3. Reasons for autism

Since Kanner’s time, many theories have been suggested to account for autism and the possible causes. (Aarons M, Gittens T, 1992, 17).

The implications of this theory were that parents were in some way to blame for the autism, and that the child should be given intensive psychotherapy to break through the “autistic barrier”. (Gerdtz J, Bregman J, 1990, 26).

For example Tinberg & Tinberg claimed that: “ Autism is caused by a breakdown in the bonding process between mother and child.” (1972). And that this theory provides the basis for a cure. (Aarons M, Gittens T, 1992, 17).

(however)There is no data to support the theory that parents caused autism, and the therapies provided were virtually useless in helping people with autism. (Aarons M, Gittens T, 1992, 17).

Since autism’s occurrence is roughly equal across all cultures, geographic areas, and socioeconomic groups, a link to social factors is unlikely. (Wolfberg P, 1999, 15).

(Statistically) There are more autistic boys than girls. Although the exact ratios vary, autistic males tend to outnumber females by 3 or 4:1. This prevalence of males over females, together with the known association of autism with severe mental retardation, provides further evidence that the causes of the condition are not psychogenetic in origin. (Aarons M, Gittens T, 1992, 19).

Recent research has shown that not only do relatives of autistic people stand a slightly greater than average chance of being autistic, but that autistic people’s families have an unusually high percentage of relatives with speech disorders, learning difficulties and other minor cognitive disabilities. (Aarons M, Gittens T, 1992, 19).

The consensus among researches now is that autism is the result of an injury or dysfunction to the central nervous system. (Anderson and Hoshino, 1987; DeMyer, 1985). (Gerdtz J, Bregman J, 1990, 27).

It seems that this injury could be the result of a wide variety of factors (Golden, 1987) including prenatal events (for example, toxemia, rubella), perinatal events (for example, trauma, anoxia), congenital factors (for example, microcephaly, tuberous sclerosis), metabolic factors (for example, PKU, Addison’s disease), chromosomal factors (Fragile X Syndrom, XYY Syndrom), and other factors (for example, meningitis, encephalitis). (Gerdtz J, Bregman J, 1990, 27).

Even with the evidence that autism is the result of a central nervous system injury, there is still no clear understanding of how these injuries lead to autistic behavior and characteristics. (Anderson and Hoshino, 1987, 183; Ornitz, 1987, 159). (Gerdtz J, Bregman J, 1990, 27).

It is not uncommon for autistic children to suffer from epilepsy, although sometimes its onset is delayed until adolescence. This association between the two conditions indicates the presence of overt organic brain dysfunction and again provides evidence of a biological basis for autism. (Aarons M, Gittens T, 1992, 20).

In general, severely handicapped autistic children are more likely to suffer from epilepsy than those at the upper end of the continuum, but this is by no means universal. Aarons M, Gittens T, 1992, 20).

There has been much speculation about the parts of the brain which are affected in autism and particular areas of interest have included the right hemisphere; recent research (based on the previous studies) in the United States has found abnormalities in the parts of the cerebellum. (Aarons M, Gittens T, 1992, 20).

However, as yet, no single area of the brain has been conclusively implicated, which could account for the wide range of presenting features, and it seems much more likely that multiple neurological deficits exist. (Aarons M, Gittens T, 1992, 20).

About one-third of autistic children tested in various studies have raised levels of blood serotonin. However, treatment with the drug fenfluramine, aimed at reducing these levels and accordingly the autistic symptoms, has not proved to be generally effective and remains experimental. (Aarons M, Gittens T, 1992, 20).

As Wolff claims: “ For autism to develop, brain damage has to occur in the setting of a genetic predisposition” and “The causation of autism which is likely to be heterogeneous, arises when a number of possibility quite common factors coincide and it is the coincidence which is rare and makes autism uncommon.” (1988). (Aarons M, Gittens T, 1992, 20).