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On an April Sunday night this year, Lesley Stahl, my favorite 60 Minutes reporter, introduced America to Julia, the newest character on Sesame Street. Julia, we were informed, has autism.
Ms. Stahl interviewed a number of producers and cast members from Sesame Street. She also spoke to parents with autistic children, and others who love them too. It was an emotional segment, in a good way. Sesame Street intends to de-stigmatize children with autism, and 60 Minutes was there to document this historic step. Everyone was proud. As a side note, I started watching 60 minutes and Sesame Street in the 1960's. Like most Americans, I learned to love, and trust, both shows.
Coincidentally, during the same decade, I first became interested in autism. Lloyd Nolan, a character actor from the 40’s, 50’s, and 60’s, was a guest one night on the Johnny Carson show. He spoke of his “strange” 4 year-old son who had something called autism. I was captivated as he described in some detail the very odd behaviors of his son, Jay. I’ve been captivated ever since.
Fifty years later, autism, Sesame Street, and 60 minutes converged in 2017, with one reviewer of the show saying: “Sesame Street’s new Muppet Julia brought 60 Minutes viewers to tears.”
Brought me to tears too. For different reasons.
It’s Not So Easy Being Mean
Dear parents and other caretakers who love and protect and cherish these very unique children, I love them too.
For me, it’s a matter of temperament. There is no flawed biology to this, or genetics. These kids aren’t defective or damaged. They aren’t disabled or disturbed or diseased either. That means they don’t they don’t need doctors, or their medicine. They do need our protection, because they are unique, and because they are so terribly misunderstood, and because someone is always trying to fix them.
From a temperament point of view, these children are born with unique talents. Some of their famous counterparts include Mozart, Steven Spielberg, Cher, Mel Brooks, Neil Simon, Michael Jackson, Bob Dylan, Jackie Onassis, and Harpo Marx. There is much more about this, for a different time. (See Blossoming Composers in Endnotes 1)
For now, parents, caretakers, teachers and others who love these children as I do, please consider the following:
In 1983, the autism rate was 4.3 in 10,000.
I know this is accurate. I was 38, in the profession for nearly 10 years, and I was in the final year of my Master’s program (I received my Ph.D. about 4 years later). As my field assignment, I selected an internship at one of California’s Regional Centers. For the next year, I was the family therapist for 6 families, each with an autistic son. (See Girls & Boys in Endnotes 2)
I researched everything known at the time about autism, beginning with Leo Kanner and Hans Asperger. I read everything they wrote, and everything written about what they wrote, and that included the entire library booklist available in 1983 about autism. My Master’s thesis was titled: Autism and Other Self Defiling Phenomena. I still have it. I was as informed about this very small population as anyone was at the time. (See Partial Bibliography in Endnotes 3)
To remind you, in 1983 the incident rate was 4.3 in 10,000. Keeping it simple, this means if there were 10,000 children randomly gathered in a large auditorium, we could expect to find 4 or 5 children who fit the description of autism at the time.
In 2017, the autism rate is 1 in 68
Doing the math, this means the same auditorium with 10,000 randomly gathered children would now have about 150 children who fit the evolving, all inclusive description of autism. That’s an increase of 3500% - in 34 years.
How did that happen?
Is autism contagious? If so, how so? If not, how does it “spread?” Is there a virus or bacterium on the loose? Did something drastic happen to our water system in the last 4 decades? In the last 34 years, did the mercury just suddenly appear in the fish these children or their parents ate, that wasn’t there before? Did someone change the formulae for vaccines? Was there some other environmental catastrophe that triggered this incredible spike in the number of diseased children in that auditorium? By the way, these are some – not all – of the speculated causes of autism. (See List of Causes/Correlations/”links”/”evidence of”/”associations”/etc. of Autism in Endnotes 4)
I’ve asked medical professionals who should know how this epidemic occurred, many, many, many times. They usually duck the question, or provide some form of psycho-babble. I’m skilled at recognizing, and confronting, psycho-babble.
So, can anyone from medicine explain this epidemic, please? Short answer? No. No one can. Long answer? No. No one can.
So what really happened?
I’ve been awestruck, and demoralized, as the rate of autism skyrocketed in the last 40 years. It’s been dramatic. Take a look:
Why the epidemic? Because there has been an epidemic of diagnosers, all of them armed with an ever-widening, all-inclusive diagnosis - nothing else.
The Psychiatric Process: Change the Definition
In 1980, autism was added to the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), psychiatry’s book of disorders-diseases-disturbances-deficiencies-disabilities. This made it official. Autism was under the purview of psychiatry. It was called infantile autism disorder back then. There were six characteristics listed. Each of the six (100%) had to be present to be diagnosed. At the time, doctors mostly ignored what was then a very, very rare phenomenon. (See what Leo Kanner said about the rarity of autism in Endnotes 5)
By 1985, the rate was 1 in 2500.
In 1988, and again in 1994, the definition of autism changed significantly. This is when I first became concerned. I knew what was coming. After a forty year career – the last 25 as director of several mental health facilities for children – I’ve seen psychiatry do this as a matter of course.
The 1988 DSM III-R declared there were now 16 characteristics of autism. Only 8 (50%) were necessary for a diagnosis. By 1994, in DSM IV, only 6 of the revised 16 characteristics (38%) were required. As a result, in just a decade, the universe of diagnosable children grew 500%. The game was officially rigged.
The autism "epidemic" began.
By 1995, the rate was 1 in 500.
Enter Autism Spectrum Disorder (ASD): The Final Solution
In 2013, DSM 5 was released. The diagnostic criteria for the newest expanded definition included these instructions to all professionals: "Individuals with a well-established DSM-IV diagnosis of autistic disorder, Asperger’s disorder, or pervasive developmental disorder (PDD) should be given the diagnosis of autism spectrum disorder."
There you have it. Psychiatry "lumped" together all the symptoms of Asperger’s and PDD with autism, and the population's diagnostic horizon widened - again. Now, any child who is a little too quiet, a little too distracted, a little too defiant, a little too introverted, a little too independent, a little too self-absorbed, can be on the “spectrum.”
By 2016, the rate is 1 in 68.
The Rest Is Easy for Psychiatry
Psychiatric scientists will continue to argue for years, in the right journals, with academic vigor, about scientific studies that expose the real cause of autism. Is it genetic? There’s some “convincing evidence.” Is it the vaccine? Studies show a “link.” What about a “chemical imbalance” in the brain? “There’s a correlation” says the psychiatric scientist.
By the way, psychiatry will neither offer, nor promise a cure. There is a good reason for this. Psychiatry has a perfect record in this regard. Zero cures. (See what Hans Asperger had to say about the cure for autism in Endnotes 6)
Will psychiatry ever find a cause? No, they won’t, for two reasons: (1) they never have, for any of the more than 400 “disorders” in DSM V and, (2) autism, like all the others, isn’t a disease, so a medical cause will never be found.
In the meantime, psychiatry eagerly “treats the symptoms” with a variety of chemicals. Here’s what they’ve tried so far with these children, with miserable results:
And, as always, psychiatry will caution us routinely, in eye-popping, fear invoking headlines that the epidemic is worsening, again. This is what psychiatry has to offer humanity, and it's 2017.
One More Thing to Consider
In 1957, Hollywood released The Three Faces of Eve. Based on a true story, the movie is about a young woman with three personalities. Joanne Woodward won an Academy Award for her portrayal of Eve. For a few years afterwards, there was a short-lived “outbreak” of what was then called Multiple Personality Disorder (MPD) as reported by psychiatrists in America. A small industry was born. As the movie faded from memory, so did the “outbreak.” With it, the industry.
If this movie was made in 2017 instead of 1957, we would all know about MPD. There would be MPD websites, MPD theories, MPD medications, and a slew of MPD books. MPD professional and lay experts would abound, and they would all be sharing their experiences, some of the more eminent appearing on Dr. Phil, Dr. Oz and, likely, 60 Minutes. Sanjay Gupta would be educating us about this plague, including the latest science from the NIH and CDC. MPD would be on Facebook, a part of our social network, and we would be educating each other.
Professionals from psychology, psychiatry, education, social work, and many, many others would be required to attend CEU workshops where they would receive news about the latest “science” and “state-of-the-art” treatment approaches. Most importantly, they would hone their ability to make an accurate diagnosis - and they would do so in "epidemic" numbers.
There would be endless studies among medical professionals searching for the cause of MPD. They would be looking at genes, brain imbalances, environmental stressors - maybe even vaccines. There would be millions of sufferers - that might even include you - or your neighbor. To the rescue, psychiatry would be there to lead the way, ready to create and supply the chemicals to “treat the symptoms,” while their scientists frustratingly continue for years and years and years – and years – to pursue the ongoing, ever-elusive, not-quite-yet discovery of the cause of MPD.
This is, as far as I'm concerned, the genesis of modern day psychiatric "epidemics."
Like I Said – It’s not so easy being mean
The people at 60 minutes, and the actors and crew at Sesame Street, and the parents and professionals who know these children have unquestioned love and honest and pure intentions. They are assertively protective of these children, and they make sure they are informed.
From my perspective, it has been a gut wrenching experience watching this tragedy unfold. I’ve known for forty years – as do many, many others, including many parents – these children need good teachers, not doctors. There isn’t a medical defect or – forgive us all – a “handicap” to fix.
I’ll Be Watching Too
How will they portray Julia on Sesame Street?
Will she be unresponsive? Will she avoid eye contact? Will she be off to herself, isolated? Will she be portrayed as socially inept? Will she be fixated on an unusual object? Will she engage in various rituals? Will she become expressionless? Will she use peculiar phrases? Will she lack an interest in making friends? These are just some of the “symptoms” of children on the “spectrum.”
Will adults – professionals and advocates – be defending her behavior by explaining to everyone, in as much medical detail as necessary, that Julia has a brain disorder and that she needs our understanding about her “medical limitations?” Not without hearing from me, for what it’s worth.
To Ms. Stahl, to Oscar, to Big Bird, and all the others at Sesame Street, and to the parents and caretakers of these very special kids – we are on the same side. I love these kids too. I want to protect them too.
Lastly, dear Julia, we all care about you, and that’s a good thing. I can already tell you're gonna be great! A few of words of encouragement.
Have some fun – and just be yourself!
1 Blossoming Composers: “Autism” - from a temperament point of view:
“Composers are in tune with their senses, and so have a sure grasp of what belongs, and what doesn't belong, in all kinds of works of art.”
“Composers have an exceptional ability - seemingly inborn - to work with subtle differences in color, tone, texture, aroma, and flavor”
. . . on their social side they show a kindness unmatched by all the other types. Composers are especially sensitive to the pain and suffering of others, and they sympathize freely with the sufferer.”
“Some have a remarkable way with young children, almost as if there were a natural bond of sympathy and trust between them. A similar bond may be seen between some Composers and animals, even wild animals. Many Composers have an instinctive longing for the wilds, and nature seems to welcome them.”
“Composers are just as plentiful as the other Artisans, say nine or ten per cent of the population, but in general they are very difficult to observe and thus greatly misunderstood. Very likely the difficulty comes from their tendency not to express themselves verbally, but through their works of art. Composers are usually not interested in developing ability in public speaking, or even in the art of conversation; they prefer to feel the pulse of life by touch, in the muscles, in the eyes, in the ears, on the tongue. Make no mistake, Composers are just as interested as other types in sharing their view of the world, and if they find a medium of non-verbal communication – some art form – then they will express their character quite eloquently. If not, they simply remain unknown, their quietness leaving their character all but invisible.”
D. Keirsey – (excerpts from Please Understand Me II)
2 Girls & Boys: In 1983, the demographics indicated autism was more prevalent among males, and that made me curious. Estimates at the time ranged from 2.5 – 4.3 to 1 ratio of boys to girls. Remarkably, and still a curiosity to me, the CDC currently reports that autism is 4.5 times more common among boys (1 in 42) than among girls (1 in 189). https://www.cdc.gov/ncbddd/autism/data.html
3 Partial Bibliography - In addition to Kanner and Asperger, some of the more influential writings at the time included:
• Your Child is Asleep – Des Laursers/Carlson • The Autistic Child – Lovaas
• Early Childhood Autism – Tinbergen/Tinbergen • “Dibs“- In Search of Self – Axlene
• A Child Called Noah – Greenfield • Infantile Autism – Churchill/Alpern/DeMayer
• Parents and Children in Autism – DeMayer • Readings In Autism – Ritvo
4 List of causes/correlations/”links”/”evidence of”/”associations”/etc. of Autism (Source: https://en.wikipedia.org/wiki/Causes_of_autism)
• Genetics/Epigenetics: heritability
• Prenatal environment: advanced age in either parent – diabetes – bleeding – use of psychiatric drugs in mother during pregnancy
• Infectious processes: cytomegalovirus – congenital rubella syndrome
• Environmental agents – teratogens – valproic acid – paracetamol – thalidomide – misoprostol – ethanol
• Other maternal conditions: thyroxine deficiency in the mother – iodine in the diet – flavonoids in food – tobacco smoke – herbicides – diabetes in the mother – maternal obesity
• Other in utero: folic acid – prenatal stress – higher levels of testosterone in the amniotic fluid of mothers – high levels of fetal testosterone – diagnostic ultrasounds administered during pregnancy – SSRI’s during pregnancy
• Amygdala neurons: “cortical areas that mediate social perception in the visual domain”
• Autoimmune disease: autoantibodies – viral infection
• Endogenous opiate precursor: digestive disorders develops opioid peptides
• Gastrointestinal connection
• Lack of vitamin D
• Oxidative stress
• Locus coeruleus–noradrenergic system impairment
• Mercury: mercury poisoning – Thiomersal
• Refrigerator mother
• Vaccines: "vaccine overload" – MMR vaccine
• Viral infection: borna disease virus – herpes virus family – multiple sclerosis
• Perinatal environment: low birth weight and gestation duration – hypoxia during childbirth – perinatal exposure to air pollution
• Postnatal environment: gastrointestinal or immune system abnormalities – allergies – exposure of children to drugs, vaccines, •, certain foods, or heavy metals.
• Social construct: boundary between normal and abnormal is subjective and arbitrary – no objective entity – social factors determine what it means to be autistic
Other “scientific” speculations include:
• Wireless radiation • Acetaminophen exposure after birth • GMO’s • Telephone wires
• Jet chemtrails • Circumcision
There's more to come, as the list continues to grow. Results so far? Other than “promising,” and “in need of further study” – nothing.
5 Leo Kanner believed, and argued over his lifetime, that autism was rare. He too must have noticed an initial “outbreak” among his colleagues. The John Hopkins psychiatrist “undiagnosed” – and sent home – 9 out of 10 children sent to his practice by other doctors.
6 Hans Asperger believed the cure for the most disabling aspects of autism is to be found in “understanding teachers, accommodating employers, supportive communities, and parents who have faith in their children's potential.” (See more here.)
FINAL NOTE: Many people have read or are familiar with Kanner’s first 11 cases of autism. Less well known is the 30 year follow up for those cases. Note the outcomes for the children left in hospitals. You can read it here.
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About the Author
R L Cima, Ph.D
For 35 years, Dr. Cima was the CEO of several MH agencies for children in California. He is a vocal opponent of psychotropics for kids. In
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