Autism refers to a spectrum of disorders, and lies somewhere
under the umbrella of a greater encompassing spectrum, that of
pervasive developmental disorders that involve the functioning of
the brain. Autism as a term is most commonly used to refer to
classical autism, towards which the texts of this page are biased.
Autism once was believed to be a psychiatric disorder but is now
known to be neurological, even though many of its characteristic
traits appear psychological.
Typical characteristics include problems with social
relationships and emotional communication, in addition to patterns
of behaviour and interests that are less common in neurotypicals,
and also involves a nontypical approach to sensory integration.
Typically, autism spectrum disorders appear during the
first three years of life. It is estimated that it occurs in
approximately 2 to 6 in 1,000 individuals, and is 4 times more
prevalent in males than females (source: The Autism Society of
America . It is most prevalent in Caucasian males, although it
occurs in every race.
As of 2004, autism is believed by some to be treatable, though no
cure exists and some controversy surrounds both its categorization
as an ailment and these treatments, such as is spoken about in
controversies in autism. Early diagnosis and intervention are held
by most professionals to be vital to the future development of the
child, and though there are instances where intervention seems
negative this is mostly true.
While treatments for autism do exist, however controversially, it
is widely considered that cure is impossible, because autism
involves aspects of brain structure that are determined very early
in development. However, there are persistent claims that some
individuals after diagnosis have been helped to recover, or at least
to mimic "normal" (neurotypical) behavior. (See references to Karyn
Seroussi, and Cheri Florance).
There is quite a bit of controversy surrounding treatments for
autism spectrum disorders and their classification as negative
ailments. It is therefore recommended that interested parties read
the controversies in autism page.
Not until the middle of the twentieth century was there a name
for a condition that now appears to affect an estimated one in every
five hundred children, causing disruption in families and
unfulfilled lives for many children.
In 1943 Dr. Leo Kanner of the Johns Hopkins Hospital studied a
group of 11 children and introduced the label early infantile autism
into the English language. At the same time a German scientist, Dr.
Hans Asperger, described a different form of autism that became
known as Asperger's syndrome.
Thus these two disorders were described and are today listed in
the Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR
(fourth edition, text revision 1) as two of the five pervasive
developmental disorders (PDD), more often referred to today as
autism spectrum disorders (ASD). All these disorders are
characterized by varying degrees of difference in communication
skills, social interactions, and restricted, repetitive and
stereotyped patterns of behavior.
Probable causes and origins of autism
A genome screen of autism. Most chromosomes seem related to
autism, in particular chromosomes 2, 7 and 15.The causes and origins
of autism and asperger's syndrome is a source of continuing
conjecture and debate. Amongst several competing theories are the
underconnectivity theory developed by cognitive scientists at
Carnegie Mellon University and the University of Pittsburgh, the
Neanderthal theory, the extreme male brain theory by Simon Baron
Cohen, the lack of theory of mind, and the Preoperational-autism
theory, which states that autistic people are those who get
neurologically stuck at the pre-operational stage of cognitive
development, where much of information processing is at a wholistic-visual
level and largely non verbal and musical. This also addresses the
issue of the theory of mind where children at the pre-operational
stage of cognitive development have not attained decentralisation
The Monotropism hypothesis argues that the central feature of
Autism is attention-tunnelling, monotropism. The hypothesis is
founded on the model Mind as a Dynamical System: Implications for
Autism (http://www.autismandcomputing.org.uk/mind.htm). In this
model of mind, the fundamental and limited resource is mental
attention. Mental events compete for and consume attention. In a
polytropic mind, many interests are aroused to a moderate degree. In
a monotropic mind, few interests are very highly aroused. When many
interests are aroused, multiple, complex, behaviours emerge. When
few interests are aroused then a few, intensely motivated,
behaviours are engendered. From monotropism hypothesis, autism
results from different strategies of distributing attention in the
The underconnectivity theory indicates a deficiency in the
coordination among brain areas. Since the brain is known to be
modular. With the aid of (fMRI), it was seen that white matter which
connects various areas of the brain like cables, have abnormalities
in people with autism.
The underconnectivity theory holds that autism is a system-wide
brain disorder that limits the coordination and integration among
brain areas. This theory is parsimonious, in that it explains why
autistic people are matured on certain dimensions eg: visual
information processing and logical analysis, and yet are socially
and sometimes neuro-physiologically, significantly younger to their
chronological age. The underconnectivity theory can be regarded as
monotropism in the brain.
Other probable theories, addresses the rise of autism in recent
times. They suggests the rise of visual media and thereby the
increasing central role of visual information processing in the
breakdown of language and the rise of autism.
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- Possible Indicators of Autism Spectrum Disorders:
- Does not babble, point, or make meaningful gestures by 1
year of age
- Does not speak one word by 16 months
- Does not combine two words by 2 years
- Does not respond to name
- Loses language or social skills
Some Other Indicators
- Lacks eye contact
- Doesn't seem to know how to play with toys in the usual
- Excessively lines up toys or other objects
- Is attached to one particular toy or object
- Doesn't smile (socially, but may smile during periods of
- At times seems to be hearing impaired
From the start, typically developing infants are social beings.
Early in life, they gaze at people, turn toward voices, grasp a
finger, and even smile.
In contrast, most autistic children prefer objects to faces and
seem to have tremendous difficulty learning to engage in the
give-and-take of everyday human interaction. Even in the first few
months of life, many do not interact and will avoid eye contact,
seeming indifferent to other people.
Autistic children often appear to prefer being alone rather than
in the company of others, may resist attention or passively accept
such things as hugs and cuddling without caring. Later, they seldom
seek comfort or respond to parents' displays of anger or affection
in a typical way. Research has suggested that although autistic
children are attached to their parents, their expression of this
attachment is unusual and difficult to "read." To parents, it may
seem as if their child is not attached at all. Parents who looked
forward to the joys of cuddling, teaching, and playing with their
child may feel crushed by this lack of the expected and typical
Children on the autism spectrum also are slower in learning to
interpret what others are thinking and feeling. Subtle social cues ?
whether a smile, a wink, or a grimace ? may have little meaning. To
a child who misses these cues, "Come here" always means the same
thing, whether the speaker is smiling and extending her arms for a
hug or frowning and planting her fists on her hips. Without the
ability to interpret gestures and facial expressions, the social
world may seem bewildering. To compound the problem, people on the
autism spectrum have difficulty seeing things from another person's
perspective. Neurotypical (popularly described as "normal")
5-year-olds understand that other people have different information,
feelings, and goals than they have. An autistic person may lack such
understanding, an inability that leaves them unable to predict or
understand other people's actions.
Although not universal, it is common for autistic people also to
have difficulty regulating their emotions. This can take the form of
"immature" behavior such as crying in class or verbal outbursts that
seem inappropriate to those around them. The autistic individual
might also be disruptive and physically aggressive at times, making
social relationships still more difficult. They have a tendency to
"lose control," particularly when they're in a strange or
overwhelming environment, or when angry and frustrated. They may at
times break things, attack others, or hurt themselves. In their
frustration, some bang their heads, pull their hair, or bite their
By age 3, neurotypical children have passed predictable
milestones on the path to learning language; one of the earliest is
babbling. By the first birthday, a typical toddler says words, turns
when he hears his name, points when he wants a toy, and when offered
something distasteful, makes it clear that the answer is "no."
Speech development in Autism takes a different path
developmentally than in neurotypical children. Some autistics remain
mute throughout their lives, while being fully literate and able to
communicate in other ways -- images, sign language, and typing are
far more natural to them. Some infants who later show signs of
autism coo and babble during the first few months of life, but they
soon stop. Others may be delayed, developing language as late as the
teen years. Still, inability to speak no more means that autistics
are unintelligent or unaware than it does in a neurotypical with his
or her mouth taped shut. Once given appropriate accommodations, many
will happily "talk" for hours, and can often be found in spectrum
chat rooms, discussion boards, websites, or even using communication
devices at the annual Autreat.
Those who do speak often use language in unusual ways, retaining
features of earlier stages of language development for long periods
or throughout their lives. Some speak only single words, while
others repeat the same phrase over and over; or repeat what they
hear, a condition called echolalia. Sing-song repetitions in
particular are a calming, joyous activity that many autistic adults
engage in. Many autistics have a strong tonal sense, and can often
understand spoken language better if it is sung to them.
Some children may exhibit slight delays in language, or even seem
to have precocious language and unusually large vocabularies, but
have great difficulty in sustaining a conversation neurotypical-style.
The "give and take" of NT conversation is hard for them, although
they often carry on a monologue on a favorite subject, giving no one
else an opportunity to comment. When given the chance to interact
with other autistics, they comfortably do so in "parallel monologue"
-- taking turns expressing views and information. Just as
neurotypicals are not designed to understand autistic body
languages, vocal tones, or phraseology, autistics similarly have
trouble with such things in neurotypicals. In particular, autistic
language abilities tend to be highly literal; neurotypicals often
inappropriately attribute hidden "meaning" to what autistics say or
expect the autistic to sense such unstated meaning in their own
The body language of autistics is uniquely designed for other
autistics, and therefore can be difficult for neurotypicals to
understand. Facial expressions, movements, and gestures are
appropriate for and easily understood by other autistics, but do not
match those used by neurotypicals. Also, their tone of voice has a
much more subtle inflection in reflecting their feelings, and the
neurotypical auditory system often cannot sense the fluctuations.
What seems to NTs like a high-pitched, sing-song, or flat,
robot-like voice is common. Some children with relatively good
language skills speak like little adults, rather than falling into
the immature "kid-speak" that is common in their neurotypical peers.
With neurotypicals often refusing to learn the autistic body
language, and with autistic natural language not tending towards
speech, autistic people often are forced to struggle to let others
know what they need. As a result, as anybody would do in such a
situation, they may scream in frustration or resort to grabbing what
they want. While waiting for neurotypicals to learn to communicate
with them, autistics do whatever they can to get through to them. As
autistic people grow up, the accumulation of mistreatment, constant
rejection from neurotypicals assuming that differences are something
to "cure", and constantly being misunderstood by neurotypicals
refusing to help bridge the neurological gap logically causes them
to become anxious or depressed.
Although autistics usually appear physically normal and have good
muscle control, unusual repetitive motions may set them apart. These
behaviors might be extreme and highly apparent or more subtle. Some
children and older individuals spend a lot of time repeatedly
flapping their arms or walking on their toes, others suddenly freeze
As children, they might spend hours lining up their cars and
trains in a certain way, rather than using them for pretend play. If
someone accidentally moves one of these toys, the child may be
tremendously upset. Autistic children often need, and demand,
absolute consistency in their environment. A slight change in any
routine?in mealtimes, dressing, taking a bath, going to school at a
certain time and by the same route?can be extremely disturbing.
Perhaps order and consistency lend some stability in a world of
Repetitive behavior sometimes takes the form of a persistent,
intense preoccupation. For example, the child might be obsessed with
learning all about vacuum cleaners, train schedules, or lighthouses.
Often they show great interest in numbers, symbols, or science
Severity of symptoms
Autism presents in a wide degree, from those who are nearly
dysfunctional and apparently mentally retarded to those whose
symptoms are mild or remedied enough to appear unexceptional
(normal) to the general public. These autistic persons are often
classified as 'nerds' by their peers.
"Low-" and "High-functioning"
In terms of both classification and therapy, autistic individuals
are often divided into those with an IQ<80 referred to as having
"low-functioning autism" (LFA), while those with IQ>80 are referred
to as having "high functioning autism" (HFA). Low and high
functioning are more generally applied to how well an individual can
accomplish activities of daily living, rather than to IQ. The terms
low- and high-functioning are controversial and not all autistics
accept these labels.
This discrepancy can lead to confusion among service providers
who equate IQ with functioning and may refuse to serve high-IQ
autistic people who are severely compromised in their ability to
perform daily living tasks, or may fail to recognize the
intellectual potential of many autistic people who are considered
LFA. For example, some professionals refuse to recognize autistics
who can speak or write as being autistic at all, because they still
think of autism as a communication disorder.
Asperger's and Kanner's syndrome
Of the most common presentations of autism, Kanner's syndrome is
often described as classical autism, implying low-functioning, while
Asperger's syndrome is described as a high-functioning form of
autism, but this is not necessarily the case.
In the current Diagnostic and Statistical Manual of Mental
Disorders (DSM-IV-TR) the most significant difference between
Autistic Disorder (Kanner's) and Asperger's disorder is that a
diagnosis of the former includes the observation of "[d]elays or
abnormal functioning in at least one of the following areas, with
onset prior to age 3 years: (1) social interaction, (2) language as
used in social communication, or (3) symbolic or imaginative
while in these areas a diagnosis of Asperger's observes "no
clinically significant delay."
The DSM makes no mention of level of intellectual functioning,
but the fact that Asperger's autistics as a group tend to perform
better than those with Kanner's autism has fed the popular
conception that Asperger's Syndrome is synonymous with 'Higher
Functioning Autism', or that it is a lesser disorder than autism.
There is also a popular but not necessarily true conception that all
autistic individuals with a high level of intellectual functioning
have Asperger's autism; or that both types are merely geeks with a
medical label attached.
Autism has evolved in the public understanding, but the popular
identification of autism with relatively severe cases as accurately
presented in Rain Man is an encouragement for relatives of family
members diagnosed in the autistic spectrum to speak of their loved
ones as having Asperger's syndrome rather than autism.
Autism as a spectrum disorder
Another view of these disorders is that they are on a continuum,
so can be known as autistic spectrum disorders. Another related
continuum is Sensory Integration Dysfunction which is about how well
we integrate the information we receive from our senses. Autism,
Asperger's Syndrome, and Sensory Integration Dysfunction are all
closely related and overlap.
Some high-achieving individuals are thought to have had some form
of autism. However, this may be favoured diagnosis due to the high
current visibility of autism in the popular press. In the 1980s,
such individuals were often characterised as dyslexic or dysmetric;
other popular diagnoses for famous achievers have included bipolar
disorder (manic depression), schizophrenia or in one lamentable
case, Tourette syndrome, (Mozart was supposed to have it because of
his reported fondness for scatological humor). However, it is true
that autistic people may have other learning disabilities such as
There are two main manifestations of classical autism, regressive
autism and early infantile autism. Early infantile autism is present
at birth while regressive autism begins at approximately 18 months.
There are also cases of children developing abnormally from birth
but regressing around the age of 18 months, causing some degree of
controversy as to when the neurological difference involved in
autism truly began.
Rare autism spectrum disorders
Rett syndrome is relatively rare, affecting almost exclusively
females, one out of 10,000 to 15,000. After a period of normal
development, sometime between 6 and 18 months, autism-like symptoms
begin to appear. The little girl's mental and social development
regresses; she no longer responds to her parents and pulls away from
any social contact. If she has been talking, she stops; she cannot
control her feet; she wrings her hands. Some of the problems
associated with Rett syndrome can be treated. Physical,
occupational, and speech therapy can help with problems of
coordination, movement, and speech.
Scientists sponsored by the National Institute of Child Health
and Human Development have discovered that a mutation in the
sequence of a single gene can cause Rett syndrome. This discovery
may help doctors slow or stop the progress of the syndrome. It may
also lead to methods of screening for Rett syndrome, thus enabling
doctors to start treating these children much sooner, and improving
the quality of life these children experience.
Childhood Disintegrative Disorder
Very few children who have an autism spectrum disorder (ASD)
diagnosis meet the criteria for childhood disintegrative disorder (CDD).
An estimate based on four surveys of ASD found fewer than two
children per 100,000 with ASD could be classified as having CDD.
This suggests that CDD is a very rare form of ASD. It has a strong
male preponderance.** Symptoms may appear by age 2, but the average
age of onset is between 3 and 4 years. Until this time, the child
has age-appropriate skills in communication and social
relationships. The long period of normal development before
regression helps differentiate CDD from Rett syndrome.
*Rett syndrome. NIH Publication No. 01-4960. Rockville, MD:
National Institute of Child Health and Human Development, 2001.
**Frombonne E. Prevalence of childhood disintegrative disorder.
Autism, 2002; 6(2): 149-157.
***Volkmar RM and Rutter M. Childhood disintegrative disorder:
Results of the DSM-IV autism field trial. Journal of the American
Academy of Child and Adolescent Psychiatry, 1995; 34: 1092-1095.
Increase in diagnoses of autism
There has been an explosion worldwide in reported cases of autism
over the last ten years. There has been considerable speculation as
to why this might be, with no conclusive proof emerging around any
theory. However, studies have ruled out the speculation that the
rise is [entirely] attributable to an improvement in diagnostic
In the last decade, the population of the United States has
increased by 13%. There has been an increase in non-autism-related
disabilities of 16%. The increase in autism is 173%.
In 2001, Wired Magazine published an interesting speculative
article The Geek Syndrome (http://www.wired.com/wired/archive/9.12/aspergers_pr.html)
exploring the surge in apparent autism in Silicon Valley. This is
only one example of the media's application of mental disease labels
to what is actually variant normal behavior. Shyness, lack of
athletic ability or social skills, and intellectual interests, even
when they seem unusual to others, are not in themselves signs of
autism or Asperger's syndrome.
Remediation of autistic behaviors
Remediation of debilitating aspects of autism was long hindered
not only by widespread disagreement over its nature and causes, but
by lack of a recognized and effective course of therapy.
Dr. Bruno Bettelheim believed that autism was linked to trauma in
early childhood, and his work was highly influential for decades.
Parents, and especially mothers, of autistics were blamed for having
caused their child's condition through the withholding of affection.
Leo Kanner, who first described autism (Autistic disturbances of
affective contact, 1943) originated the concept of "refrigerator
mothers" in regard to autism, although he eventually renounced the
concept and apologized publicly. Bettelheim took the theory further.
These theories did nothing to address the fact that having more than
one autistic child in a family is exceptional, not the rule.
Treatments based on these theories failed to help autistic children.
A major breakthrough in the remediation of autistic behaviors
came through work spearheaded by Ole Ivar Lovaas, who believed that
success could be obtained by behavioral approaches.
Lovaas' approaches?often referred to as Discrete Trial, Intensive
Behavior Intervention, and Applied Behavior Analysis?are some of the
best known and most widely used in the field and focus on the
development of attention, imitation, receptive or expressive
language, and pre-academic and self-help skills. Using a one-to-one
therapist-child ratio and the ?antecedent-behavior-consequence?
(ABC) model, interventions based on this work involve trials or
tasks. Each consists of (a) an antecedent, which is a directive or
request for the child to perform an action; (b) a behavior, or
response from the child, which may be categorized as successful
performance, noncompliance, or no response; and (c) a consequence,
defined as the reaction from the therapist, which ranges from strong
positive reinforcement to a strong negative response, ?No!?(Autism
Society of America, 2001). (http://www.aann.org/ce/jnn04-02b.htm)
Lovaas' Applied Behavioral Analysis (ABA) methods were the first
scientifically validated therapy for autism. Early intervention,
generally before school-age, is critical for children who would
benefit from these programs.
The scientific validity of Lovaas's methods is questioned by many
professionals as well as parents and autistics themselves, however,
who point out that true ABA is based around the use of aversives
which could be experienced by an autistic person as confusing and
painful. Nevertheless, some believe that ethical reasons exist for
applying Lovaas's techniques. Some behaviorist programs for
autistics employ no aversives at all and do not attempt to
"extinguish" behaviors such as rocking or spinning which autistics
use for calming purposes.
ABA may not be appropriate for every autistic or developmentally
delayed child. ABA has come into widespread use only in the last
decade and the demand is outstripping the supply of committed and
experienced service providers. As a result, parents of children need
to be extra vigilant in choosing appropriate treatments for their
children and especially in choosing providers, who may be
inexperienced, use questionable methods or even deceive parents that
they are competent to run an ABA or any other program. Such problems
have led to horror stories from some parents.
Autism and Computing
Computers can be an ideal environment for promoting
communication, sociabilility, creativity, and playfulness for
individuals even at the extreme of the autistic spectrum. This is
the opinion of the non-profit group Autism and Computing. They argue
that the central feature of Autism is attention-tunnelling,
monotropism. Computers would afford an easy way of joining attention
tunnels with minimal mutual discomfort, so circumventing some of the
most disabling features of autistic spectrum disorders. The
potential for computers in Autism would not just be educational but
therapeutic. The group presents both theory and practise on its
website Autism and Computing.
Aspects of autism
Some things to mention here:
the autistic savant phenomenon occasionally seen in people with
autism. Calendar calculators and fast programming skills are the
most common form.
Simon Baron-Cohen's team at the Autism Research Centre in
Cambridge, UK, measured testosterone levels in the amniotic fluid of
mothers while pregnant. This is presumed to reflect levels in the
babies themselves. The team found that the babies with higher fetal
testosterone levels had a smaller vocabulary and made eye contact
less often when they were a year old.
His group has looked at the original 58 children again, at age four.
The researchers found that the children with higher testosterone in
the womb are less developed socially, and the interests of boys are
more restricted than girls. The results will be published in the
Journal of Child Psychology and Psychiatry (2004).
Baron-Cohen theorizes that high fetal testosterone levels push
brain development towards an improved ability to see patterns and
analyse systems. Males supposedly tend to be better at these tasks
than females. But the high levels are thought to inhibit the
development of communication and empathy, which are allegedly
typical female skills.(New Scientist, 24 May 2003). There is still
no demonstrable evidence that testosterone levels affect brain
development at all, let alone autism. Gender or bio-determinism is a
fashionable explanation for many human behaviours, but has been
challenged by other professionals.
Research by Andrew Wakefield in the UK, published in The Lancet
in February 1998 suggested a possible link between autism and the
MMR vaccine. This was very controversial. Subsequent studies failed
to confirm the link, and some in fact showed a lack of such a link.
The original research has come under criticism, largely due to a
conflict of interest on Wakefield's part. In February 2004 The
Lancet described the research as "entirely flawed" and said that it
should never have been published. Controversy continues, with
Wakefield defending his integrity.
Aspies with statistical skills have claimed that Andrew Wakefield
was, and still is, severely incompetent in statistics and failed to
recognize the extreme bias of his sample among other obvious flaws.
Wakefield's nonscientific study and its continuing circulation in
autism societies is sometimes depicted by the media as a "proof" no
autism-vaccine connection exists and "it's all hype".
Research in the US suggesting a similar link between autism and
DPT vaccine. It isn't however the large majority of autism that
would come from vaccines, unlike early claims from Wakefield.
Susan Bryson has proven autistics have a much smaller brain stem in
99% of autism cases; and that a small portion of the Thalidomide
victims have become autistic. Limbs were normal unless Thalidomide
use continued later in the pregnancy. The brain stem anomaly's most
striking feature is inability to focus attention away from a
stimulus in a short time like neurotypicals, as demonstrated in a
Neurology-skilled Aspies claim the inability to shift attention
away in a very short time (i.e. overfocus) interferes with the
ability to read nonverbal language where fast attention shifts are
needed like eye language; suggesting that being nonverbal is not a
primary feature of autism. Strong and shiftless focus is however a
quality in some areas like science, programming, and advanced
mathematics. This is supported by the monotropism hypothesis.
the analysis of autism as "mind blindness"?the inability to create
models of other people's thoughts. The typical example of this is
"where does X look for the object they stored, but which was moved
by Y"?see theory of mind. Not all autistics fit this pattern, and
more study is clearly needed.
Dr. Bernard Rimland's influential research and his book Infantile
Autism (1967) which argued that autism was not caused by childhood
trauma or abuse, but by damage to certain areas of the brain,
particularly the reticular formation which associates present
sensory input with memories of past experiences. Dr. Rimland is a
foremost advocate of the theory that autism may be precipitated by
mercury/heavy metal toxicity. (http://www.curezone.com/art/read.asp?ID=79&db=2&C0=735)
He also is prominent in increasingly common claims of successful
treatment of autism in children -- particularly regarding
improvements in ability to comprehend the spoken word -- with the
gluten-free, casein-free diet & mercury chelation therapy.
Neurobiology-skilled aspies have often claimed Dr. Bernard Rimland's
methods cure heavy metal poisoning, but not autism. Curing heavy
metal poisoning when it is present is a worthy goal (it helps with
IQ and other learning difficulties as well as general health), but
claiming a cure for autism is a misrepresentation. Heavy metal
poisoning may be more common among autistics due to a severe
Metallothionein deficiency; but heavy metals don't cause autism.
They might make you more likely to get an autism diagnosis, though.
Dr. Karl Ludwig Reichelt claims to have found peptides from
casein and gluten which worsen the symptoms of autistic children.
The peptides are casomorphines and gluten exorphines which influence
the brain. Significant improvement is seen when they are on a strict
Relationship Development Intervention (RDI) is a proprietary
treatment program targeting the core social/relationship deficits of
The social alienation of people with autism and Asperger's
Syndrome is so intense from childhood that many of them have
imaginary friends as companionship.
Both Oliver Sacks and Torey Hayden have written about their
autistic patients or pupils, respectively. Temple Grandin has also
written about her own life as a person with autism. Donna Williams
in her books, including (Autism: an inside-out approach, ISBN
1-85302-387-6) gave an interesting perspective on the experience of
a person with autism and the degree to which recovery is possible.
Many other people who have autism have written books on the
condition (and on other topics).
The Options (http://www.son-rise.org/) program. In the early
1970s, advertising executive Barry Kaufman published a book, Son
about his son Raun Kahlil's "triumph over autism". Raun apparently
had regressive autism subsequent to a series of life-threatening ear
infections. (He was never actually diagnosed, and may only have been
speech-delayed with a few autistic traits.) As he describes in his
polemic, Kaufman and his family "chose to feel happy" about Raun's
condition. They tried to communicate with Raun not by overt attempts
to force neurotypical behavior, but by imitating his endless
rocking, plate spinning and other rituals, while gently introducing
eye contact, speech, song, etc. for him to imitate if he would.
Supposedly, Raun snapped out of it and began behaving as a
completely neurotypical child. The book was embraced by thousands of
parents in desperate hope. Raun's story seemed to prove the myth of
the "real child" trapped in a shell of autism, and many others would
still choose to uphold this myth.
Kaufman's ideas led to the creation in 1983 of the Options
Institute, in which children with all sorts of autistic-spectrum
conditions receive the same sort of interactive training in hopes
that they will "choose" not to be autistic. The program emphasizes
loving and accepting the child just as he is, but the attitude
exemplified by the language used -- "rescuing" the child from
autism, "rebirthing" him from a "living death", and so on -- would
seem to belie this. In the program's view, a positive attitude is
mandatory -- the institute's motto is "Happiness is a Choice" -- and
a child's failure to respond is blamed on parents' "negative
attitude" rather than any defect in the program itself. In more
recent years, the program has expanded to include children diagnosed
with ADHD and group therapies for adults. Some ex-members describe
Options as cultlike (http://www.freedomofmind.com/resourcecenter/groups/o/option/oi_statements.htm),
while some autistic individuals feel that Options is not geared for
all autistic persons and that its goals are unrealistic (http://rsaffran.tripod.com/sonrise.html).
In any case, "choosing" not to be autistic certainly won't magically
make appear the two missing brain structures shown to be missing or
altered in autism  (http://www.unc.edu/~cory/autism-info/orgautsa.html)
or make autistics think about people in the same area of the brain
that normal people use. Those features will continue to make the
autistic internally different, and inherently uncomfortable with
some aspects of neurotypical behavior, regardless of how he is fully
trained/self-trained at pretending to be normal.
Adults with an autism spectrum disorder
Some autistic adults, especially those with high-functioning
autism or with Asperger syndrome, are able to work successfully in
mainstream jobs. Nevertheless, communication and social problems
often cause difficulties in many areas of life.
Many other autistics are capable of employment in sheltered
workshops under the supervision of managers trained in working with
persons with disabilities. A nurturing environment at home, at
school, and later in job training and at work, helps autistic people
continue to learn and to develop throughout their lives.
In the United States, the public schools' responsibility for
providing services ends when the autistic person is in their 20s,
depending of each state. The family is then faced with the challenge
of finding living arrangements and employment to match the
particular needs of their adult child, as well as the programs and
facilities that can provide support services to achieve these goals.