Facing facts: Science has established that autism is a developmental brain disorder, but experts have not yet been able to pinpoint why the behavioral outbursts associated with this disorder occur, says Richard Foxx, Ph.D. Foxx is professor of psychology at Penn State University, an adjunct professor of pediatrics at Penn State College of Medicine, and co-editor of Making a Difference: Behavioral Intervention for Autism (Pro-Ed, 2001). What experts do agree on is that these behaviors—which may include tantrums, self-injury and aggressiveness—are learned, says Foxx, whose specialty is treating behavioral problems in people who have autism. The behavior, he says, is a way for a child with autism to communicate the need for attention or to escape from an undesirable situation.
What to do: Foxx suggests parents enlist the services of a board-certified behavior analyst who can help assess the motivation behind the disruptive behavior. (You can find one at http://www.bacb.com/.) For example, he says, a child may have a strong negative reaction to taking a bath and will throw a tantrum whenever asked to take one. However, a behavior analyst might determine that the child was watching a favorite DVD when asked to take a bath, and was expressing frustration over being interrupted. Possible solutions might be to schedule the bath at a different time, and then, using positive reinforcement, letting the child watch that DVD.
If parents cannot afford a private behavior analyst, Foxx suggests requesting one through the school district or a mental health organization.
Oppenheim says autism symptoms usually appear when a child is between 18 months and 3 years of age. Most children who are eventually diagnosed as having autism initially show gradual abnormal development. However, others appear to be developmentally on track, and then suddenly undergo behavioral changes and lose language skills. "This abrupt turn of events can make parents desperate to figure out what happened to their child," says Oppenheim. "And, if the child was vaccinated during this time, some parents tend to connect the vaccine and the onset of autism because of this coincidental timing." Sometimes, says Oppenheim, some of these parents, either first-timers or those who already have an older child who has autism, therefore decide not to vaccinate their children.
What to do: Parents needn't worry about vaccines, says Oppenheim. Experts at the Center for Disease Control and Prevention (www.cdc.gov), and at the American Academy of Pediatrics (aap.org), agree that the MMR vaccine is not responsible for the rise in cases of autism. She advises that parents base their decisions on facts, rather than on fear.