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FACT-BASED AUTISM INFORMATION: Biological Developmental Domain

This domain includes the physical growth, change, stability and diversity of the structures and functions of the human body and brain. This article first discusses a very important biological aspects of human development and Autism, and then summarizes various physical impacts that Autism has on the structures and functions of the brain.

What does "Autism Spectrum Disorder" mean?
Autism is a medical/mental health term in the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition with Text Revisions) (DSM-IV-TR) of the American Psychiatric Association (APA), which describes a set of developmental symptoms, rather than any singular cause or specific physical condition. In the first chapter of this text, "Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence." there is a description of the behavioral symptoms of the overall spectrum and various subtypes of Autism, and related disorders as well.

A person's childhood behavioral symptoms must then meet a specific set and degree of neurologically related features from the standardized criteria for what is a larger category (but not a diagnosis of) Pervasive Developmental Disorders. This means, that as a group, people within the whole Autism Spectrum do share certain atypical developmental characteristic features, but with highly varied presentations that create unique sensorimotor, communication, and social behavior profiles. This text also provides the recognized diagnostic standards (criteria) for Autism and reliable and valid professional tools for "differental" diagnostic criteria to be able to more accurately (but not exclusively) distinquish Autism from other distinct developmental conditions. This is because Autism often co-occurs with related neurological and developmental conditions, which will require professional expertise to identify and sort out for our families.

This complex condition can then often confound and confuse both the inexperienced professional and the well-intended layperson alike. It is no wonder new families feel so confused. However, the category of pervasive developmental disorders and the Autism Spectrum set of diagnoses are useful in naming a wide range of degrees of this neurological disorder and its heterogeneous behavioral presentations and diverse developmental patterns as they exist across the whole population of all people with and without Autism. However, this means that, even if a family member or service professional have known even a dozen people with Autism, we have only begun to know us all. Therfore it helps to seek out professionals with long term experience in working with this disorder across the Autism community, if you are seeking a clear and accurate primary and secondary diagnostic identifications.

What has happened to my child's brain and body?
From the time of conception to five years of age a person's brain undergoes a huge and complex series of growing, changing, and stablizing processes and outcomes. The many structures of the brain continue to develop from the time the nervous system first forms in the fetus during the first trimester, up to three years of age. Some cellular formations and chemical processes are still developing up to five years of age. This longer developmental process of our more complex and larger brains is why human beings' infants are born helpless and only become as functionally competent as other species after these early years of development outside of our mothers' bodies. This longer emergent phase allows our human brain's development to be more extensive and it makes it more vulnerable too. During this whole critical period the structures and functions of brain of a person with Autism have become damaged, disorganized, and/or atypically altered in very serious and significant ways. Sometimes actually structures of the central nervous system may be missing, and/or are malformed, or grow, change, and stablize in very unusual ways. Sometimes certain kinds of brain cells are systematically underformed, overgrown, mispositioned, and/or chemically misfunctioning in patterns unique to each person. So Autism may involve what we think of as brain defects and damage and underactivity of cognitive capacity, but just as often it involves very significance brain differences that generate atypical cognitive gains and overactivity. Together, this combination of atypical features makes it difficult for the person to behave, learn, and function in age appropriate typical ways.

Autopsy results of people with Autism have shown many differing patterns of these abnormalities that can exist across many key areas of the human brain, but which still effect development and behavior in very similar ways. This is because they all interfere with the typical processing and learning of sensorimotor, communication, and social information to a greater or lesser degree. But any form of interference in these capacities is a very serious condition, which may impede learning and functioning more than retardation, blindness, deafness or paralysis. It can be one of the hardest and must frustrating aspects of the families diagnositic experience that the prognosis for their childs specific brain’s developmental course is not predictable during childhood and only becomes stable after puberty. The fact that some individuals with Autism greatly improve during childhood, others regress, while many remain unusually stable in their brain function/Autism and so their development, compared to the degree of growth and change during typical childhood, is yet another stressor that families must adjust to over time. Therefore, it is very important to emphasize that vast majority of children with Autism, regardless of the severity of their Autism at any point, and adults with Autism along the full spectrum profile will usually shown the capacity to show significant positive growth, and ongoing maturity in their skills, in relation to their innate biological potentials. Not only will the person experience this growth, but they often are the source of great inspiration and growth in others who follow best Autism practices. The author of this web page has lived and worked with hundreds of people with Autism and has witnessed this research finding as very real.

What can we do to test for, treat or cure this physical condition?
No credible scientific studies claim to cure complex, heterogenous, and innately structural problems of the human brain. The interventions proven to be most effective are educational and therapuetic in nature, and therefore are nuturing and not predictably curative. This does not mean they are not effective in reducing the impacts of Autism long term. They are, particularly the earlier we implement them. It is also important to note that like most complex disorders about a third of people with Autism will significantly improve despite the lack of curative treatments and a third will not improve significantly despite heroic treatment efforts. Well-established biomedical and early educational intervention methods help brain functions develop in the most optimum ways possible for each of us whether we have Autism or not. However, currently there are not many specific technological screening tools, medical tests, medications, or other physical treatments that can provide ways to accurately predict, prevent, identify and directly treat such complex neurological conditions in the human brain for every person with Autism, nor any one person either. Families can trust that when that happens it will be medical history that will be a major historical event in brain research. There is no secret clinic to look for that will have a cure. If there was any readily available and affordable cure it would be mandated to cut the life span service costs to people with Autism. So we are all on the same side of finding such a cure.

Some new brain scanning technologies are now proving to be useful research tools. In addition some traditional and alternative biomedical treatments have emerged in the last decade, and are being tested and proving useful to address certain symptoms of related biochemical imbalances. However, because of the diverse nature of Autism, no one of these emergent treatments has been shown to work for all children with Autism. Usually research outcomes on treatments reveal the true nature of Autism being a wide Spectrum Disorder with, yet to be identified, sub groups. This is because Autism is still relatively rare and our group is not really a single biomedical group, which makes scientific research very difficult and expensive to conduct, which what are still very few and underfunded research centers. However, each day we are discovering ways to promote optimum development and functioning of peoples' brains, whether they are developing in healthy typical ways or not. So there is hope, there is always real hope. Because, any research that adds to our knowledge the physical nature of Autism and the human brain, can help us all better recognize the innate aspects of the condition we cannot yet change, realize those potentials we can change, and understand how to tell the difference.

•What can we do to test my own child for this physical/biolgicial/neurological condition?
We may only evaluate the living nervous system and its more subtle developmental features in a young child through external and ongoing observation of the person's volitional behaviors. While various electrical recording and imaging technologies have been developed, medical ethics and economics dictate that professionals may not utilize expensive or invasive technologies, if and when, these tools will not provide available treatment options for what is an observable diagnosis. Therefore, most often children with Autism are not provided with extensive initial testing or indepth evaluations. This is because the technical tools we now have still do not show the details of the growth, change, stablity and physical functioning of the highly intricate structures and biochemical functions of a living central nervous system (the brain and nerves in the body of a living person) in relation to the evolving physical features of any one individual within the Autism Spectrum. Therefore, we rarely can be sure of just what has happened to the brain of any one child with Autism, or is happening now, or will happen to their nervous system as it develops over a life span. New tests and technologies have shown a number of common atypical features shared by significant numbers of, but not all, persons with Autism, however, this research finding has not yielded any new neurological treatment options for all people with Autism. What people with Autism share in their nervous systems of their brains and bodies have proven to be many different physical conditions that create a shared pattern of atypical negative impacts on our early innate development of sensorimotor processing and integration, cognition and communication, and social awareness and relatedness. These problems are integrated into the brain in very complex ways that function beyond the detection of any existing technologies. Therefore, the diagnostic spectrum of Autism works like an umbrella. It is a broad cover under which we organize and name all the symptoms that we have then linked to name one shared developmental condition.

•What are the different degrees or kinds of Autism?
While the level of this pervasive developmental condition ranges from mild to moderate to severe, Autism ALWAYS represents a very serious challenges for the individual with Autism, their family, and the whole community across the settings we may life, work and cope each day. This is because Autism always alters a person's learning and reasoning processes at a physical level in ways that create a very different perception of our outer environment, experience of our inner realities, and perspective of our human interactions as social beings and groups. Children and adults with Autism and related disorders most often show combinations of different levels of more or less severe, moderate, or mild degrees of their sensory, communication and social features. Any one person with AUtism may have any or all of these three levels across these three features. By its very nature Autism represents both a diverse spectrum of individuals and a splintering of development within each individual. This is why understanding any one individual's true profile of Autism requires sharing of family and professionals observations over time and across settings.

A few people with Autism may show high or savant level skills in one or more of these sensory abilities. This is why in the early twentieth century people with severe Autism, but intact high splinter skills such as rote memory skills, music, math and art were labeled as Idiot Savants. While savant skills are impressive in children with Autism, maximizing or even maintaining such extreme splinter skills may come at the long term cost of some critical neurological forms of imbalances in developing other important knowledge, skills or abilities people with Autism can learn to live more typically and independently. While it is an individual judgment call (AND an emerging issue of social empowerment for self advocacy by the group of adults with Autism for their member group of children with AUTISM) savant skills probably should NOT be over-focused on in the hope of fostering exceptional giftedness, or other areas of development and independent functioning may seriously suffer.

•What types of biological causes Autism have been identified?
Autism has proven to have a large number of causes that may fall into two basic categories: genetic (internal/innate) and environmental (external/nurtured). Genetic means that the person has blood relatives that have had Autism or related disorders, or experienced genetic mutation or damage, which have occured in ways that may cause other family members to inherit a greater or lesser tendancy to also have an Autism Spectrum Disorder or related condition. There is no one gene that has shown to correlation to families that have patterns of Autism. Recent Genome Project research shows that as many as 27 genes may be involved in Autism. This means that we do not yet have a single genetic marker test to predict risks of Autism or to identify prenatal or newborn infants with Autism. Environmental means that some non-genetic element that the child was exposed to during pregnancy or infancy (birth to three), may cause pervasive changes or significant damage to the anatomical structures or biochemical systems of the brain during any one of several critical phases of development during the pregnancy and/or the early years of life.

What has the history of biologically-based research of this neurological condition revealed?
Autism is the result of neurological disorders that affects the typical growth, change and stability of the structures and function of the central nervous system/the brain. As early as 1960 Autism was thought to be an emotionally-based psychodynamic illness. However, there is now a huge and still rapidly growing base of biological research on the neurological etiology of this condition. Currently medical diagnosis of Autism notes characteristic behavioral symptoms related to communication, social, sensorimotor and functional abilities. These behavioral symptoms are now seen as indicative of underlying biological problems in the central nervous system. Current genome research indicates that Autism can be linked to a complex genetic predispositions to the condition, involving nearly 30 different genes. This could mean that the disorder could present itself congenitally as part of a person’s innate developmental potential or possibly be triggered by some environmental factors during pregnancy or infancy. Therefore, Autism is not caused by non-biologic events such as poor parenting or inadequate education, although timely diagnosis and early provider training means that parents and teachers can make a critical difference in each child’s development. It may be possible for us to make significant changes at a physical level from birth to five yrs. old--and provide care lifelong.

The biological condition of the structures and functions of the brains of people with Autism vary a great deal across the population and do not always correlate to the severity of the Autism. Earlier autopsy research revealed a wide variety of neurological differences and/or damage in the individual brains of people with Autism, rather than finding a single biological brain disorder. Modern autopsy results indicate that people with Autism may actually belong to a number of different subgroups with atypical development in certain structures or cellular functions of the brain that result in similar behavioral symptoms and developmental limitations. Current brain scans confirm this wide range of findings indicating a very heterogeneous population. Brains of people with Autism may appear typical or show significant structural (anatomical/using MRI) and/or functional (electrochemical/using SPEC scans) problems. This makes Autism a spectrum disorder in both its biological conditions, behavioral features, and developmental outcomes. This wide variety in the causes and presentation of this condition make it difficult to research and treat as a single population. In the future, it is likely that identifying specific biological/brain disorder subgroups within the spectrum of Autism will improve the validity of scientific research, increase the significance of research results and improve intervention efficacy.

Early Autopsy research revealed a wide variety of neurological differences and damage in the brains of individuals with Autism, rather than finding a single biological brain disorder. More recent detailed microscopic forensic studies have revealed several features that can be identified in significant numbers of people with Autism, but not all people with Autism. This supports the proposal that Autism is really a set of biological subgroups with a variety of neurological conditions that create similar symptoms. Contrary to a lay assumptions, the brain’s degree of atypicality and even damage may not correlate to the severity of the Autism in each individual. It can appear normal or show significant anatomical (structural) and/or electrochemical (functional) problems. Modern brain scans of people with Autism confirm these heterogeneous findings. Some of the structural and functional features that have been found across subgroups of people with Autism, that can be directly related to the features of Autism are:

Changes in the size and thickness of the Cerebral Cortex. This is the big sheet of brain tissue that folds up to create the rib-like appearance of the brain. In people with retardation it is usually smaller in area dimension, while in some people with Autism it may be measurable bigger than normal. But the thickness and quality of the sheet may be thinner and atypical in its structure. The “association areas” where incoming messages from the senses are combined into meaningful impressions and interpreted in communication and social terms and responded to with outgoing motor behaviors are located across the cerebral cortex. This would account for the impairment of early learning and life spanexecutive and higher reasoning functions, as well as narrower high splinter skills common to some people with Autism. Very recent research confirms that some infants with Autism may have sudden periods of atypically large head size. This is an important finding that may someday reveal causes of the onset of Autism.
Changes in the neural fibers of the Corpus Callosum: This is the netweork of specialized nerve fiber that connects the hemispheres. These were seen as normal in early autopsies, yet later microspophic cellular scans showed atypical higher numbers of fibers than typical brains, but with poorer quality of the connecting cells. This could correlate to the difficulty in rapid automatic processing of information and integration of various mental functions in the brain seen in some people with Autism.
Changes in the functional activity of the Front Lobes:: This area of the brain is very important but less understood in how it functions in typical people. It controls goal planning, following complex and reversable directions and task completion and what we see as emotional control and personality. It is atypically active/less active in people with Autism and ADD/HD. Yet this lower activity that may contribute to hyporesponsiveness to the environment can actually produce aggitation and experiences of stress.
Changes in the functional activity of the Temporal Lobes: This area of the brain effects motivation as well as hearing, recognizing faces and smell, which include several are core symptoms of Autism such as auditory processing and poor recognition of faces, and facial expressions of emotional feelings and nonverbal social communications.
Changes in the structure of functional activity of the Limbic System: This is a ring of structures around the brain stem that effect sensory processing, reticular formation (which is the alert and arouse control of higher brain functions), and learning and emotional behavior. In typical people it has fewer longer loser type cells. However, In people with Autism has shown to have more shorter tighter packed cell groups This would explain why people with Autism report being overwhelmed by input and their internal experience of thinking and feeling, even while the majority of their brains and response indicate a hypo arousal response pattern.
Changes in the stucturs and functional activitys of the Thalamus which controls processing of sensory input--except smell, the Hypothalamus which produces and regulates motivation and emotion, and the Hippocampus and Amygdala which helps manage Information processing and integration in ways that effects behavior. All of these are shown to be involved in Autism.

These emergent biolomedical findings mean that developmental systems science approach to research may soon become of critical interest to the Autism community in the last decade. New medical technologies combined with the current scientific interest in how the body and brain interact and how genetic and environmental influences operate could yield new and important information about Autism. Within a systems science approach we could advocate that the medical community work together in an organized way with the psychological and educational communities to research the biological nature, screening, diagnosis, possible prevention and treatment strategies for this complex and heterogeneous spectrum disorder. Exploring the similarities and differences in how the brains and bodies of individuals with, and without, Autism are structured and function could help us understand each other.

Well-founded theory and well-supported forensic, experimental, correlational, longitudinal and case study research in the fields of neurophysiology and psychology have clearly demonstrated the critical biological and significant cognitive aspects of the brain’s early sensorimotor development in all infants and toddlers, including children with Autism. The main developmental task of infants between birth and 24 months of age is to become aware of how each of their senses and body parts work and then to begin to integrate that consciousness back into automatic processing as a foundation for later higher executive functions of the brain. While the typical growth, change and stability of sensorimotor abilities will continue to develop and mature through puberty, these first two years are seen as a critical period of essential development of the brain. To continue to develop typically a baby must become able to process and integrate both internal and external sensorimotor information quickly and accurately. This time of basic organization of all the senses and body is believed to create a strong foundation for the development of functional visual and verbal memory abilities, the innate cognitive capacity of the mind and so effective functional skills, flexible learning strategies and adaptive behaviors. Therefore, a strong biologically-based sensorimotor foundation is needed to support more successful cognitive and psychosocial growth during the preschool to kindergarten years. This foundations then serves to support the rapid growth in learining, communication and social skills seen during the schoolage years. But while, children have completed much of their critical biosocial, cognitive and psychosocial development by age five, from birth to five the central nervous system's development remains extremely plastic and a person's general health can support or hurt that development. Early interventions that may support/remediate sensorimotor development problems and any secondary biological problems that may cooccur with Autism are very important for all children, and therefore they are also very important for children with Autism.


A.D.A.P.T.™ Training Series. Copyright © 2000-03 by Sharone Lee. ALL RIGHTS RESERVED. All names, concepts, methods, materials, products and publications are protected by trademark and copyright, and no part of this text or this web page may be reproduced or distributed in any manner, for any purpose, including educational purposes, without express written consent from: THRESHOLD • SALEM, OREGON • 503-375-9462 • sharone@understandingautism.org. Portions originally published in the 1999 Fall Issue and 2002 Complimentary Edition of The Net Journal of the Autism Society of Oregon, with the Author's permission.