Monday, April 30, 2012

Three things we've learned about autism in the last decade

By Elizabeth Athens

April is autism awareness month. In honour of this, I am going to highlight the three most recent things we have learned about autism. But first, what exactly is autism?

Autism spectrum disorder is a complex neurological disorder that prevents individuals from understanding what they see, hear or sense. It affects reasoning, social interaction and communication as well as the functioning and development of the brain.

Autism disorder exists along a continuum and can present with a myriad of symptoms, such that not every child with autism will have identical needs. Some children with autism are highly verbal but have difficulty with social interactions, while others may have no language ability and struggle even with the most basic self-care skills.

Some of the frequently seen behaviours include hand-flapping or rocking, as well as rigid behaviour patterns that make transitions across settings difficulty (e.g., having to go a specific direction to school, or sitting in a particular chair at lunch). This same rigidity in behaviour could also make it difficult for the child to talk about anything other than trains, for example. Also seen with autism are varying delays in communication, such as limited or no vocal language, and difficulty with social interactions.

Thanks to dedicated researchers and a powerful community of advocates for research into autism, we have learned quite a bit about it the past decade. In fact, I have found the past few years to be some of the most exciting in light of autism research. Here are three important things we have recently learned:

Vaccinations do not cause autism

This is a common misconception that was scientifically disproven in 2011. It started with an article in the Lancet in 1998 suggesting autism spectrum disorders could be caused by the MMR vaccine, an immunization against measles, mumps and rubella. Following this claim, numerous studies were undertaken to research this association, and over repeated independent tests, no causal relation was found.

In fact, it was eventually found the lead author of the original investigation had not presented his supposed evidence truthfully (he actually was found to have manipulated data) and was found guilty of serious professional misconduct and is no longer allowed to practise medicine. The Lancet paper was fully retracted in 2010, the research declared fraudulent, and the medical community as a whole agrees that the benefits of vaccines far outweigh any risks.

Genes do have a role in causing autism

In 1997 the National Institute of Child Health and Human Service and the National Institute on Deafness and Other Communications Disorders began a long-reaching study on the neurobiology and genetics of autism. Their research is not finished, but so far it has shown that there are up to 12 or more genes that may be involved with autism to different degrees.

This genetic link helps explain why a brother or sister of someone with autism has a two to eight percent chance of also having autism (which is much higher than if a family has no history with autism). In addition, when identical twins have autism, both have autism more than 60 percent of the time. When fraternal twins have autism, both have autism up to six percent of the time. If genes were not involved in autism, the rate of autism would be the same for both types of twins.

The environment most likely causes autism, too

Recent research has shown that sometimes genes may make one more susceptible to developing autism, which means that without certain triggers, an individual may never actual develop autism. Research has begun to investigate what these environmental triggers may be. A recent finding suggests a link between autism and a mother's obesity. It has also been found that children born to mothers living less than two blocks from a freeway are twice as likely to have autism – presumably because of auto exhaust and air pollution, the researchers speculated.

These advances into autism research promise to give us a better view of the causes of autism as well as possible medical treatments for autism. Until we have a medical treatment, however, research has shown that an individualized, early, intensive intervention is the most effective method for improving skills in children with autism, and treatments based on the science of applied behaviour analysis are the most effective for skill development.

Elizabeth Athens is a board-certified Behaviour Analyst with a PhD in psychology who has been working in the field of autism for more than 12 years. She is an instructor in the Department of Classroom and Community Support at Douglas College and is Clinical Director of the ABA Learning Centre.