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All in the Mind

Prescience from January 2002: The Myth of Autism

In Leo Kanner's now classic 1943 paper he outlined the behavior pattern, present from early in life, which he named 'early infantile autism'. Prior to this, there were, in the literature, occasional accounts of individual children whose behavior fitted the picture Kanner later described. Kanner described only the autistic children referred to his clinic and, later on, those attending a particular special school (Kanner,1973). He made no estimates of the numbers in the general population, but thought that his syndrome was rare.

Later on Kanner and Eisenberg (1956) discussed Kanner's original conception of autism and the five features he considered to be diagnostic. These were, a profound lack of affective contact with other people; an anxiously obsessive desire for the preservation of sameness in the child's routines and environment; a fascination for objects, which are handled with skill in fine motor movements (an area of actual weakness in many of the children being diagnosed today); mutism or a kind of language that does not seem intended for inter-personal communication; good cognitive potential shown in feats of memory or skills on performance tests, especially the Séguin form board. Kanner also emphasized onset from birth or before 30 months.

In the same paper, Kanner and Eisenberg modified the diagnostic criteria by selecting two as essential.

These were:

  1. a profound lack of affective contact
  2. repetitive, ritualistic behavior, which must be of an elaborate kind.

They considered that, if these two features were present, the rest of the typical clinical picture would also be found THEN: 1 – 2 children / 10,000

Now: 1 child / 500, with much higher numbers being quoted routinely. So, how can so many children now have such a previously rare disorder? How can a rare, almost unheard of “severe mental dysfunction†become something every pediatrician is seeing, something every parent is concerned about? How can we now have this rare misfortune become an epiphenomenon threatening to overwhelm our school and social systems, while destroying families across this country, and around the world?

To understand this, one needs to go back to the beginning. Per above, Kanner (1943) described a disorder by its “behavioral†features. Needless to say, “behavioral†dysfunction can be caused by many factors, NOT just the idea of a developmental or psychiatric dysfunction, as held forth, for so many years. Think of it, an idea, literally now dictum, held forth over decades, with ONLY a “behavioral†pattern for diagnosis, not one objective or consistent physiologic dysfunction or finding required to prove or disprove this “disorder / diagnosis,†(but “somehow†all these children have it FOR LIFE). In fact, over the years, to this day, health professionals have had no idea what causes this disorder. Explanations have ranged from childhood schizophrenia to bad parenting to “something†biologic, all with the underlying concept that “something†must have happened “developmentally.â€

Somehow (mechanism unknown) the brain was “miswired,†these children were not okay, COULD NOT be okay (but with NO idea of what was happening, WHY it happened, even HOW it happened).

Graduating medical school (UCLA) I was told that IF I saw one Autistic child in my entire lifetime of practice it would be “one too many.†Over the last 10 – 15 years that is sadly no longer true for myself or many other pediatricians. How can this be? Scientifically (logic not myth) how can this be possible?

Since “developmental†disorders were NOT considered “medical†disorders, medical doctors were not the primary physicians consulted or involved with their management. Likewise, the brain was essentially a “Black Box,†with essentially no real evidence allowing study or insight into what was really happening with this or most “neurological†or “psychological disorders. If there was NO definable objective reason for what was happening, “it must be psychological†seemed the standard cry of medicine. Therefore, as Psychologists and Psychiatrists rapidly expanded the above definition to include all the children appearing with “spectrum†dysfunction, the first large mistake was made.

Suddenly (mid - late 80's / early 90's) there were a lot of children appearing that did NOT fit “classic†Autism. This should have created appropriate questions and initiated scientific, medical investigations.

“What's going on? Why are we suddenly seeing so many dysfunctional children? Maybe something is wrong here? MAYBE this is not Autism? Instead, literally the “definition†just kept being expanded, modified, and ALL the new children were just put into a variation of the OLD basket. It is very likely, children and society itself would be way ahead IF instead of expanding the “basket†enlarging the alphabet soup of Autism (PDD, Aspergers, Autistic spectrum, LKS variant, etc.), experts had said,

maybe this is NOT Autism, maybe we have another problem (with some “Autistic†like symptoms) occurring. Instead they (the “expertsâ€) just kept expanding the definition, expanding the “basket†but NEVER asked the critical question, do these children even belong in this basket? How many parents (often against their own belief) presently are being told their children have this strange disorder (or are on the spectrum) and they must learn to live with it, accept it? How many parents think their children even come close to meeting Kanner's main criteria “a profound lack of affective contact and elaborate repetitive, ritualistic behavior?â€

The good news is science is finally on the children's side, but sadly it appears the old logic and system are many years away from changing or waking up. A cold, hard fact of science says “You cannot have an epidemic of ANY type of genetic or developmental disorder†It is impossible, cannot happen, there are NO exceptions!! And yet, the vast majority of the researchers in this country, the world, are still studying these children as if they truly had some undefined, unknown “developmental†disorder.

Instead of looking for the correct answers, instead of focusing on at this point what can ONLY be understood as a DISEASE (not developmental) process, the “system†continues to fund researcher's trying to figure out and understand “Autism†(as a developmental disorder). This is why so little progress has occurred in spite of millions of dollars being spent. Researchers are being funded to study what 99.9% of the children appearing today CANNOT have. IF this process continues,

EVERYONE will lose (except the researchers and universities receiving mass amounts of funding and the “industry†of “alternative therapists†helping to try and “treat†these sadly dysfunctional, “special needs†children).

As noted, it is blatantly obvious to all but the “system,†99.9% of your children do not come close to meeting Kanner's definition of Autism. It has become absolutely safe to say, 99.9% of children being diagnosed as “Autistic†do not have Autism (as the term is understood or used), but rather reflect a disease state, a CNS dysfunction, manifested by many Autistic symptoms, but unlike a developmental disorder, treatable, changeable IF we act quickly enough. But, how many of the present “leaders,†how many of the existing “Autistic†groups are questioning present funding, present efforts? How many are going before congress saying we have a large group of children that IF helped, IF treated might grow up to be productive citizens, might pay taxes (rather than utilize tax services) one day? Why NOT?

That is the “myth†of Autism. Children are being “labeled†with a disorder they DO NOT really have. Parents are being told there is little hope, when there should be a lot of reasons for hope. As long as we continue to “label†so many children / families with this “undefined,†“unexplained†disorder, few physicians, parents, or congressman EXPECT these children could ever really recover, really regain regular function. In the “myth†of Autism, many dangerous or partially successful therapies abound,

with “some success (often with large risks) being better than nothing.†Think of the difference, if physicians, therapists EXPECTED a child to recover, were focused on finding answers to fix this now, for this generation of children, rather than accept any degree of “minute†improvement as “wonderfulâ€.

It has become obvious, that “neuro-immune,†and / or chronic viral connections are the only pathways,

the only “proposed†mechanisms that have NO scientific contradictions, and an ever-enlarging compendium of articles in support. While many will pose the questions “where are the controlled studies,†EVERY medical fact and recent discovery helps substantiate the likelihood of an autoimmune, “neuro-immune†related process. Perhaps it's time this question / challenge should be turned around.

WHERE are the studies, where is the data showing all these children, all these families have to resign themselves to some permanent dysfunction, incurable disorder? Based on what “objective†data,

based on what “objective†studies are we committing so many children and families to this bleak prognosis, a very bleak future?

We ARE presently at a major crossroads. Are we going to continue to follow (blindly) OLD logic, OLD thinking with NO consistent physiologic dysfunction measurable / documented; OR can we unite behind scientifically sound data, more than “reasonable medical probability,†and clinical logic before we lose forever the chance to help THIS generation of children. There are excellent researchers, clinicians, and scientists ready to focus on solving this disease NOW, rather than study the “myth,†but this effort

(NIDS) remains buried under the wall of “controlled†misinformation. Unless, we all step up now to change this, to demand clinical science and logic, not “mythology†be applied to these children, the “system†could easily take another 10 – 15 years (or longer) to come around to the right answers. How are ready to step up and say, “enough is enough� How many millions of dollars have been spent (particularly in the last 6 – 7 years) with NO answers, NO new hope? Are we all going to wait another decade (or longer as many researchers predict) for possible answers or are we going to help solve this NOW? The NIDS effort was formed to help look at this crisis appropriately scientifically,

logically, MEDICALLY. Many parents are working hard to help make a real future for their children. It is up to all of you to decide if that effort is going to get a chance to succeed NOW for your children. Do we continue to follow “mythology†or do we turn to clinical logic and a true scientific understanding of your children's dysfunction / disease??

Respectfully submitted for consideration of all parents, educators, therapists, and health professionals being overwhelmed by “The Myth of Autism†(perhaps its time to change the focus, maybe really change the future for this generation of children and families)

PS: This was authored 8 years ago, shortly after I has received an odd ASD diagnosis, but 3 years before I reached the same conclusion and contriibuted to a book of the same the name, fimally published in November 2010.

Categories
All in the Mind

Denying the Effects of Violent Video Games

As a result of the Anti-Terrorism Crime and Security Act the UK government has recently given the police new powers to monitor e-mails and web sites. The pretext is to fight terrorism, political extremism and Internet paedophilia as sensationalised in the mainstream media, but the real purpose is to crack down on subversion. Tabloids spread rumours about paedophiles prowling 10 year olds in chat rooms. While such an invasion of privacy will not stop child abuse, it will curtail the free speech of all but powerful corporate and state organs.

By contrast the same media outlets not only sport high-profile advertisements for violent video games such as Tomb Raider, Quake III, Half Life, Soldier of Fortune etc. to name but a few, but hail them as cool pastimes, praise the developers as talented export-oriented entrepreneurs and review accompanying movies as works of art. Meanwhile the corporate PR machine via the computer press is busy proving such games not only appeal to young and old alike, but teach co-ordination skills and help to channel our anger in a safe virtual medium.

Genetic vs Environmental Causes

The video games lobby's chief argument is that other factors such as genetic predisposition to aggression play a much greater role than mass media violence in determining violent outcomes to conflicts. Many like to quote Adrian Rain from the University of Southern California, who has undertaken extensive research into genetic markers for violence in psychopaths. However, in a June 2001 TV debate he did not deny that social factors also play a role in determining how neurologically diverse individuals channel their innate aggressiveness. In all but the most extreme cases people are not born killers. The nature versus nurture debate could be widened to consider the other effects of pervasive media. To what extent does advertising, merchandising and corporate sponsorship encourage the masses to squander hard-earned cash on designer clothes and other superfluous consumer goods that will soon be superseded anyway? Would advertisers be wasting billions of dollars, euros or pounds to persuade us to buy more if purely genetic factors determined prodigality too? Violent media may not change our natural propensity to aggression, but they can channel our natural urges for revenge, communicate with our subconscience and justify violence as a means of conflict resolution.

Video Violence Threat is just a Media Scare

A classic tactic employed by lobbyists ever since the American free speech movement of the 1960s is to dismiss a problem as a mere mass media scare. In recent years global warming, the ill-effects of factory farming (e.g. BSE, foot and moth disease, salmonella, E-coli, overuse of antibiotics in animal husbandy weakening our immune system), the big-business-friendly corruption of most world governments, the imminent end of the oil age, the mass extinction of many large wild animal species outside zoos etc. have all been dismissed by various lobbies as media scares. Ironically they have a point. Mass circulation newspapers and popular TV channels in countries with nominal democratic institutions repeatedly launch scare campaigns, which are later revealed as either unfounded or taken out of context e.g. paedophilia is nothing new and its apparent rise may owe more to children's exposure to media and peer pressure that promote sexual promiscuity among young teens as well as early onset puberty. However, only 40 years ago the establishment ritually condemned all sexual practices out of wedlock as buggery. Everyone knows the way in which children discover their sexuality will affect an important part of their adult lives, but any attacks on media's role in teenagers is almost off-limits, so public anger is simply channelled against paedophiles, convenient scapegoats for society's ills. So intent is the government on curtailing personal liberties in the cybernetic age that is now offence to own digital paedophile imagery, as according to the government someone who would pay to view such picture may abuse children. Indeed such an assumption may have some truth in it, but without proof of sexually motivated physical contact with children, conviction under this law would like arresting Playboy subscriber for rape - offering the magazine as the sole piece of evidence. As many owners of e-mail accounts are aware without prudent spam filtering measures, one's hard drive can fill with explicit pornography, including kiddy porn, in no time simply by clicking on an HTML-enabled e-mail. By the same logic someone who pays to engage interactively in a simulation of a mass murder might want to reenact the scenario in real life against perceived enemies. Luckily most know that they would never get away with such wild fantasies, until they find themselves in a new position of power over defenceless individuals, e.g. in a war zone or in counter-insurgency operations. However, the former group don't have a multibillion dollar industry behind them yet.

Let's take a look at another analogy. If global warming is caused by a massive rise in human depredation of the earth's resources over the last century, then major multinationals stand to lose billions as we lower consumption. The best counterclaim the oil lobby can make is dismiss global warming scientists as green fascists intent on denying ordinary working people the right to drive gas guzzlers on multilane highways. Likewise if violent video games do adversely influence kids' behaviour, the entertainment industry will be held responsible for destabilising communities. In the same way as some lobbyists claim ecstasy is a relatively harmless recreational drug, they claim Quake III Arena is just fun. If you read computer magazines you've probably encountered the well-rehearsed line "I play violent video games, but I don't feel like killing someone afterwards".

That's because everyone knows murder is morally reprehensibe, but can be strategically justifed in self-defence or to fight a greater evil. Brainwashed youngsters do not consider themselves potential killers, just liberators or protagonists in an exciting adventure that bears little semblance to real life situations. Be honest! Outside the makebelieve world of Hollywood movies, how many Lara Crofts successfully fight off enemies single-handedly at gunpoint while flaunting their sexual prowess?

Re-enforcing Self-righteous War Propaganda

Video-games come in two varieties: Glorified violence and liberating force. In the first genre à la Tomb Raider, gamers play sexy or muscular role models ready to fight off evil or unwtiting rivals. In the second genre à la Wing Commander, gamers play their heroic role in the battle against murderous enemies, reinforcing mainstream war propaganda. Both forms cheapen life and stress the self-righteous may murder with impunity. Gaming is also a highly addictive lifestyle and is actively promoted by the same corporate machine that brought neoliberal governments such as New Labour to power. European age certificates are meaningless. Theoretically recommended for 15+, Tomb Raider is advertised on kids TV and played by six and seven year olds. Even children's shows on the BBC offer Play Station ® consoles as prizes. Anyone who thinks 8 to 10 year kids will play The Tweenies and Winnie The Pooh on their consoles, or be contented with Colin McCrae's Rally or Driver 2 are seriously mistaken. Besides even many racing games contain elements of violence and promote a high-consumption lifestyle with minimal effort and maximal thrills.

Meanwhile the devious youth press spreads rumours that the government plans to ban such games and thus crush a multibillion-dollar industry. Such logic is perverse. Not surprisingly the same Labour government is quietly deregulating the gambling industry, something else that may appeal to vast swathes of the public. We'll see entertainment complexes with 24-hour casinos and virtual shooting ranges. We need not worry much about the free speech of violent game developers, they can hire the best PR firms and lobbyists in the world, nor will the current government stop anything that not only earns billions but also plays a key role in conditioning millions of future adults.

The current ethos is anything that seems fun and boosts business must be good, unless officialdom deems it politically incorrect. With the right marketing the games industry could effortlessly sell virtual rape games or simulations of Israeli incursions into Palestinian territory with graphic detail of wanton butchery. Indeed such games have already been developed. With the release of Flashpoint Kosovo and Operation Desert Storm, computer games are reinforcing media-fed misconceptions. If killing Serbs is okay, it only takes a small leap of imagination to slaughter minority groups in one's own backyard. A seven-year old Tomb Raider fan could soon be saving the Western world from the yellow peril by nuking Shanghai, petrol-bombing alleged paedophiles or sinking ships carrying desperate Afghan asylum seekers. Freedom is no longer seen as the universal right to nourishment, clean water, shelter, peace, education and gainful employment, it is freedom to protect one's living standard from the marauding masses, whoever they may be.

The intellectuals behind the current neoliberal governments of Western Europe and North America know these self-evident facts only too well. Neoliberalism has a liberal attitude to corporate power and people's freedom to indulge corporate-sponsored activities, but a restrictive attitude to ideas that may challenge corporate hegemony. As a result emotive epithets like fascist or Stalinist are liberally employed to describe opponents of NATO bombing over Kosovo, as such a pacifist stance would have allegedly given Demon Milosevic a green light to execute a systematic genocide. All well-meaning individuals had to back the good guys, in this case NATO, against the forces of evil personified in the late 1990s by the mass media's caricature of Serb nationalists. In the current propaganda offensive against the perpetrators of the horrific terror attacks killing thousands in Manhattan and Washington DC, the new bad guys are Islamic suicide pilots trained on Microsoft Flight Simulator, which featured the World Trade Center.

Opium of The Masses

After a lone gunman entered a Scottish nursery school in Dunblane and shot dead 16 toddlers in April 1997, the UK government proceeded to ban handguns in marked contrast with gun laws in most American states. Handguns are designed to kill, no doubt about that, but may also serve as the ultimate defence against armed intruders, whether burglars, gangsters or police officers raiding the wrong house. However, firearms have not disappeared from British TV screens, computer simulations of gun battles are forever more realistic and criminals have encountered few obstacles in importing weapons. Despite a media frenzy the frequency of armed robberies and street shootings actually continued to rise in the first two years after the handgun ban, as have police the deployment of firearms and the shooting of unarmed citizens.

While making ordinary citizens less able to defend themselves in an increasingly atomised world, the root causes of violence have actually worsened: More violence on more TV channels at any time, more shoot-'em-up video games and a greater social and educational divide.

The last factor is usually overlooked, but Play Stations, X-Boxes Nintendo Gamecubes and Gameboys are clearly aimed at the mass market. Leading kids titles such as Buzz Lightyear, Dexter's Laboratory or Power Puff Girls are often based on cartoons with proven antisocial effects, i.e. they actively encourage teasing, bullying and attacking baddies or weirdoes, whoever they may be. As a result the main role of the police is now to contain the masses adversely effected by the wares distrubuted by the corporate machine, whose interests the police are also required to defend. As big business promotes the scourges of booze, drugs, late night discos and video violence, the forces of law and order sweep up the mess.

Sowing the Seeds Of Hatred

While we should not dismiss the disruptive effects violent video-games have on many vulnerable minds, they play a greater role in re-enforcing existing prejudices and triggering ingrained aggressive responses. They effects may in some respects be likened to addictive and hallucinogenic drugs. The big question is whether violent video-games merely reflect society's warped values or amplify the agressive side of human nature i.e. are they incidental or causal? Their effects are greatest on teenagers and young adults raised on violent media from an early age. It is the combination of passive TV violence, rampant consumerism, neighbourhood and school violence and interactive electronic violence in the absence of dependable role models that is most lethal. By contrast the effects are probably limited on adults deprived of violent electronic media in their formative years.

The gaming lobby maintains that sex and violence have always aroused intense interest. Only the medium has changed. Literary portrayals of gratuitous violence can be both gruesome and educational. Even documentaries and movies may highlight the horrors of war, persecution, slavery or gangland fighting, but may also glorify the aggression of one side or demonise the other side to justify a given political agenda. The same can equally apply to the print media, but the reader's experience is never the same as a passive viewer's or an interactive gamer's. In truth only in recent decades have most people had so much leisure time to devote to such trivial pursuits and 3 to 4 generations ago few had time to read or the means to listen to the radio. For most of human history we learned about violence the hard way in real-life situations. Knowing how and when to fight was a matter of life or death. Today street violence is greatest in unequal societies, where the poor enviously watch the opulence of the consumerist classes. What will happen when the Quake II and Doom generation join the jobless masses in a future recession? Will they seek to rebuild their local communities, stay at home addicted to their aging game consoles or reenact their fantasies on the streets?

Is Censorship the Answer?

Censorship has always benefited the ruling classes. Time and again the surest way to guarantee the cult status of many books, films or video games has been to ban them, assuming a little prior publicity. Corporate lobbies like to talk of regulation, in the full knowledge that big business can always buy its way through hundreds of loopholes. Having popularised violent video-games through multimillion dollar advertising campaigns with Tomb Raider featured on the back of cereal packets, the gaming industry, almost inextricably linked to the movie and TV business, would seek new devious means to distribute its wares if tighter controls were introduced, while the state would be delighted to apply new restrictions to clamp down on dissent e.g. video footage of real violence perpetrated by a superpower or friendly militias could be banned.

Not only is censorship both impractical and counterproductive, it is also only conceivable because our consumerist society plays on people's basest instincts, but as usual we need to attack the root causes. In the short term we may need to campaign to stop schools or libraries distributing such poisonous games, but the emphasis should be on raising awareness of the harmful effects that exposure to violent propaganda has on young kids. However, in the long run we should strive to replace the greed and mindless self-indulgence of today's consumerist society with peaceful, playful and constructive activities in a socially coherent and sharing community. Sport offers a much better outlet for our pent-up frustrations. Parents of shy kids may be better advised to enrol them in karate lessons, teaching practical self-defence and co-ordination skills, than let them undergo premature military brainwashing.