Autism can be defined as a non-progressive, lifelong neurological disorder that significantly affects non-verbal and verbal communication as well as social interaction (Volkmar & Reichow, 2013). It typically occurs before a person attains the age of three years. According to Center for Disease Control, nearly one in sixty-eight children present with Autism and it affects all the socioeconomic, ethnic and racial groups. Studies carried out in North America, Europe, and Asia concluded that the average prevalence of Autism lies between 1% and 2%. “Autism” as a word means that the affected person has a developmental disability that significantly affects his or her social interaction and non-verbal and verbal communication.
The classic form of autism is characterized by three impairments which include language use and communication, social interaction and limitation in imagination that presents as repetitive, restrictive and stereotyped patterns of activities and behaviors. Autism is considered as a spectral disorder since there is a wide combination in the presentation of the symptoms which can be mild to severe (Volkmar & Reichow, 2013). Even though particular behaviors define autism, any set of behaviors occurring at any level of severity can be exhibited by adults and children. Two people having the same diagnosis can present with different actions and skills. The disabilities of Autism are regarded as permanent and no cure has been identified. However, improvements can be achieved by sensitive support as well as training.
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History of Autism
Eugen Bleuler, a Swiss psychiatrist was the first person to introduce the concept of Autism into historical literature in 1911. He made use of the term Autism to describe unique symptoms that were previously associated with schizophrenia (Cook & Willmerdinger, 2015). Autism originated from the Greek word autos and it was commonly used in explaining conditions of extreme social withdrawal linked to psychiatric illnesses presenting with psychosis. Until 1980, no diagnostic manual classified Autism as a disorder on its own. One of the earliest strategies used in managing autism was the electroconvulsive therapy that was historically associated with a lot of controversies (Verhoeff, 2013). There has been an improvement in the ECT methods and it is now widely applied in treating psychiatric disorders including bipolar disease and schizophrenia. Some autism spectrum disorder cases still use electroconvulsive therapy, however, behavioral therapies have proved to be efficient hence its use is increasingly becoming rare.
The idea of changing diet in treating autism originated in the 1920s and this was based on the thought that toxic dietary factors caused autism. Although there have been changes in nutrition recommendations and exact dietary factors, strict restrictive diets are still being utilized by parents, physicians, and researchers (Cook & Willmerdinger, 2015). It has been suggested that diet free of gluten and casein as well as wheat and milk proteins can improve symptoms associated with autism in children. Proponents are of the opinion that leaking of these proteins from the gastrointestinal tract and finding their way to the brain can lead to autism.
In 1943, Dr. Leo Kanner, a United States child psychiatrist categorized autism as an emotional and mental disorder. In a journal named Autistic Disturbances of Affective Contact, he gave a description of a distinct syndrome that was characterized by highly intelligent children with emotional limitations and social withdrawal tendencies (Verhoeff, 2013). Meanwhile, Hans Asperger in Germany defined autism of a different form. In his article of autism psychology published in 1944, he described the term autism as a disorder affecting children of normal intelligence, who experience difficulties with communication and social skills. This is now mostly referred to as Asperger’s disorder and it was later considered to be a milder form of autism.
Children presenting with Asperger's disorder tend to exhibit similar challenges in terms of social interactions. However, there is a difference in language development challenges. The contribution of the concept of heredity towards autism remained unknown during this time of history. Bruno Bettelheim in the 1950s came up with "Refrigerator Mother Theory" He argued that apathetic mothers who had an uncaring attitude towards their children caused autism. Parentectomy was applied as a treatment approach in the 1950s, and it involved removing the affected child from the parents for a long time (Cook & Willmerdinger, 2015). The reputation of Bettelheim was however later tarnished since it was found that he lacked psychoanalytical training.
In the 1970s, Temple Grandin developed a squeeze machine to assist children with autism. The machine was known to give the body a squeezing pressure, giving it a sensory input of pressure and touch. There was hardly any evidence that the machine was efficient in managing the symptoms associated with autism (Verhoeff, 2013). Autism was still considered a behavioral disorder in the 1970s. It was therefore believed that applying some form of punishment could prevent the children from exhibiting extreme behaviors such as aggression and dissociation that are linked to autism. Consequently, shock therapy was introduced as a mainstream treatment procedure. However, the United States Federal Drug Administration in 2016 stated that the method was potentially harmful hence proposed a ban on shock therapy.
Guy Berard in late 1970s developed Auditory Integration Training as a treatment method for autism. Until 1991, the method did not gain much recognition when a book called The Sound of a Miracle was published by a mother who claimed that Auditory Integration Training had cured her son of autism. Michael Rutter and Susan Folstein in 1997 found that there was a 36% concordance rate (heritability statistics) between twins and this meant that there was a probability of 36% of an identical twin developing autism in case one has autism. Pharmacotherapy as a method of treatment of autism was introduced in the 1970s and it demonstrated success in reducing some behavioral symptoms including self-inflicting injurious behaviors, irritability, and aggression (Verhoeff, 2013). The Diagnostic and Statistical Manual of Mental Disorders for the first time listed infantile autism in 1980 and this included the criteria for diagnosis.
In 1995, a cohort study published in the Lancet by some British researchers indicated that people who were vaccinated with measles-mumps-rubella vaccine (MMR) were likely to develop bowel disease compared to those not receiving MMR (Bagasra, Heggen & Hossain, 2018).. Andrew Wakefield, a gastroenterologist, was one of the researchers and he further studied a possible connection between MMR vaccine and neuropsychiatric disorders, particularly autism. Other researchers have also suggested part of this hypothesis. For instance, Fudenberg and Gupta posited this relationship while reviewing possible treatment methods for autism.
My Views on Autism
I have generally opposing views on how autism has been handled by some researchers. First, there is no evidence of any association between autism and MMR vaccination. There is similar risk of autism in both unvaccinated and vaccinated children. I have also not found any temporal clustering of cases after the immunization process. Majority of the previous studies connecting the MMR vaccines to autism failed to make use of optimal data for risk assessment. The hypothetical association between MMR vaccination and Autism has also been disputed by the World Health Organization hence they have requested more research on this matter.
Secondly, the argument that genes play a significant role in causing autism is untrue and is not founded on evidence and is, therefore, a subject that requires much debate (Bagasra, Heggen & Hossain, 2018). The environmental factors that contribute to autism including cell phone radiation, particular types of sugars, vaccines, gluten, and childhood illnesses have little or no scientific validity.
Regarding the cure for autism, there is a lot of controversies in the conversations involving cure of autism. For instance, there are a number of reported cases of people cured of autism such as the mother who claimed that Auditory Integration Training had cured her son of autism. I find that these methods are only used in managing the symptoms hence give a false impression of cure.
There have also been many instances of people misdiagnosed with autism. It is still not proven that autism as a disorder can be cured. Many autistic people view autism as part of themselves and may not think that saving is necessary. Therefore, many attempts aimed at finding a cure would be of less benefit in comparison to acceptance for these people. Treatment methods for treating autism are also full of controversies, for example, chelation that involves removal of heavy metals from the body of autistic persons (Rutter & Schopler, 2012). Chelation can be quite dangerous treatment strategy and is not supported by any science.
Aversive treatments such as applying painful shock and training children to avoid repeating their behaviors that remains in limited use in the United States is not right and can cause harm to children. Bruno Bettelheim philosophy of parentectomy that is still being promoted by some psychoanalytical theorists is controversial and should not be applied because children with autism should receive maximum support from their parents.
Conclusion
To conclude, autism is a neurological disorder that acts as a form of disability for children since their social interaction, language and communication is impaired. It is, therefore, a significant issue that requires necessary attention in terms of diagnosis and treatment. A number of studies have been carried out with respect to autism in which some are controversial and others are practical. It is important that all findings whether involving diagnosis or treatment be thoroughly assessed and not just based on assumptions.
References
Bagasra, O., Heggen, C., & Hossain, M. I. (2018). Vaccines and Autism. Autism and Environmental Factors , 261-286.
Cook, K. A., & Willmerdinger, A. N. (2015). The History of Autism.
Rutter, M., & Schopler, E. (2012). Autism: A reappraisal of concepts and treatment . Springer Science & Business Media.
Verhoeff, B. (2013). Autism in flux: a history of the concept from Leo Kanner to DSM-5. History of Psychiatry , 24 (4), 442-458.
Volkmar, F. R., & Reichow, B. (2013). Autism in DSM-5: progress and challenges. Molecular autism , 4 (1), 13.
