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So far, we have discussed:
1. The clinical features that comprise "autistic spectrum disorder" (ASD): Social, language, repetitious thoughts & behavior; sensory/motor issues
2. The known causes of ASD (genetic, teratogenic)
3. Brain regions known to be associated with ASD (sometimes)
4. The natural history of ASD (predictable change over time), and the necessity of looking at IQ as well as degree of atypicality: Atypicality, IQ and Time = ASD in 3D
5. The epidemiology of ASD (the differences between incidence, prevalence and service data; lack of proof of an epidemic; ample explanation for the rise in service data based on factors other than a change in incidence)
In the next several posts, we are going to move away from etiology and epidemiology for a bit, and talk about treatment. Many of you are following this blog because you have a child on the spectrum. For you, all this talk about where your child's ASD came from is a bit academic. Your child already has ASD; you need to know where to go from here.
So in these next posts, I will discuss the more popular forms of therapy for ASD. These will include behaviorally-based, and educational interventions, hands-on therapies such as Occupational Therapy, and medication. We will also have a few blog posts on the subject of quackery - how to recognize it, and how to protect your child and your wallet from people who make unfounded promises, and then cash in on the natural history of ASD to "cure" children of the disorder.
Alright, now that I've "told you what I'm going to tell you," let's jump in.
A Bit of History
150 years ago, cognitive science did not exist. We had "mentalists" such as Franz Mesmer (the inventor of hypnotism, from where we get the word "mesmerized"), who performed on stage, but nothing in the way of serious research, or a body of scientific knowledge. The turn of the 20th century gave us Freud (who started as a neuropathologist, before creating psychiatry), Cattell and Binet (who created modern IQ testing), and Spearman and Pearson (who created the statistical tools necessary to analyze the results of psychological tests). From the time of the Ancient Greeks, philosophers had argued about the nature of intelligence, thought, insight, and what it means to be human. But the early 20th century marks the first time that researchers got into the game. And this, as they say, is where the fun begins.
From the very outset, there was (and remains!) a deep schism between two schools of thought: On one side are the Behavioral Psychologists, who trace their intellectual patrimony back to two figures: E. L. Watson and J. B. Thorndike. In order to raise psychology up to the level of a "hard" science (like physics or chemistry), Watson and Thorndike limited themselves to the study of outwardly observable behavior (hence the term "behaviorism"), while utterly rejecting such notions as "insight," "intention," "emotion," etc. To Watson and Thorndike, terms such as these represented a mentalist's tricks, rather than science. (See http://www.psychology.sbc.edu/Thorndike%20and%20Watson.htm for a nice discussion). Watson and Thorndike trained BF Skinner, who in turn trained Ivar Lovaas, the father of ABA. On the other side of the chasm we find William James, a professor at Harvard, who in 1890 published The Principals of Psychology. James' position was that "consciousness" is the proper subject of study for psychologists, and that a reductionist view (breaking everything down into individual bits) could never provide a satisfactory understanding of the human brain. ("The whole is greater than the sum of its parts" - Aristotle). For an illuminating lecture by James, see http://psychclassics.asu.edu/James/energies.htm , wherein he alludes to "fluctuations that can not easily be translated into neural terms" - at least, not with the tools of neuroscience then available.
The dispute between these two schools of thought carries on today, in the differing approaches to the treatment of ASD. More on this next time.
August 29, 2010: Correction: Skinner studied the works his predecessors (Thorndike and Watson); Lovaas in turn studied the works of all 3. But none ever took a class from another. Sorry for the error. JC
