1993 / 2月
Chang Chung-fang /tr. by Peter Eberly
Autism was once categorized as child schizophrenia because no physical abnormalities could be detected. During the past 20 or 30 years, however, studies have found that autism should be characterized instead as an "extensive developmental disability."
As far as their course of development is concerned, some mental disorders can be cured, some are permanent disabilities, some recur intermittently and some gradually worsen. Autism rarely worsens. It usually improves gradually with age.
As for response to drug therapy, antipsychotic medication can be helpful in treating mental disorders, but it is used for autism sufferers only as an option to suppress severe behavior that might cause injury to themselves or others--improving or eliminating the behavior depends on behavioral therapy.
The direct pathogenic factors of the condition remain a riddle. Two related factors have been discovered. One is brain damage caused during delivery or fetal development. The other is the factor of heredity. The ratio of incidence between boys and girls is about five to one, and around 20 percent have a family history of language development retardation, inadequate intelligence or learning disabilities.
The vast majority of autism cases are congenital. Because sufferers are no different from normal children in appearance, the condition is difficult to discover during early infancy. The symptoms become more apparent at the age of 12 to 30 months.
1. Emotional disabilities: ignoring people, not looking at them, keeping a distance, not fearing strangers, masturbating, persisting in fixed behavior regardless of others, a lack of interest in others, a lack of emotional exchange with family members or a lack of emotional dependence.
2. Language disabilities: slow language development, marred by grammatical mistakes, odd inflection or indistinct pronunciation; inability to communicate despite possessing language abilities; talking to themselves or constantly repeating the same words; some possess no language ability at all.
3. Perceptual disabilities: hearing or seeing without perceiving, reacting differently to outside stimuli than normal people do; no reaction to pain, cold or heat.
4. Odd ways of playing: having an odd, unvarying way of playing with toys, such as turning a toy car over and constantly spinning the wheels or lining cars up in a row.
5. Abnormal behavior: hyper-or hypoactive, walking on tiptoe, turning in circles, banging head, constantly holding a certain object or eating only certain foods, refusing to change fixed behavior.
Generally speaking, autistic children are normal physically, although they do suffer from a higher than normal incidence of tubercular sclerosis and epilepsy. About one third to one fifth of autistic children suffer from epilepsy.
Given these complications and the fact that they lack a sense of danger and are rather prone to accidents, autistic people have a lower than normal life expectancy. Those two factors set aside, their life expectancy would be no different from that of normal people.
Due to their difficulties in communicating with people, their intelligence is hard to measure. Judged by the criteria of standard intelligence tests, 10 percent have normal IQs, 20 percent are slightly retarded and 70 percent are severely retarded.
Despite scoring low on intelligence tests and being poor at abstract thinking and reasoning, autistic people often have very good memories. But very few have the superhuman memories and calculating abilities of the character portrayed in Rain Man.
No. They will not attack people for no reason. Because they are poor at communicating, however, if they encounter uncomfortable stimuli, interruption of persistent behavior or other setbacks, they may try to harm themselves by bumping their head or biting their hands or try to hurt those around them.
The rate is about 4 to 15 cases per 10,000 births. It occurs three to five times more frequently in boys than in girls. Since its causes have not been determined and there is no way to check for it during prenatal examinations, there is no way to prevent it.
There are still no documented cases of autism being completely cured. Education and behavioral therapy can diminish the symptoms, and those who have been effectively treated can progress nearly to the level of a normal person, but deficiencies persist in certain areas and complete normality is impossible.
Autistic people have normal sexual drives, but being unable to establish interpersonal relationships very few of them marry. There are only a handful of instances in the whole world. There is still no answer as to whether or not they will pass the condition on. An autistic person in Britain who married is known to have produced a normal child.
Autistic children like to watch things rotate. Instead of riding it, they prefer to turn over a bicycle and watch one of the wheels spin. (photo by Vincent Chang)