechanical objects, show prolonged rocking or swaying,
hand-flapping, over-or under-responsiveness to stimulation, sometimes
engage in self-mutilation, such as head-banging or self-biting. 

4) Show mental retardation although the extent of retardation varies
greatly

It was once claimed that autism was caused by bad parenting but this
is now known to be a false and malicious hypothesis. There is now
widespread agreement that the cause of autism is genetic, although
the specific cause is unclear.

There are many different kinds of treatment for autism, most
unscientific and unproven, some bizarre (such as swimming with
dolphins). There are many expensive quack treatments, unfortunately. 

At present, there is only one form of treatment which has been proven
to be of benefit based on scientific evidence. This is treatment by
behaviour modification, which means a highly-structured and intensive
training procedure by which the child is taught appropriate behaviour
using systematic rewards and punishments. The world leader in this
field is a psychologist at the University of California, Los Angeles
named Ivor Lovaas.

Two technical references I have handy at the moment are McEachin et al
(1993), which details the success of the Lovaas method, and Bailey et
al (1996) which reviews recent work in this field. There are a variety
of non-technical books as well, although I don't know them well enough
to recommend one. Once again, remember that there is an enormous
amount of unscientific, misleading, expensive, useless, and even
dangerous claims in this field. The best attitude is extreme
scepticism. There are reputable autistic associations which can help
cut through the quackery. You can easily find them through a web
search.

-Stephen

References

McEachin, J. et al (1993). Long-term outcome for children with autism
  who received early intensive behavioral treatment. American journal
  on mental retardation, 97, 359--

Bailey, A. et al (1996). Autism: towards an integration of clinical,
  genetic, neuropsychological, and neurobiological perspectives. 
  Journal of child psychology and psychiatry, 37, 89--

------------------------------------------------------------------------
Stephen Black, Ph.D.                      tel: (819) 822-9600 ext 2470
Department of Psychology                  fax: (819) 822-9661
Bishop's University                    e-mail: sblack at ubishops.ca
Lennoxville, QC           
J1M 1Z7                      
Canada     Department web page at http://www.ubishops.ca/ccc/div/soc/psy
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