Some “treatments for autism” that have recently made the news:

Magnets, in a method called transcranial magnetic stimulation; a study is be published this month in the Journal of Autism and Developmental Disorders by neuroscientist Manuel Casanova.

Horseback therapy that is to “restart the development of the left side of the brain,” at Spirit Horse Therapy in Corinth, Texas.

At the risk of sounding like an über-cynic—and not to deny that results can be seen from the above—have to say I’m wondering what remains to be tried.

Autism’s terrible toll: Parents risk hitting “a breaking point” is the headline in today’s Denver Post for a story about 13year-old Jacob Grabe, who was shot by his father, Alex Grabe, early in September. The article notes, and lists “similar chilling stories of sudden parental breakdowns have played out in the U.S. in the past several years,” and mentions Katie McCarron, Ulysses Stable, Kyle Dutter—shot this month by his father—and too many others.

Too many others.

When Charlie was formally diagnosed with autism in July of 1999, “autism” seemed like something strange and puzzling and (to be very honest) unfathomable to me. I didn’t know anything about it, and I didn’t understand why it was necessary to apply such a “label” onto my toddler.

Nine years later, and not only do I know a great deal more about autism (with much more still to learn). It seems that people in general know a lot more autism, or are at least familiar with the word; it’s been some time since I said “autistic” and someone said back to me, “You mean he’s artistic?”.

At 10 months, Charlie’s then-pediatrician noticed that he had a “minor gross delay”: He’d just started rolling over at 9 months and, too, just started to sit independently. He had other gross motor delays and, taken on their own, these didn’t, and don’t, add up to an autism diagnosis. But Charlie, as I realize in thoughtful hindsight, did not display joint attention. He loved to be carried and held and smiled; he tended to stay put in one spot. Now, every time I read about some researcher’s latest new method for identifying autism in infants, I wonder, what would such a test have noted about Charlie? And I as often think, it’s likely they would have noted “something” about Charlie—-that, today, he might have been diagnosed at an even younger age; researchers are, indeed, evaluating the accuracy of autism screening tools for children 18–24 months of age.

A study in the December Archives of Pediatrics and General Medicine examines autism prevalence trends over time in Denmark and states that “the apparent increase in autism in recent years is in part attributable to a decrease over time in the age at diagnosis.” A cohort of more than 400,000 children—all children born in Denmark from January 1, 1994, through December 31, 1999—were studied. From the abstract:

Results Statistically significant shifts in age at diagnosis were observed for autism spectrum disorder; children diagnosed before age 9 years in the cohorts born between January 1, 1994, and December 31, 1995, between January 1, 1996, and December 31, 1997, and between January 1, 1998, and December 31, 1999, were on average diagnosed at ages 5.9 (95% confidence interval [CI], 5.8-6.0), 5.8 (95% CI, 5.7-5.9), and 5.3 (95% CI, 5.2-5.4) years, respectively. The relative risk comparing the 1996-1997 birth cohort with the 1994-1995 birth cohort at age 3 years was 1.20 (95% CI, 0.86-1.67), which decreased to 1.10 (95% CI, 1.00-1.20) at age 11 years. Similarly, the relative risk comparing the 1998-1999 birth cohort with the 1994-1995 birth cohort at age 3 years was 1.69 (95% CI, 1.24-2.31), which decreased to 1.23 (95% CI, 1.11-1.37) at age 11 years. Similar results were observed for childhood autism.

Conclusions Shifts in age at diagnosis inflated the observed prevalence of autism in young children in the more recent cohorts compared with the oldest cohort. This study supports the argument that the apparent increase in autism in recent years is at least in part attributable to decreases in the age at diagnosis over time.

When Charlie was just diagnosed and shortly after (in 1999-2000), we were often told that he—he was 2-3 years old then—was “very young” to be diagnosed. Now, it seems standard for children to be diagnosed by the time they’re the age Charlie was when he was diagnosed with autism back in 1999. It seems more than obvious to me that we would have been told that they were seeing “red flags” about, who knows, 6-month-old Charlie’s development, and we would have started out on the road to a diagnosis even earlier than we did. A summary of the articles in the December Archives of Pediatrics and General Medicine displays two graphs, which show that, between the two birth cohorts studied (one from 1994-1995 and the other from 1998-1999), the age of a child at the time of autism diagnosis decreased, even as the prevalence rate has been increasing.

Again, the authors of the study note that it’s possible that “the apparent increase in autism in recent years is at least in part attributable to decreases in the age at diagnosis over time.” Thus, early detection and diagnosis of autism—-and increasingly earlier detection and diagnosis, at that—are, it can be argued, contributing to the increase in the prevalence rate of autism. Our ability to better diagnosis autism isenabling us to identify autism earlier in younger children and this is a contributing factor to the rise in autism cases. There’s not so much an “autism epidemic” occurring, as that our knowledge about autism is growing and will, it seems and I hope, continue to.

Corduroy, velvet, denim. Leather, silk, a rock. Bubble wrap, fake fur, burlap. Not a list of supplies for a craft project, but a list of things with different textures—but if you felt each, with your fingers or on the soles of your feet, would they just be so many sensory sensation? Or might one say “security” to you, or one make you agitated, even angry? Does touching certain textures evoke certain emotions in you?

If so, you may have “tactile-emotion synesthesia.” Synesthesia is an “involuntary joining in which the real information of one sense is accompanied by a perception in another sense”; it’s thought to be much more common in the general population than previously thought. Someone with synesthesia might attach certain textures or sounds to numbers or colors, as Daniel Tammet describes in his autobiographical Born on a Blue Day: Inside the Extraordinary Mind of an Autistic Savant. It’s been found that synesthesia can be auditory (certain sounds are felt, smelled, and so forth).

Here’s today’s Neurophilosophy on work published in the journal Neurocase by researchers at the Center for Brain and Cognition at the University of California, San Diego:

In patient AW, a 22-year-old female, the most vivid emotions are evoked by denim, which causes in her strong feelings of depression and disgust, and silk, which produces feelings of happiness and contentment. Other textures evoked a wide variety of emotions and feelings: when she touched corduroy, AW felt confused; leather aroused feelings of receiving criticism; multicoloured toothpaste made her feel anxious; wax made her feel embarrassed; tylenol gel caps made her feel jealous; and different grades of sand paper made her feel either guilt, relief, or as if she was telling a white lie. In patient HS, a 20-year-old female, the same textures often evoked different feelings. She felt no real emotion when touching denim but was disgusted instead by the texture of fleece and wax; corduroy made her feel disappointed; bok choy made her feel irritated, but smooth metal made her feel sedated and calm. In this subject, the strongest emotion was evoked when she touched soft leather, which made her feel extremely scared - she described the sensation as “making my spine crawl.”

Charlie’s always been drawn to things based on color and shape and also—as we later noted—texture. When younger, he seemed to prefer toys (blocks, puzzles, beads) made of wood, rather than plastic (ok sometimes, but much more rarely) and metal (never an interest). As I’ve often noted, he (and we) have become a bit dependent on polarfleece in the form of jackets, vests, gloves, hats, and blankets. Light cotton t-shirts and pants made from some kind of cotton-based material with not too many fasteners are pretty much what Charlie wears day in and day out, along with a dark blue hooded sweatshirt—a long time since we’ve bothered with knit sweaters for him and forget the potential slipperiness of polyester. While Charlie seems quite uninterested in drawing or coloring or painting with a brush, we’ve been noticing that when he can touch the materials—-clay or putty—he’s been quite motivated.

Kind of gives the phrase “how are you feeling” a whole new dimension.

Kev writes about 12-year-old Kyle Dutter, who was shot and killed by his father, Ryan Dutter, who then shot and killed himself, on Tuesday. Ryan Dutter had created a website about his son; he had filed for bankruptcy last fall. Kyle was in the the sixth grade at Glacier Creek Middle School in Cross Plains, Wisconsin.

No words can say……

9-year-old Zachary Vitto—who’s autistic and wears leg braces for cerebral palsy—hikes with his fellow scouts on a rocky path from Borrego to Red Rock Canyon and more than perseveres, as told in the OC Register.

Never ever give up, right?

A long article to appear in the October 19th’s New York Times Magazine describes the D.I.R./Floortime approach for teaching autistic children and, specifically, autistic teenagers. A Decatur, Georigia, school, The Community School is profiled. D.I.R./Floortime is contrasted to Applied Behavior Analysis (ABA), which is based on the principles of behavioral science and is widely used to teach autistic children. The goal of D.I.R./Floortime is said to be a “kindling of a student’s curiosity, intelligence, playfulness and energy, the lessons can take on a spontaneous, electric quality” and the “essence” said to be that “a person learns best when self-motivated, when an inner drive sparks the acquisition of skills and knowledge.”

It’s the case that ABA—which the New York Times Magazine describes, rather succinctly, as using “well-established techniques of reward and punishment to shape a student’s actions” and equates with “rote learning”—-has been a crucial method of teaching my son, and I don’t just meaning for addressing behavior problems.” ABA is how Jim taught Charlie to ride his bike; it’s helped Charlie to learn to play the piano and cello, read music, talk. ABA has a troubled history and I think of it as a most imperfect “science” that can be effective when combined with constant awareness of a child’s sensory needs and communication challenges; recognition of the dignity and competence of a child; the ability to be flexible and keep learning fun. When Charlie struggles to learn or do something new, Jim and I focus on what we can change in our teaching and in our approach, just as we adapt and revise our teaching of students in the college classroom.

That may not sound like what people think of when they hear “ABA,” but that’s what we’ve found to be a good teaching mindset for Charlie. Teaching (at least from what I’ve learned from my own years of teaching involves, again, flexibility and the willingness to combine approaches, to try new things, and to realize when one needs to make changes to best teach one’s students. Charlie’s best teachers have always had teaching him as their most important goal, over and above adhering to any one teaching methodology.

The New York Times Magazine says this about the challenges of teaching autistic teenagers:

With the skyrocketing diagnoses of A.S.D.’s in recent years, parents and school systems are challenged as never before to find techniques to keep these teenagers engaged, productive and nondespairing. Boys with A.S.D. (they outnumber girls four to one) who were difficult to console, to teach, to restrain at age 4 or 8 can be nearly impossible for parents and teachers to manage and to steer at 14 and 18. While a 25-pound toddler’s tantrum is wearying, a 150-pound teenager’s tantrum is dangerous. Puberty and young adulthood take many of these young people unawares.

How best to serve this population remains a subject of debate, because autism is a “final common pathway” diagnosis, meaning children arrive here from different points of origin, are troubled by a wide variety of issues and respond to different strategies. “You meet one child with autism and, well, you’ve met one child with autism,” says Linda Brandenburg, the director of school autism services at the Kennedy Krieger Institute in Maryland. Given the wide range of expression in autism and related disorders, there is no one-size-fits-all intervention. “We now know that there are several different models that seem to work — some more behavioral, some more developmental, some more eclectic,” Dr. Fred R. Volkmar, director of the Yale Child Study Center, told me. “What we really need to be doing, what the law says, is design programs around the kids rather than force kids into a program.”

My son Charlie, as I regularly note, is now an adolescent and well on his way puberty; he’s in the midst of many new changes for him in many ways. He really strugles to talk so communicating strong, complicated and new feelings and sensations is not at all easy. The New York Times Magazine talks about how difficult it can be to console, to teach, to restrain” a 4 or 8 year old and describes the same in older children as “dangerous.” Yes, it’s not easy and every day I wake to a new adventure with Charlie, new challenges, new worries, new hopes. Autistic adolescents and teenagers don’t have to be “dangerous” and difficult behaviors can be addressed in ways that always keep in mind a child’s dignity and presume competence.

I don’t think they’ll be a consensus anytime soon on the best way to teach autistic children and teenagers. And it’s a discussion that needs to happen.

The PETA “Got Autism? billboard has been taken down by the advertising company that was hosting it. PETA’s blog nonetheless noted that the billboard garnered tons of feedback,” with “support from parents of autistic children who have seen noticeable improvements after removing dairy from their child’s diet” specifically noted but not more, ahem, “sour” responses.

It’s a too familiar story to too many of us: Growing numbers of children diagnosed on the autism spectrum and school districts straining, and groaning, under the need (the onus) to provide appropriate services and educational placements, aides and speech therapists who know how to teach an autistic child and not only run articulation drills, and to educate students with widely varying needs and levels of skills. Inadequate funding for special ed and all the more so as districts facing rising costs and no change in state funding, so that districts have to seek support locally from taxpayers.

Does this sound like something that happened in your school district, and is even happening now?

Yesterday’s Flathead Beacon (Montana) notes that

In Montana, statistics from the state’s Office of Public Instruction show the number of autistic students has swelled from 212 in the 2001-2002 school year to 442 last year – a 52 percent increase in just seven years. The number of autistic students jumped 9 percent between 2006 and 2007 alone.

“Our increase follows the national trend; it’s our fastest growing need,” OPI Superintendent Linda McCulloch said. “I’ve requested funding this year for five autism specialists – one specialist for each mental health region in the state – to assist with needs for the schools.”

The Montana Quality Education Coalition and other education groups have filed a lawsuit against the state and say that the state has failed to come up with a formula for adequate special ed funding.

And due to recent current events in the US, increases in funding for education seem unlikely—one suspects that the same stories will be heard numerous times over.

Given what’s going on in the world right now—this thing called an “economic crisis“—reporting about what one celebrity said about what another actress said about vaccines seems, well, something to remark upon and move on from, in order to read about how the financial crisis might affect credit for school districts. From Education Week today:

With investment firms such as Lehman Brothers Holdings Inc. going out of business, and others consolidating, there are fewer buyers for the bonds issued by districts to pay for such projects as new schools and major repairs, according to Susan Gaffney, the director of the federal-liaison center for the Government Finance Officers Association, in Washington.

“The market dynamic is that there are fewer players, and that could drive up the cost of borrowing in the long run,” she said.

In 2007, about $107 billion in education- related bonds was issued.

The financial crisis hit home this week for Laurens County School District 56 in Clinton, S.C., which postponed selling $28 million in bonds on the advice of the district’s financial adviser, said the superintendent, Wayne Brazell. The district planned to try again Oct. 1.

“We have been advised that there will be buyers on that day,” Mr. Brazell said in an e-mail. “We are building a new high school, and we need [the money] to finish the project.”

Education Week also notes that another shock to school budgets is likely to occur early next year year, due to home foreclosures stemming from troubled subprime mortgages.

“We’re just starting to realize what’s going on with the home foreclosures,” said John Musso, the executive director of the Association of School Business Officials International, based in Reston, Va.

Collectively, states have amassed more than $40 billion in budget deficits, in large part because of a drop in tax revenues from the slumping real estate market.

A dozen states—maybe more—have had to impose “targeted cuts on K-12 education programs.”

On the other hand, if all of this makes you get a pit in your stomach, a little a verbal vaccine catfight might be a relative …. innocuous….?…… way to distract your midnd.