May 03, 2004 October is Koufax Pledge Drive month

The Doctor Is In

I have long struggled with the fact that the medical establishment has been unable to develop any pharmacological or other medical treatment for autism.

Bobby was diagnosed as autistic about six years ago. At the time, everything I knew about autism I had learned from Rainman. Upon receiving the diagnosis, I immediately began to gather information about autism. I was lucky. I had access to a superb medical library at the Emory University Medical School. I had access to on-line databases of medical research. I had advice and support from family members trained in medicine and medical research.

I began with high hopes that the marvels of modern medicine would show us a way to cure our son. Those hopes were soon dashed as my research revealed that there were no approved medical treatments for autism. I learned that the state of the art therapy for autistic kids was Applied Behavioral Analysis. ABA involves intensive application of social science methods to alter the behavior of autistics.

We followed the ABA methodology with decidedly mixed results. At some point, the hope that our son would be “cured” faded into a reluctant acceptance that Bobby’s autism would forever remain the central organizing fact of his life and ours.

You can imagine my chagrin when I discovered that I had been mistaken to confine my research to the New England Journal Of Medicine, research funded by NIMH and other scholarly sources. The whole time I spent in the Emory University Medical School library should have been devoted to listening to right wing radio. Rush Limbaugh, Neal Boortz and Michael Savage know more about neurological disorders than all of the medical experts and researchers combined. Or at least they think they do.

Last week the New York Times ran a long article on Asperger’s syndrome. Asperger’s is a form of autism. As the Times reports:

autism is now believed to encompass a wide spectrum of impairment and intelligence, from the classically unreachable child to people with Asperger's and a similar condition called high-functioning autism, who have normal intelligence and often superior skills in a given area. But they all share a defining trait: They are what autism researchers call "mind blind." Lacking the ability to read cues like body language to intuit what other people are thinking, they have profound difficulty navigating basic social interactions.

For a description of what it is like to grow up and live as an Aspie, I highly recommend Natasha’s three part series on the subject.

After the Times article appeared, the subject of Asperger’s arose on the Rush Limbaugh radio program. The proprietor of BLOGGG, as the parent of an Asperger's child, has been all over this issue, see here, here, here, and here for the details.

Now although Dr. Limbaugh does not have much formal education (he is a college drop out), he is the head of the Limbaugh Institute for Advanced Conservative Studies. In that role, Limbaugh has heretofore confined his pharmacological research to issues involving the effects of certain opiates known as blue babies. Now, however, he has revealed a cure for the social interaction issues experienced by sufferers of Asperger’s syndrome:

I would assume that copious quantities of adult beverages might lessen the strain of Asperger's syndrome…

That’s right, according to Dr. Limbaugh, people with Asperger’s syndrome no longer must strive to deal with a neurological issue or with a set of social norms and cues that make little sense to them. They can simply get drunk.

Is being ignorant about neurological conditions and insensitive to the challenges presented by such conditions some sort of prerequisite to being a right wing radio host? First, Michael Savage, acting like a school yard bully, mocked autistic kids and their families.

Then Neal Boortz and other conservatives argued, incorrectly, that ADD and ADHD were just some phony conditions created to allow parents and teachers to drug our kids thereby covering their own inadequacies.

Now Limbaugh recommends that people with Asperger’s syndrome should just get drunk.

I suspect that if a way could be found for Savage, Boortz, Limbaugh and others to spend a little time in my shoes, in Natasha’s shoes or in the shoes of any parent with an ADHD child, the total amount of stupid, cruel and insensitive remarks about neurological conditions and the people who suffer from them could be reduced substantially. I will not be holding my breath.


Posted by Dwight Meredith at May 3, 2004 02:29 PM | TrackBack
Comments

Thanks for the link.

Just read your post about Michael Savage (and the accompanying links). The 1992-1998 increase did not surprise me - I have noticed there are Many, many children in this age group in this area as well, not just CA. Must have had a bad batch of vaccines back then....some incompetents working in the labs.....

I was not a blogger back then, I only wish I had been. :/

Posted by: Moi ;) at May 3, 2004 03:02 PM

HEY - His "Across the fruited plane" website you linked to above is GONE....

Posted by: Moi ;) at May 3, 2004 03:17 PM

I hate Rush Limbaugh, but the "mental block" of viewing neurologically based "behavioral impairments" applies to some extent across the political spectrum. Yesterday, while visiting with an elderly relative we were discussing her grandson, who has been diagnosed with ADD. His mother, a dyed-in-the wool liberal abhors the use of pharmacological intervention and pushed therapy 'til every therapist recommended Ritalin (which did help him). Now, the child has developed fairly disabling phobias -- also increasingly seen as neurologic in origin -- along with other probably similar behavioral problems. When I discussed this with the boy's grandmother, she said that her daughter just goes to pieces when she considers giving more drugs. Yet, if this child were diagnosed with diabetes, she would not think twice about giving insulin. I'm not a big fan of better living through chemistry, but this woman's fear and loathing of drugs for her son is clearly the flipside of Rush's views: Somehow, a disbelief in the idea that these and similar disorders are biological. In fact, there should be no greater shame in accepting medical intervention here than there is for, say, heart disease, and correspondingly, that there should be no greater aspersion cast in the direction of those who suffer from these disorders. Indeed, one can argue that there should be less, since many "modern" diseases are aggravated if not caused by behavioral patterns.

Posted by: Barbara at May 3, 2004 04:18 PM

His mother, a dyed-in-the wool liberal abhors the use of pharmacological intervention and pushed therapy 'til every therapist recommended Ritalin (which did help him). Now, the child has developed fairly disabling phobias -- also increasingly seen as neurologic in origin -- along with other probably similar behavioral problems.

If the child developed disabling phobias after taking Ritalin, I'd say the mother was correct in resisting it in the first place. Allopathic medication or doing nothing aren't the only choices. Amy Lansky successfully treated her son who had Asperger's syndrome with homeopathy. The treatment was so successful that she wrote a book about it, Impossible Cure.

Posted by: Bernie Simon at May 3, 2004 09:02 PM

Lamb, I am utterly convinced that if Rush Limbaugh lived your lives for a single day, he would spend the rest of his life in a monastery sanding the points of the hairshirts with his armpits.

On the other hand, I've never heard him say anything which didn't suggest to me that his criterion for enlightenment is the ability to visualize Rush Limbaugh's intestinal polyps.

No kidding. I wonder if there's an NA program on earth that the man wouldn't have been factchecked out of by now.

Posted by: julia at May 4, 2004 01:16 AM

I was going to post a link to that article over the weekend, got it in email from a fellow non-neurotypical, but a power outage ate my post. You wrote a better one anyhow, so I don't feel the least bad now about not bothering to recreate the thing.

Anyway, I was also going to point out that the more I study biology and evolution, the more autism seems like a sort of neurological paedomorphosis, a retention of juvenile features in the adult that's caused by a change in the pace of development. And the thought was hammered home by the article's closing bit:

"..."It does seem like people with Asperger's, once they click, have a lot of advantages in life," Jared said. "It's like we stay tadpoles for longer, but once we're ready, we're no less of a frog.""

Paedomorphosis has often been a critical factor in generating evolutionary diversity among complex animals. It is likely responsible for the evolution of chordates (critters with a dorsal nerve cord, aka, our great-grandparents), wherein the first chordate is almost a dead-ringer for the larval stage of its predecessor. And possibly for the development of the primate line that became modern humans.

Our ancestors' large brains started developing around the same time that their jaws began getting smaller, and the morphology of their skulls began remaining closer to that of a juvenile primate ancestor. It's fascinating how similar the overall shape of a young chimp skull is to that of a human, before the jaw begins thrusting forward and the relative proportions of the face and brain case change.

Another factor in the development of humanity as we know it is our extended childhood. Such a development would be counterproductive in most sorts of animals, but in a species capable of forming a cooperative society with extended parental involvement, it can become a long-term boon. Maybe the first proto-humans were considered slow and impaired when they were young, when they were still child-like after younger siblings had already integrated into the pack's adult life.

I don't know if that makes it seem any different, but it's helped me begin to think of my life as just having an exceedingly long maturation period. And I honestly couldn't say whether that spiel is a rationalization to make myself feel more normal, or any kind of useful observation.

But I think I'll stop myself there. I just erased two paragraphs of an utterly geeky ramble, and I think it's time to call it quits for tonight. Got a test on animal evolution and the nervous system tomorrow, or today, if you want to be picky about which side of midnight it is.

Also, if you want to link to a NYTimes article, go here to generate a permalink that won't get lost behind a ppv firewall. This is the permalink to the autism article in your post.

Posted by: natasha at May 4, 2004 05:53 AM

If only we could still hope these blowhards had no influence on policy.

FYI, I've linked this entry on my blog (blogger doesn't do trackback).

Posted by: Michael at May 4, 2004 09:27 AM

Bernie, the phobias are still being evaluated and they do not appear to be related to taking Ritalin. This child does not have Asperger's Syndrome, and he is not autistic. He is an only child, which probably magnifies the sense of the problem, at least. They haven't decided to give any other drugs, they are obviously very cautious but they were amazed at how much he improved after taking Ritalin (or one of the others).

The problem with Ritalin, Prozac, and all other drugs is that they are extremely blunt instruments, because we understand so little about what is actually happening neurologically. BTW, I do agree that behavioral therapy is good -- that you can, to a certain degree, and with a reasonably cooperative child, "rewire" the brain to act more "normally" by actively reinforcing certain patterns of thinking and behavior. For instance, I have read about the positive impact of martial arts training (really, enforced concentration) for ADD sufferers. We all have fears, behavioral oddities, and anxieties -- the mystery is why, for some people, they rule every waking moment instead of being just fleeting and manageable. You may have to start with drugs simply to get to a point where such intervention is possible. I would never give a child a drug and then assume that everything has been cured.

Posted by: Barbara at May 4, 2004 09:46 AM

You know, every day I go to bed and think to myself "They cannot get any worse. The depths of depravity and outrage have been plumbed." And every day the Limbaugh's of the world prove me wrong.

Posted by: kevin at May 4, 2004 12:03 PM

rush limbaugh is an idiot. i have heard one "whopper" after another on his lame radio program and it would be great relief if he just crawled into a hole somewhere. the real frightening part is that there are a lot of people out there who believe the crap that he says. they actually think that he is some "rhodes scholar" who is very knowledgeable in all areas! the man is a racist, hypocritical, insensitive, self serving bum who dropped out of college. i just wish he would go back to hooterville and quit poisoning our airwaves.

Posted by: gail at June 22, 2004 07:33 AM