Letters to the Editor
Re: Autism—Its Detection, Causes, and Treatment
Dear Editor:
I welcome the reviews of autism in the September 2003 issue of the CJP. I was a little saddened that there was no reference to the research I have conducted, but not surprised. After all, I concluded that the “pathology” of autism is not an illness or deficit but, rather, a condition of being extra sensitive. It is less a case of autism sufferers being abnormal in a normal environment than it is of their being supernormal in an abnormal environment. Tinbergen, Wing, and Rimland (personal communication) thought the findings and treatment I described were quite useful. Further, I have had the unique opportunity to help establish autistic societies in 5 cities in 4 countries and also to set up 4 treatment programs for autism. As did the authors contributing to the September 2003 In Review section, I found very few, if any, abnormalities after conducting behavioural, physiological, and psychological research. I chuckle a little at the air of confidence expressed by those authors who indicate they are quite sure autism is a genetic disorder that alters neurology and expresses itself in terms of affective and communication abnormalities: no one has found much to support these conclusions. Although there are a “few consistently identified biological abnormalities in autism” and “no single environmental risk factor has been shown” (1), the authors are sure they are on the right track and sure they will find something in the near future.
Why, when there is increasing evidence that the plastic brain of an infant is moulded by experience, particularly emotionally charged experience, is this not considered? More particularly, why isn’t the possibility consisdered that autism is not an abnormality but a variation of the brain that puts the child at risk in the average, but not necessarily normal, environment. I believe most, if not all, symptoms shown by an autistic child can be explained by the child’s auditory hyperacuity. Our research was able to establish that, given an opportunity, autistic children are very keen to control the level of sound in their environment (2–5). This accords with their parents’ accounts of their children being extremely responsive to distant sirens when no one else in the family (apart from, possibly, household animals) could hear the sound. We found the auditory evoked potentials to be quite unusual in autistic children—larger and faster, but not necessarily abnormal. Additionally, the typical autistic child is very good looking. That is partly what creates such deep dilemmas for the parents. Can anybody think of a single genetic disorder that leaves the child looking more, rather than less, beautiful? I can’t.
Reference
1. Nicolson R, Szatmari P. Genetic and neurodevelopmental influences in autistic disorder. Can J Psychiatry 2003;48:526–37.
2. Ney PG, Palvesky AE, Markely J. Relative effectiveness of operant conditioning and play therapy in childhood schizophrenia. J Autism Child Schizophr 1971;1:337–49.
3. Ney PG. Effect of contingent and noncontingent reinforcement on the behaviour of an autistic child. J Autism Child Schizophr 1973;3:115–27.
4. Ney PG. Infantile autism. Can Psychiatr Assoc J 1974;19:133–5.
5. Ney PG. A psychopathogenesis of autism. Child Psychiatry Hum Dev 1979;9:195–205.
Philip G Ney, MD
Victoria, British Columbia
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