Autism Through Ages Baffles Science

   For years past people with autism were placed in institutions all over the world. Autism is not a modern problem, even though it has only recently gained vast recognition. It is difficult to discuss the history of autism treatment without paying particular attention to the history of "autism" as a concept and the ways in which autism has been conceptualized and theorized about over the past 100 years.

The ways in which we understand and think about autism have directly and indirectly formed our conceptual responses to autism over the years. The very concept of "treatment" carries with it many presumptions about the nature of autism, its origins and its potential outcomes. The history of autism is not a linear one, and regardless of the past or present debates over treatment, origin or outcome, as more and more studies and research are conducted the greater the understanding of autism will become.

Swiss psychiatrist Eugen Bleuler first introduced the term autism in 1911. Autism and autistic stem from the Greek word "autos," meaning self. The term autism originally referred to a basic disturbance in schizophrenia, in short, an extreme withdrawal of oneself from the fabric of social life, but not excluding oneself.

          Bleuler also coined the term ambivalence to designate one of the major symptoms of schizophrenia, the others being autism, disturbances of effect (emotion) and association (thought disorders). Ambivalence is a coexistence of two opposing drives, desires, feelings or emotions toward the same person, object or goal. The ambivalent person may be unaware of either of the opposing wishes. Bleuler felt that there were normal instances of ambivalence--such as the feeling, after performing an action, that it would have been better to have done the opposite; but the normal person, unlike the schizophrenic, is not prevented by these opposing impulses from deciding and then acting. Bleuler's schizophrenia differs in terms from the Freudian theories, in which ambivalence was described as feelings of love and hate toward the same person. (E.L. Horwitz, "Madness, Magic, and Medicine: The Treatment and Mistreatment of the Mentally Ill." [Lippincott, 1977])

          In the early 1900s, psychologist Carl Gustav Jung introduced the well-known personality types, extroverts and introverts, further broadening Sigmund Freud's psychoanalytical approach. However, this approach appears to have indirectly classified the autistic person as a schizophrenic introvert. Jung saw the activity of the extrovert directed toward the external world and that of the introvert directed inward upon him- or herself. Jung, who removed from the term the sexual character ascribed to it by Freud, called this general activity or drives of the individual the libido. The extrovert is characteristically the active person who is most content when surrounded by people; carried to the neurotic extreme, such behavior appears to constitute an irrational flight into society, where the extrovert's feelings are acted out.

          The introvert, on the other hand, is normally a contemplative individual who enjoys solitude and the inner lifeof ideas and the imagination. Severe introversion was believed to be characteristic of autism and some forms of schizophrenia. (C.G. Jung, "Psychological Types." [tr. 1923, repr. 1970]) Jung did not suggest strict classification of individuals as extroverted or introverted, since each person has tendencies in both directions, although one direction generally predominates. Jung theorized a patient could achieve a state of individuation, or wholeness of self. (E.H. Ackernecht, "A Short History of Psychiatry." [Hafner, 2d ed., rev., 1970])

          In 1944, American Bruno Bettelheim directed the Chicago-based Ortho-genic School for children with emotional problems, placing special emphasis on the treatment of autism. Bettelheim believed that autistic children had been raised in unstimulating environments during the first few years of their lives, when language and motor skills develop. He saw parents unresponsive to their child as an underlying cause of autistic behavior. (L. Wing, ed., "Aspects of Autism." [1988]) Although subsequent studies of the parents of autistic children have discredited Bettelheim's psychological explanation, his ideology carried into the general populace for generations to follow, germinating red herring terms like "refrigerator mother."

          The highly complex treatment of childhood autism began with the early-childhood development pioneers Leo Kanner and Hans Asperger, who each published accounts of this disorder. Kanner published his report in 1943 while at Johns Hopkins. He conducted a case study of 11 children who appeared to share a number of common characteristics that he suggested formed a "unique 'syndrome' not heretofore reported." He titled the article, "Autistic disturbances of affective contact," and characterized the children as possessing, from the very beginning of life, what he called an "extreme autistic aloneness." The following year, Asperger published "Autistic psychopathy in childhood." The article presented a case study of several children whom he described as examples of "a particularly interesting and highly recognizable type of child." Both Kanner and Asperger believed that the children suffered from a fundamental disturbance that gave rise to highly characteristic problems.

They both chose the word autism, a term coined by Bleuler in reference to the aloneness experienced by schizophrenic patients, in order to characterize the nature of the underlying disturbance. The common feature of this disturbance was that the children seemed unable to entertain normal relationships with people.

          In contrast to Bleuler's schizophrenia, the disturbance observed by Kanner and Asperger appeared to have been there from birth. Kanner's paper has become the most quoted, while Asperger's paper, written in German during World War II, was largely ignored. The belief has grown that Asperger described quite a different type of child, not to be confused with the one Kanner described.

Asperger's definition of autism or, as he called it, "autistic psychopathy," is far wider than Kanner's, including cases that showed severe organic damage and those that shaded into normality. In 1943 and 1944, "autistic disturbances" and "autistic psychopathy" became known as syndromes. (U. Frith, "Autism: Explaining the Enigma." [1989]) Asperger's syndrome as defined today is clearly not what Asperger intended, but having this special category has proved clinically useful.

          Kanner's syndrome is often used to indicate the child with a constellation of classic, "nuclear" features, resembling in astonishing detail the features that Kanner identified in his first, inspired description. Again, the category is clinically useful since it communicates a prototypical pattern. From the 1980s through the early 1990s, the cause, prognosis, and treatment of autism were vigorously under study. Research suggested that a genetic defect caused the disorder, which was presumed to be some form of autoimmune disease or degenerative disease of nerve cells in the brain.The preferred treatment for the autistic child was special education, stressing learning in small increments, and a strict behavioral control of the child.

          In general, about half of the children with autism were considered mute; those who remained mute through age 5 were given a poor prognosis for recovery. The children with autism who spoke were given a prognosis that they would fare better, and possibly even recover. (Autism, ENCARTA'95; Computer program; [1995]) Since 1911, the understanding of autism has grown to such a degree that we know there is not yet a cure.

          However, researchers all across the nation are working diligently to produce more information on autism, and possibly a cure. "Cure" means "restoration of health; recovery from disease." To "recover" means "to regain a normal or usual condition, as of health." While "cure" and "recovery" prognoses for autism might have been the expectation of 80s and early 90s, they do not represent expectations today.

Today we know that with highly structured and appropriate interventions the behaviors of a child or adult with autism may change to the point where he or she may appear to no longer have autism to the untrained person. However, while they have changed, they still have the autism.

          In 1995-1996, only 5.6 million children (ages 0 to 21), or about 12 percent of public school children, were enrolled in special education programs. The number of students participating in federal programs for children with disabilities has increased at a faster rate than the total public school enrollment.

          Between 1977 and 1995 alone, the number of students involved in federal programs for children with disabilities increased 47 percent, while the total public school enrollment decreased by 2 percent. These counts are based on reports from the 50 states and submitted to Congress to aid in the enactment of the Individuals with Disabilities Education Act by the National Center for Education Statistics, U.S. Department of Education, "Digest of Education Statistics," 1997.

It is also noted in this study that as early as 1976, as new types of disability categories began to emerge (specific learning disabilities, serious emotional disturbance, multiple disabilities, other health impairments, autism, preschool disabled), the percentages of federal programs for students with mental retardation disability began to lower.

          It is evident that autism as a diagnosis was non-existent prior to the early 1900s, and the people who had what we call autism today were diagnosed with some other disorder. It was not until the mid 1900s that people with autism were no longer institutionalized for their problem. Despite the persistence of old theories, no factors in the psychological environment of a child or adult have been shown to cause autism. There is no proof that autism is due to bad parenting, neglect, abuse or tragedy. Children with autism are not unruly youngsters who choose not to behave. Professionals have long since disproved all of these "causes" and theories. Unfortunately, the general understanding of the word autism hasn't kept up with the newer medical research shared today. It is proven that people with autism can lead happy and productive lives when appropriate supports and therapies are provided.

By Robert Williams Jr., June 12, 2000 at Health24 News

http://www.pediatricservices.com/prof/prof-26.htm 

Have Scientists Just Cracked the Autism Code?

Once again, technology is stepping up to the plate to tackle a serious and debilitating medical condition.
One that the Centers for Disease Control and Prevention says is diagnosed in 20 out of every 1,000 children in the United States – up from 11 in 1,000 in 2008.
We’re talking about autism – a neural development disorder that inhibits both verbal and non-verbal communication and, as a result, stunts social interaction and maturity.
It’s a notoriously tricky condition to fully diagnose, with the biggest clue coming from the fact that it’s heavily genetic. In fact, children with older family members who have autism are 20 times more likely to develop autism themselves.
As with every disease and condition, the key to better diagnosis – and, consequently, better treatment – is to identify the condition as early in life as possible.
The trouble is, signs of autism usually don’t fully manifest themselves until the child is a few years old.
But researchers at Emory University and the Marcus Autism Center in Atlanta are changing that…

The Eyes Have ItThey’re using eye-tracking technology to screen babies for signs of autism in the first few months of their lives.
Specifically, they’re measuring the babies’ ability to respond to social cues when placed in a routine situation. For example, when watching videos.
In partnership with the Marcus Autism Center, the trials took two groups of babies. One group was at high risk of developing autism, while the other was low risk. Using the videos, the researchers monitored the babies’ progress in social development, interaction and attention span every couple of months.
As Warren Jones, Director of the Marcus Autism Center, explains, “We traced the way babies were looking at the world from the second month of life all the way to 24 months and even to 36 months when we confirmed the final outcome diagnosis for the children.”
And the result?

The Earliest Autism Diagnosis EverThe babies who were later diagnosed as autistic did indeed demonstrate a decline in their social awareness as early as the first two months of their lives.
Given that autism is typically diagnosed between four and five years old, suffice it to say, these findings are a significant improvement.
As Jones confirms, “What this study really shows us is that it’s possible to identify robust signs of social disability within the first months of life. And these are the earliest signs of autism ever identified.”
That early diagnosis is critical in then allowing doctors to get behavioral therapy and medication to the kids before they deteriorate.

For the Full Story Watch this video!
http://signups.techandinnovationdaily.com/X3TIPC01 

In new trials, scientists have used eye-tracking technology to monitor babies’ levels of social interaction and attention span in an effort to spot signs of autism earlier. Their results identified key markers at the earliest ever stage – a crucial breakthrough in diagnosing children earlier and getting them the essential therapy and medication they need faster.

Source: http://www.techandinnovationdaily.com/2014/01/01/autism-diagnosis-breakthrough/ 

UofL Neuroscientist So Close To Autism Breakthrough He's Helping Fund Research

By Lori Lyle

(LOUISVILLE) -- New findings could mean an incredible treatment for people with autism -- so incredible that a researcher at the University of Louisville is digging into his own pockets to make it happen as quickly as possible.

Dr. Manuel Casanova, a neuroscientist at the University of Louisville, is passionate about his research. His most recent published study finds drastic differences in the brains of autistic individuals. And now, with this knowledge, he's eager to move to the next step: treatment.

The breakthrough discovery is the result of a 3-year study involving top scientists around the world.

Dr. Casanova's team at the University of Louisville was responsible for conducting the study that analyzed tissue from 12 brains -- six of them taken from people with autism.

He says the results are unquestionable, and explain symptoms exhibited from autistic patients, such as trouble speaking.

"It means that we have uncovered something very important, because it has explanatory powers," Casanova says.

The brain strands or minicolumns of autism patients have more cells, but they are narrower and more densely packed -- which can limit the brain's ability to send messages.

Dr. Casanova says that's because "there's not enough juice to actually power very long connections in the brain."

Examining tissues from a normal brain and the brain of an autistic person, Dr. Casanova explains the differences. "The more bluish staining actually means more cells present," he says.

More cells and smaller cells, making up tiny brain strands, or minicolumns. These minicolums take in information, process it and respond to it.

But the increased amount of cells works to increase other abilities -- like mathematics.

Armed with this knowledge, Dr. Casanova is ready to begin working on wiping out autism entirely. "Knowing the pathology, what is wrong with the brains of autistic individuals, opens the door to potential strategies that may actually even lead to a cure."

Dr. Casanova's first step: developing a brain stimulator to bulk-up the brain strands. And he feels so strongly about the potential that he's ready to pay for it with his own money. "I approached the university, told them I needed equipment for preliminary studies and I would match the money with my own money."

The cost for the equipment that could forever change the diagnosis of autism: $40,000. Dr. Casanova is confident he's on the verge of a major breakthrough. "Something good is about to happen," he said.

Prevention is of course the main goal for a cure, and Dr. Casanova is working on that, too. He says research findings so far point to both genetics and the environment.

New Therapeutic Approach to Managing Autism

Summary: 

New research in mice suggests that autism is characterized by reduced activity of inhibitory neurons and increased activity of excitatory neurons in the brain, but balance can be restored with low doses of a well-known class of drugs currently used in much higher doses to treat anxiety and epileptic seizures. The findings, which are reported in the March 19th issue of the Cell Press journal Neuron, point to a new therapeutic approach to managing autism.

Article:

"These are very exciting results because they suggest that existing drugs -- called benzodiazepines -- might be useful in treatment of the core deficits in autism," says senior author Dr. William Catterall of the University of Washington, in Seattle.

In addition to finding that mice with autistic characteristics had an imbalance between the inhibitory and excitatory neurons in their brains, Dr. Catterall and his team found that reducing the effectiveness of inhibitory neurons in normal mice also induced some autism-related deficits in social behavior. Classical benzodiazepine drugs had the opposite effect, increasing the activity of inhibitory neurons and diminishing autistic behaviors.

"Our results provide strong evidence that increasing inhibitory neurotransmission is an effective approach to improvement of social interactions, repetitive behaviors, and cognitive deficits in a well-established animal model of autism, having some similar behavioral features as human autism," says Dr. Catterall.

Therapeutic approaches to treat autistic traits in animal studies or in clinical trials have primarily focused on reducing the activity of excitatory neurons, with only modest success to date. The results reported by Dr. Catterall and his colleagues suggest that augmenting the activity of opposing, inhibitory neurons could be an alternative strategy.

Clinical trials of classical benzodiazepines and next-generation drugs that have a similar mechanism of action are now needed to determine whether the researchers' findings in mice are relevant to humans. Astra-Zeneca and the National Institutes of Health have initiated one such trial.

Written on: 

March 19, 2014

Source:

Cell Press. "Low doses of antianxiety drugs rebalance autistic brain, study shows." ScienceDaily. ScienceDaily, 19 March 2014. <www.sciencedaily.com/releases/2014/03/140319124806.htm>.

A Realistic Perspective of Bullying

On this occasion I will begin my analysis of an academic journal titled “Bullying in School: An Overview of Types, Effects, Family Characteristics, and Intervention Strategies” which was written by Paul R. Smokowski and Kelly Holland Kopasz. According to the journal, “one in three children” is affected by bullying within U.S. schools. However, the journal notes that the National School Safety Center has “called bullying the most enduring and underrated problem in U.S. Schools.” In fact, a recent national survey found that “nearly 30% of the students surveyed reported being involved in bullying […] as either a perpetrator or a victim.” In reality the aforementioned statistic translates to approximately “3,708,284 students reporting bullying and 3,245,904 students reporting victimization.”   

Before reading this article it was really hard to put into perspective and visualize the different bullying percentages given by different resources. However, now that a physical number has been given it is hard to understand why the problem is being overlooked. As mentioned within this article, bullying is “underrated.” As a result, perhaps anti-bullying strategies should focus on helping parents and other adults identify bullying. The problem of bullying cannot be addressed if it is not first identified and accepted as an existing problem.

The journal notes that a power imbalance is a feature typically found within bullying relationships, with “the bully being either physically or psychologically more powerful [than the victim].” The journal states that bullies may use bullying as “a means to establish dominance or maintain status.” Although the journal provides various examples of bullying including, name calling, physical assault, threatening, stealing, vandalizing, slandering, excluding and taunting, the journal notes that “regardless of which behavior is chose, bullying is marked by intense intimidation that creates a pattern of humiliation, abuse, and fear for the victim.”

In my opinion, the struggle for power is not the problem. Competitiveness is what has driven humanity to progress and improve. The problem begins when the struggle for power gets out of hand. When the power struggles transforms into bullying, healthy competitiveness stops and a unproductive monopoly begins. As a result, just as forming and maintaining a monopoly is illegal, so should maintaining a bullying relationship. This does not mean that all incidents of bullying should be treated as heinous crimes, but rather that each bullying case should be treated seriously and be responded to independently according to its own circumstances.

Bullying Linked to Suicide

             Recently I posted a blog regarding a young teenage girl who committed suicide.  Although it has not been confirmed that bullying was the main cause of the young girl’s suicide, the girl’s parents feel that bullying played a major factor in the girl’s death.  On this occasion I will discuss an article regarding bullying and its link to suicide among teenagers. The article I will be discussing is titled “Teens taunted by bullies are more likely to consider, attempt suicide” and can be found on the “latimes.com”.

 According to the article, researchers in a study conducted by JAMA Pediatrics quantified the “emotional effects of being teased, harassed, beaten up or otherwise harmed by one’s peers” by citing 34 reliable studies regarding the relationship between peer victimization and suicidal ideation (with total of 284,375 participants) and 9 studies regarding the relationship between peer victimization and suicide attempts (with a total of 70,102 participants). The aforementioned studies were found within medical literature published in English, Spanish, German, French, Dutch, Portuguese, and Lithuanian since 1910, and all participants were aged from 9 to 21. In the end, an analysis of the aforementioned studies revealed that victims of bullying “were 2.23 times [more] likely to think about killing themselves than kids who had not been victimized.” In addition, it was revealed that “kids and teens who were bullied were 2.55 times [more] likely to attempt suicide than their counterparts who had not been victimized.”

One of the great features of the JAMA Pediatrics study is that it does not rely on only one study to conduct its conclusions, but rather uses a collection of studies to formulate its conclusions. In my opinion the aforementioned statistics highlight how devastating bullying can be to the self-esteem of victims. It is disturbing to realize the effects bullying can cause on children. Although all children do not respond to bullying in the same manner, the fact that suicide attempts have been linked to bullying should highlight the importance of this topic.

            The article also notes that previous studies “reported that cyber bullying could be just as bad as traditional bullying. However, this study found that victims of cyber bullying are especially vulnerable because “being bullied in person increased one’s risk for suicidal ideation by a factor of 2.16, while being bullied via e-mail, via text messages or in videos posted on the Internet increased the risk by a factor of 3.12.” A possible explanation offered by Mitch van Geel, the study leader, was that cyber bullying “victims may feel they’ve been denigrated in front of a wider audience” and that the “material can be stored online, which [… can] cause victims to relive the denigrating experience more often.”

The aforementioned claim and statistic provided by the article does not paint a promising feature for the future. As previously discussed, technology has led to the creation of cyber-bullying, a trend that has become increasingly prevalent within society and a trend that should continue to increase with the passage of time. As a result one can only expect suicide attempts to continue to increase. Researchers need to place emphasis on cyber bullying before it gets out of hand.

Example of a Possible Bullying Incident that Led to Suicide

           On this occasion I will discuss an online article regarding the suicide of Hailee Joy Lamberth, a 13 year old girl from the state of Nevada. The article is titled “Father: School received bullying report before daughter’s suicide” and can be found on the “reviewjournal.com”.

According to the article, Hailee Joy Lamberth committed suicide on December 12, 2013 and left a “farewell note” in which she mentioned that she had been bullying in school. Despite the aforementioned “farewell note,” school officials initially reported that Hailee had no bullying record. However, Hailee’s disciplinary file, which was recently requested by Hailee’s father, proves otherwise. According to Hailee’s disciplinary file, on November 21, 2013, an anonymous tip was submitted to the school district’s website in which someone reported that Hailee was being harassed. The school district’s policy requires school administrators to investigate the incident within 10 days and report their findings. According to Hailee’s father, “the incident was confirmed” and “the school’s administration told him the child was disciplined.”  However, now the school district will not confirm nor deny the incident because of federal student privacy laws. Currently Nevada law requires “principals to investigate all suspected incidents of bullying within 24 hours of receiving notice [… and] if bullying is found to have occurred, the principal must provide written notice to the parents.” According to Jason Lamberth, the father of Hailee, nobody in his family was contacted about any bullying issue.

The lack of adequate communication between school officials and parents is a key feature I noticed within this article. Although it is unknown if informing Hailee’s parents about her harassment report would have prevented Hailee’s suicide, I still believe it was wrong that Hailee’s parents were never informed about Hailee’s possible harassment incident. It is possible that by informing Hailee’s parents about the possible harassment, they would have been more attentive to Hailee. The fact that this window of opportunity for a possible intervention was completely taken away is undoubtedly an issue that should be addressed, especially since it is an easily amendable issue. Perhaps one feature school officials should try to implement is revising school policies regarding bullying by making it mandatory to immediately inform parents about bullying incidents, even if they are still being investigated and have not been completely confirmed. The aforementioned article demonstrates just how much little time is needed before disaster strikes. Perhaps school bullying policies should be revised in order to leave someone explicitly responsible for informing parents. In my opinion creating this role and sense of accountability will improve the lack of communication highlighted within the article analyzed within this blog.

            According to the article, current Nevada laws define bullying as “a willful act that ‘exposes a person repeatedly and over time to one or more negative actions which is highly offensive to a reasonable person’ and either physically or emotionally harms, threatens to harm, or exploits an imbalance in power.” It is uncertain whether Hailee’s case is an isolated case of error on behalf of the school district or if the incident met the state’s definition of bullying which would have required the parents to be notified. In either case, the Lamberth family feels that they should have been informed when Hailee was harassed, especially after Hailee’s death. Recently the superintendent of Hailee’s former school announced the creation a bullying task force to address the concerns of the Lamberth family.

            The normalization of bullying is a feature I also noticed within this incident. It seems as though the school is downplaying the incident as an isolated case that is very unlikely to occur once again. In my opinion every case not only should every case be taken seriously, they should also be studied in depth so that future incidents may be prevented. In addition, schools should be focusing on preventing bullying from occurring, not on helping families cope with the disastrous effects of bullying.