Autism Awareness Month: Causes and treatments

04/17/2008 at 09:30 AM ET

Autism_logo The autism community, in many ways, is a community divided.  Experts disagree on everything from what causes the disorder, to how best to treat it, to even — in some circumstances — who has it.  And they’re not alone.  You may have read on CBB recently about Jenny McCarthy’s op-ed in honor of World Autism Day; If you managed to sort through the 50+ comments which followed, you’d know that parents are equally at odds.  In this second installment of CBB’s coverage of Autism Awareness Month, we’ll look into the different theories at play as our society comes to terms with what many believe to be an autism epidemic. 

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Few issues are more hotly debated among the medical community today than the question of what causes autism.  There are three main schools of thought — Those who believe that the disorder is rooted solely in genetics, those who feel that it is an environmental illness and, lastly, those who fall somewhere in the middle. 

The first group argue that there are specific chromosomal regions which contain autism-related genes, and that this accounts for why an estimated 1 in 150 children is currently diagnosed with the disorder.  As proof, the genetics-only advocates rely on evidence that siblings of autistic people are more likely to be autistic, that twins are extremely likely to share autistic traits and that many individuals with autism have other unique health issues in common, such as difficulty sleeping, hyperactivity, etc. etc.  The second group believe that environmental toxins present in things like heavy metals, pesticides and childhood vaccines result in autism.  As proof, many parents of children with autism point to stark regressions in their children after exposure to these triggers.  The third, and likely the largest, group believe that multiple genetic factors are present in an individual which make them predisposed to developing the disorder, but the aforementioned environmental factors are needed to push an individual onto the spectrum.

But the controversy doesn’t end there.  After a diagnosis has been allowed to sink in decisions must be made about which treatment(s) to pursue — and much to the chagrin of parents, pediatricians can be as far apart on this issue as researchers are on the cause.  At least in this instance, however, the disagreement is largely attributable to the vastly differing degrees to which individuals with autism are affected by the disorder.  Just as no two children are the same, no two children with autism are the same — and no two therapies will yield the same result. 

Traditional therapies include speech therapy, which is largely self-explanatory, and occupational therapy, which teaches self-help skills.  Developmental therapies like ABA (Applied Behavior Analysis) rely on a system of rewards and consequences to shape behavior, while Floortime builds skills through therapeutic play.  Biomedical approaches — such as those advocated by Jenny McCarthy and the network of Defeat Autism Now (DAN) doctors who helped treat Jenny’s son Evan, turning 6 next month — are based on the premise that the disorder can be treated with vitamin and mineral supplements, making dietary changes (including going gluten-free, casein-free) and undergoing detoxification treatments like chelation to correct imbalance in the body, among other methods.  And still there are more options:  Music therapy, art therapy and animal therapy have proven beneficial in some instances, while other therapies like auditory integration and holding therapy have helped others.

While its always better to have more options than not, parents who are new to the diagnosis can easily find themselves feeling overwhelmed by the choices that must be made, discouraged if the course they’ve charted fails to yield dramatic results and frustrated when a therapy — as is often the case — proves to be too expensive.  Harvard professor Michael Ganz estimates the cost of caring for an autistic child at $3 million over the course of their lifetime;  It’s important to pace yourselves as a family both emotionally and financially while setting realistic goals for your child. 

But most importantly, abandon the notion that you are in this alone.  Approach treatment as a team.  Contact your local school district (or early intervention unit if your child is under the age of 3) to secure services.  Set up a rotating appointment schedule with a developmental pediatrician, some of whom can have wait lists of 12-months+.  Find a good, local child psychologist.  And visit with your local autism support group.  Other parents of children with autism are an invaluable resource and are always willing to help, whether you need a physician referral, a shoulder to cry on, or a play date free of judgment.  You need only ask!


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Christine on

My sons autism dx is a result of a cord injury at birth. We used Floortime successfully and have now moved onto RDI – an AMAZING program.
We also do some dietary interventions (he’s GFCF) and some holistics.
Another program I have found immensly helpful to his sensory system is a program called “Handle”
The changes have been amazing.

There IS hope.

dena on

thank you for bringing more awareness!!! I have a 7 year old son with regressive Autism. He lost everything he had learned by 18 months after having a series of shots, including MMR. I am in the group that firmly believes there is a genetic link and an environmental link. We had 2 years of ABA therapy and are now concentrating on Speech Therapy. Please think twice before you give your babies a series of shots. I am not against vaccines, but I am against the amount at one time that children receive.

Tessa on

My 8 year old daughter was diagnosed with autism. I believe that vaccines have nothing to do with her condition, and that the explanation ultimately lies with genetics. It is important to realize that there are two sides to this debate. Many alternative treatments are not regulated by the FDA. When my daughter was first diagnosed, many of these options were presented to me. It is only when my doctor explained that many of them were unsubstantiated, and even dangerous, that I became wary. Obviously any parent will do what they feel is in the best interest of their child, but I would advise any parent with a recent diagnosis not to let their desire for a “cure” overide their gut instinct in a quest for treatment options.

Melissa on

My 3yr old daughter was dx’d with Autism at the age of 2 and I can’t even begin to emphasize the importance of early intervention. It has made such a HUGE difference in her life, she’s become a much more vocal child.

I am 7 months pregnant now, and I am very confused about the vaccines, my hubby and myself believe there is more of a genetic link that the vaccine may trigger. Of course with all the debates, unfortunately no real hard facts are out there yet

But information is key, so thank you for bringing more awareness!!

Lenny on

My son is 2.5 years old. He has not been diagnosed with autism and shows no signs of it. When it came time to do vaccinations, including MMR, we considered the pros and cons and attendant risks of him developing autism, as well as developing a deadly illness. It just so happened that at the same time were considering this, yet another couple lost their child to a preventable, flu-related complication. That did it for us. While we certainly can’t appreciate how difficult it may be to raise an autistic child, I’ve no doubt that death trumps that by a long shot. We simply could not have been able to live with ourselves if our son died from a preventable illness because we were concerned about him developing an illness that would make life more difficult but not kill him.

Kelli on

To Lenny,

Until you’ve had a child with autism, I wish that you would refrain from making such statements. While autism in better than death, it’s a lot more than making their life “more difficult”.

The mortality rates for measles, mumps and rubella are quite low in developing countries.

Of course, with any illness their can be complications.

I am glad that your child is doing well, and that you are happy with your decision to vax.

Jen on

My six-year-old son has autism. Looking back, the signs were there from almost the beginning. I believe he was born with autism — that it is part of his genetic makeup — and not caused by any outside influence (vaccines or whatever). We do receive some services to help him (OT and social skills). However, I think it is even more important that we as a society learn to accept and embrace people with autism instead of forcing our definition of normalcy on them. I am not saying we should not help our children but there is line between helping and forcing.

Lenny on

Dear Kelli,
I am sorry that you find my comments upsetting, but I believe they directly embraced the topic (in that we specifically considered the possibility of our child becoming autistic as a result of certain vaccinations) and were not offensive. More importantly, the whole point of the article was that there are differences of opinion concerning what causes autism; and certainly no suggestion was made in the article that comments were unwelcome by those who did not have autistic children. Thanks.

Sandi on

I would have to say that I believe it is genetic in intital origin.
Possibly affected by environmental factors, and definitely affected by how you choose to proceed with raising your child.
I have a 25 yr old neuro typical daughter who is on her own, a 16 yr old son on the spectrum, a husband on the spectrum and now my 4 yr old son, who is being evaluated.
Prior to my first son being dxed in the 3rd grade – I had never heard of Aspergers Disorder or met anyone with autism.
Being the only NT person in our home has challenges that should not be taken lightly.
I basically have to do everything – and my husband just works his job.
He has no involvement in finances, teaching the boys or planning anything.
He has no hobbies, no active friendships and no desire to do anything more than work as a cashier forever and watch tv/movies.
He cannot handle responsibility or decision making and he is an inconsistent disciplinarian and not the best role model for his boys.
But he is my husband – and with these characteristics – I still love him.
He learned to mimic ‘proper social behavior’ at a very young age – being in a large family – so when I met him, fell in love and married him – I was under the impression that he was a very different person.
He is an example of NO intervention.
Our oldest son has come so far – and is more successful at the things his father has not been able to accomplish.
He has been taught and modeled the right behaviors by our extended family and is a bright, healthy and handsome teenager.
He has overcome many tactile, sensory and social issues without any special treatments.
He is an example of EARLY intervention.
With autism and spectrum disorders – the point of taking a ‘village to raise your child’, is huge.
Support is key.
Empathy, eye contact, hugging and making a joke – are things we take for granted with our children – I know I did with my daughter.
Then you have your child on the spectrum – and when they do look you in the eye, initiate a hug or dish out some sarcasm – you want to cry out of the joy you feel that your child has connected, yet again.

Thank you for this posting and educating others that April is the month for Autism Awareness!

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