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December 17, 2001
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Autism - And Its Milder Cousin Asperger’s Syndrome - Is
Surging Among the children of Silicon Valley.
[By Steve Silberman. Wired Magazine. Wired Magazine,
for those
unfamiliar, is published out of San Francisco and fashions
itself as the
record of the cultural avante guard hi-tech set, possible
oxymoronism
notwithstanding (“wired” means both being electronically
connected and being
high on stimulants. The disparaging “Geek” headline is meant
to stimulate
the interest of their presumably hip and jaded readers. You
can decide if
the article makes up for it. Related articles reprinted in
subsequent
postings. Thanks to Simon Morton. -LS]
http://www.wired.com/wired/archive/9.12/aspergers.html
Nick is building a universe on his computer. He’s already
mapped out his first planet: an anvil-shaped world called Denthaim that is home
to gnomes and gods, along with a three-gendered race known as kiman. As he tells
me about his universe, Nick looks up at the ceiling, humming fragments of a
melody over and over.
“I’m thinking of making magic a form of quantum physics,
but I haven’t decided yet, actually,” he explains. The music of his speech is
pitched high, alternately poetic and pedantic - as if the soul of an Oxford don
has been awkwardly reincarnated in the body of a chubby, rosy-cheeked boy from Silicon
Valley. Nick is 11 years old. Nick’s
father is a software engineer, and his mother is a computer programmer.
They’ve known that Nick was an unusual child for a long
time. He’s infatuated with fantasy novels, but he has a hard time reading
people. Clearly bright and imaginative,
he has no friends his own age. His inability to pick up on hidden agendas makes
him easy prey to certain cruelties, as when some kids paid him a few dollars to
wear a ridiculous outfit to school. One
therapist suggested that Nick was suffering from an anxiety disorder.
Another said he had a speech impediment.
Then his mother read a book called Asperger’s Syndrome: A
Guide for Parents and Professionals. In it, psychologist Tony Attwood describes
children who lack basic social and motor skills, seem unable to decode body language
and sense the feelings of others, avoid eye contact, and frequently launch into
monologues about narrowly defined - and often highly technical - interests.
Even when very young, these children become obsessed with
order, arranging their toys in a regimented fashion on the floor and flying
into tantrums when their routines are disturbed. As teenagers, they’re prone to
getting into trouble with teachers and other figures of authority, partly because
the subtle cues that define societal hierarchies are invisible to them.
“I thought, ‘That’s Nick,’” his mother recalls. Asperger’s syndrome is one of the disorders
on the autistic spectrum - a milder form of the condition that afflicted
Raymond Babbitt, the character played by Dustin Hoffman in Rain Man. In the
taxonomy of autism, those with Asperger’s syndrome have average - or even very
high - IQs, while 70 percent of those with other autistic disorders suffer from
mild to severe mental retardation.
One of the estimated 450,000 people in the US living with
autism, Nick is more fortunate than most. He can read, write, and speak. He’ll
be able to live and work on his own. Once he gets out of junior high hell, it’s
not hard to imagine Nick creating a niche for himself in all his exuberant strangeness.
At the less fortunate end of the spectrum are what diagnosticians call “profoundly
affected” children.
If not forcibly engaged, these children spend their waking
hours in trancelike states, staring at lights, rocking, making high-pitched
squeaks, and flapping their hands, repetitively stimulating (“stimming”) their miswired
nervous systems. In one of the uncanny
synchronicities of science, autism was first recognized on two continents
nearly simultaneously.
In 1943, a child psychiatrist named Leo Kanner published a
monograph outlining a curious set of behaviors he noticed in 11 children at the
Johns Hopkins Hospital in Baltimore. A year later, a pediatrician in Vienna
named Hans Asperger, who had never seen Kanner’s work, published a paper describing
four children who shared many of the same traits. Both Kanner and Asperger gave
the condition the same name: autism - from the Greek word for self, autòs -
because the children in their care seemed to withdraw into iron-walled
universes of their own.
Kanner went on to launch the field of child psychiatry in
the US, while Asperger’s clinic was destroyed by a shower of Allied bombs. Over
the next 40 years, Kanner became widely known as the author of the canonical textbook
in his field, in which he classified autism as a subset of childhood
schizophrenia. Asperger was virtually ignored outside of Europe and died in
1980.
The term Asperger syndrome wasn’t coined until a year
later, by UK psychologist Lorna Wing, and Asperger’s original paper wasn’t even
translated into English until 1991. Wing built upon Asperger’s intuition that
even certain gifted children might also be autistic. She described the disorder
as a continuum that “ranges from the most profoundly physically and mentally
retarded person ... to the most able, highly intelligent person with social
impairment in its subtlest form as his only disability. It overlaps with
learning disabilities and shades into eccentric normality.”
Asperger’s notion of a continuum that embraces both smart,
geeky kids like Nick and those with so-called classic or profound autism has
been accepted by the medical establishment only in the last decade. Like most distinctions
in the world of childhood developmental disorders, the line between classic
autism and Asperger’s syndrome is hazy, shifting with the state of diagnostic
opinion.
Autism was added to the American Psychiatric Association’s
Diagnostic and Statistical Manual of Mental Disorders in 1980, but Asperger’s
syndrome wasn’t included as a separate disorder until the fourth edition in
1994. The taxonomy is further complicated by the fact that few if any people
who have Asperger’s syndrome will exhibit all of the behaviors listed in the
DSM-IV. (The syn in syndrome derives
from the same root as the syn in synchronicity - the word means that certain
symptoms tend to cluster together, but all need not be present to make the
diagnosis.)
Though Asperger’s syndrome is less disabling than “low-functioning”
forms of autism, kids who have it suffer difficulties in the same areas as classically
autistic children do: social interactions, motor skills, sensory processing,
and a tendency toward repetitive behavior.
In the last 20 years, significant advances have been made
in developing methods of behavioral training that help autistic children find ways
to communicate. These techniques, however, require prodigious amounts of
persistence, time, money, and love. Though more than half a century has passed
since Kanner and Asperger first gave a name to autism, there is still no known
cause, no miracle drug, and no cure.
And now, something dark and unsettling is happening in
Silicon Valley.
In the past decade, there has been a significant surge
in the number
of kids diagnosed with autism throughout California. In
August 1993, there were 4,911 cases of so-called level-one autism logged in the
state’s Department of Developmental Services client-management system. This
figure doesn’t include kids with Asperger’s syndrome, like Nick, but only those
who have received a diagnosis of classic autism. In the mid-‘90s, this caseload
started spiraling up. In 1999, the number of clients was more than double what
it had been six years earlier. Then the curve started spiking. By July 2001,
there were 15,441 clients in the DDS database. Now there are more than seven
new cases of level-one autism - 85 percent of them children - entering the
system every day.
Through the ‘90s, cases tripled in California. “Anyone who
says this is due to better diagnostics has his head in the sand.”
California is not alone. Rates of both classic autism and
Asperger’s syndrome are going up all over the world, which is certainly cause
for alarm and for the urgent mobilization of research. Autism was once
considered a very rare disorder, occurring in one out of every 10,000 births.
Now it’s understood to be much more common - perhaps 20 times more. But
according to local authorities, the picture in California is particularly bleak
in Santa Clara County. Here in Silicon Valley, family support services provided
by the DDS are brokered by the San Andreas Regional Center, one of 21 such centers
in the state. SARC dispenses desperately needed resources (such as in-home
behavioral training, educational aides, and respite care) to families in four
counties. While the autistic caseload is rising in all four, the percentage of
cases of classic autism among the total client population in Santa Clara County
is higher enough to be worrisome, says SARC’s director, Santi Rogers.
“There’s a significant difference, and no signs that it’s
abating,” says Rogers. “We’ve been watching these numbers for years. We feared
that something like this was coming. But this is a burst that has staggered us
in our steps.”
It’s not easy to arrive at a clear picture of whether
there actually is a startling rise in the incidence of autism in California, as
opposed to just an increase in diagnoses. One problem, says Linda Lotspeich,
director of the Stanford Pervasive Developmental Disorders Clinic, is that “the
rules in the DSM-IV don’t work.” The diagnostic criteria are subjective, like “Marked
impairment in the use of nonverbal behaviors such as eye-to-eye gaze, facial
expression, body posture, and gestures to regulate social interaction.”
“How much ‘eye-to-eye gaze’ do you have to have to be
normal?” asks Lotspeich. “How do you define what ‘marked’ is? In shades of
gray, when does black become white?”
Some children will receive a diagnosis of classic autism,
and another diagnosis of Asperger’s syndrome, from two different clinicians.
Tony Attwood’s advice to parents is strictly practical: “Use the diagnosis that
provides the services.”
While diagnostic fuzziness may be contributing to a pervasive
sense that autism is on the rise, Ron Huff, the consulting psychologist for the
DDS who uncovered the statistical trend, does not believe that all we’re seeing
now is an increase in children who would have previously been tagged with some
other disability, such as mental retardation - or overlooked as perfectly
healthy, if quirky, kids.
“While we certainly need to do more research,” says Huff, “I
don’t think the change in diagnostic criteria will account for all of this rise
by any means.”
The department is making its data available to the MIND
Institute at the University of California at Davis, to tease out what’s behind
the numbers. The results of that research will be published next year. But the effects
of a surging influx are already rippling through the local schools. Carol Zepecki, director of student services
and special education for the Palo Alto Unified School District, is disturbed
by what she’s seeing. “To be honest with you, as I look back on the special-ed
students I’ve worked with for 20 years, it’s clear to me that these kids would
not have been placed in another category. The numbers are definitely higher.”
Elizabeth Rochin, a special-ed teacher at Cupertino High, says local educators
are scrambling to create new resources. “We know it’s happening, because they’re
coming through our schools. Our director saw the iceberg approaching and said, ‘We’ve
got to build something for them.’”
The people scrambling hardest are parents. In-home therapy
alone can cost $60,000 or more a year, and requires so much dedication that
parents (particularly mothers) are often forced to quit their jobs and make
managing a team of specialists their new 80-hour-a-week career. Before their
children become eligible for state funding, parents must obtain a diagnosis
from a qualified clinician, which requires hours of testing and observation.
Local facilities, such as the Stanford Pervasive Development Disorders Clinic
and its counterpart at UC San Francisco, are swamped. The Stanford clinic is able
to perform only two or three diagnoses a week. It currently has a two-to
six-month waiting list.
For Rick Rollens, former secretary of the California
Senate and cofounder of the MIND Institute, the notion that there is a
frightening increase in autism worldwide is no longer in question. “Anyone who
says this epidemic is due to better diagnostics,” he says, “has his head in the
sand.”
Autism’s insidious style of onset is particularly cruel to
parents, because for the first two years of life, nothing seems to be wrong.
Their child is engaged with the world, progressing normally, taking first steps
into language.
Then, suddenly, some unknown cascade of neurological
events washes it all away.
One father of an autistic child, Jonathan Shestack,
describes what happened to his son, Dov, as “watching our sweet, beautiful boy
disappear in front of our eyes.” At two, Dov’s first words - Mom, Dad, flower,
park - abruptly retreated into silence. Over the next six months, Dov ceased to
recognize his own name and the faces of his parents. It took Dov a year of intensive
behavioral therapy to learn how to point. At age 9, after the most effective
interventions available (such as the step-by-step behavioral training methods
developed by Ivar Lovaas at UCLA), Dov can speak 20 words.
Even children who make significant progress require levels
of day-to-day attention from their families that can best be described as heroic.
Marnin Kligfeld is the founder of a software mergers-and-acquisitions firm. His
wife, Margo Estrin, a doctor of internal medicine, is the daughter of Gerald
Estrin, who was a mentor to many of the original architects of the Internet
(see “Meet the Bellbusters,” Wired 9.11, page 164). When their daughter, Leah,
was 3, a pediatrician at Oakland Children’s Hospital looked at her on the
examining table and declared, “There is very little difference between your
daughter and an animal. We have no idea what she will be able to do in the future.”
After eight years of interventions - behavioral training, occupational therapy,
speech therapy - Leah is a happy, upbeat 11-year-old who downloads her favorite
songs by the hundreds. And she is still deeply autistic.
Leah’s first visit to the dentist required weeks of
preparation, because autistic people are made deeply anxious by any change in
routine. “We took pictures of the
dentist’s office and the staff, and drove Leah past the office several times,”
Kligfeld recalls. “Our dentist scheduled us for the end of the day, when there
were no other patients, and set goals with us. The goal of the first session
was to have Leah sit in the chair. The second session was so Leah could
rehearse the steps involved in treatment without actually doing them. The
dentist gave all of his equipment special names for her. Throughout this
process, we used a large mirror so Leah could see exactly what was being done,
to ensure that there were no surprises.”
Daily ordeals like _________________________________
this, common in the autistic
community, underline the
folly of the hypothesis that >> DO SOMETHING ABOUT AUTISM NOW <<
prevailed among
psychologists 20 years ago, Subscribe, Read, then Forward
who were convinced
that the FEAT Daily
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autism was caused by a lack
of parental affection. The To Subscribe go to
influential psychiatrist
Bruno Bettelheim www.feat.org/FEATnews
aggressively promoted a
theory that has come to No Cost!
be known as the
“refrigerator mother” _________________________________
hypothesis. He declared in
his best-selling book,
The Empty Fortress, “The
precipitating factor in infantile autism is the parent’s
wish that his child should not exist. ... To this the child responds with
massive withdrawal.” He prescribed “parentectomy” - removal of the child from
the parents - and years of family therapy. His hypothesis added the burden of
guilt to the grief of having an autistic child, and made autism a source of
shame and secrecy, which hampered efforts to obtain clinical data. The
hypothesis has been thoroughly discredited. Richard Pollak’s The Creation of
Dr. B exposed Bettelheim as a brilliant liar who concocted case histories and
exaggerated both his experience with autistic children and the success of his treatments.
One thing nearly everyone in the field agrees on: genetic predisposition.
Identical twins share the disorder 9 times out of 10.
But the debates about the causes of autism are certainly
not over. Controversies rage about
whether environmental factors - such as mercury and other chemicals in
universally administered vaccines, industrial pollutants in air and water, and
even certain foods - act as catalysts that trigger the disorder. Bernard
Rimland, the first psychologist to oppose Bettelheim and promote the idea that
autism was organic in origin, has become a leading advocate for intensified investigation
in this area. The father of an autistic son, Rimland has been instrumental in
marshaling medical expertise and family data to create better assessment
protocols.
The one thing that almost all researchers in the field
agree on is that genetic predisposition plays a crucial role in laying the
neurological foundations of autism in most cases. Studies have shown that if
one identical twin is autistic, there’s a 90 percent chance that the other twin
will also have the disorder. If parents have had one autistic child, the risk
of their second child being autistic rises from 1 in 500 to 1 in 20. After two children with the disorder, the
sobering odds are 1 in 3. (So many parents refrain from having more offspring
after one autistic child, geneticists even have a term for it: stoppage.) The
chances that the siblings of an autistic child will display one or more of the
other developmental disorders with a known genetic basis - such as dyslexia or Tourette’s
syndrome - are also significantly higher than normal.
The bad news from Santa Clara County raises an inescapable
question. Unless the genetic hypothesis
is proven false, which is unlikely, regions with a higher than normal
distribution of people on the autistic spectrum are something no researcher
could ask for: living laboratories for the study of genetic expression. When
the rain that fell on the Rain Man falls harder on certain communities than
others, what becomes of the children?
The answer may be raining all over Silicon Valley. And one
of the best hopes of finding a cure may be locked in the DNA sequences that
produced the minds that have made this area the technological powerhouse of the
world.
It’s a familiar joke in the industry that many of the
hardcore programmers in IT strongholds like Intel, Adobe, and Silicon Graphics
- coming to work early, leaving late, sucking down Big Gulps in their cubicles while
they code for hours - are residing somewhere in Asperger’s domain. Kathryn Stewart, director of the Orion
Academy, a high school for high-functioning kids in Moraga, California, calls
Asperger’s syndrome “the engineers’ disorder.” Bill Gates is regularly
diagnosed in the press: His single-minded focus on technical minutiae, rocking
motions, and flat tone of voice are all suggestive of an adult with some trace
of the disorder. Dov’s father told me that his friends in the Valley say many
of their coworkers “could be diagnosed with ODD - they’re odd.” In Microserfs,
novelist Douglas Coupland observes, “I think all tech people are slightly
autistic.”
Though no one has tried to convince the Valley’s best and
brightest to sign up for batteries of tests, the culture of the area has subtly
evolved to meet the social needs of adults in high-functioning regions of the spectrum.
In the geek warrens of engineering and R&D, social graces are beside the
point. You can be as off-the-wall as you want to be, but if your code is
bulletproof, no one’s going to point out that you’ve been wearing the same
shirt for two weeks. Autistic people have a hard time multitasking -
particularly when one of the channels is face-to-face communication. Replacing
the hubbub of the traditional office with a screen and an email address inserts
a controllable interface between a programmer and the chaos of everyday life.
Flattened workplace hierarchies are more comfortable for those who find it hard
to read social cues. A WYSIWYG world, where respect and rewards are based
strictly on merit, is an Asperger’s dream.
Obviously, this kind of accommodation is not unique to the
Valley. The halls of academe have long been a forgiving environment for
absentminded professors. Temple Grandin - the inspiring and accomplished
autistic woman profiled in Oliver Sacks’ An Anthropologist on Mars - calls NASA
the largest sheltered workshop in the world.
A recurring theme in case histories of autism, going all
the way back to Kanner’s and Asperger’s original monographs, is an attraction
to highly organized systems and complex machines. There’s even a perennial cast
of hackers: early adopters with a subversive streak. In 1944, Asperger wrote of
a boy “chemist [who] uses all his money for experiments which often horrify his
family and even steals to fund them.” Another boy proved a mathematical error
in Isaac Newton’s calculations while he was still a freshman in college. A
third escaped neighborhood bullies by taking lessons from an old watchmaker.
And a fourth, wrote Asperger, “came to be preoccupied with fantastic
inventions, such as spaceships and the like.” Here he added, “one observes how
remote from reality autistic interests really are” - a comment he qualified
years later, when spaceships were no longer remote or fantastic, by joking that
the inventors of spaceships might themselves be autistic.
Clumsy and easily overwhelmed in the physical world,
autistic minds soar in the virtual realms of mathematics, symbols, and code.
Asperger compared the children in his clinic to calculating machines: “intelligent
automata” - a metaphor employed by many autistic people themselves to describe
their own rule-based, image-driven thought processes. In her autobiography,
Thinking in Pictures, Grandin compares her mind to a VCR. When she hears the word dog, she mentally
replays what she calls “videotapes” of various dogs that she’s seen, to arrive
at something close to the average person’s abstract notion of the category that
includes all dogs. This visual concreteness has been a boon to her work as a
designer of more humane machinery for handling livestock. Grandin sees the
machines in her head and sets them running, debugging as she goes. When the
design in her mind does everything it’s supposed to, she draws a blueprint of
what she sees.
“In another age, these men would have been monks,
developing new ink for printing presses. Suddenly, they’re reproducing at a
much higher rate.”
These days, the autistic fascinations with technology,
ordered systems, visual modes of thinking, and subversive creativity have
plenty of outlets. There’s even a cheeky Asperger’s term for the rest of us -
NTs, “neurotypicals.” Many children on the spectrum become obsessed with VCRs, Pokémon,
and computer games, working the joysticks until blisters appear on their
fingers. (In the diagnostic lexicon, this kind of relentless behavior is called
“perseveration.”) Even when playing alongside someone their own age, however,
autistic kids tend to play separately. Echoing Asperger, the director of the
clinic in San Jose where I met Nick, Michelle Garcia Winner, suggests that “Pokémon
must have been invented by a team of Japanese engineers with Asperger.” Attwood
writes that computers “are an ideal interest for a person with Asperger’s
syndrome ... they are logical, consistent, and not prone to moods.”
This affinity for computers gives teachers and parents
leverage they can use to build on the natural strengths of autistic children.
Many teenagers who lack the motor skills to write by hand find it easier to use
a keyboard. At Orion Academy, every student is required to buy an iBook fitted with
an AirPort card. Class notes are written on electronic whiteboards that port
the instructional materials to the school server for retrieval. (At lunch, the
iBooks are shut off, and if the kids want to play a two-person game, they’re
directed to a chess board.) The next generation of assistive technology is
being designed by Neil Scott’s Archimedes Project at Stanford. Scott’s team is currently developing the
equivalent of a PDA for autistic kids, able to parse subtle movements of an
eyebrow or fingertip into streams of text, voice, or images. The devices will
incorporate video cameras, head and eye tracking, intelligent agents, and
speech recognition to suit the needs of the individual child.
The Valley is a self-selecting community where
passionately bright people migrate from all over the world to make smart
machines work smarter. The
nuts-and-bolts practicality of hard labor among the bits appeals to the predilections
of the high-functioning autistic mind. The hidden cost of building enclaves
like this, however, may be lurking in the findings of nearly every major
genetic study of autism in the last 10 years. Over and over again, researchers have
concluded that the DNA scripts for autism are probably passed down not only by
relatives who are classically autistic, but by those who display only a few
typically autistic behaviors. (Geneticists call those who don’t fit into the
diagnostic pigeonholes “broad autistic phenotypes.”)
The chilling possibility is that what’s happening now is
the first proof that the genes responsible for bestowing certain special gifts
on slightly autistic adults - the very abilities that have made them dreamers and
architects of our technological future - are capable of bringing a plague down
on the best minds of the next generation. For parents employed in prominent IT
firms here, the news of increased diagnoses of autism in their ranks is a
confirmation of rumors that have quietly circulated for months. Every day, more
and more of their coworkers are running into one another in the waiting rooms
of local clinics, taking the first uncertain steps on a journey with their
children that lasts for the rest of their lives.
In previous eras, even those who recognized early that
autism might have a genetic underpinning considered it a disorder that only
moved diagonally down branches of a family tree. Direct inheritance was almost
out of the question, because autistic people rarely had children. The
profoundly affected spent their lives in institutions, and those with Asperger’s
syndrome tended to be loners. They were the strange uncle who droned on in a tuneless
voice, tending his private logs of baseball statistics or military arcana; the
cousin who never married, celibate by choice, fussy about the arrangement of
her things, who spoke in a lexicon mined reading dictionaries cover to cover.
The old line “insanity is hereditary, you get it from your
kids” has a twist in the autistic world. It has become commonplace for parents
to diagnose themselves as having Asperger’s syndrome, or to pinpoint other relatives
living on the spectrum, only after their own children have been diagnosed.
High tech hot spots like the Valley, and Route 128 outside
of Boston, are a curious oxymoron: They’re fraternal associations of loners. In
these places, if you’re a geek living in the high-functioning regions of the spectrum,
your chances of meeting someone who shares your perseverating obsession (think
Linux or Star Trek) are greatly expanded. As more women enter the IT workplace,
guys who might never have had a prayer of finding a kindred spirit suddenly
discover that she’s hacking Perl scripts in the next cubicle.
One provocative hypothesis that might account for the rise
of spectrum disorders in technically adept communities like Silicon Valley,
some geneticists speculate, is an increase in assortative mating.
Superficially, assortative mating is the blond gentleman who prefers blondes;
the hyperverbal intellectual who meets her soul mate in the therapist’s waiting
room. There are additional pressures and incentives for autistic people to find
companionship - if they wish to do so - with someone who is also on the spectrum.
Grandin writes, “Marriages work out best when two people with autism marry or
when a person marries a handicapped or eccentric spouse.... They are attracted because their intellects
work on a similar wavelength.”
That’s not to say that geeks, even autistic ones, are
attracted only to other geeks. Compensatory unions of opposites also thrive
along the continuum, and in the last 10 years, geekitude has become sexy and associated
with financial success. The lone-wolf programmer may be the research director
of a major company, managing the back end of an IT empire at a comfortable
remove from the actual clients. Says Bryna Siegel, author of The World of the
Autistic Child and director of the PDD clinic at UCSF, “In another historical
time, these men would have become monks, developing new ink for early printing
presses. Suddenly they’re making $150,000 a year with stock options. They’re
reproducing at a much higher rate.”
Genetic hypotheses like these don’t rule out environmental
factors playing a role in the rising numbers. Autism is almost certainly not
caused by the action of a single gene, but by some orchestration of multiple
genes that may make the developing child more susceptible to a trigger in the environment.
One consequence of increased reproduction among people carrying some of these
genes might be to boost “genetic loading” in successive generations - leaving
them more vulnerable to threats posed by toxins in vaccines, candida, or any
number of agents lurking in the industrialized world.
At clinics and schools in the Valley, the observation that
most parents of autistic kids are engineers and programmers who themselves display
autistic behavior is not news. And it may not be news to other communities
either. Last January, Microsoft became the first major US corporation to offer
its employees insurance benefits to cover the cost of behavioral training for
their autistic children. One Bay Area mother told me that when she was planning
a move to Minnesota with her son, who has Asperger’s syndrome, she asked the
school district there if they could meet her son’s needs. “They told me that
the northwest quadrant of Rochester, where the IBMers congregate, has a large
number of Asperger kids,” she recalls. “It was recommended I move to that part
of town.”
For Dov’s parents, Jonathan Shestack and Portia Iversen,
Silicon Valley is the only place on Earth with enough critical mass of supercomputing
resources, bio-informatics expertise, genomics savvy, pharmaceutical muscle,
and VC dollars to boost autism research to the next phase. For six years, the
organization they founded, Cure Autism Now, has led a focused assault on the
iron-walled fortress of the medical establishment, including the creation of
its own bank of DNA samples, available to any scientist in the field on a Web
site called the Autism Genetic Resources Exchange (see “The Citizen Scientists,”
Wired 9.09, page 144).
At least a third of CAN’s funding comes from donors in the
Valley. Now Shestack and Iversen want to deliver the ultimate return on that
investment:
better treatments, smarter assistive technology - and,
eventually, a cure.
“We have the human data,” says Shestack. “Now we need the
brute-force processing power. We need high-density SNP mapping and microarray
analysis so we can design pharmaceutical interventions. We need Big Pharma to
wake up to the fact that while 450,000 people in America may not be as large a market
as for cholesterol drugs, we’re talking about a demand for new products that
will be needed from age 2 to age 70. We need new technology that measures modes
of perception, and tools for neural retraining. And we need a Web site where
families with a newly diagnosed kid can plug into a network of therapists in
their town who have been rated by buyers - just like eBay.”
The ultimate hack for a team of Valley programmers may
turn out to be cracking the genetic code that makes them so good at what they
do. Taking on that challenge will require extensive use of technology invented
by two people who think in pictures: Bill Dreyer, who invented the first
protein sequencer, and Carver Mead, the father of very large scale integrated circuits.
As Dreyer explains, “I think in three-dimensional Technicolor.” Neither Mead
nor Dreyer is autistic, but there is a word for the way they think - dyslexic.
Like autism, dyslexia seems to move down genetic pathways. Dreyer has three daughters who think in
Technicolor.
One of the things that Dan Geschwind, director of the
neurogenetics lab at UCLA, finds fascinating about dyslexia and autism is what
they suggest about human intelligence: that certain kinds of excellence might require
not just various modes of thinking, but different kinds of brains.
“Autism gets to fundamental issues of how we view talents
and disabilities,” he says. “The flip side of dyslexia is enhanced abilities in
math and architecture. There may be an aspect of this going on with autism and
assortative mating in places like Silicon Valley. In the parents, who carry a
few of the genes, they’re a good thing. In the kids, who carry too many, it’s
very bad.”
Issues like this were at the crux of arguments that Bryna
Siegel had with Bruno Bettelheim in a Stanford graduate seminar in the early ‘80s,
published in Bettelheim’s The Art of the Obvious. (Siegel’s name was changed to
Dan Berenson.) The text makes poignant reading, as two paradigms of scientific
humanism clash in the night. Siegel told “Dr. B” that she wanted to do a large
study of children with various developmental disorders to search for a shared
biochemical defect. Bettelheim shot back that if such a marker were to be
uncovered it would dehumanize autistic children, by making them essentially different
from ourselves.
Still an iconoclast, Siegel questions whether a “cure” for
autism could ever be found. “The genetics of autism may turn out to be no
simpler to unravel than the genetics of personality. I think what we’ll end up
with is something more like, ‘Mrs. Smith, here are the results of your amnio. There’s a 1 in 10 chance that you’ll have an
autistic child, or the next Bill Gates. Would you like to have an abortion?’”
For UCSF neurologist Kirk Wilhelmsen - who describes himself
and his son as being “somewhere on that grand spectrum” - such statements cut
to the heart of the most difficult issue that autism raises for society. It may
be that autistic people are essentially different from “normal” people, he says,
and that it is precisely those differences that make them invaluable to the
ongoing evolution of the human race.
“If we could eliminate the genes for things like autism, I
think it would be disastrous,” says Wilhelmsen. “The healthiest state for a
gene pool is maximum diversity of things that might be good.”
One of the first people to intuit the significance of this
was Asperger himself - weaving his continuum like a protective blanket over the
young patients in his clinic as the Nazis shipped so-called mental defectives
to the camps. “It seems that for success in science and art,” he wrote, “a dash
of autism is essential.”
For all we know, the first tools on earth might have been
developed by a loner sitting at the back of the cave, chipping at thousands of
rocks to find the one that made the sharpest spear, while the neurotypicals
chattered away in the firelight. Perhaps certain arcane systems of logic,
mathematics, music, and stories - particularly remote and fantastic ones - have
been passed down from phenotype to phenotype, in parallel with the DNA that helped
shape minds which would know exactly what to do with these strange and elegant
creations.
Hanging on the wall of Bryna Siegel’s clinic in San
Francisco is a painting of a Victorian house at night, by Jessy Park, an
autistic woman whose mother, Clara Claiborne Park, wrote one of the first
accounts of raising a child with autism, The Siege. Now 40, Jessy still lives
at home. In her recent book, Exiting
Nirvana, Clara writes of having come to a profound sense of peace with all the
ways that Jessy is.
Jessy sent Siegel a letter with her painting, in flowing
handwriting and words that are - there is no other way to say it - marvelously
autistic. “The lunar eclipse with 92%
cover is below Cassiopeia. In the upper right-hand corner is Aurora Borealis.
There are three sets of six-color pastel rainbow on the shingles, seven-color
bright rainbow on the clapboards next to the drain pipe, six-color paler pastel
rainbow around the circular window, six-color darker pastel rainbow on the
rosette ...”
But the words aren’t the thing.
Jessy’s painting is the thing. Our world, but not our world. A house under the
night sky shining in all the colors of the spectrum.
Lenny Schafer, Editor@feat.org • CALENDAR EVENTS@feat.org
Michelle Guppy
Catherine Johnson PhD
• Ron Sleith •
Kay Stammers • Edward Decelie
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