Children in the grip of autism

Molly Masland

Adam Walden’s best friend is his cello — and that’s just fine with him.

Like all children with autism and related disorders, the 8-year-old boy from Los Angeles has trouble interacting with others and forming relationships. Learning to speak has been an enormous challenge for him and, at an age when many kids are being scolded for chatting in class, Adam sometimes has problems even recognizing the human voice.

Once regarded with suspicion by his classmates, Adam rarely got invited to birthday parties and during those few occasions that he was asked, he was often found hiding under beds or running away down the street. But life took a positive turn for Adam once he was introduced to the cello. Recently admitted to the Colburn School of Performing Arts, Adam has learned to communicate with others through his music and performs regularly in recitals, where he hams it up and loves to be on stage.

“Now he’s known in school not as the autistic kid, but as a cellist,” says Adam’s mother, Rosanne Walden, who has fought for years to keep him in regular classrooms and is currently suing the L.A. Unified School District to allow children with autism access to gifted-learning programs.

Not just 'quirkiness'
After more than four years of intensive therapy and treatments, Adam has reached the point where most people who meet him would at first just think he's a little eccentric or different. But, as many experts point out, autism is not simply "quirkiness" or an unusual personality trait, but a serious disorder capable of destroying families and children's futures. Like others with the condition, Adam's progress has been hard-won.

His struggles are increasingly shared by many across the United States as rates of autism continue to skyrocket. Some experts estimate that as many as 1 in 166 children born today will be diagnosed with an autistic disorder. Autism is now the second most commonly diagnosed serious developmental disability in children after mental retardation.

While the causes for the dramatic rise in cases over the past decade are the subject of much debate, one thing is certain: early diagnosis is crucial. By being aware of key symptoms to watch for, parents can help spot the disorder and, if necessary, ensure their child begins treatment.

“One of the factors in a good [autism] prognosis is early intervention,” says Dr. Sally Ozonoff, associate professor of psychiatry at the MIND Institute at the University of California, Davis. “It’s been shown pretty clearly that starting an intervention at age 3 is better than 5, or starting intervention at 2 or potentially even earlier than that is better.”

But while most experts agree that beginning treatment for autism at an early age is important, the process of diagnosing children can be fraught with difficulty and makes the goal of early treatment sometimes easier said than done.

'Experts on things'
First identified back in the early '40s, autism was once thought to be the initial stages of schizophrenia. The name derives from the Greek words “autos,” meaning “self,” which describes the often withdrawn and self-focused perspective people with the disorder appear to have.

“There was lots of confusion about what it was,” says Dr. Fred Volkmar, professor of child psychiatry, pediatrics and psychology at Yale University, who co-authored the latest definition of autism and related disorders in the Diagnostic Statistical Manual of Mental Disorders (Fourth Edition).

Decades of research have now made autism the most well-known disorder in a category recognized by the American Psychiatric Association as pervasive developmental disorders. In addition to autism, the category includes Asperger Syndrome, Rett’s Syndrome, Childhood Disintegrative Disorder, and Pervasive Developmental Disorder Not Otherwise Specified, a catch-all category for children who clearly have impairments but don’t meet the criteria for any of the other disorders (see box below). In many cases, the differences between the various disorders are often slight and easily confused even by specialists.

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