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AUTISM FIRST STEPS
AUTISM DAILY NEWSLETTER
Tuesday January 22, 2002
INDEX:
* Autism and Massage
Therapy
* Autism's Picky Eaters
* Verbal Association For Simple Common Words In High-Functioning
Autism
* Goal-directed Behaviors in Autistic Children
* Birth Order and Non-Verbal IQ
* On the Differential Diagnosing of Autism, Language Disorder
* Why Neuropeptides And Neurotrophins Are Important To Autism
* Commentary 'Geeks' Get Lucky
******************************
Autism and Massage Therapy
Brief report: improvements in the
behavior of children with autism following massage therapy.
Escalona A, Field T, Singer-Strunck R, Cullen C, Hartshorn K.
Touch Research Institute, University of Miami School of Medicine, FL 33101,
USA.
Twenty children with autism, ages 3 to 6 years, were randomly assigned to
massage therapy and reading attention control groups. Parents in the massage
therapy group were trained by a massage therapist to massage their children for
15 minutes prior to bedtime every night for 1 month and the parents of the
attention control group read Dr. Seuss stories to their children on the same
time schedule. Conners Teacher and Parent scales, classroom and playground
observations, and sleep diaries were used to assess the effects of therapy on
various behaviors, including hyperactivity, stereotypical and off-task
behavior, and sleep problems. Results suggested that the children in the
massage group exhibited less stereotypic behavior and showed more on-task and
social relatedness behavior during play observations at school, and they
experienced fewer sleep problems at home.
PMID: 11794416 [PubMed - in process]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11794416&dopt=Abstract
******************************
Autism's Picky Eaters
"An
assessment of food acceptance in children with autism or pervasive
developmental disorder-not otherwise specified
Ahearn WH, Castine T, Nault K, Green G.
The New England Center for Children, Southboro, MA 01772-2108, USA.
Bahearn@necc.org
Some children with autism and pervasive
developmental disorder-not
otherwise specified (PDD-NOS) have been reported to have atypical feeding
behavior, such as sensitivity to food texture and selective preferences for
particular foods.
No systematic studies of feeding behavior in this
population have been
published. Munk and Repp (1994) developed methods for assessing feeding
problems in individuals with cognitive and physical disabilities that allow
categorization of individual feeding patterns based on responses to repeated
presentations of food. In this study, we systematically replicated the Munk
and Repp procedures with children with autism and PDD-NOS. Thirty children,
ages 3 to 14 years, were exposed to 12 food items across 6 sessions.
Food acceptance, food expulsion, and disruptive
behavior were recorded
on a trial-by-trial basis. Approximately half of the participants exhibited
patterns of food acceptance, indicating selectivity by food category or food
texture. Others consistently accepted or rejected items across food
categories.
Whether these patterns of food acceptance are
atypical remains to be
determined by comparison with the feeding patterns of typically developing
children and other children with developmental delays
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ui
ds=11794415&dopt=Abstract
******************************
Verbal Association For Simple Common Words In
High-Functioning Autism
Toichi M, Kamio Y.
Division of Child & Adolescent Psychiatry, Case Western Reserve
University/University Hospitals of Cleveland, OH 44106, USA.
We investigated conceptual relationships in
semantic memory using an
indirect priming technique in high-functioning autistic adolescents and
their controls who were matched for age, verbal IQ, performance IQ, and
nonverbal reasoning ability. The prime was a single word and the target task
was completing a word fragment that was semantically related or unrelated to
the prime word.
The autistic subjects and controls showed similar
semantic priming
effects, indicating intact conceptual relationships for simple common words
in those with autism. Only in the autistic group was a significant
correlation found between performance for the related items and two
nonverbal cognitive measures, which suggests a possibility that semantic
processing in individuals with autism might be qualitatively different from
that in controls.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11794413&dopt=Abstract
******************************
Goal-directed Behaviors in Autistic Children
"Analysis
of social interactions as goal-directed behaviors in children with
autism
Ruble LA.
Treatment and Research Institute of Autism Spectrum Disorders, Child
Development Center, Vanderbilt University, Department of Pediatrics,
Nashville, TN 37232, USA. lisa.ruble@mcmail.vanderbilt.edu
An ecological psychology framework that considers
the intentions of
the child within the child's own social context was used to study the
complexity of social interactions of 16 children with autism or Down
syndrome. Children were observed in their homes and behaviors were recorded.
Records were then analyzed by dividing behavior based on the children's own
goals.
Goal-directed behaviors were then categorized.
Statistical analyses
revealed similar social contexts and opportunities to receive bids from
others for both groups. Differences in the frequencies and complexities of
children's behaviors depended on behavioral intent. Socially intended
behaviors were less frequent, less self-initiated, and less complex in
children with autism.
These findings are discussed as problems of
attention and executive
function, because social behaviors were more likely to occur secondarily,
within the context of another ongoing behavior.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11794412&dopt=Abstract
******************************
Birth Order and Non-Verbal IQ
"Birth order effects on nonverbal
IQ scores in autism multiplex families."
Spiker D, Lotspeich LJ, Dimiceli S, Szatmari P, Myers RM, Risch N.
Department of Psychiatry and Behavioral Sciences, Stanford University School
of Medicine, CA 94305-5719, USA.
Lord (1992) published a brief report showing a
trend for decreasing
nonverbal IQ scores with increasing birth order in a sample of 16 autism
multiplex families, and urged replication in a larger sample. In this
report, analyses of nonverbal IQ scores for a sample of 144 autism multiplex
families indicated that nonverbal IQ scores were significantly lower in
secondborn compared with firstborn siblings with autism. This birth order
effect was independent of gender as well as the age differences within sib
pairs.
No such birth order effects were found for social
or communicative
deficits as measured by the Autism Diagnostic Interview-Revised (ADI-R), but
there was a modest tendency for increased scores for ritualistic behaviors
for the firstborn sibs. Further, there were no gender differences on
nonverbal IQ scores in this sample. Results are discussed in terms of
implications for genetic studies of autism
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11794410&dopt=Abstract
******************************
On the Differential Diagnosing of Autism,
Language Disorder
"The use of the ADI-R as a
diagnostic tool in the differential diagnosis of
children with infantile autism and children with a receptive language
disorder"
Mildenberger K, Sitter S, Noterdaeme M, Amorosa H.
Heckscher Klinik fur Kinder- und Jugendpsychiatrie, Abteilung fur
teilleistungs- und verhaltensgestorte Kinder, Munchen, Germany.
Children with infantile autism and children with
a specific receptive
language disorder often show similar behavioural problems, making the
differentiation between these two diagnostic categories difficult. The
purpose of this study is to evaluate the usefulness of parental information
in the differential diagnosis of the two types of disorders mentioned above.
Sixteen children with a receptive language disorder and 11 children with
infantile autism participated in the study.
All children had normal non-verbal IQs. The ADI-R
(Autism Diagnostic
Interview-Revised) was performed with all children. The results showed that
the ADI-R items reflecting behavioural features at pre-school age (age range
4-5 years) were better suited to differentiate the groups than the items
reflecting behavioural features at the time of the investigation (mean age:
9 years).
The items on the dimension "Reciprocal
social interaction" and
"Communication and language" discriminated the groups better than the
items
of the dimension "Restricted interests". According to the ICD-10 algorithm
of the ADI-R one child with autism and one child with a receptive language
disorder were falsely classified. These false classifications were mainly due
to a distorted parental perception of the child's behaviour. The ADI-R is a
useful tool in the differential diagnosis of developmental disorders
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11794550&dopt=Abstract
******************************
Why
Neuropeptides And Neurotrophins Are Important To Autism
"What are neuropeptides and neurotrophins and why are they imortant in
autism?"
Minshew N. Publication Types: * Editorial
COMMENTARY
'Geeks' Get Lucky
Mark Blaxill
Autism experts have a long tradition of
displaying contempt for the
parents of autistic children. Most famously, Bruno Bettelheim propounded the
theory of the "refrigerator mother", while boasting that "all my
life, I
have been working with children whose lives were destroyed because their
mothers hated them" (1). More recently, Chistopher Gillberg turned the
spotlight to socially unfit fathers, speculating in a peer-reviewed article
that autism might be increasing because of "indirect associations of
maternal immigrant status and paternal Asperger's syndrome", creating a
situation in which "men...with increased risk of fathering children with
autism and with difficulty in finding a native partner, might have children
by women from far-away countries, who would not immediately identify the
social anomalies or ascribe them to a difference in culture" (2).
I have used Gillberg's odd contention in recent presentations
as a
joke. It's a reliable laugh line. To Gillberg's modest credit, his
speculation was buried deeply in a long paper in an obscure journal. He
certainly did not seek to call attention to it.
But now, Simon Baron-Cohen has taken this
"geeks get lucky" theory out
in the open. In a recent essay (3), Baron-Cohen develops Gillberg's
speculation into a full-fledged argument. Autism increases, Baron-Cohen
claims, are the direct consequence of advances in transportation and
information technology. Dads of today's autistic children, "would
traditionally have not competed well in the competition for mates, as
appearing socially odd might have either put off prospective females from
choosing them, or put off prospective parents-in-law from arranging such a
marriage for their daughters."
Too bad, lonely geek! But in the modern world,
claims Baron-Cohen,
"two massive changes hit the planet: the airplane and the computer. The
airplane has allowed unprecedented opportunities for changing your culture.
And when you go from your native culture into another one, your social
oddness may be far less obvious." Score one for the dating strategy of the
mysterious stranger.
But that's not all of the good news for our
strange friend. Now he can
even get a job! "In just 50 short years, there is now no office in the
developed world where computers are not essential, and we need those people
with the cool, razor-sharp logic to fix them, reconfigure them, develop
them, adapt them, program them. The autistic mind was sitting around for
centuries, even millennia, under-employed, because how many jobs were there
for mathematicians and scientists, who also needed this style of
thinking?"
It's hard to make this stuff up. Under most
circumstances, one would
be tempted to write this off as lunacy from some out-of-touch crackpot. But
here is the astonishing part. Baron-Cohen is an autism expert, and a
respected academic as well. As Professor of Developmental Psychopathology
and Co-Director of the Autism Research Centre at Cambridge University, he
has published widely on autism and is one of the small cadre of
epidemiological researchers who have been responsible for investigating the
prevalence of autism and how it is detected. Most notably, he led a research
effort that tried to develop tools (4) for diagnosing autism in infants. He
failed (5). Neglecting to notice that this failure might actually support a
case for an increase in regressive autism (why did the early detection tools
fail to find over 60% of the infant autism population if autism is
determined in utero?), he has now moved on to unsupported theories of
natural selection and new-economy mating patterns.
But this is pure nonsense. Malicious nonsense.
And we must expose
nonsense when we see it. Especially when it comes from Cambridge professors
with international reputations as autism experts. Bruno Bettelheim was one
of the most celebrated psychologists of his time: can we calculate the
emotional damage he inflicted on a generation of mothers? As for
Baron-Cohen, I suspect he would prefer that those of us he would judge as
unfit to mate would simply to withdraw to our computer programs. We must
not. We need to hold him accountable for his theory.
I would suggest that the scientific method is the best way to
hold the
good professor accountable. He has a theory. Can he provide plausible
evidence to support it? Can he provide a rigorous test for it? Can he defend
it against the simple standard of common sense? More specifically, he offer
two hypotheses: * The mobility hypothesis.
Baron-Cohen argues that social
mobility created by air travel has allowed "geeks on the go" a chance
to
mate. If this were true, then Baron-Cohen would have to explain why other
increases in cross-cultural mobility and mating would not have produced
similar increases in autism. The mobility hypothesis would predict higher
autism incidence in: historical periods of high migration; periods of
involuntary mating (e.g., war); societies with higher rates of internal
migration; cross-cultural and mixed race marriages; female populations with
lower degrees of social standing and ability to attract "normal"
mates; and
countries with high and rising rates of immigration
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11794417&dopt=Abstract
******************************
Commentary
'Geeks' Get Lucky Mark Blaxill
Autism experts have a long tradition of
displaying contempt for the parents of autistic children. Most famously, Bruno
Bettelheim propounded the theory of the "refrigerator mother", while
boasting that "all my life, I have been working with children whose lives
were destroyed because their mothers hated them" (1). More recently,
Chistopher Gillberg turned the spotlight to socially unfit fathers, speculating
in a peer-reviewed article that autism might be increasing because of "indirect
associations of maternal immigrant status and paternal Asperger's
syndrome", creating a situation in which "men...with increased risk
of fathering children with autism and with difficulty in finding a native
partner, might have children by women from far-away countries, who would not
immediately identify the social anomalies or ascribe them to a difference in
culture" (2).
I have used Gillberg's odd contention in recent
presentations as a joke. It's a reliable laugh line. To Gillberg's modest
credit, his speculation was buried deeply in a long paper in an obscure
journal. He certainly did not seek to call attention to it.
But now, Simon Baron-Cohen has taken this
"geeks get lucky" theory out in the open. In a recent essay (3),
Baron-Cohen develops Gillberg's speculation into a full-fledged argument.
Autism increases, Baron-Cohen claims, are the direct consequence of advances in
transportation and information technology. Dads of today's autistic children,
"would traditionally have not competed well in the competition for mates,
as appearing socially odd might have either put off prospective females from
choosing them, or put off prospective parents-in-law from arranging such a
marriage for their daughters."
Too bad, lonely geek! But in the modern world,
claims Baron-Cohen, "two massive changes hit the planet: the airplane and
the computer. The airplane has allowed unprecedented opportunities for changing
your culture. And when you go from your native culture into another one, your
social oddness may be far less obvious." Score one for the dating strategy
of the mysterious stranger.
But that's not all of the good news for our
strange friend. Now he can even get a job! "In just 50 short years, there
is now no office in the developed world where computers are not essential, and
we need those people with the cool, razor-sharp logic to fix them, reconfigure
them, develop them, adapt them, program them. The autistic mind was sitting
around for centuries, even millennia, under-employed, because how many jobs
were there for mathematicians and scientists, who also needed this style of
thinking?"
It's hard to make this stuff up. Under most
circumstances, one would be tempted to write this off as lunacy from some
out-of-touch crackpot. But here is the astonishing part. Baron-Cohen is an
autism expert, and a respected academic as well. As Professor of Developmental
Psychopathology and Co-Director of the Autism Research Centre at Cambridge
University, he has published widely on autism and is one of the small cadre of
epidemiological researchers who have been responsible for investigating the
prevalence of autism and how it is detected. Most notably, he led a research
effort that tried to develop tools (4) for diagnosing autism in infants. He
failed (5). Neglecting to notice that this failure might actually support a
case for an increase in regressive autism (why did the early detection tools
fail to find over 60% of the infant autism population if autism is determined
in utero?), he has now moved on to unsupported theories of natural selection
and new-economy mating patterns.
But this is pure nonsense. Malicious nonsense.
And we must expose nonsense when we see it. Especially when it comes from
Cambridge professors with international reputations as autism experts. Bruno
Bettelheim was one of the most celebrated psychologists of his time: can we
calculate the emotional damage he inflicted on a generation of mothers? As for
Baron-Cohen, I suspect he would prefer that those of us he would judge as unfit
to mate would simply to withdraw to our computer programs. We must not. We need
to hold him accountable for his theory.
I would suggest that the scientific method is the
best way to hold the good professor accountable. He has a theory. Can he
provide plausible evidence to support it? Can he provide a rigorous test for
it? Can he defend it against the simple standard of common sense? More
specifically, he offer two hypotheses: * The mobility hypothesis.
Baron-Cohen argues that social mobility created by air travel has allowed
"geeks on the go" a chance to mate. If this were true, then
Baron-Cohen would have to explain why other increases in cross-cultural
mobility and mating would not have produced similar increases in autism.
The mobility hypothesis would predict higher autism incidence in:
historical periods of high migration; periods of involuntary mating (e.g.,
war); societies with higher rates of internal migration; cross-cultural and
mixed race marriages; female populations with lower degrees of social standing
and ability to attract "normal" mates; and countries with high and
rising rates of immigration. There is no evidence whatsoever of any such
patterns in autism prevalence. If Baron-Cohen wants to offer a serious
hypothesis, however, he would need to follow its implications. Where is the
data? * The occupational hypothesis. Baron-Cohen is pleased to cite
that paragon of epidemiological science, Wired Magazine, as proof that rates of
autism are higher in areas with high concentrations of computer professionals.
This is the sole apparent basis for his suggestion that the new economic
viability of the autistic mind ("geeks in the money?") is the driver
of the increase in autism rates. Perhaps he is behind in his reading, but the
occupational hypothesis has actually been examined in quite a number of autism
prevalence studies. Early studies in the U.S. (6) and Japan (7), found some
evidence for higher rates of autism born to fathers in professional
occupations. These studies were conducted well before the revolution in
information technology, however, and were not supported by follow-up studies
(e.g., 8). There is some evidence in developing countries for higher rates of
autism among children of parents in elite social classes (9,10, 11). Yet these
studies offer more support for the vaccine theory of autism that Baron-Cohen
rejects (elite children would have greater access to public health services)
than for his computer theory, since none of these countries had significant
computer usage. If Baron-Cohen wants to resubmit a new theory as new, he should
be expected to do his homework. Where is the due diligence?
More to the point, what is the reason to offer
such nonsense in a public forum? Why would such a prestigious researcher make
such unsupported claims? Who else in this man's circle of professional
colleagues shares his views? What are the implications for progress in autism
science if these ideas are taken seriously? What are we to make of the
significance of this theory? I cannot claim to offer the answer to all these
questions, but I can offer an interpretation, albeit speculative, of his
motives.
Let me be blunt. This man is one of the small
group of academics that has shaped the science of autism for many years. He has
been carrying on studies of the rates of autism in the middle of the largest
increase ever seen in a developmental disorder and has failed to detect the
changes or to sound the alarm. He has a large number of colleagues who have
joined him in this pattern of error. Now, in the face of failure and
contradictory evidence, he has resorted to concocting one of the most absurd
arguments one could imagine in order to reconcile a genetic model with the
inescapable evidence. This is a thinly veiled attempt to diminish the significance
of the increases by diminishing the fitness of the parents, just as the attempt
to dismiss AIDS as the "gay disease" was an attempt to minimize the
gravity of that epidemic.
This is bad science. It is malicious propaganda.
It is supported by no research and refuted by every shred of available
evidence. Yet, like Bettelheim before him, Baron-Cohen commands respect in the
scientific community and his arguments will have a way of creeping into the
discussion and gaining respectability as they are whispered in corridors of
leading institutions. So we all must challenge them. We must call out nonsense
when we see it and, most important, hold these so-called experts accountable
for their errors. If it weren't all such a tragedy, we could all share a good
chuckle.
Instead it makes you want to cry. Where has the
integrity gone in autism science?
Mark F. Blaxill Cambridge MA
References: 1. Dolnick, Edward, "Madness on
the Couch" (New York, Simon and Schuster, 1998). 2. Gillberg C, Wing L.
Acta Psychiatr Scand 1999 Jun;99(6):399-406. Autism: not an extremely rare
disorder 3. Baron-Cohen, Simon, "Have the airplane and the computer
changed the architecture of the mind? And is that why autism is on the
increase?" reprinted in FEAT DAILY NEWSLETTER, January 17, 2002. 4.
.Baron-Cohen S, Cox A, Baird G, et al. Br J Psychiatry 1996;168:158-163,
Psychological markers in the detection of autism in infancy in a large
population 5. Baird G, Charman T, Baron-Cohen S, Cox A, Swettenham J, Wheelwright
S, Drew A. J Am Acad Child Adolesc Psychiatry 2000 Jun;39(6):694-702. A
screening instrument for autism at 18 months of age: a 6-year follow-up study.
6. Treffert DA. Arch Gen Psychiatry 1970 May;22(5):431-8. Epidemiology of
infantile autism. 7. Hoshino Y, Kumashiro H, Yashima Y, Tachibana R, Watanabe
M, Folia Psychiatr Neurol Jpn 1982;36(2):115-24, The epidemiological study of
autism in Fukushima-ken. 8. Ritvo ER, Freeman BJ, Pingree C, Mason-Brothers A,
Jorde L, Jenson WR, McMahon, WM, Petersen PB, Mo A, Ritvo A. Am J Psychiatry
1989 Feb;146(2):194-9. The UCLA-University of Utah epidemiologic survey of
autism: prevalence. 9. Lotter V. J Child Psychol Psychiatry 1978
Jul;19(3):231-44. Childhood autism in africa. 10. Tao KT. J Autism Dev Disord
1987 Jun;17(2):289-96. Infantile autism in China. 11. Dhadphale M, Lukwago MG,
Gajjar M. Indian J Pediatr 1982 Jan-Feb;49(396):145-8. Infantile autism in
Kenya.
http://www.angelfire.com/on/FEATNews/MBlaxill.htm
******************************
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