by Frances L Ilg, MD, and Louise Bates Ames, PhD, from the Gessel Institute of Child Development
Dear Doctors: Our 3-1/2 year-old son Teddy has been diagnosed as autistic. I have been sending him to a nursery school attached to a local child guidance clinic. These people tell me that autism is not a condition in itself, but rather a symptom of emotional disturbances caused by the parents’ attitudes to the child and their handling of him. I don’t agree. I think he behaves in this abnormal way because of his inborn personality structure, and our family doctor agrees with me.
Nevertheless I have been willing to go along with the clinic program of psychotherapy, which explores my childhood and my relations to those around me, just so he can go to the nursery school. However, since the clinic is so busy with my childhood, they never give me any help about Teddy. Can you give me a little information about autism?
The experts answer
A well-run nursery school can do a world of good for almost any autistic child, if he can adjust to it. You’re being realistic — and a marvel of patience — to undertake the psychotherapy required in order to assure your child a place in the group.
In our opinion, the advice you’re getting is 100 percent wrong. We know of no earthly reason to believe that autism is a symptom of emotional disturbance stemming from the parents’ attitudes or their handling of the child. Handling can make things worse, to be sure – but only in a secondary way.
We don’t think exploring your own childhood relationships with your mother, father, sisters or brothers is useful or important to your handling of Teddy or your understanding of him.
Dr Leo Kanner of Johns Hopkins University and other authorities on autism make it quite clear that autism is a condition of personality, resulting from the kind of structure a child is born with. You and your doctor both seem to realize this. You don’t make a child autistic by treating him coldly. An autistic child seems to be born without a normal ability to understand and respond to the approaches of others.
He doesn’t lack a sense of self because you don’t love him; he lacks it as some other child is color blind, or tone deaf. As one mother of an autistic child touchingly put it, “He rejected us long before we rejected him.”
Many authorities consider autism to be not unlike the psychosis called schizophrenia. The disturbance is often milder, however, and hopes for the future are often brighter. Many autistic children grow up to lead relatively normal, independent lives. Many marry and have children.
Success in toilet training and response to discipline (which you ask about) usually come in during the late preschool years. These children are by no means all slow intellectually. Many go on to do well, even brilliantly, in school. But most seem to have to learn how to make the personal responses that come to other people as naturally as breathing.