Wednesday, January 23, 2013

Can we really 'cure' autism?

Some claim that new research shows people can grow out of autism, but it is more likely that they simply cope better with the condition over time

The New York Times has pointed to an intriguing study ostensibly showing that some small percentage of people with autism can "outgrow" their symptoms. The story was oddly unsatisfying, claiming in one paragraph that the study, published in The Journal of Child Psychology and Psychiatry, will alter the way parents "think and talk about autism" but also cautioning against false hope.

The writer seems only dimly aware how this half-hearted message will set off a bomb in the world where Jenny McCarthy lives ? that she will turn on that wicked grin and brandish this study to launch another 40 years of vicious debate over whether autism is caused by environmental factors, namely vaccines, and thus can be cured by brave and dedicated parents like her, or whether it's just a condition people are born with.

Thankfully, science writer Emily Willingham has parsed through the study in Forbes to show us what it really finds, which is not much that's new and certainly nothing that will change our thinking about the progress of autism or make us believe in the McCarthy miracle cure. As Willingham points out, the people who seem to have "grown out" of their autism had higher cognitive functioning and milder symptoms in the first place, and "many of them had behavioral interventions in childhood".

One measure the researchers used to evaluate progress was "typically developing friends", which people with autism sometimes have anyway. Seven of the 34 had some impairment in "non verbal social interactions" which the researchers decided, somewhat arbitrarily, was due to other factors such as anxiety or depression.

Anyone who has read a single memoir by someone with Asperger's or known someone well with the condition can intuit what's going on. At the moment, I happen to be reading Look Me in the Eye: My life with Asperger's by John Elder Robison. Over the course of his life, Robison learns to compensate for his social limitations. As a child he teaches himself to say appropriate things to children and not just foist on them his own obsessive interests. As an adult he learns that blurting out the truth ? "you look fatter" ? is not always the right thing to do.

Working around autism

He doesn't "outgrow" his autism, he just learns to work around it. Even later in his life he writes that he wishes his disability were more obvious; when we see someone in a wheelchair we know they can't walk, so we help them across the street. There is no way to "see" Asperger's so people just assume he's a jerk.

Willingham makes the comparison to diabetes, which I have. I have learned how to control my blood sugar pretty well, but I still have diabetes. Autism for high-functioning kids works something like that, even more so these days.

When Robison was a kid, no one understood him at all. They just thought he was odd and would grow up to be a failure. But now there is a well-developed understanding of Asperger's and its symptoms, and many behavioural therapies that can help people, especially if they are smart enough to absorb them. So it stands to reason that as time goes on, more people with Asperger's or autism will look, to all the world, as if they are "cured" without actually being so.

This article originally appeared in Slate. Hanna Rosin is the author of The End of Men and a co-founder of Slate's Double X

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