Psychoanalysis Helps Kids With Autism

(WebMD)  From the strict dairy-free and wheat-free diet that actress Jenny McCarthy details in her best-selling book, "Louder Than Words: A Mother's Journey in Healing Autism," to mercury detoxification and other types of speech and behavior therapies, there is little that parents of children with autistic spectrum disorders will not try to help reach their children.

And psychoanalysis may be a valuable addition to the mix, researchers said at the annual meeting of the American Psychoanalytic Association in New York City.

The CDC estimates that one in 150 individuals has autism, a disorder that begins in early childhood and is marked by developmental delays and lagging social and communication skills.

Autism is part of a larger group of disorders that is referred to as autism spectrum disorders. The symptoms of autism can range from very mild to quite severe. Children who are diagnosed with autism often see numerous specialists several times a week for various types of speech and behavioral therapy.

Psychoanalysts see autistic children four times a week, typically with a parent in the room. They also counsel parents once a week separately to keep them abreast of progress. In a nutshell, the analyst serves as a sensitive translator who attempts to decode what the child is thinking, feeling and doing.

"A major piece is to make sense of what the child is trying to communicate, translate it to the mother, and give her the confidence that she can do it, too," explains Susan P. Sherkow, MD, a New York City psychoanalyst who works with autistic children and their families.

"The therapist focuses on the behavior, mood, or emotion of the child and then translates it to the child and waits for a sign that the child feels understood, such as a furtive glance. And from there, the therapist enters the child's world," she explains. Sometimes this translation is putting the child's actions into words, such as saying "you are picking up a cup."

"Psychoanalysis should be part of the package because unless you have a really gifted specialist, you are not going to get at the meaning of what these children are trying to convey," she says.

Another therapy known as applied behavior analysis (ABA) is aimed at supporting the behaviors that you want in the child and extinguishing those you don't, while psychoanalysis works at trying to understand the child.

Is Autism Reversible?

Sherkow and others believe that autism may be reversible with early intervention - including psychoanalysis. The theory is that the brain is more malleable than previously believed and can be reconfigured with proper therapy.

To that end, the American Academy of Pediatrics (AAP) is now urging pediatricians to screen every child for autism twice by age 2. Some early red flags include: not turning when a parent calls the baby's name; not turning to look when the parent says, "Look at me!" and not pointing themselves to show parents an interesting object or event; a lack of back-and-forth babbling; smiling late; and failure to make eye contact with people.

"Autism was considered a brain condition that can't be changed, and I think that is now dated and not right," says Martha Herbert, MD, a pediatric neurologist at Massachusetts General Hospital in Boston.

And this is just not the case anymore.

"I have seen enough kids do substantially better than when they came in, and I think we can no longer assume that autism is not reversible, but we don't know whether it is reversible for everyone or subgroups," she says. "The real gauntlet it throws down is that if some kids can get a lot better and you don't know which ones it will be, how do you justify limited care?"

Now if a definitive diagnosis is made, the child should be in intensive intervention at least 25 hours per week, 12 months per year, according to the AAP.

"We used to have soccer moms and now we have therapy moms," Herbert tells WebMD. "Moms are running themselves into the ground and yet they are not really present, so they become part of the process and not part of solution."

Parents of children with autism need to relate to the child in whatever state they are in - and this is where psychoanalysis may be helpful, she says.

Psychoanalysts can be sensitive to the inner world of the child. "It's a skill you can't package, but it's wonderful," Herbert says.

Many Approaches To Autism Treatment

"Very little is known about effective treatments for autism," says Andy Shih, PhD, vice president of scientific affairs at Autism Speaks, a New York City-based nonprofit group aimed at increasing awareness of autism spectrum disorders and funding research into its causes, prevention, and treatments.

"The only approach that has evidence behind it is ABA," he tells WebMD. "In many cases, this approach has been helpful in allowing children to lead a healthy and more normal life."

There are things that parents are trying today that may lack solid evidence such as diet changes, he says. "One of the major challenges is that this population is so [diverse] that what works for one parent may not work for your children. There is a lot of confusion and lack of clarity about what works or doesn't work."

Shih doesn't discount any treatments including psychoanalysis. "All are possibilities, but what we really need is more research assessing how interventions work and what children they work for," he says. While he is not sure whether or not the disorder is reversible, "I think that it is certainly a possibility."
By Denise Mann
Reviewed by Louise Chang
© 2008 WebMD, Inc. All rights reserved

[elarsson]

Tired of being written off, and with money to be made on the heels of the AAP''s 2007 report, Psychoanalysts put out a press release in which they write, "researchers say" instead of "research shows," deftly insinuating that their field is grounded on evidence, when in actuality, the field of Psychoanalysis has been a bastion of anti-research. There is not one shred of actual research about Psychoanalysis cited in this article.

[elarsson]

Tired of being written off, and with money to be made on the heels of the AAP''s 2007 report, Psychoanalysts put out a press release in which they write, "researchers say" instead of "research shows," deftly insinuating that their field is grounded on evidence, when in actuality, the field of Psychoanalysis has been a bastion of anti-research. There is not one shred of actual research about Psychoanalysis cited in this article.

[garbosmed]

Notice how this article has not a single quote from a parent, or single example of a kid who has benefited? The only thing it mentions about parents is that they''ll do anything (i.e. spend whatever it takes) to cure their kids, and that even though they are caring for their kids 24/7 and taking them to 25+ hours a week of therapy appointments they are "not really present". Yeah, that''s a group of people I''d trust my kid''s future with. The ones who have no explanation for the rise in autism, and no understanding of what causes it, but yet seem convinced that they have a cure even though they don''t seem to have any actual examples of it. So the answer must be that they need to try to get a bigger piece of the pie by putting kids into more hours of therapy. Yikes! Run away!

[garbosmed]

This lame article is of a piece with the Parade article in Sunday''s paper, and a new study trying 25 hours a week of ABA training for INFANTS who have older autistic siblings to see if autism can be prevented that way. The closer parents and researchers get to the truth -- that autism is not an incurable psychological disorder but rather a physically based, medical disorder that that is medically reversible -- the more the shrinks and ABA practitioners will fight to try to hold on to their lucrative turf. Guess what? Autism is preventable and reversible. Parents and doctors are proving it every day. Psychology, ABA and other therapies might help, but autism can be truly reversed only if the underlying medical cause is addressed.

[aheadofcrowd]

I trust a psychiatrist like I trust the Bush administration. Be careful of psychiatrists telling you that your children have a mental illness because this is just an excuse to put your child on power mind-bending, highly profitable drugs for a lifetime.


HTTP://WWW.SSRISTRORIES.COM/INDEX.PHP

[lucasnico]

bmsbms29.......you have a great point about diet. In some cases it''s soy...others wheat, gluten..... with our son, we tried every diet suggested....including the elimination diet. None of it worked. He''s just not a diet candidate. However, these are relatively easy to implement, and worth trying.......and while they may work for some, certainly not the answer for most.

[velika-2009]

GrammaWhamma, too late, they are starting to do that now. Two year olds are tested for bipolar, add, odd you name it. and pregnant women are on Prozac. wow what a nation we live in

[lloydbest1]

Posted by AutismDad3 at 12:53 AM : Jan 27, 2008

Bettelheim has a lot to answer for....
Way back in 1951 or early ''52, my mother, a degree''d psychologist in her own right, was enough fed up with my distancing tactics, complete inability to talk, failure to engage with anyone, and general lack of typical development that she had me evaluated. What she got back was a diagnosis of "profound and incurable autism" (her words).
If that wasn''t bad enough, these folks went on to rub salt into the wound. They spent the next hour or so serving up pretty much the same sort of garbage that Bettelheim pushed since the late 40''s; that my mother was cold and incompetent. They then suggested she leave me at the institution, forget she ever had me and remember her mistakes so she wouldn''t repeat them with her next child should she be so ill advised as to have another.
I don''t remember any of this, of course, and when she shared that story with me some 21 years after it happened, she was still livid with indignation.
My suggestion to those who opt for psychoanalysis is be careful to choose a therapist who completely rejects Dr. Bettelheim''s useless theories.
AutismDad3, I may be assuming too much but if you are the parent or close relative of an autistic child, please take heart...Some of us do get better and while my verbal and social skills are still pretty anemic, I am holding down a job and have managed to raise a family successfully.

[livsparents]

I find this take on autistic therapies equally reprehensible and self serving for the American Psychoanalytic Association to suggest it. These children and parents would do far better with their 5 days a week seeing a good ABA therapist, a good speech therapist or a good occupational therapist. Unless they are specifically trained, a psychiatrist is not qualified to deal with a developmental disorder like autism. Leave the communication training to the professionals, Sigmund...

[autismdad3]

This article is reprehensible. It was the psychoanalytic understanding of autism, promoted in the US by the fraud Bruno Bettelheim, who beat the autistic children in his care, that condemned autistic children to institutions for years. Why? Because the psychoanalytic explanation of autism was that it was caused, not by neurological defects in the brain, as the science now tells us, by "refrigerator mothers" who rejected their children. At least the psychoanalytic establishment, clearly desperate to maintain its fraud in the face of real science, could acknowledge the horrors that Bettelheim caused.