The Age of Autism: Videos

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The Age of Autism: Videos
By DAN OLMSTED

Do parents know what they're talking about? That has turned out to be a key
question in the debate over autism and its possible causes and cures.

The most recent case in point: a study last month from the University of
Washington Autism Center that examined first-birthday videos of infants
later diagnosed with autism. Described as "the first objective evidence of
regressive autism," the study found marked differences in behavior between
the first and second birthdays in children later diagnosed as regressive
cases -- in which an initial period of normal development is followed by a
loss of social and communications skills.

Among other indicators, there was a clear decline in complex babbling and
word use between the first and second birthdays. Those children babbled and
used words much more frequently at age 1 than children later diagnosed with
early, non-regressive autism.

In addition, children with regressive autism had other impairments that
didn't show up at age 1, but were clearly visible a year later. By their
second birthdays, they were no longer pointing, responding to their names
or looking at other people -- all hallmarks of autism.

The study, published in the Archives of General Psychiatry, is interesting
on its own terms, in that it documents regression for the first time, more
than 60 years after autism was first recognized. (The researchers said
about a quarter of autism cases are considered regressive.) Some previous
studies have suggested that parents simply missed early signs the child was
different from birth.

"Once again, this study provides objective evidence that parents are good
reporters on what is happening with their children," said Geraldine Dawson,
director of the University of Washington Autism Center. "It underscores the
importance of professionals to listen to parents."

That is the larger significance of the study, because the current debate
over autism can be characterized, with only slight exaggeration, as a
debate between parents and professionals.

On one side are parents who say they have witnessed their children slip
away from them at some point in the first two years of life. On the other
are professionals who treat autism as a mostly genetic disorder present
from birth.

That divide was captured in a recent New York Times front page headline:
"On Autism's Cause, It's Parents Vs. Research."

The idea that autism is always innate began with the very first cases. Leo
Kanner, the leading child psychiatrist of his day, made the first autism
diagnoses among 11 children born in the 1930s. He was emphatic that every
one of those children was autistic from birth, as evidenced by a lack of
interaction with parents; Kanner made a great deal of the children's
general lack of an anticipatory "shrug" or tensing when being picked up.

As outlined in a previous Age of Autism, a re-examination of those cases
suggests Kanner may have painted them with too broad a brush. Looking at a
new disorder that manifested so early in life, he might have interpreted
all the evidence as suggesting autism was, as he put it, "inborn." In that
column, we asked a pediatrician who treats autistic children to review
those first cases, and she told us she suspects several might, in fact,
have been regressive.

In one of those cases, Kanner quoted the mother as saying the child lost
touch beginning at about age one, but Kanner, the professional, appeared to
discount that first-hand observation by the parent rather than adjust his
hypothesis to account for it.

The University of Washington study is careful to point out it drew no
conclusions about whether vaccines might have triggered autism in the
regressive cases; even mentioning that issue shows how relevant the study
might be to the debate over whether an environmental trigger -- and in
particular a mercury-based preservatives in vaccines -- was responsible for
a huge increase in autism diagnoses in the 1990s. The preservative was
phased out of most childhood vaccines beginning in 1999.

Some parents say their children began regressing after suffering bad
reactions to vaccines -- fever, fitfulness, prolonged high-pitched
screaming and sleeplessness. What's more, some say their child's autism
improved -- even disappeared -- after treatments designed to augment the
body's ability to get rid of heavy metals like mercury.

Last month, we found the very first child diagnosed with autism, who still
lives in the small Mississippi town where he was born in 1933. We learned
Donald T., as Kanner identified him, had a life-threatening attack of
juvenile arthritis in 1947, for which he was treated with gold salts. The
arthritis cleared up -- and his autistic symptoms improved -- in what his
brother described as a "miraculous response" to the medicine.

We couldn't find any writings by Kanner that mention this incident,
although Donald's family clearly made a connection between the treatment
and improvement in his autistic symptoms. Like the new University of
Washington study, "it underscores the importance of professionals to listen
to parents."

If they did, perhaps we would know a lot more about autism.

This ongoing series on the roots and rise of autism welcomes reader
comment. E-mail:

Copyright 2005 by United Press International. All Rights Reserved.