Diagnosis and Treatment of Autism

Diagnosis and Treatment of Autism

Diagnosis and Treatment of Autism Edited by University of Goteborg GOteborg, Sweden Springer Science+Business Media, LLC

Library of Congress Cataloging-In-Publication Data State-of-the-Art-Conference on Autism, Diagnosis and Treatment f1989 Goteborg, Sweden! Diagnosis and treatment of autism I edited by. p. em. "Proceedings of the State-of-the-Art-Conference on Autism, Diagnosis and Treatment, held May 8-10, 1989, 1n Giiteborg, Sweden"--T.p. verso. Includes bibllograoh1cal references. ISBN 978-1-4899-0884-1 ISBN 978-1-4899-0882-7 (ebook) DOI 10.1007/978-1-4899-0882-7 1. Autism--Congresses. I. Gillberg, Christopher, 1950- II. Title. [DNLM, 1. Aut1sm, Infantlle--d agnosis--congresses. 2. Aut1sm, Infantlle--tharapy--ccr.gresses. WM 203.5 S797d 1989] RJ506.A9S74 1989 618.92'8982--dc20 DNLMiDLC for Library of Congress 89-71050 CIP Proceedings of The State-of-the-Art-Conference on Autism: Diagnosis and Treatment, held May 8-10, 1989, in Goteborg, Sweden 1989 Springer Science+ Business Media New York Originally published by Plenum Press, New York in 1989 Softcover reprint of the hardcover 1st edition 1989 All rights reserved No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher

Foreword In 1987, The Swedish Medical Research Council's Group for Evaluation of Medical Technology approached me on the subject of organizing a conference on Autism - Diagnosis and Treatment. The original idea for this conference had come from a Stockholm politician, Leni Bjorklund, who had felt that, at least in Sweden, autism appeared to be an area in which conflicting views on etiology and treatment had led to children and parents not always receiving adequate help. Professors Agne Larsson, MD, Tore Schersten, MD and Bjorn Smedby, MD in particular showed a keen interest and it was decided to hold a State-of-the-Art-Conference on autism in Gothenburg. The State-of-the-Art-Conference on Autism - Diagnosis and Treatment was held in Gothenburg May 8-10, 1989. A panel of international experts was selected because of outstanding research or clinical activity in the field and in order to represent a wide variety of professional and theoretical approaches ranging from epidemiology, neurobiology and cognitive psychology to psychiatry, neurology, education, behavioural treatment and psychoanalysis. A group of professional observers involved in the field of autism was chosen so as to cover Sweden in a representative fashion. This group consisted of administrators, child psychiatrists, psychologists, social workers, pediatricians, nurses and teachers. The aim of the conference was for the expert panel to provide a review of the state-of-the-art in their particular field of autism and for the organizer to compile a document of basics in the field of Autism - Diagnosis and Treatment on which all the members of the expert panel could agree. The task for the invited observers was to receive the information from the expert panel and then, hopefully convey this information locally in their professional capacities. The conference resulted in a State-of-the-Art document on Autism -Diagnosis and Treatment which is published at the end of this book. This book covers all the presentations from the conference. I thank all the authors for their dedicated efforts to meet the manuscript deadlines and for the high quality of their contributions. I am very grateful to Inger Sahlstrom and particularly to Carina LOf v

for typing and word-processing work. I am deeply indebted to Gun Jakobsson for her unselfish secretarial assistance in all matters concerned with producing this book. The people at Plenum have been very helpful at all stages. The conference would not have taken place without the initiative and fmancial support of the Swedish Medical Research Council, and their help has been gratefully appreciated. It is hoped that this book will be seen to represent a small but important step forward in the history of autism and that it will receive a wide readership. vi

Contents Introduction The Diagnosis of Autism Lorna Wing Early Symptoms in Autism Autism and "Theory of Mind" Uta Frith Social or Cognitive or Both? Crucial Dysfunctions in Autism Lynn Waterhouse and Deborah Fein The Etiology of Autism Suzanne Steffenburg and Recent Neurobiological Findings in Autism LukeY. Tsai Chromosomes, Genes and Autism Randi J. Hagerman Autism: Inmmunological Investigations Audrius V. Plioplys The First Evaluation: Treatment Begins Here Educational Evaluation Margaret D. Lansing Principles for Directing Both Educational Treatment and Research Eric Schopler Help for the Family Patricia Howlin Pharmacotherapy in Autism: An Overview Magda Campbell 5 23 33 53 63 83 105 133 139 151 167 185 203 vii

Autism: Non-Drug Biological Treatments 219 Mary Coleman Psychodynamically Oriented Psychotherapy in Autism 237 Sheila Spensley Comprehensive Treatment Program for Autistic Children and Adults in Denmark 251 Demetrious Haracopos Exchange and Development Therapies (E. D. T.) for Children with Autism: A 263 Treatment Program from Tours Catherine Barthelemy, Laurence Hameury and Gilbert Lelord The Nature of Behavioral Treatment and Research with Young Autistic Persons 285 Ivar Lovaas, Katherine Calouri and Jacqueline Jada Treating Autistic Children at Home: A London Based Programme 307 Patricia Howlin and Pamela Yates The REBECKA-Project: A Short Summary 323 Lena Andersson Habilitation for Children with Autism: A Swedish Example 329 Steps Towards the Organization of Services for Autistic Children and Their Family 347 Michael Bohman, Inga Lill Bohman and Eva Sjoholm-Lif State-of-the-Art Programming in Massachusetts: A Brief Description of the 363 May Institute Stephen C. Luce and Walter P. Christian Autism: Specific Problems of Adolescence 375 and Helen Schaumann Pharmacotherapy of Adolescent Problems 383 Magda Campbell, Richard Perry and Richard P. Malone Educational Issues in Adolescence 405 Borgny Rusten Psychotherapeutical Help in Adolescence 413 Henrik Pelting Autistic Adults 419 Lorna Wing Addendum: Is the Primary Lesion in Autism Related to the Locus Coeruleus? 433 Annica B. Dahlstrom Autism: Diagnosis and Treatment. The State of the Art, May 1989 441 Lena Andersson, Michael Bohman, Magda Campbell, Mary Coleman, Uta Frith,, Randi Hagerman, Demetrious Haracopos, Patricia Howlin, Margaret Lansing, Gilbert Lelord, Ivar Lovaas, Henrik Pelling, Audrius Plioplys, Borgny Rusten, Eric Schopler, Sheila Spensley, Suzanne Steffenburg, Luke Tsai and Lorna Wing viii

Contributors Index 443 445 ix