Kanner

The first use of the word Autism in the scientific literature was by the Swiss psychiatrist Eugen Bleuler in 1908. Bleuler was not only the first person to use the word Autism but also Schizophrenia. In fact it was during his study of patients with Schizophrenia that he identified Autism as being a condition whereby the patients withdrew into themselves.

Bleuler formulated the word Autism from the Greek 'Autós' which relates to the self and he believed that the word could help explain how the Autistic person has difficulties with social interactions, experiencing change including daily routines and sensory problems. Autism is often co-morbid with sensory difficulties such as Sensory Processing Disorder.

Wind forward to 1943 and the Austrian born Leo Kanner at Johns Hopkins University in America studied 11 children with similar symptoms to those described by Bleuler, such as wanting to be alone and the desire to avoid change. In his paper, Kanner described the condition as 'Early Infantile Autism'.

Today communication is instant by the use of email and the internet, but back in 1944 the sharing of ideas wasn't so easy. Yet on the other side of the world from Johns Hopkins University in America, Hans Asperger,  a Viennese child psychologist was apparently unaware of the work of Kanner and vice versa, was studying children with similar symptoms to the Kanner group of children. In his study 'Autistic Psychopathy in Childhood', Asperger also found some differences in the children in his study, notably an absence of echolalia which is the repetition of meaningless words. Asperger described similar but less severe symptoms of those in the Kanner study and found that many of the children had a desire for social interaction but lacked the ability.

Other factors such as lack of eye contact and empathy were similar to classic Autism but Asperger found that the children in his study were like 'Little Professors' with normal to above average intelligence. In fact, Asperger believed that having the condition was necessary to excel in the sciences and engineering and interestingly it has long been suggested that Albert Einstein may have suffered from Asperger's.

DSM

Typically, children with Asperger's will be extremely knowledgeable in a particular area. For example, they may well know all there is to know about trains such as the types of trains and the engines and their histories. Because they lack the ability to follow normal social conventions such as turn taking in conversations, eye contact, reading visual cues from the other person, people with Asperger's may continuously talk about there favourite subject without realising that the other person has lost interest or wasn't interested in the first place.

Because of the Second World War taking place in Europe and the fact that Asperger's work was published in German, Kanner's work gained more prominence and widespread recognition. It wasn't until the publication of 'Asperger's Syndrome: A clinical Account' by Lorna wing in 1981, that Asperger's gained currency and became well known. It was Lorna Wing who identified Autism as being a spectrum of related difficulties and not one discrete condition.

 Autism appeared in the Diagnostic and Statistical Manual of Mental Disorders I (DSM I) (1952) and  DSM II (1968) but was only included  as a subset of Schizophrenia and it was not until DSM III (1980), due to the work of Kelvin in 1971, that Autism or Infantile Autism, to be specific, was included as a separate disorder to Schizophrenia.

Until 2013 Autism was included as one of five pervasive developmental disorders. As well as Autism, there were Asperger’s, Pervasive Developmental Disorder Not-Otherwise Specified (PDD-NOS), Childhood Disintegrative Disorder and Rett’s Syndrome. However after 2013, all five were recategorised as Autistic Spectrum Disorder (ASD) in DSM IIIII (2013). See link for further details.

Kanner first came across Autism when he was studying patients with Schizophrenia and modern research has found that the two disorders share some similar clinical features such as social withdrawal, communication problems and poor eye contact.

Brain Autopsies

Recent research by Dr. Dan Arking at Johns Hopkins, in 2016, found that on autopsy, brain tissue analysis of subjects with Autism and and Schizophrenia were found to have lower levels of expression in 106 gene expression when compared to controls. This is now leading scientists to think the disorders are more related than believed before.

Arking has also discovered that there is a common theme found in the brains of people with Autism discovered at autopsy. Glia cells which surround the neurons in the brain help and support the brain and in non Autistic people they are normally found to be in a resting state and non-inflammatory. However, he found widespread persistent activation in the brains of Autistic people supporting existing claims that Autism that there is an inflammatory component involved in the disease. Curcumin supplements as mentioned elsewhere have powerful anti inflammatory properties and as such could be considered as a useful adjunct in the treatment of Autism (see our inflammation page).

Not only are issues of inflammation implicated in Autism but also oxidation and anti-oxidant activity. In a 2004 study by  Dr S Jill James entitled 'Metabolic bio-markers of increased oxidative stress and impaired methylation capacity in children with autism' looked at blood concentration of metabolic markers of children with Autism. The results showed that the children had imbalances in methionine and homocysteine metabolism due to impaired methylation. Methylation is a chemical process involved in detoxification and  helps enzymes function correctly. Methylation is also beneficial because it helps convert homocysteine into methionine. Homocysteine is a toxic amino acid whereas methionine is helpful and therefore any imbalance could be indicative of disease. Therefore low levels of methylation could lead to deficiencies in vitamins and amino acids, including B6, B12 and glutathione.

Another study by Farida M. ElBaz entitled 'Study of plasma amino acid levels in children with autism: An Egyptian sample' also studied blood samples of Autistic children and found that concentrations of leucine, Isoleucine, Phenylalanine, methionine and Cysteine were found at lower levels than non Autistic children. Poor methylation can lead to problems with production of Glutathione , Co enzyme Q10, Melatonin, Serotonin, Nitric Oxide, Norepinephrine, Epinephrine, L-Carnitine, Cysteine and Taurine.

Andrew Wakefield

There is no definitive answer to what causes Autism, with many researchers suggesting that it may result from prenatal diet to genetics to environment or both. There has also been much controversy about the effect of vaccinations with many government organisations around the world suggesting that vaccinations do not cause Autism. There are however many that suggest that vaccine programs might be associated with Autism. In a 1998 paper, Dr. Andrew Wakefield suggested that there may be an association between the measles-mumps-rubella (MMR) vaccine and Autism. There was much controversy about Dr. Wakefield's paper which was later withdrawn from the Lancet.

A General Medical Council 2010 investigation into Dr Wakefield's study was conducted at the behest of a Sunday Time's reporter Brian Deer. The General Medical council found against Dr Wakefield much to the consternation of parents of children who believed that their children had been damaged by vaccinations.

Furthermore, it did little to allay fears of many when it was disclosed that Brian Dear was an employee of News Corporation whose owners were Rupert Murdoch and James Murdoch. James Murdoch had joined the board of GlaxoSmithKline in 2009 months before the General Medical Council instigated their 2010 investigation into Dr Wakefield's study, GlaxoSmithKline being a manufacturer of the measles-mumps-rubella (MMR) vaccine at the time.

Andrew Wakefield continues to receive support from many quarters in including the American actress Jenny McCarthy who wrote the forward to Wakefield's book 'Callous Disregard - Autism - The Truth Behind A Tragedy'. Jenny McCarthy has a child called Evan who has Autism and she claims that vaccines can trigger Autism as do many other parents around the world. She wrote a book about the subject in 2007 called 'Louder than Words: A Mother's Journey in Healing Autism'.

The debate over the causes of Autism continue to rage, whether they are prenatal diet, prenatal exposure to toxins, vaccinations or the now well debunked theories by Bruno Bettelheim in 1967, who blamed it on the Refrigerator Mothers who psychologically harmed their children by their cold parenting styles.

 

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