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In an article appearing in the October issue of Scientific American, McLean Hospital biostatistician Nicholas Lange, ScD, asserts that although the road to more accurate diagnosis and treatment of a disease as complex as autism is long, some existing therapies are already showing lasting effects, and more are on the horizon.
“Autism is a complex disease with multiple causes, differing degrees of severity, and the involvement of large areas of the brain,” said Lange, associate professor of Psychiatry and Biostatistics at Harvard Medical School. “Begun early, therapies that ground the child with autism in appropriate forms of social behavior may mean the difference between years in a special school or institution versus a normal track for the elementary and secondary years and the eventual hope of an adulthood with a job and family.”
In the US alone, about 800,000 people younger than 18 years old are on record as having autism spectrum disorder, and the number continues to move upward. For the thousands of parents whose children receive an autism spectrum disorder diagnosis every year, the condition remains largely a mystery, without a molecule, gene or difference in brain size to mark its origination. And while some drugs have been shown to manage the irritability, mood swings and tantrums of children with autism, there is no FDA-approved drug that deals with the basic symptoms of the disease, including communication deficits, social problems and repetitive gesturing.
The genetic underpinnings remain largely a mystery because identifying the relevant mutations is a daunting task. Some studies suggest that an individual’s predisposition is rooted in alterations in as many as 400 to 800 genes. Basic research into how autism develops is now trying to disentangle this complex genetic web and to follow other leads in brain imaging.
Help may come in the form of early intervention therapies that improve communication and social skills, laying the groundwork for entering regular schools and engaging in relationships with friends and family. And improved understanding of the biology of autism may permit development of new diagnostic techniques and a range of drugs to complement behavioral therapies aimed at enhancing social skills. But whatever the future holds, a multipronged approach will be needed to develop ways to ameliorate the initial symptoms in an 18-month-old toddler and to devise treatments that extend ultimately to correct the abnormal functioning of brain cells.
Read Lange’s article “Intensive, Early Therapy Helps Children with Autism Improve Communication Skills,” online or in the October issue of Scientific American.