The word autism stems from the Greek word autos which means “self.” This term was first applied to schizophrenics in 1890 by Eugen Bleuler, a Swiss psychiatrist. Bleuler used this term to address the characteristic of certain schizophrenics who appeared to have their own style of thinking, autistic thinking. Autistic thinking is the view that the universe revolves around oneself and that the outside world has no effect on the self. (Gibbs, 2017). However, now we know that autism refers to a spectrum of dire developmental disorders in the brain. People commonly apply the term to people to who seem to be self-absorbed, which relates to the way it was initially applied. My mother is actually employed in a school where she works in a classroom with autistic and low-functioning students. One day, I accompanied my mother to her school, where I taught her class a lesson. I experienced first-hand how autistic children think and interact. It was truly an eye-opener, as I realized that they are just like everyone else except for a few differences. Some kids would have trouble expressing needs/emotions, some would only get signals from body language and some would be sensitive to smell. This interaction really fueled my desire for further inquiry about autism. It raised the question: What genetic and environmental factors entail whether Americans will develop autism, and how can the medical community treat autism? I wanted to find out more about why these kids are the way they are and if is curable in any way. Researching this question would also allow me to understand and appreciate my mother’s job even more. In order to understand the causes of this disability, it is first mandatory to understand the diagnosis and symptoms of an individual living with autism.

 

The diagnosis of autism is a difficult one to make. Autism is very common; approximately 1 in 68 children in the US have autism, increasing from 1 in 150 in 2000 (Szalavitz, 2016). The guidelines for the diagnosis of autism are not universal which is why some countries report higher rates of occurrence whereas other countries, Japan for example, report lower rates of occurrence (NINDS, 2018). Many children who would be diagnosed with autism today would not have been diagnosed with autism 15 years ago. In a blog “Autism on the Rise” by Vicki Gibbs, the author’s son is a clear case in point. He is 21 years old and is clearly on the autism spectrum but this was not picked up in his preschool years, despite being seen on two occasions by a very well regarded assessment team. However, Gibbs is pretty confident that if we could teleport that same assessment team to reassess her 3 year old son today, they would recognise his autism this time around. Autism affects individuals in varying degrees; some people will have mild symptoms while others will have severe ones. This is something I have personally noticed when teaching some autistic children. Some of them were capable of having a complete, logical conversation with me. However, some didn’t seem to know I was three inches from their nose. Even though a diagnosis of autism is usually made by the child’s third birthday, there are signs from birth that the child is different. “An autistic child is more likely to resist affection, arching back and not staying still when being held, than is a child without autism” (Baggers, 2018). Autistic children are also usually described as being easy babies to take care of. It is not until the child should be developing language and social skills that parents realize something is different about their child. One-third of autistic children develop “normally” until age two. Features of autism may also include the following: resistance of being touched, ignorance of heat and cold, no sensation of pain, fascination with sounds and tastes, giggling or weeping for no apparent reason, absence of emotions or reactions, self-injurious behaviors and self-stimulatory behaviors.

 

Experts are still uncertain about the causes of autism. Early views were focused on the family structure of the child. It was believed that parents of autistic children must be cold and detached. The term given to such parents, usually the mother, was that of “emotional refrigerator” or “refrigerator mother” (Baggers, 2018). The general thought in the psychology field today is that autism may be caused by a variety of coexisting problems. There are definitely many environmental factors that could possibly increase the risk of autism in a child. They include a high parental age at time of conception (both mother and father), maternal illness during pregnancy, extreme prematurity, very low birth weight and certain difficulties during birth, particularly those involving periods of oxygen deprivation to the baby’s brain. Mothers exposed to high levels of pesticides and air pollution may also be at higher risk of having a child with ASD. There is also some evidence to support the claim that autism may be an effect of exposure to a virus. The virus at hand is that of rubella. Studies have shown that there is an increased risk of a child being born with autism if the mother was exposed to rubella during the first trimester of pregnancy. It has also been proposed that toxins and pollution may lead to autism. Furthermore, autism tends to occur more frequently among individuals who have certain medical conditions, including fragile X syndrome, tuberous sclerosis, congenital rubella syndrome and untreated phenylketonuria. False claims in the news have made some parents concerned about a link between autism and vaccines. The controversy began in 1998 when British researchers published a paper stating that the measles-mumps-rubella (MMR) vaccine caused autism. However, in 2004, more than 12 follow-up studies were conducted by the Immunization Safety Review Committee of the Institute of Medicine. One study compared groups of children who received vaccines on the recommended schedule and those whose vaccines were delayed or didn’t get them at all. There was no difference in the autism rate between the two groups. The other studies found no evidence of there being a relationship between vaccines and autism as well, which was released in their 200 page report (NINDS, 2018).

 

Even though there are many theories connecting environmental conditions to the prevalence of autism, the widest held beliefs about the causes of autism appear to be in the fields of genetics and neurology. There is an abundance of evidence that points to genetic factors. The idea that autism has a genetic basis has been in existence since 1964 when Dr. Bernard Rimland discovered that monozygotic twins had a more frequent showing of autism than did dizygotic twins. Since 1964, this finding has been confirmed by other researchers. A supporter of the genetics theory is the Semel Institute for Human Behavior at the University of California Los Angeles (UCLA). In the 1980’s, they conducted a widespread study that resulted in the following findings: In a family with one autistic child, the chance of having another child with autism is about 5 percent – or one in 20 – much higher than in the normal population. (Martínez-Pedraza et al, 2009). It is generally accepted that autism is abnormalities in brain function. Brain scans show differences in the shape and structure of the brain in children with autism as compared to in neurotypical children. Many of the genes found to be associated with autism are involved in the function of the chemical connections between brain neurons. The spectrum usually is associated with more than one gene, which complicates things. An individual’s genes can determine the severity of their symptoms. Some genetic problems seem to be inherited, while at other times, these genetic changes arise spontaneously in an early embryo or the sperm and/or egg that combine to create the embryo. While no one gene has been identified as causing ASD, scientists are searching for irregular segments of genetic code that children with autism may have inherited. People with autism often had dozens of mutations that may have caused their symptoms — an average of 73 unique mutations. A study conducted by researchers at the University of North Carolina (UNC) School of Medicine in Chapel Hill found that mutations in UBE3A gene, which is on the long (q) arm of chromosome 15, destroy the regulatory switch – which they identified as protein kinase A (PKA) – meaning the gene cannot be turned off, causing it to become hyperactive. This hyperactivity, according to the team, could cause autism (O’Gallagher, 2002). It also appears that some children are born with a susceptibility to autism, but researchers have not yet found a “trigger” that causes autism to develop. Others are investigating the possibility that under certain conditions, a cluster of unstable genes may interfere with brain development, resulting in autism. Interestingly, boys are about four times more likely to develop autism than girls are (Szalavitz, 2016). Even though there is no definitive answer to why this ratio exists, researchers are a step closer to finding out. A study led by a team of Toronto scientists in 2010 undertook a genetic study of ASD patients and found that around one percent of the males tested had a particular mutation in a certain gene on their X-chromosome. Girls are different in that, by nature, they always carry a second X-chromosome, shielding them from ASD (NHGRI, 2017).

 

Considering the severity of this disorder and the lengthy duration of time it has existed for, it is surprising that there is no cure for autism. However, there are treatment plans which aim to reduce the symptoms as much as possible and maximize functional independence and quality of life. The ideal treatment plan combines therapies and interventions that meet the needs of the individual. Most health care professionals say that the earlier the intervention, the better (Baggers, 2018). Some treatments given to someone may work for them but may not work for another. The basis of a treatment plan should come from a thorough evaluation of the child’s strengths and weaknesses. Options include: behavior and communication therapies, medications and family therapies. Therapists use structured and intensive training sessions to help children develop social and language skills, such as applied behavioral analysis, which encourages positive behaviors and discourages negative ones. There is also speech therapy with a licensed speech-language pathologist, which help to improve a person’s communication skills, allowing him to better express his needs or wants. Unfortunately, these therapies can take a toll on a family as prices can add up to a hefty sum; almost a whopping $2,800 a month (NHGRI, 2017). Tarkan’s newspaper article in The New York Times lists some non-conventional therapies that may be easier on the wallet. They include: Anti-Yeast Therapy, Dimethylglycine Supplements, The Son-Rise Program and Higashi. Whereas the Anti-Yeast and the Dimethylglycine therapies focus on medical findings and/or vitamins to help modify the behaviors of an autistic individual, the Son-Rise Program and Higashi, which means Daily Life Therapy in Japanese, focuses on the roles that the people around an autistic person have in modifying behaviors. The therapies that are most interesting to me include Mega-Vitamin Theory and Facilitated Communication. Dr. Bernard Rimland researched the claims from parents that certain vitamins and foods affected their autistic child’s behaviors. It was concluded that Vitamin B6 is an effective treatment for forty-five percent of autistic people. The taking of vitamin B6 helps to improve: speech, sleeping patterns, lessened irritability, attention span and decrease self-stimulatory behaviors. Family counseling for the parents and siblings of children with ASD often helps families deal with the challenges of living with a child with autism. Also, they could recommend genetic testing to identify whether you have a genetic disorder. Medications can only help control symptoms of autism spectrum disorder. For example, certain medications may be prescribed if a child is hyperactive; antipsychotic drugs are sometimes used to treat severe behavioral problems and antidepressants may be prescribed for anxiety. Seizures can be treated with one or more anticonvulsant drugs (Martínez-Pedraza et al, 2009).

 

Autism is a lifelong, developmental disability. By understanding both genetic and environmental causes of autism, scientists may be able to better understand how to treat it and maybe even how to prevent it. It is justifiable to believe that genes play a huge role in the development of autism, as there is a multitude of studies and research to support it. We as a society have definitely improved our understanding of autism over time. In the past, it was about working hard to try and make them appear as “normal” as possible. The focus is now turning to understanding them as individuals and supporting them with their challenges to give them the best chance for at a normal life. Working with autistic children has taught me this on a personal level. Those living with autism may be helped, not cured, with available treatments. However, with genetic technologies improving at an astonishing pace, as well as global cooperation that will lead to a majority of people being studied, a cure is probable in the near future. I hope that we will keep exploring until we solve the mysteries of autism.

 

Works Cited

• “Autism Spectrum Disorder Fact Sheet.” National Institute of Neurological Disorders and Stroke, U.S. Department of Health and Human Services, 2018 www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Autism-Spectrum-Disorder-Fact-Sheet.

• “Learning About Autism.” National Human Genome Research Institute (NHGRI), Last Reviewed: 18 Jan. 2017, www.genome.gov/25522099/.
• Martínez-Pedraza, Frances de L., and Alice S. Carter. Child and Adolescent Psychiatric Clinics of North America, U.S. National Library of Medicine, July 2009, www.ncbi.nlm.nih.gov/pmc/articles/PMC3166636/.
• O’Callaghan, and F.J. “Autism-What Is It and Where Does It Come from? | QJM: An International Journal of Medicine | Oxford Academic.” OUP Academic, Oxford University Press, 1 May 2002, academic.oup.com/qjmed/article/95/5/263/1503009.
• Szalavitz, Maia. “Autism–It’s Different in Girls.” Scientific American, 1 Mar. 2016, www.scientificamerican.com/article/autism-it-s-different-in-girls/.
• Gibbs, Vicki. “Autism Spectrum Australia.” Autism on the Rise? | Autism Spectrum, 5 Aug. 2017, www.autismspectrum.org.au/blog/autism-rise-0.
• Saggers, Beth. “Supporting Students with Autism in the Classroom: What Teachers Need to Know.” The Conversation, 26 Sept. 2018, theconversation.com/supporting-students-with-autism-in-the-classroom-what-teachers-need-to-know-64814.
• Tarkan, Laurie. “New Study Changes Everything About Autism.” The New York Times, The New York Times, 4 July 2011, www.nytimes.com/2011/07/05/health/research/05autism.html