I believe that if Micheal Savage was forced to spend time with Autistic people, his mind would change and he would take back everything he said. I believe that he should be sentenced to spending a week with all ages of people, from every spectrum of autisims. I mean a week with each level.

Micheal Savange is what a call a steriotypical self centered being, that cannot understand anything unless he is challeneged with it. Heshould go on a reality show for dealing with autism; like the Baby Borrower’s Show.

For example, he describes a pervasive lack of responsiveness to other people. And yet, most of his patients did respond to other people.

He also described one patient as understanding instructions without listening to them.

The frustrating thing about his comments and generalizations in that manner, is that the way he wrote things down, we’ll never know what body language in that particular patient prompted his (biased) appraisal that she was not listening to the instructions, and we’ll never know what precisely he saw as making his patients unresponsive. He didn’t just record and observe what people were doing, he recorded and observed biases that have been present in the field ever since him. And entire ideas about autism have taken a long time to be seen as false, because of the amount of authority Kanner was given.

Powers: Now as a psychiatrist is it, and you, how long have you been practicing as a psychiatrist?

Leventhal: finished my residency and fellowship in 1978, so thirty years…

Powers: In the years preceding 1978, isn’t it true that psychiatrists attributed autism in large part to what is called the refrigerator mother, or the lack of affection a lack of bonding. Was that the general cause of autism that was attributed in describing the etiology.

Leventhal: No that’s not actually accurate.

Powers: Refrigerator mom was a descriptive term generated by Dr. Bettleheim, post Vienna, post World War II, to describe what he believed was the cause of autistic spectrum disorders. Isn’t that correct?

Leventhal: It was one of his concepts, but Dr. Bettleheim wasn’t a psychiatrist, he was actually not even a psychologist, he was an educator.

Powers: And in the years since then that theory of causation has been disproven. Correct?

Leventhal: It was never proven, so other theories have taken form it was never a proved theory.

Powers: The theory you believe that autism is entirely genetic. Do you believe that autism is entirely genetic?

Leventhal: No sir.

Powers: Do you see room for environmental contributions to the appearance of autistic symptoms in some children.

Leventhal: Yes

Powers: Can you identify what you believe to be known environmental contributors to the appearance of autistic symptoms in children?

Leventhal: Well we know very well that the environmental interventions make a difference, and the modification of the environment, so things like ABA affect the clinical presentation of the disorder, education, speech and language, change the clinical presentation of the disorder. Those are all environmental interventions.

Powers: And I’m not speaking of environmental interventions you would agree with me that be that environmental exposures can actually be the biological cause of autism. So for example prenatal exposure to thalidomide, do you believe that prenatal exposure to thalidomide can cause autism?

Leventhal: I think what you are trying to do is make a sweeping generalization and as I think Mark Twain once said no generalization is worth a damn including this one. And I think generalizations just aren’t terribly useful here. you have to talk about specifics.

Powers: And that’s why I asked you …

Leventhal: (interrupting) So if there’s,

Powers: (simultaneously with Leventhal) Let, let

Leventhal: if I

Powers: (over the top of Leventhal) I asked you

Leventhal: ..if I can finish my question, uh answer I’d be happy to

Powers: Well, I asked you a specific question

Leventhal: I’d be happy to…

Powers: (cutting Leventhal off) Do you believe that prenatal thalidomide exposure can contribute to the appearance of autism in some children.

Leventhal: This is not a matter of belief.

Powers: Do you believe that there is, or let me put it this way, as a scientist do you recognize that there is an association between prenatal thalidomide exposure and the appearance of autism?

Leventhal: What do you mean by association?

Powers: A causal relationship.

Leventhal: That has not been demonstrated, so the answer to that is, until it’s been demonstrated I can’t really tell you.

Powers: Do you believe that, or do you think that evidence shows an association between terbutaline exposure prenatally and the appearance of autistic symptoms?

Leventhal: I am not aware of any causal mechanism that would support that.

Powers: Are you aware of any scientific data or scientific literature that would support an association between maternal rubella and the appearance of autistic symptoms in the child?

Leventhal: You just used the word association, so there are data on an association between maternal rubella and autism.

Powers: Would it be your scientific opinion that those associations are suggested of a causal link between maternal rubella and the appearance of autistic features in some children.

Leventhal: It’s not been demonstrated. Until it’s been demonstrated, I don’t know if there is a causal link. There’s a big difference between association, correlation and causality.

Powers: And that’s why I am asking you specifically if you believe that there’s a causal association between these various prenatal exposures and the appearance of autistic symptoms in the children who were the product of those exposed pregnancies. Do you believe that there is scientific evidence supporting that there is a causal relationship?

Leventhal: As I said to you, I don’t believe. There’s what I know and what I don’t know. I am not aware of, I have no knowledge of, a casual link between rubella and autism. There’s an association but there’s not a causal link to my awareness.

It should be noted that Kanner (1965) did say the following:

Out of this emerges a rather disturbing dilemma. We seem to have reached a point where a clinician, after the full study of a given child, can say honestly: He is schizophrenic because in my scheme I must call him so. Another clinician, equally honest, can say: He is not schizophrenic because according to my scheme I cannot call him so. This is not a reflection on anyone in particular. The whole concept has obviously become a matter of semantics.

There’s a lot in that paper that reflects on debates we have today.

What Kanner said about speech was encoded in DSM-III:

D. If speech is present, peculiar speech patterns such as immediate and delayed echolalia, metaphorical language, pronominal reversal.

The problem with language problems in truly autistic children is the language problems Kanner described are not specific to autism.

The same problems are also reported in children with a developmental language disorder and even in a passing phase in normal children and even in many patients with Alzheimer’s Disease.

Kanner’s brilliance as a clinician was his powers of observation and insight that allowed him to seperate out what he called ‘isolated symptoms that are part features of the overall syndrome’ while being the first to identify the highly specific and core defining feature of ‘autism which was also encoded in DSM-III:

‘A pervasive lack of responsiveness to other people”

In 1994 with the publication of DSM-IV Kanner’s definition entirely removed and replaced by ‘Qualitative impairment of social interaction’. ICD-10 soon followed and all the Gold Standard diagnostic tools also followed DSM-IV’s lead.

The Gold Standard diagnostic tools can confer an ASD diagnosis on Romanian orphans who were subjected to extreme emotional deprivation and children with developmental language disorders who did not meet diagnostic criteria for ‘autism’ prior to 1994. Children with genetic mental retardation syndromes such as Fragile X and Down’s Syndrome are also now included under the umbrella label of ‘Autism Spectrum Disorders’ even though their social problems do not meet Kanner’s definition:

http://www.ncbi.nlm.nih.gov/pubmed/2816996?

How bad is the overdiagnosing of autism. Schizophrenic children now also meet Gold Standard diagnostic criteria for ‘autism’

http://www.ncbi.nlm.nih.gov/pubmed/18411867?

The fact that autistic traits, just like basically all human traits, have a distribution in the whole population is not evidence that autism is being misdiagnosed on a global scale. It could be evidence that people might disagree on where the threshold for a diagnosis should be located. But it’s not evidence of wrongdoing is what I’m saying.

Of course, Kanner had his own ideas of what “real” autism is, and they might have carried a lot of weight simply because he invented the construct. But I would say his own ideas were not necessarily consistent. For example, the first operationalized definitions of autism by Kanner indicated that muteness (or a kind language not intended for interpersonal communication) was a requirement. Yet, many of his original patients were clearly able to speak.

http://www.ncbi.nlm.nih.gov/pubmed/18651205?

It appears that the prevelance of ASD’s
will continue to expand and 40% of the entire population may be eligible for an ASD diagnosis.

In 1965 Kanner explained another long forgotten rise in the incidence of ‘autism’.

http://neurodiversity.com/library_kanner_1965.html

A few of his spot on observations:

“Moreover, it became a habit to dilute the original concept of infantile autism by diagnosing it in many disparate conditions which show one or another isolated symptom found as a part feature of the overall syndrome. Almost overnight, the country seemed to be populated by a multitude of autistic children, and somehow this trend became noticeable overseas as well. Mentally defective children who displayed bizarre behavior were promptly labeled autistic”

And:

“By 1953, van Krevelen rightly became impatient with the confused and confusing use of the term infantile autism as a slogan indiscriminately applied with cavalier abandonment of the criteria outlined rather succinctly and unmistakably from the beginning. He warned against the prevailing “abuse of the diagnosis of autism”

And:

“To complicate things further, Crewel, in the hope of avoiding confusion between true autism and other conditions with autistic-like features, suggested the term pseudo-autism for the latter. Even this term came to be employed haphazardly, and conditions variously described as hospitalism, anaclitic depression, and separation anxiety were put under the heading of pseudo-autism”

The term ‘Pseudo-Autism’ has returned and Romanian orphans who were institutionalized at birth and experienced severe emotional deprivation also meet criteria for an ASD using Gold Standard diagnostic tools such as ADI-R.

http://www.ncbi.nlm.nih.gov/pubmed/18093025?

The publication of DSM-IV in 1994 can be used as a carbon dating tool identifying the exact moment that the global autism pandemic began. The framers of DSM-IV removed Kanner’s defnition entriely from the diagnostic criteria and replaced it with vague, ambigous and subjective ‘Qualitative impairment in social interaction’ producing what might be described as the second autism pandemic.

Dr. Attwood was just in our area (CA) and was speaking about how in CA for example, you do not get services from the state if you have a Asperger’s DX….only if it is “autism”. Because most MD’s and esp. Ph.D’s are aware of this….they DX as autism to help the family. These are the “good” examples. There are also Ph.D’s that will spend 15 min with my son and say he is ADHD and push me and my MD to give RX. I said no by the way!! It’s this type of “bad” doc that he is against. Dr. Savage has spent a lot of air time talking about what he thinks is child abuse and putting kids on tons of very strong anti-psyc drugs and giving 2 yr old a Bipolar DX, etc. He feels that is child abuse by the medical community. He also feels that that fathers in this country have given up on their duties as parents. Kev, you, I am sure am a wonderful father as has been shown here at your long time Blog. That is why, I believe you are so upset at what he said…...Papa Bear wants to protect his child. BUT, there are many fathers in this county that have no idea what is means to be a father and our kids are suffering. Obama has been talking about this too. It is a problem and that is partly what he was talking about is his “insensitive rant”. Regarding his background, some of you may not know this but he has a Ph.D in nutritional ethnomedicine. He is a strong supporter of “diet” vs RX for kids. Some of his other books besides Healing Children Naturally are: Maximum Immunity, Earth Medicine Earth Foods, The Complete Book of Homeopathy, Secrets of Fijian Medicine, The Herbal Bible, Plant-A-Tree A guide to Regreening America and many others. Yes, his political views are sometimes very very Right-Winged, I agree but I so strongly believe he is worried about the kids and the lack of parenting and he just did not realize what damage he could do with his words for those of us that do have children DX with Autism and Asperger’s.
And, lastly I must add that we do have Free Speech in America….at least for now.