IamA a Professor of Psychological and Brain Sciences at Boston University (Helen Tager-Flusberg). I have been doing research on autism for over 40 years..... AMA!

Hi there - I'm HF female with atypical autism and I'm finishing up my PhD in structural biochemistry. I've been going through the primary literature and, wow, over 40 years you must have seen the research landscape change quite a bit. Sensory gating/sensory processing is one of the main biological components of ASD that appears to get overlooked (funding) in favor of social deficit research. Why is this? I feel like the focus on the social aspect is more a symptom of problems we have with sensory integration and the complex neuronal processing associated with social reward (namely endocannabinoid-mediated oxytocin release). Do you think research funding is guided by the neurotypical (NT) population's desire for people with ASD to assimilate because assimilation has the outward appearance of happiness/functionality? Also, how do you feel about selection criteria for the ASD population - should we be more general or should we take intersectionality into account? How has this changed over the years? Lastly, what is your opinion of ABA therapy? Thanks so much for doing this - perhaps we will brush shoulders somewhere in Boston soon!

You're asking lots of really good questions and I don't really have much time now to address them all...my personal view is that autism is complex and we should be studying all the different facets (social, sensory, etc.) - but I don't think NTs guide the research toward assimilation ( so many NTs I know are neither happy nor so functional!). ABA has been extremely important for many people with autism.

Why did Asperger's Syndrome get voted out of the DSM? I thought that diagnosis was a good fit for a lot of people, much better than the blanket "ASD."

For many reasons....one is that there was no evidence that people with Asperger syndrome were any different from people diagnosed with autism who had no cognitive or linguistic impairments. A second reason is that while clinicians can agree about who does and who doesn't have ASD (autism spectrum disorder) they didn't agree on whether a person met criteria for Asperger or autism. We now use the umbrella ASD BUT recognize that it is important to evaluate a person's cognitive and language level - these are not part of the ASD diagnosis but they impact many aspects of how the ASD is expressed.

Backstory: I grew up in the 90s/early 00s, my parents were of the type that didn't like having their kids tested and medicated (due mostly to ignorance and the idea that doctors then we're all pill pushers). I have long suspected myself of having high functioning autism/aspergers and that it has negatively impacted my life. In the last few years I have developed Lupus/RA overlap after taking seroquel, and consequently the suspected manifestations of ASD became more pronounced. After many hours of reading, emailing, and introspection, I have concluded that I am on the spectrum; however, I have also realized that adults are pretty much screwed for help unless they have money.

Questions: While current times see a major movement of awareness for autism, what, if any, are the estimated numbers of patients with HFA that make it to adulthood undiagnosed?

I have participated in 23andme's genetic ancestry and genome reports, what genes can I search for that might provide stronger evidence for presence of autism? Can I take my raw data and submit it to a particular team to evaluate for the presence of "autism genes"?

Are there any "holy grails" to autism that researchers are looking into?

We know from a recent study conducted in the UK that many people go undiagnosed until they are adults - and as you say, there are few if any resources available. Adult psychiatrists don't often think ASD so even if you went to someone they may not recognize the symptoms.

The vast majority of genes associated with increased risk for autism involve what are called 'common variants' - we all show these in some form or other so I don't think 23 and me is likely to be helpful. We aren't yet at a place where even the top geneticists can run a gene screen and provide you with any informative feedback.

Not sure what you mean by holy grails - ...can clarify your question?

Thank you for your answers.

What I mean when I asked about "holy grails" is:

Are there any major breakthroughs that have been hypothesized that researchers are specifically working towards that would change the way we handle autism forever?

I would say so far no holy grails are in sight but we have made enormous progress on so many fronts over the course of my career ---we are learning how complex this disorder is and that there are no simple answers.

What are the biggest misconceptions about autism?

1. That it is caused by vaccines!
2. That people with autism don't love other people - most children with autism form strong attachments to their parents and siblings even if their behaviors may be different (e.g., not wanting to be hugged too often).
3. That people with autism aren't able to learn, work or enjoy living in the world.

Why can't I stop look at that flower pot? Is there a story about it?

Just an artist whose work I like - he's Israeli. I love flowers but it's too hard to keep them alive in my office!

I'm diagnosed with autism and have been told that a big difference between me and other is that I have to learn social cues because Its not native to me and that NT's just 'know how to read social cues'. My rather long question is related and it would mean the world to me if you could tell me your opinion.

This theory that autistic people "can't"understand neuro typical cues has always surprised me. Whenever I see an adult NT women speak to her dog I think the same thing; the dog doesn't understand you, it isn't human, you can't put yourself into the shoes of others as much as I can't when I'm not aware of the psychology of others. It seems to me that everybody Autistic or not has to learn about social cues. My leading thoughts are that the problem with autistic children is that they just not spend as much time socially because it is too intense for them and that they simply get too little practice.

After a long journey of developing skills in the dating scene and learning from a true pro, in combination with a finite set of MDMA experiences, I personally find that my social difficulties are gone completely. I no longer have the same problems.

I wonder what you professional opinion is on the 'chronic handicap or inability' of autistic people to 'put themselves into the shoes of others'. That is at least how it is explained to me. Do you think people with autism have the potential of completely overcoming their social problems (all of them)? Except for the intense experience of them which leads to exhaustion perhaps more than for others.

Many people with autism do learn how to handle social situations and can be very successful. I think Temple Grandin is a wonderful example of an accomplished woman who is still autistic but has overcome so many of her earlier difficulties. I recommend her books and the lovely HBO film starring Clare Danes.

I'm very appreciative of your reply but I am not sure if by 'handle social situations' you mean that we simply find 'a different way' to be social as compared to neurotypicals or just that whatever reason causes us to have difficulties in the first place are gone?

Please don't take this as a personal attack because this following point is not aimed towards you at all, but I always feel insulted when people tell me that 'i find a way to deal with it' where in my opinion, I found a way to solve the problem. I'm always unclear whether or not people (experts on the subject) tell mean that I have solved whatever underlying cause there was in the first place or simply found a way to work around it. Because I really see no difference with how I function socially as compared to other people.

Perhaps you could clarify.

There is some brain imaging evidence to suggest that people with autism solve social problems using alternative brain systems - but the real truth is that we don't know how much variability there is in the social systems (behavioral or brain) used by the general population. Even if you (or others with autism) use a 'different way' - I know many people with autism who handle social situations extremely well. I use the analogy of finding my way somewhere. I personally find it easier to follow directions to find my way to a new location (written/verbal - turn left, go straight etc.) whereas other people prefer to look at a map because they have far better visual-spatial skills than me. We can all find the place but have used different cognitive approaches for getting there.

I heard before that people with autism don't actually have a lack emotions but instead feel too much emotions. Can you expand on this?

Does your work revolve around children? I am asking this because as someone with high function autism we seem to be ignored when we are older, thoughts?

I agree that people with autism do experience emotions - exactly how probably varies.

We study children and adolescents but have also included adults in our earlier brain imaging studies. I completely agree with you that there is far too little work focusing on autistic adults.

What are the biggest risk factors that predict autism in a child?

So far we have good evidence to suggest that genes play a significant role - both ones inherited from parents and also gene mutations that are not inherited. Additional risk factors include age of parents (a small increase in risk for older parents, especially fathers), infection in mothers during pregnancy (especially in the second trimester) and other non genetic factors.

How much does environment play a role?

We can't really quantify this but infections are one type of environmental factor. There is also evidence for increased risk (small) related to living very close to traffic pollution or to fields treated with pesticides - but only if you are living in very close proximity.

Where is the research on autism headed?

There is potential now for the research to go in many exciting and important directions all of which will lead to greater understanding of autism itself and how to provide the best services, supports and treatments to those who need them. Unfortunately there isn't enough funding available to support even the very best projects! We will see in the coming years more on what causes autism and, I hope, more on novel treatments, especially for people who have the most severe problems not just with autism itself but with many co-occurring condition such as lack of speech, medical problems, sleep difficulties, anxiety, depression etc.

Adult diagnosis is problematic and often expensive in a lot of countries. Have you come across any resources in your research which might be useful for people, particularly those on low incomes or in poverty, who are looking for formal diagnoses?

Sorry I haven't

What research projects do you have going on right now? What affects will they have in practice and treatment?

please check my website for details - my current projects include: identifying early signs of autism in infants at risk; developing new measures for expressive language that could be used in treatment studies; research on minimally verbal children and adolescents with autism; and on the so-called mirror neuron system in toddlers with autism. See https://www.bu.edu/autism/current-research/

What are some of the early indicators of autism and how early do these start to manifest?

At the behavioral level we don't see signs until close to the end of the first year. Then we might notice subtle delays in language and gestural communication (e.g., not yet pointing), poorer visual attention and subtle motor differences. Only in the second year of life do the symptoms begin to show - with reduced social smiling, eye contact and speech and perhaps an unusually strong interest in objects.

Why did it take so many years for "professionals" to realize we in fact have emotion often moreso than most people? Did no one think to actually ask autistic people.

I don't know that professionals actually thought this. Do also keep in mind that not all autistic people can report on their mental state.

Have you noticed a correlation between Autism and insomnia? Looking online it said that up the seventy five percent of people have sleep issues (getting to sleep and staying asleep)

As someone on the spectrum I have also had issues with sleep. I could never nap much even as kid and would never fall asleep being rocked or in the car as a baby. As an adult I have had more issue with getting to sleep and am on sleep meds... which I have found to a lifesaver. I just cant seem to shut off my mind, which could also be other issues such as my anxiety.

I as just curious if it was something you see or have looked into.

I haven't investigated sleep but you are right to highlight the fact that many people with ASD also have sleep problems. There is some research being done on this by other people.

Is it possible for someone on the spectrum to be good at reading facial expressions and understanding emotions for the most part but not as good at reciprocating emotions?

Probably yes!

Why do you think people use the word autistic as an insult?

People use all sorts of words as insults ---unfortunately, any group that carries a social stigma (minority, handicapped, gay) will be used by some people to insult people.

How would society be different if everyone had a form of autism?

This is a very interesting question or 'thought experiment'....I'd love someone to write a novel that captured this!

How do you involve autistic people across the research you do? Not just as participants but as researchers, consultants, or employees?

As an autistic adult slowly getting more involved in the research field, this is a question of personal curiosity. On another note, I have referenced your work many times during my Masters so I feel I owe you a thank you.

I'm glad my work has been helpful to you. We haven't had that much opportunity to involve people with autism in our work - but we learn a great deal from all the people with autism and their families to guide our questions and approaches.

I'm very late, but I just found this link.

What would be the point of getting diagnosed in your 40s or 60s or later?

One of my uncles has recently been diagnosed at 62. We are fairly sure that several others of us are on the spectrum. My mother keeps encouraging me to get 'tested'.

I'm honestly not sure that I see a point in it? I'm pretty comfortable with who I am, even if I'm not like other folks. I don't care why I'm different any more, I just accept that I am. I have friends, I have a career that I love working with animals, even if it'll never make me rich.

What would the benefits be of having an actual diagnosis? Is it just self-knowledge? What am I missing?

See my earlier responses ---unless you are experiencing problems that require help you wouldn't meet criteria for a clinical diagnosis. So, personally I wouldn't bother --perhaps try to explain to your mother the difference between ASD traits vs a clinical diagnosis.

any ideas on how to get children with ASD into an MRI machine? i think it's important to get the 'lower functioning' end of the spectrum into brain studies as well but it seems super difficult w motion, and behavioral confounds.

This is something that we are trying to do in our current work. Researchers at the MIND Institute/UC Davis have achieved some success and published their methods in a recent paper in the open access journal: Journal of Neurodevelopmental Disorders.

Cake or pie?

?

As a budding professional in applied behavior analysis, are there any evidence based/effective treatments for autism outside of ABA? It seems like a lot of alternative treatments are ABA with a different name or frankly seem like bullshit.

ABA is a term that can be used to cover a range of different therapies. The original studies focused on 'discrete trial training' but in the past few years evidence based on well conducted randomized controlled trials have shown that developmentally based interventions, which may use ABA techniques, are very effective. Examples include ESDM (Early Start Denver Model), JASPER (joint attention, symbolic play, emotional regulation, PRT (pivotal response training) are among the best examples.

Hello! So I'm an adult (29) woman and I'm fairly sure I'm somewhere on the spectrum. I was mostly nonverbal till I was 5, toe walked so bad that my gait is still messed up & causes pain, (probably mis)diagnosed with tourettes (instead of being recognized as stimming), sensory issues, along with many of the other standard issue problems of autism, some to the point of being debilitating. However, I don't have a formal diagnosis. From what I've heard from others, a dx is expensive, takes months to get, women are often still misdiagnosed, and it usually doesn't help much unless you're trying to get disability benefits or are facing discrimination.

My question for you is, if I can't get a formal dx and possibly help that way, what would you advise as another option for help? I've heard that neuropsychologists are good, but psychologists aren't. Is this true? Most of my difficulties seem to come from sensory issues. Should I just seek out an occupational therapist?

Thank you for doing this and your work :)

This is a really hard question to address ---a diagnosis itself isn't that meaningful (and as you say, it is often different for women) without knowing why you'd want it. You seem to suffer most from the sensory difficulties so yes, perhaps a sensitive OT is the way to go (but it will depend on how informed the therapist is about autism - or autism symptoms - in adults).

How long would a PhD in neuroscience take to get?

Depends on your starting point. If you have some background from a Bachelors degree then a typical PhD program is 5 years.

Also, I've read a theory, most likely BS as it was just an internet theory from some joe schmoe, interesting nonetheless. They theorized that autism could be a natural progression in human evolution. Have you come across this in any real publications in your field?

Theories are theories --- what we need is for 'joe schmoe' to think about how we could test this theory!

I have come across papers that make the argument that autistic traits have value for our society and this is why they have persisted and not become extinct. I can sympathize with this line of thinking but don't have any evidence.

Who are some celebrities with autism?

Several people say they have autism, but I suspect, given their success in life, they don't warrant a clinical diagnosis.

What are the best autism charities?

This depends completely on what aspect of autism you want to support. First ensure that the charity is legitimate then decide if you want to support services, housing, research etc.

I have many autistic friends and extended family, some diagnosed and some not. I believe I'm somewhere on the spectrun myself.

I think its awesome that you're helping the newest generations understand their mind and find ways to cope, but I have a question about the whole nature vs nurture thing.

I have two cousins, one diagnosed asd and one highly likely. The former has been treated as a special case from birth and has become an arrogant, ignorant, selfish brat, while the other was always treated as a normal kid and has become a pretty great person.

Obviously no two people are the same and there's plenty of variables to consider, but what is your opinion on 'coddling' autistic children vs regular development? Is it better to ensure someone is happy or that they can be a productive adult?

We really don't know whether autism has anything to do with the way your cousins have turned out!

1st off, thank you for doing this AMA! My 30 year old husband has Aspergers and my 4 year old son has autism. We are wanting to try for a second child but I am concerned with how well I could handle having 2 children on the spectrum (my husband acts as a part time 2nd child now as it is haha) Is there any testing us parents can do to determine the likelihood of having another child on the spectrum just so we are better prepared for whatever outcome finds us?

From what we know, the chances of a second child to be diagnosed would be around 20% -- higher if this child is a boy. I recommend you seek genetic counseling.

What made you go into the autism field?

Probably a confluence of different factors....but one important reason was a love for the children that I worked with - they got me hooked!

I've read about research trying to link ASD with food intolerances/stomachal diseases. Has any correlation been found?

The research is mixed and for the most part not well controlled.

Have you found any differences in the brain activity of a person with autism for common problem solving tasks?

We haven't looked at this but there is likely to be other studies on this topic- check PubMed.

Which, in your opinion, is the most suitable psychological approach to treat autism?

I think this depends on the particular individual - for young children however I would argue in favor of developmentally informed treatments.

Research suggests that OCD patients develop their condition during their teenage years and before 25. Do you have a hypothesis as to why there is a correlation to this?

Since you research brain development, can comment maybe how OCD develops at all?

Although outside your research or interests could you comment on what treatments of the future will look like for anxiety disorders such as OCD?

Are you familiar with inhibitory learning theory model? Given your expertise, do you have any comment on this over previous models with regards to fear extinction?

Lastly, given the antibiotic use and the important of the immune system in development, do you feel that antibiotics can do more harm during brain development thus leading to a higher rate of mental disorders?

I am not an expert on OCD - but your point about different neurodevelopmental disorders emerging at different time points is a very important one that is, indeed, linked to aspects of brain development that we don't fully understand yet. Another good example is schizophrenia, which emerges in the late teens/early 20s for the most part. I don't think we know what the impact is of antibiotics on brain development - I haven't seen any studies on this yet.

I was originally diagnosed with Tourettes, OCD, Aspergers and ADHD, but now with the new DSM my official diagnosis is just Autism Spectrum Disorder. Is that really more accurate than my old diagnosis? Why was the DSM changed in that way?

DSM5 opens up the possibility of more than 1 diagnosis - the changes for you are not related to DSM5.

I have a five year-old who has sensory sensitivities, difficulty with emotional regulation, and has an IEP for social/pragmatic skills. I mention this because we have not had him evaluated for ASD but I know that these traits are often linked with ASD.

He also is somewhat gender non-conforming. From the time he was 2 he had a consistent and abiding passion for stereotypically "girl" interests: princesses, fairies, etc. Whenever he would dress up or roll-play he would be a female character (we have many dresses for costumes at home).

My wife and I have been very supportive of his interests and are letting him take the lead. At the moment he refers to himself as he (he is biologically male), dresses like a boy (though prefers leggings and pastel colors) and does not seem to show any distress with being a boy. I'm mentioning this just to convey that at the moment he's gender non-conforming but doesn't show signs that would more strongly indicate that he's transgender, though we'll continue to see how this evolves.

I guess what I was wondering is: is any relationship between ASD and being gender-nonconforming/transgender or are these best thought of as being separate traits? Of course, not everyone who is one is the other (and vice versa) but are there any relationships that have been reported and if so, are there any theories as to why they might be related?

You have made some very interesting and sensitive observations about your son. Anecdotally there does seem to be some overlap between ASD traits (or ASD) and gender-nonconformity but I don't know off-hand whether there is evidence for this or whether other researchers are studying this. This is somewhat outside my own expertise so I can't offer you any theories to explain the relationship.

Ma'am,

I am currently an Army medic (9 years active) blessed with two children with autism. I am leaving the service in 2 years and I am currently in college part time pursuing an online degree BS in psychology in ABA.

My goal is to be able to work (and bring home an income) on researching Autism (the cause and treatment). What should be my college goals to make this happen? Should I go for MD, clinical psychologist, etc.

Thank you so much!

There are many career pathways to supporting research and treatment for autism.

Being on the spectrum myself, I have noticed something I want to ask you about what some people cal speaking in aspie. For those that are unfamiliar with the term, it refers to when two or more people with high-functioning autism with a similar level of intelligence and interests start talking, and then nobody can follow the conversation.

My specific question is, is this a quantifiable or autism specific phenomenon?

I doubt that it is specific to autism (I've listened, for example, to 2 physicists talking to one another and not understood a word!) - and I'm sure an enterprising scientist could find ways to quantify such behavior.

1) While the scientific community has made known their general agreement that there is no proof that vaccines are triggering autism, do you see it valid to say "there is no link" versus "there is no known link"?

2) There is a new movement among adults with autism of "neurodiversity" stating that they believe that Autism is just a natural variation, and the reason we see it as an "epidemic" is because of increased awareness/diagnosis techniques. How do you see this from a scientific perspective?

Personally I would say 'no link' - leaving the door open by adding the word known doesn't help move the field forward. Moreover, it may lead to people doubting the importance of vaccines, which will have enormous consequences for the health and lives of many children and adults.

Autistic traits/behaviors are likely to be part of natural variation --but there is an important difference between a person who has these traits but no functional impairment, and a person for whom the severity, number, and presence of co-occurring conditions (from psychiatric to cognitive to medical issues) interferes significantly with his or her ability to function. In the latter case we would diagnose ASD.

What was your undergrad in?

Psychology

What are your thought on an existential humanistic approach to treating individuals with autism?

I don't know much about these approaches as methods for intervention - but I will say that all people with autism deserve to be treated in a humanistic way - as wonderful individuals who deserve our respect!

First off, thank you so much for taking the time to do an AMA. My son is almost 5 years old. He is non-verbal, not potty-trained and is starting kindergarten in about 4 months. My wife and I have no idea how to get him out of diapers. We've talked to his pediatrician and read countless articles online but so far nothing seems to work. Any advice for us?

I don't know where you live but your son would be an excellent candidate for autism-specialty interventions including applied behavioral analysis (ABA). I urge you to ask your pediatrician for a referral to specialists.

Is Autism more prevalent in certain places?

This is a good question - but we don't really know the prevalence rates in most places. Interestingly, the data from the United States show that there is enormous variation between different states - highest is Utah/New Jersey; lowest in Alabama. The main reason seems to be availability of services (if there aren't services for the children then clinicians are probably more reluctant to diagnose a child).

Hello, how important are SLP? And do you have any in your lab? What would you say to an aspiring SLP?

As someone who studies language in autism I would say very important! I have 2 post-docs affiliated with my lab and many former students and research assistants who are now SLPs. Kudos to you for wanting to come into this field ---this is very important work with many needs among children and adults.

To jump off /u/switcherman s comment, How do you keep track or all your studies and projects? I feel like if it were me, even as organized as I am, that would be a huge undertaking. Second, how do you adapt your projects with new developments in autism.

It is indeed a huge undertaking to keep track of everything that's going on - my problem is that I can't say no to new opportunities as I love everything that I am working on!

One way I have adapted projects is to bring in new technologies to my work. For example, I'm interested in how tablets, which so many children with autism love (as do the rest of us!), could be used for collecting data or providing interventions.

If one was to be having an argument with someone who made the claim that vaccines cause autism, what evidence or theory could you easily cite to show such is not the case, or does the science go deeper than a fast quip in an argument?

See my response to one of the other questions on this topic.

Hello, this is Oscar. How do you see the research field changing in the next few years? Are there new topics that are on the rise?

I think there will be far more research on topics that have been quite neglected: females with ASD, adults with ASD, minimally verbal people with ASD. There will also be more work on how we can best serve older individuals with ASD (so far much of the research has addressed diagnosis and intervention for young children which has led to so many important changes).

Why are so many children with autism so interested in technology like apps and tablets? Do you think they are becoming too heavily dependent on them?

Whenever I begin to think about this I look around me and see all of us spending far too much time with our phone/tablet/laptop. I know that I am guilty of being tethered to my technology and completely dependent on them (all 3 devices) almost every waking hour!

Does autism happen by degrees? Can you be somewhat autistic? Have autistic moments? It's not all or nothing, is it?

It is likely that the characteristics of autism (social communication skills, very focused interests etc.) are normally distributed traits - so they vary across the population even among non-autistic people. Definitely not all or nothing!

That sounds cool! I have autism myself, actually! Do you like your job?

If this is for me - yes I love my job!

Hello! First, thank you for taking time to answer questions! I have a question regarding neuroscience and graduate school. I am starting a Neurochemistry PhD program in the fall and would like your advice. I have a B.S. in chemistry and have done some neuroscience coursework and research, but I'd like to know how I should best prepare for the neuroscience portion of my program. Can you recommend any resources I can use to familiarize myself with current research and trends in the field? I have my old textbooks and notes from college, although I'm worried my current material may be a bit dated. Any advice you can provide would be most appreciated. Thank you!

I recommend that you sit down with an advisor in your current program (or ask your advisor to refer you to someone in neuroscience at your university) to review your background and provide you with good feedback and readings.

So what's with all of the vitamin D stories? I've seen reports there's a heavy correlation.

Studies have found small correlations between vitamin D deficiency and many medical conditions - if there are studies on autism showing this I don't really know what this means. It might be that autism itself leads to lower levels of vitamin D rather than the other around. We know for example that some people with autism have limited diets; others may not spend as much time outdoors. Low levels of vitamin D don't really tell us much.

I was removed from the spectrum when I was 8. A lot of people say "it is impossible to leave the spectrum", but I did. 1 out of every 10 kids did and my brother did as well. What are your thoughts on this?

There is good evidence that a minority of children who receive behavioral interventions end up 'off the spectrum' supporting your personal experience.

In your professional opinion, Would high-functioning autistics benefit more from traditional therapy or "parent led" therapy?

I don't think we have any evidence to decide!

My 17 yo cousin has been diagnosed with autism since he was a toddler. He doesn't talk. If he wanted to say hi, it sounds like "heh" Is there any treatment that can get him to talk? My mom says that electroshock therapy might be able to make him talk. Also I don't understand what emotions he feels, can he feel sad, does he understand death etc. ? He has a very severe form of autism , we constantly have to tell him to eat or he won't, we have to take him to the bathroom, etc

Your cousin has a severe form of autism - as do many others. Behavioral treatments have been shown to be the most effective in improving their ability to function.

How much of a role do brains and other donated tissues play in research?

A great deal these days

Hi, my son is 18 months old, he doesn't respond when called by his name yet, talks gibberish, very interested in phones and TV, once the TV is on, he loses focus on everything around him and just focuses on the TV. but, he's very social, when he's around strangers he's very friendly, goes well with other children his age and older. How am I to tell if he's got autism spectrum disorder? or if he's just a little late to talk for his age? P.S(He's the first and only child) Thank you very much.

I would recommend that if you do have concerns you talk to your child's pediatrician -- if he/she is worried then you could be referred to a specialist who could sort out what's going on. But...keep in mind 18 months is very young! I'd monitor his language but for now don't worry about autism.

I currently live in Iraq, and there are no specialized centers for autism diagnosis, are there any way I could get a diagnosis somewhere online? Thank you very much for your time.

I don't know of any on-line services but if you are able to travel there are some very good centers in other parts of the Middle East such as Jordan.

A simple question here.

What is your favorite book or one book you think everyone should read?

Hard to choose - but the one that I found the most insightful was written by Clara Claiborne Park about her daughter Jessie. She also wrote a follow up book.

How many different types of Autism are there?

As many as there are people with autism!

How many years can a person have a type of autism without them or their loved ones know it?

This is not an easy question to answer - you could be thinking of so many different aspects of the disorder

What do you think of the term "idiot savant"?

We tend not to use that term now to refer to the special talents that a minority (maybe 10%?) of people with autism might have.

What do you think of the movie "Rain Man"?

I thought it was a brilliant movie - which changed many people's ideas about autism. That said, we are fortunate that we have so many more diverse representations of autism now in movies, books, art and even TV (witness Julia, the newest muppet to join Sesame Street).

I have trouble trying to figure out what people want to hear, Is it possible I have a form of autism?

This one symptom doesn't lead to a diagnosis of autism

Different time zone oh no, hope I can get a reply!

How unusual is it for an individual with ASD to have better Theory of mind/cognitive and affective empathy than their Non-autistic peers? I ask because I am like this, I can provide lots of evidence for my behaviour, However, I have not found any research or pieces of scientific literature where individuals or an individual presents with an ASD like I do.

I haven't seen any evidence for this either.

Do you think people are being over diagnosed with ASD's now? It seems that the number of people with Asperger's syndrome has skyrocketed. I was diagnosed with Asperger's syndrome, and I don't believe it.

Well, DSM5 has eliminated the diagnosis of Asperger but your question about over-diagnosis of ASD is interesting and important. See my comment above ---the diagnosis should ONLY be given in cases where the person is suffering from functional impairment that requires some intervention/support. In cases where a person is able to live independently, work, go to school, and feels satisfied with their lives (whether or not they have signs of ASD) no diagnosis is warranted.

is it possible for some asperger symptoms to show up in later years? for example, sensory issues and over thinking?

ASD is made up of behavioral signs that every one of us experiences at different times, in different contexts. To be diagnosed with ASD requires that a person meet on ALL the symptoms to a degree that leads to 'functional impairment' meaning that you need supports/services/treatment to improve your ability to function in everyday life activities (from school to work to life).

If they discovered a genetic cause or causes for autism, if they used something like CRISPR to "repair" them, do you think it would alter or diminish the expression of ASD in a given person?

It's too early to say how these new technologies will play out for ASD

Do you support autism speaks?

Thanks!

I was until a couple of months ago a member of the board for the New England/Greater Boston chapter. I have received a number of research grants from Autism Speaks and my students have also been supported by this important organization. In my view AS has been a critically significant organization for raising knowledge and awareness about autism not just in the USA but, perhaps even more importantly, around the world in places where it really matters. The global health initiative has made a huge difference in the lives of individuals and families who would never have access to the knowledge, diagnostic and intervention services that we all know matter. There are many other programs that AS has supported that matter too - for example their 'kits' providing detailed information on everything ranging from diagnosis, the first 100 days, to toilet training to behavior management. I haven't agreed with everything they have done (or not done) over the years ---but to be honest, I probably haven't agreed with anyone (even myself!!) 100% of the time. I see that they have changed with the times, embraced many of the concerns that people have raised and they continue to work hard to improve the lives of all people with autism.

What specifically limits the Autistic when it comes to athletic pursuits? Is there any hope in technology and science helping overcome these hurdles? Any examples of cases who have gone against this trend?

Many autistic people have achieved a good deal in the athletic arena - as with everything else there is huge individual variation. For some people there are subtle motor/motor coordination difficulties that may limit athletic skill.

Hi I had a couple suspicions about my son, he's going to be 6 next month. He's a pretty good kid at home aside from usual arguing. Likes video games WAY to much. He is a problem at school though. He is defiant and tells them no often but never throws tantrums. I guess he's pretty calm about being defiant most of the time. He doesn't have self esteem issues. He's very social yet he doesn't have the best social skills. His teacher would describe him as socially behind. He wants and tries to make friends and does well sometimes but other times behaves innapropriate or in ways that makes others uncomfortable. He's awkward sometimes. Like if he gets stresses or is in a confrontational issue with an adult he will act goofy. Roll his eyes, stick his tongue out. Make gawking noises. I'm not sure if it's to deflect the confrontation away from him or what but it's weird. He's kind of a sissy when it comes to most things. He has very good academics. But he won't sit still or be quiet for long. Punishment doesn't work. Like nothing works. Every single day is a bad day at school. He says he can't help it. He says he gets crazy sometimes. I'm not sure what that means. He's being looked at by a counsoler but says he's too young to do the usual testing for adhd. So we're gonna test other ways. Still in the early stages. I'm not sure what to do to help him. Do you have any idea or know of any recourse to point me to? Does it sound like a type of autism? I seriously need help here.

Your son's behavior might signal several different diagnoses - ASD might be the least likely! I recommend that you ask your pediatrician for a referral to a child clinical psychologist or child psychiatrist.

why do so many 4chan users have autism?

Sorry I am not familiar with this.

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Sorry I don't know what this is....

Are you surprised you still have a job since a former Playboy model has definitively proven that vaccines are the sole cause of autism?

I haven't seen her 'proof' or evidence ---but I have read many studies (all published in the scientific literature) that haven't found any evidence linking vaccines to autism.

Guess I forgot my sarcasm tags

Guess I lost my sense of humor! Thank you for clarifying....!

Here's what I really wanted to respond to your original question: Well I still have my job but she doesn't!!

What are the top 3 reasons we know vaccines dont cause autism?

1. There is now very good evidence showing that there are differences in the brains of infants as early as 6 months which foreshadow a later diagnosis of autism.

2. Multiple well conducted epidemiological studies have found NO link between the onset of autism symptoms and receiving vaccines.

3. Millions of children around the world receive vaccines which keep them from getting ill or dying ---99% don't have autism.

Do you have any crazy stories from your experience with working with the population? If so, what was the most crazy one?

I probably have more crazy stories about working with non-autistic people!!

I've read articles that talk about the autism spectrum... Saying most people are on it to some extent. It really seems like you guys have your heads up your asses and are searching for reasons to get more school and government funding because to my knowledge, there is no cure and will never be a cure for genetic disorders unless you deal with the DNA itself. I understand some people clearly have autism but if it's a spectrum type situation how can you clearly define it as autism when maybe it's something you don't even know about? Are there blood tests/ dna tests you can do to prove someone has autism or is it just one persons professional opinion against another. Not trying to put a cramp in your lifestyle but unless you are actually modifying DNA (which can't be done in humans on a (dr./ patient level) I see no point in your research and if you can't test different situations on animals as you can with disease or other disorders, how will you make progress? Seems like the best approach would be to dedicate money towards those who are impacted by their disability instead of researching bs causes/ ways to prevent it because it is my understanding that this isn't a new development and has just gone unrecognized. Is this situation one that is truly getting worse and is preventable? I have seen no medication or even attempts at creating a medication but I have read about environmental factors to ease the impact. I understand where money would come in handy with caring for people with the disorder... But there are limits. It seems to me like you're trying to play god on a playing field where a god already exists and there's a government preventing you from even getting close being able to find a resolve for the issue you're spending millions/billions of dollars researching involving genetic mutations. Seems more like evolution and while it's a sad reality, I'm fairly certain only genetic changes can make this happen. I doubt they'll ever let you touch people's DNA if they can be labelled as being on a spectrum with no definite or incremental scale... Seems like blanket term for a wide range of cognitive disabilities. I'm not saying it doesn't exist, I just find Autism to be a blanket diagnosis and I think genetic research has it's limits and will continue to remain that way until medical procedures catch up with what you're doing. It's kind of like researching aliens. Forms of life exist out there but you don't know exactly what they are and there would be a million barriers getting in your way even if you wanted to... And guess what... NASA is not a heavily funded program any longer for valid reason. They attempted to do something that was very expensive and had serious limitations and money needed to be diverted elsewhere. Just seems like in a time where Cancer and other deadly issues would clearly be treatable/ curable you are spending money and diverting it from what's really pressing. Sorry in advance for what i'm sure you will establish as my ignorance on the subject.

You make some very important points here even if I don't agree with everything. I do believe the work I do (and the work of my many colleagues) in the field is important on lots of levels even if right now it's not leading to a cure (which need not be the only end point, as you point out too). I couldn't find a question in your comments to address.