Autism is a neurodevelopmental disorder that affects many aspects of an individual’s cognitive ability. These include impaired social interactions, repetitive movements, lack of empathy, and even self-abusive behavior. Many with autism also have accompanying conditions like seizures, epilepsy, attention deficit disorder, and learning disabilities, among others. Because autism manifests as a very broad and diverse range of symptoms, many often refer to individuals with autism as being on an autism spectrum.
The symptoms of autism typically appear in childhood, from as early as infancy, but generally by the age of 2. However, diagnoses are usually not made until after age 3. A diagnosis is based on demonstrations of a combination of characteristics, including delayed speech, unresponsiveness to verbal cues, little to no eye contact, weak social skills, and minimal expressiveness.
Autism: The Early Years
Autism was first identified in 1911 by German scientist Eugene Bleuler, who initially used the term to describe a subset of severe schizophrenic symptoms. Specifically, Bleuler used the term to represent a type of thinking that was “infantile” and involved hallucinations. For the next four decades, Bleuler’s term would continue to be used in the context of schizophrenia, rather than as a specific disorder of its own. It wasn’t until 1943 that a more accurate description of what we know about autism today emerged. Leo Kanner, a child psychiatrist, studied nearly a dozen children who he noticed all demonstrated high intelligence, but who had trouble interacting with others. Later on, Kanner would describe the characteristics of these children as “early infantile autism.”
The next year, Asperger’s Syndrome, a less severe form of autism, was identified by Hans Asperger. The children Asperger studied also were very intelligent but had social difficulties and demonstrated obsessive behaviors, much like the children Kanner studied.
Throughout the 1950s, this vague understanding of children with autistic symptoms continued and didn’t gain much public attention. However, in the late 1960s the term “refrigerator mothers” became popular after psychologist Bruno Bettelheim used it to hypothesize that children with the symptoms Bleuler, Kanner, and Asperger described were the result of mothers neglecting or not loving their children enough. This, of course, was still far from what we know about autism today.
Autism in the 1970s and 1980s
Autism became much more widely understood in the 1970s and 1980s, when people didn’t just become more aware of autism, but had a better grasp of its defining characteristics. The “refrigerator mom,” whose inability to properly nurture her child was said to be the cause autism, was debunked as an ungrounded theory during this period as more substantial research demonstrated how the disorder was actually a neurological condition.
Research during this time included investigations into the genetic liability of autism; one of the most influential studies carried out in this decade used twins to conclude that genetics did influence a child’s risk for developing autism. The 1970s was ultimately a decade in which autism was understood to be a biological disorder of brain development.
However, the controversial autistic interventions implemented throughout the 1970s reflect how understandings of autism were still far from adequate.
Popular interventions during this time included:
- Behavioral punishment
- Electro-shock therapy
- Removal from the home environment
By the 1980s, autism was officially added to the Diagnostic and Statistical Manual, reflecting its official recognition as a disorder. The Erica Foundation was also formed in the 1980s, which provided education and therapy for children with autism. Through this effort, it was realized that autism was not a form of psychosis, but the product of a number of different factors. It was also agreed that autism was not a manifestation of schizophrenia, as it was previously believed to be. Additionally, at this time the term “autism spectrum” emerged as doctors began to understand that the symptoms of autism could be highly individualized; not every child with autism demonstrated the same symptoms at the same level of severity; thus, individuals began to be described as falling on a wide spectrum that included a range of symptoms.
The 1980s also witnessed the emergence of the Wing’s Triad, a diagnoses created by Lorna Wing and Christopher Gillberg that identified some common threads within autistic symptoms, including difficulty communicating with others and the performance of repetitive behaviors.
Interestingly, data collected from children with autism also changed significantly in the 1980s. Whereas data collected about autistic children prior to the 1980s demonstrated that children typically showed symptoms between birth and their first year of life, from the 1980s onward, more parents reported their autistic children showed signs of abnormal behavior after age 1 and a half. The number of children that developed autism after 1 and a half years of age soon outnumbered the number of children that showed autistic behaviors in infancy two-fold.
Autism in the 1990s
The 1990s ushered in a wave of interest in the Autism Spectrum Disorder, although as we know, there was still much to learn about the disorder by decade’s end. As understandings of the disorder continued to develop, it became clear that individuals needn’t just display severe ASD symptoms to have the disorder. Rather than confining the diagnosis to a lack of intellectual ability or difficulty with social interaction, physicians built upon the theory that autism operated on a spectrum of symptoms and altered the parameters of ASD diagnosis to be more inclusive of a variety of manifestations. This was in part the reason that more individuals were diagnosed with ASD in the 1990s, but the dramatic rise in cases seemed more than what a change in diagnosis could explain. In 1990, 6.2 out of every 10,000 births were children with ASD. In 2001, this rate of prevalence increased to 42.5 for every 10,000 births. During this decade, it was also found that diagnoses were occurring at younger ages; ASD diagnoses for 2 and 3 year olds increased by 12%.
Given the disorder’s growing prevalence, autism was brought to the forefront of public awareness, and many important organizations dedicated to learning more about the disorder, like the National Alliance for Autism Research, The Center for Autism and Related Diseases, and Cure Autism Now were founded.
At the same time, more questions were raised as to the etiology of autism. What was causing such a sharp increase in the prevalence of this disorder? Could it be explained by the population’s shift in genetics, or were there unknown environmental factors at play?
Research into genetic etiology did yield some informative results; for example, it was found that certain genes were affected by autism, and that there was <a href=”http://readingroom.mindspec.org/?page_id=5662″title=”ASD genetic research”>between a 12-20% chance that a child with ASD would have a sibling with the disorder</a>, too.
However, other researchers, like Mark Geier, began looking into exposures to toxic elements and their potential causal role in autism. As Geier’s research revealed, Thimerosal, a mercury-containing compound that was used as a preservative in many common childhood vaccines, was a likely culprit of many of the symptoms of ASD. The association between vaccines and autism was also echoed by researchers like Andrew Wakefield, who argued that MMR vaccine administration could be linked to the onset of autism.
In 2001, the CDC removed Thimerosal from many childhood vaccines, though it did allow for the continued inclusion of Thimerosal in approximately half of all flu vaccines, which are still regularly administered to children and pregnant mothers. However, the CDC asserted that there was no link between autism and vaccine administration.
As yet another decade passed and the rates of autism increased, public ASD awareness grew and researchers began to ask more critical questions about its origins, but for the most part, it seemed that there were even more questions about autism than ever before.
Autism in the 2000s and Today
By the year 2000, concerns about autism had reached somewhat of a fever pitch, and in turn, research during this decade skyrocketed. While autism research in the 1990s yielded 2,322 articles published in scientific journals around the world, from 2000-2010, this number soared to 8,575. This surge in research was also a consequence of the Children’s Health Act, legislation which provided funding for the long-term study of autism, as well as established a committee to oversee and facilitate research. Funding for research was also made possible with the creation of large foundations like Autism Speaks and the Organization for Autism Research, which were able to further raise autism awareness and secure significant contributions from donors.
Despite the fact that far more research was being conducted on autism, the overwhelming majority of this research was specifically focused on genetic causes. The introduction of new technologies had made examining genetic factors more accessible and interesting, and for that reason attention was focused towards things like copy number variants and other gene-specific elements. Researchers found that two genes, the NLGN3 and NLGN4, could be linked to autism in the case of a mutation, and also discovered that mutations on a chromosome of the SHANK3 gene could lead to the social and communication deficiencies characteristic of individuals with autism.
However, not all researchers believed that a narrow focus on genetics would reveal the comprehensive cause of autism. Autism rates in the 2000s continued to increase, surging higher than rates of the 1980s and 1990s. The hypothesis of a genetic predisposition, purported by many invested in the genetic approach to autism etiology, therefore wasn’t adding up, and led some researchers to direct their focus towards environmental causes. As mentioned, research by Mark Geier concerning the toxic vaccine preservative Thimerosal, helped to support its removal from a number of childhood vaccines; however, Thimerosal still remained present in many flu vaccines that are administered to infants, young children, and pregnant mothers. Geier and other scientists who argued for the removal of toxic elements like mercury and aluminum from childhood vaccines therefore continued prolific research throughout the decade, publishing dozens of compelling papers that highlighted strong relationships between vaccine administration and an individual’s risk for developing autism.
Today, autism research continues full steam ahead. While the focus of this research is still largely directed toward genetic causes, a growing movement of both parents and researchers stand behind the science that identifies clear environmental causes. Because autism rates have yet again significantly increased in the last decade—now 1 in every 68 children is diagnosed with ASD—and because vaccine administration schedules continue to increase and feature more doses of vaccines with toxic elements, the debate over the true cause of autism continues.