My personal observations about autism in children

Since The Egyptian Autistic society was established in 1999 I have met and diagnosed thousands and thousands of children. I meet at least 4-5 new families a week coming from all over the world but mainly from Egypt and the Arab world. Without realizing I noticed several patterns and had many observations. Very often I would catch myself asking the parents questions related to the patterns I found. This article is nothing more than my personal observations. It is not supported by any research by me (although some of the patterns after looking at literature seem to have been noticed and researched by others).

-      The most “exciting” and baffling observation in my eyes, is the fact that so many of the children I see are a result of either IVF or at least their mothers had taken hormones to speed up pregnancy. I said “exciting” and baffling because of the implications this observation could have if it is indeed true that there may be a link between hormone imbalance (excessive male hormone) and autistic symptoms. The second observation is that even though it is usually one twin affected, you can always see ‘traces’ of autism or some of the deficits associated with autism (under developed social skill/ delayed communication).  We know for sure that Autism is more common in males than females (4:1), we also know that Autism has previously been associated with elevated prenatal levels of testosterone, which are linked to slower social and language development, autistic traits and attention to detail. Dr Michael Lomardo and Prof Simon Baron -Cohen looked at the amniotic fluid surrounding the babies in the womb. They found that the 128 boys that later developed autism had higher levels of steroid hormone than 217 in control group. This is one of the first studies that points at hormones rather than genetic bio-markers. Steroid Hormones affect how orders in the DNA are translated into important proteins thus possibly altering brain and increasing genetic risk factors related to autism. Recently A study at the university of Strasbourg in France, identified key genes that are regulated by testosterone contributing to the risk of autism. Exposure to androgens during male development alters genes related to autism and thus may explain why males are more susceptible to autism. The androgens increase the spread of cells and prevents them from dying which may lead to excessive brain growth which occurs in people with autism in the early years of life.

This could change the path researchers are taking to discover the cause of autism, it could also one day lead to pre-natal detection (by testing amniotic fluid) of autism. –That’s why its exciting !!

-      Other less exciting observations include that I have noticed that many of the children have parents who have a high IQ and are usually both doctors or a doctor and an engineer. Note that children with autism are usually very good at puzzles, play with blocks (rather than imaginary games) and are very strong visually. I wonder if this is related or affects the wiring of the brains.

-      I have been asked several times by guilt driven parents if their child ‘became autistic’ because they left him for hours in front of the T.V  I usually give the same response, “nothing you did made him autistic “. The thing which caught my attention though, was that the children were all watching the same TV channel.....  Even though I haven’t watched it myself I was told it is an Islamic channel which plays children’s songs which are repetitive in nature. Most probably either the tone, repetitive rhythm etc. attracts them and makes them sit for hours. Similarly, the “azzan” – calling to prayer attracts many children with ASD. Some parents can only feed their children while the azzan is on. Why is it that certain videos, pictures, shots , parts of movies attract them so much?  I can’t begin to count how many times I’ve been with an autistic child who played a particular part of a cartoon over and over again, or froze it or drew it exactly the same.

I cannot deny I am fascinated by the autistic brain and have always believed that they are somehow blessed to not have “the box”. We always say “think outside the box”….. what is the box actually? The box is a bunch of norms, rules , structure learnt from experience or implicitly taught to you by society. What if you were born without this manual? You could not implicitly understand all the social rules and the concept that you now take for granted (such as gravity for example)?   You will then have to discover everything yourself….by throwing things on the floor repeatedly until you understand that things will always go down (gravity). This will appear as odd behavior or perhaps even stereotypical behavior to observers. This exact same “deficit” of not having a box is the same blessing that make some adults with autism the best physicist. There is a certain freedom or blessing in starting off as a clean slate, untainted by society giving you the opportunity to discover everything yourself.

-      The “super powers” or special skills often associated with autism such as superior mathematical skills, memory, sense of direction, art,  and guessing dates correctly.  There used to be a myth that we only use 10 per cent of our brain. This is in fact not true. We use virtually all the parts of our brain but maybe savants somehow use it differently . I also can’t help but notice that many of the skills ASD children are good at are associated with typical “male” skills.

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