This week, during autism awareness month, the PBS News Hour is airing a special 6-part report on childhood autism by Robert MacNeil. MacNeil has a personal interest in autism because it afflicts his six-year-old grandson. Autism has become an exploding epidemic in our society, affecting one in 110 American children. Research for the past three decades has focused on genetic and biochemical causes, but so far scientists are not any closer to isolating a cause for autism. The researchers interviewed on the show believe that there is not one single cause, but rather a number of different causes.

Although a few researchers are now turning their attention to external factors in the child's "environment" that might be causes for autism, one particular aspect of the environment still remains taboo for research. It is the elephant in the living room that everyone carefully tip-toes around, afraid even to hint at its existence. This last taboo is the social environment of the child. Since autism is, as scientists on the show tell us, primarily a disease of communication, should researchers not be looking at how interpersonal relationships in a child's social environment-that is to say, in the child's family-have some bearing on the child's ability or willingness to communicate?

Looking for causes of autism in the nurturing environment has remained taboo for half a century for one very good reason: researchers do not want to blame parents. Parents of autistic children suffer enough without having the finger pointed at them for being "schizophrenogenic," "refrigerator mothers" or living in a delusional "folie à deux".

The word autism comes from autos, the Greek word for self . Eugen Bleuler coined the word to describe a withdrawal into the self--a kind of extreme narcissistic preoccupation. This kind of person experiences intrusion from other people as intolerably painful. Five decades ago, before the ascendance of biological psychiatry and pharmaceutical therapy, some academic psychiatrists believed that autism, or childhood schizophrenia as it was called then, was a reaction to a stressful situation in the child's home. Dr. Theordore Lidz argued that researchers who looked exclusively for biological causes of autism were barking up the wrong tree. Other psychiatrists of this persuasion believed that emotional trauma, not limited to physical or sexual abuse, could cause a child to become autistic. In their view, the autistic child withdraws from a parenting environment that has become too painful to tolerate.

In their attempt to identify the family causes of autism, psychiatrists such as Lidz and Harry Stack Sulliven were too quick to objectify parents as objects for scientific observation instead of looking at them as people with whom the psychiatrist must form a working alliance in order to help an afflicted child. Of course parents fled from such explanations and embraced theories of biological causality that left them entirely out of the picture in the etiology of their child's problems.

In rejecting all research into the child's social environment as a possible cause of autism-perhaps in conjunction with genetic, epigenetic or biochemical factors--aren't researchers throwing out the baby with the bath water? I believe that there is a synthesis to be found between the two extremes of strictly biological causality on the one hand and an emotionally damaging nurturing environment on the other. In the interests of helping the exploding numbers of children who are suffering the pain of autism, I believe that researchers need to stop searching exclusively for causes that are palatable to parents (and pharmaceutical companies), and turn their eyes to nurture as well as nature.

Copyright 2011 Marilyn Wedge

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