AUTISM (ASD) IS NOT A SINGLE SYNDROME

AUTISM (ASD) IS NOT A SINGLE SYNDROME

There is much controversy over, and millions if not billions of dollars are being spent on an attempt to find a cause for autism or as it is now called: Autism Spectrum Disorder (ASD).

Researchers are desperate to understand the aetiology of the condition so that that an appropriate ‘cure’ can be developed.

However ASD is not an easily definable condition but rather a set of behaviours, which are gathered together under an umbrella. Even then there remains controversy as to what properly fits under the umbrella. The last official definition under the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM 5), has Social Communication

Disorder (SCD) as a separate category removing perhaps 20% of children who suffer from this disorder, which was previously included under autism in DSM 4. This can leave them without access to services available under a diagnosis of ASD but not available under a diagnosis of SCD. But DSM 5 then goes on to include a measurement of SCD to establish the severity level

of a person diagnosed with ASD. So if we cannot agree even to such an apparently simple question as to who has ASD and the role of SCD in the diagnosis it is unlikely that we will find a single cause or even to establish a simple diagnostic test.

Even if a cause of autism could be found it would require a very early screening mechanism and an effective early therapy to exclude the development of the challenging behaviours, and social isolation which are dominant features of ASD. Although there is important ongoing research into both areas no early diagnostic test and no early treatment protocol has yet been proven.

Research continues in the following non exhaustive list of possible causes: genetics; mirror neuron disorder; absence of a Theory of Mind or Theory of Own Mind; an insufficient decay of neurons causing a neuronal surplus in the infant brain; sensory overload; movement disorder

in utero; encephalitis in utero; birth trauma leading to lack of brain oxygenation; gastro-intestinal disease; vaccination; maternal prenatal medication; environmental problems – including air pollution and food additives; food engineering; high maternal age at conception; high paternal age at conception; and many more . There is evidence for all of these causes and others not listed here or not yet imagined but the multiplicity of possible reasons for autism would lead one to believe that there is no one cause for the condition.

It is a well known saying that: “if you have seen one child with autism you have seen one child with autism”; that all children with autism are different from each other. Which brings me back to my earlier statement that autism is not a condition or syndrome but rather a set of behaviours. What, you may legitimately ask, is the cause of this set of behaviours.

Children with cognitive difficulties or delays will be placed by their caring adults or by their peers under pressure to perform or act in the same way as their neuro-typical peer group. In response they frequently adopt avoidance behaviours including having a tantrum, stiffening the body, averting the gaze, running away to a safe place and over or under social behaviour.

Or they may adopt self-delighting behaviours such as rocking, spinning, hand flapping, and other ‘stimming’ activities, which provide the child with the greatest feedback for the least amount of effort.

These avoidance or repetitive behaviours are not the primary impediment, which may be a reflection of one or more of the aetiologies outlined above; but are secondary impediments – behaviours adopted to avoid or escape external pressures. The child adopts them as a diversionary mechanism or to provide simple and undemanding pleasures in a surrounding world, which is hard to comprehend.

So Autism or ASD is not a simple to understand single syndrome. Rather autistic behaviour is a reaction to an underlying condition, and comes in many forms or severities. In DSM5 the child without speech and with severe cognitive delay is bundled together with the high performing young adult who cannot find his or her independent route through life.

In my next post I will turn to the mechanism of the adoption of autistic behaviours and later, how these behaviours can be slowly ameliorated.

Walter Solomon

April 2017

MEANING FROM MOVEMENT

This, the first blog in what is planned as a monthly series, is about how understanding arises in the typical child and what may get in the way of, or obstruct, ‘normal’ development.

‘Meaning from movement’ is an expression Geoffrey Waldon used constantly; it is foundational to his theory of learning. Waldon believed that movement is the most consistent and regular source of experience and provides the structure of understanding, which develops alongside the movements.1

Piaget had previously written2 that the sensory-motor structures constitute the source of the later operations of thought. Intelligence proceeds from action, and that knowledge is essentially an active and operatory assimilation.

In simple language what both Waldon and Piaget were saying, over 30 years ago, is that it is movement which creates understanding. From the child in the womb, to the newborn, to the infant, then toddler, then child, then the adolescent, typical children move to learn. One researcher, R.W Sperry3 went so far as to say: “The sole product of brain function is motor co-ordination.”

And it is not only in development that movement matters. Many children with ASD have continued motor problems – problems in moving their bodies as they wish.

Charles Hale4 described his difficulty with actions and movements: “I think my movement disorder is most apparent in the fact that I am unable to respond to someone or something, when my intelligence would tell me to respond in an appropriate manner. For instance, when I should be smiling, sometimes I know that I am not smiling but may be even frowning. This causes me a great deal of pain and makes me look as though I am not comprehending when, in fact, I am trying to respond in an appropriate manner.”

Another individual with autism, Therese Jolliffe5 commented: “It [stress] occurs at any time, but always when I know I have to go somewhere stressful. Sometimes the pain is so bad that my whole body becomes stiff and then I am unable to move.”

 A third person with ASD, Barbara6, said: “I want people to let me be. I’ve had all kinds of people who thought they were helping me stop doing things. I have been endlessly criticized about how different I looked, criticized about all kinds of tiny differences in my behavior. There’s a point where you say to hell with it, its impossible to please you people…. No one ever tried to really understand what it was like to be me…. I wish they had accepted some of my behaviors I didn’t have any control over. You don’t criticize people with cerebral palsy.”

Professor Colwyn Trevarthen wrote7: “A primary cause of autism spectrum disorders is an error in early growth of intrinsic motive and motor systems of the brainstem during prenatal
ontogenesis.” He explains that some babies do not move in a typical manner in the womb. I am not trying to get into the thorny question of why ASD arises. Even problems in the womb may have different causes. They may be genetic, it may be that the embryo was affected by an encephalitis, (brain inflammation), or it may be that there is some musculature issue. But children who do not move in a typical manner in the womb are at risk for developmental issues, which may translate into perceptual, cognitive and emotional issues as a child or as an adolescent.

If ASD in children is caused by sensory motor problems in utero this should put a final nail in the coffin of the concept of the Refrigerator Mother.

Jodi Robledo et al.wrote8: It is essential that the exploration of autism include sensory and movement differences and involve the people who experience autism first-hand for a number of reasons: (1) professionals investigating autism from a perspective that separates mind and body may have overlooked sensory and movement differences, and/or their possible effect on behavior; (2) published first-hand accounts of autism suggest that this is a fruitful area for investigation; (3) in studying autism we need to elicit information from one of the most valuable resources—people with the label of autism.

What this does make clear is that at the first signs of atypical behaviour, which parents often recognize before the professionals, they should seek a movement based therapy and not “wait and see what happens because all children develop at different speeds.” This is indeed a time when “mother knows best.”

References:

  1. Walter Solomon with Chris Holland and Mary Jo Middleton: Autism and Understanding, The Waldon Approach to Child Development SAGE Publications 2012 p 62
  2. Piaget J. The Psychology of the Child (Basic Books, 1969 p. 28)
  3. Sperry R. W. (1952) Neurology and the mind-brain problem. American Scientist, 40, 291-312
  4. Hale, M., and Hale, C. (1999) I had No Means to Shout. 1st books, Bloomington IN
  5. Jolliffe, T. Lansdown R (1992) Autism: A Personal Account. Communication 26 12-19
  6. Jodi Robledo, Anne M Donnellan and Karen Strandt-Conroy: An exploration of sensory and movement differences from the perspective of individuals with autism. Frontiers in Integrative neuroscience November 2012 Volume 6 Article 107
  7. Colwyn Trevarthen and Jonathan Delafield-Butt: Autism as a developmental disorder in intentional movement and affective engagement. Frontiers in Integrative Neuroscience July 2013 Volume 7 Article 49

Walter Solomon
September 2015

New blog for parents and guests of Autism & Understanding

We are going to create a blog that will focus on helping parents of autistic children, along with our other guests learn how to lovingly guide his young child to success using the Waldon Method.

For people who want a more in-depth study of autism, feel free to visit our regular blog.

We look forward to helping you and your child on the road to success.