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Autism: what it is, and what it isn?t
Pete McMartin
Vancouver Sun

In the course of doing this series, several times during those interviews a parent or academic would mention ?the Rain Man thing.?

Probably, you?ve seen Rain Man -- the movie that featured Dustin Hoffman in the role of a long-institutionalized adult with autism. (Tom Cruise played his slimeball brother).

Hoffman?s depiction of autism alternated between vacant stares and a monotone recitation of trivia, punctuated by screaming fits when he became frightened. He also exhibited a savant?s computer-like talent for numbers -- which Cruise?s character used for his own profit.
It was in many ways an accurate portrayal of autism.

In many more ways, as those parents and academics well knew, it was not.

The incidence of savantism, for instance, is statistically rare among those with autism. Most are not human calculators.

And while many do exhibit that sense of isolation and removal from the real world, there are degrees to those conditions, just as there are degrees of severity to the types of autism.

Not that those with autism are emotional and intellectual voids. Many show moments of love and need that are positively heart-rending. Many are sweet-natured and inquisitive. One of the concerns of some parents of children with autism is that their children can be too friendly and too trusting, and thus can expose themselves to risk.

Simply put, there is no one profile that fits those diagnosed with autism. So, to define what autism is, it might be best by pointing out what it is not.

It is not a mental illness or a disease.

It is a neurological and, ultimately, a biological disorder that affects the normal development of the brain in areas of social interaction, communication and sometimes cognitive skills. Usually, that disorder manifests itself before the child reaches three. (More on those symptoms and their diagnosis in a later instalment).

Autism is not a singularity.

It is a spectrum of disorders. On that spectrum are five related disorders, the three most common of these being classic autistic disorder (AD), pervasive developmental disorder not otherwise specified (PDD-NOS) and Asperger?s syndrome. They share some behaviours but not others. Those with AD, for example, are often withdrawn and can be completely non-verbal, while those diagnosed with Asperger?s syndrome can have normal verbal and academic skills but have extreme difficulty interacting socially with others.

There is no mental standard or median for those on the autism spectrum.

Some have below-average intelligence, some are average and some are above average.

Additionally, mental abilities can be uneven. A person on the autism spectrum might be able to do complex math but be unable to tie his or her own shoes.

Some are capable of holding jobs and of living independently or semi-independently; some have the intellectual capacity to work but not the social skills to make their way in the work environment; some must receive 24-hour care their entire lives.

The causes of autism are still unknown.

There is no magic bullet for autism because science has yet to identify the target. What causes autism disorders is still a matter of scientific investigation and heated debate, just as there is a heated debate over whether the number of cases is rising or not. (More on causes and incidence in a later instalment.)

In 1930, autism was first described in psychiatric literature as being the social withdrawal observed in some schizophrenics. In 1943, John Hopkins psychiatrist Leo Kanner was the first to describe it as a discrete childhood disorder.

The confusion between autism and schizophrenia continued for years afterwards, however, with the result that many people with autism ended up being institutionalized for what was essentially a misdiagnosis of mental illness (including, I was told more than once, many of the former residents of Riverview). Even when autism was recognized as a separate disorder, some of the theories behind its cause were positively medieval. Even as late as the 1970s, it was promoted by psychologists that ?refrigerator mothers? -- mothers who were distant and unnurturing -- caused autism in their children.

Autism is not curable.

It is a life-long condition. As one parent of a 12-year-old girl diagnosed with severe autism said:

?Parents have to understand:

?This isn?t a sprint. It?s a marathon.?

The initial symptoms, however, can be ameliorated through a combination of intensive early childhood therapy and, it has to be said, the fierce and protective love of parents and family.
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