CAN WE CURE AUTISM?

An article in the New York Times titled The Kids Who Beat Autism generated a lot of buzz. It is perfectly understandable, such an affliction to a human being which often causes untold havoc and anxiety in the family would naturally compel parents and professionals to seek a cure. The desire is so great that we even had a parent organization named Cure Autism Now (which merged with Autism Speaks), and the "Now" in the namesake speaks volume for the urgency.

The NY Times story describes how approximately 9 to 10% of autistic children grow out of it and become totally normal, especially after receiving treatment of Applied Behavior Analysis (ABA) and intensive training from the parents. It asks repeatedly why some other children never became normal, no matter how intensive the ABA and how involved the parents are.

To me, the most likely explanation is that the curable autistics are really not true autistics. They might have shown symptoms of autism like poor eye contact, language deficiency, social avoidance, or repetitive movement like flapping or rocking, but their brain's learning capacity is intact. On the other hand, a 'true' autistic person suffers from cognitive defects or developmental disabilities that make it difficult for them to ever totally be able to process complex linguistic information or social stimuli. The cognitive limitation makes repetitive movement an easier form of self-stimulation or expression. We all self-stimulate, like rocking in a chair, twirling our hair, biting our finger nails. But as we acquire more language and other experiences, we either grow out of it or incorporate it as one part of a much vaster array of self-stimulation like listening to music, playing video games, taking daily strolls, practicing the violin, jazz dancing in front of the mirror, etc., all of which require higher cognitive processes than just flapping the hands or rocking in a chair. If one defines autism as a pervasive deficiency of the brain, it would not be difficult to understand why autistic people never grow out of it unless the brain can become normal.

Of course, where these deficiencies are in the brain remain a conjecture, and hence the problem of diagnosing autism. The label is not a medical diagnosis as it is not based on existence of physical markers but is based on external behavioral features, and hence the unreliability of the diagnosis and

overinclusion of population. Without clearly defined markers in the brain, some children could be simply labeled autistic just because they show the behavioral features.

I too, 'cured' a four-year-old girl who was diagnosed as autistic by the famed UCLA Autism Clinic's two psych assistants (graduate students) along with the supervisor. The symptoms were lack of eye contact, poor language, asocial behaviors, unaware of social settings. She was put on their waiting list for the Autism class. Her mother, the main caretaker, spoke broken English and talked to her mainly in Korean while father speaks fluent English. My diagnosis: language delay due to cultural forces and perhaps some deficits in learning to be bilingual, which in turn led to shyness and withdrawal especially with strangers in a clinic or school. We started intensive ABA (2 hrs twice a week 1:1) and also home school for kindergarten, focusing on English communication, math, in-seat behavior, and tantrum reduction. Within six months, she was chatting away with me and socializing with peers in English. When the UCLA clinic called to inform availability in their autism class, parents wisely declined. After one year, she was enrolled in a regular popular private school for 1st grade, and by 2nd grade was among the top of her class.

Was this autistic child 'cured'? I don't think so. She was not truly autistic to start off with. She showed symptoms of autism but her brain was basically intact and the true causes of her earlier withdrawal, tantrums, or language delay lie elsewhere. Like ADHD, the Autism Spectrum paradigm will allow for a cure of some children, although I doubt if the cured children really belong there.