Autism is increasing at an alarming rate, according to Autism Society Canada, and may have doubled in the past decade. About 105,000 Canadians have an autistic or other developmental disorder, and 3,000 new cases were diagnosed in Canada in 2002. Statistics from school boards in Saskatchewan, British Columbia and Quebec show an average increase in autism cases of 63 per cent over the last two years. Experts see no clear reason for the increase. The answer appears invisible only because it's too close for us to recognize it.
Autism is a disorder of development, characterized by impairments in interpersonal and social interaction and communication, along with rigidly repetitive and apparently purposeless behaviors such as tics. Genes are the usual suspects cited by researchers. However, the gene pool does not change so rapidly that it could even remotely account for the epidemic in autism and its related disorders. Nor does heightened awareness of the condition provide a clue. Although there was a nearly 300-per-cent rise in autism cases in California between 1987 and 1998, a major study at the UC Davis Medical School in 2002 found that the increase was real and not due to statistical factors.
What, then, is happening to so many of our children?
In a word, it's a matter of connection. On the neuroanatomical level, the brains of children with autism have reduced connections between important emotional centres and other brain regions. Psychologically, the autistic child lives in a world of his own, largely isolated from emotional contact with those who love him.
Such disconnect, though to lesser degrees, is also a feature of the many other developmental disorders now afflicting burgeoning numbers of children, including Asperger's syndrome, Tourette's and attention-deficit disorder. We all know the frustration, and even rage, we can experience when we make a phone call and instead of getting a responsive human being, we are greeted by a mechanical recorded menu. Such frustrated rage at the disconnect is the constant emotional realm of the autistic child.
The physiology of brain development can no more be understood in isolation from the environment than we can explain a flower's growth without reference to soil conditions or climate. Even more than the flowering plant, the human brain develops in interaction with the environment. Genes, while important in their own right, are activated or turned off by external triggers.
Ninety per cent of brain development occurs after birth, during the first two or three years of life. It is during this time that the genetic material is triggered to express itself in healthy or in disordered ways.
Input from the nurturing environment heavily influences the chemistry of the brain, the growth and interconnections of neurons, or nerve cells, and the development and interconnectedness of brain regions. The most crucial of these inputs are the subtle and often unconscious emotional interactions between the infant and his caregivers. To comprehend what is happening to the brains of children, we need to look at what has happened to the child-rearing milieu over the past few decades.
Fewer children today have the luxury of being born into the non-stressed, emotionally balanced and nurturing environments that the optimal biological development of the human brain requires.
Parents of children with autism and other disorders do not love their children any less than other parents; they are not less skilled or devoted to the parenting task. To explain the explosion in childhood disorders we need to look to broad social factors, not to individual parental failure.
Throughout human evolution, children have been reared in the context of strong emotional relationships, in what may be called the "attachment village." In tribe, clan, village, community, neighbourhood and in the clasp of the extended family, children were assured of the nurturing influences necessary for healthy brain development.
That emotional nexus is, with catastrophic rapidity, disappearing from our lives. Tribe, clan, village, community are things of the past. We are less and less connected to our neighbours, extended family or fellow workers, even to our own spouses.
Recent economic, social and cultural changes mean the family is functionally less and less intact. Parents are increasingly stressed and isolated. If the connections in our children's brains are not as developed as they ought to be, it's because the social connections on which they depend have been greatly weakened.
On the positive side, the human brain retains a capacity for development throughout childhood and beyond. Emotional connection is the key. The greatest successes in the treatment
of autism rely on building and maintaining a secure and powerful emotional
relationship with the child.
Gabor Maté, a Vancouver physician, is the author of Scattered Minds: A New Look at the Origins and Healing of Attention Deficit Disorder.