Showing papers by "Michael Rutter published in 1978"

Autism: A Reappraisal of Concepts and Treatment

Abstract: ion, 88,90 Addison's disease, 243 Adenosine triphosphate (ATP), 170

Diagnosis and Definition

Abstract: Most of the chapters in this book take for granted the definition of infantile autism and the criteria to be used in its diagnosis. That is right and proper, but the questions of definition and diagnosis have given rise to such controversy over the years that it is necessary to set the scene for what follows by some discussion of the issues involved.

Treating Autistic Children in a Family Context

Abstract: Infantile autism is a complex disorder which involves abnormalities of development and of behavior, both of which need to be taken into account in planning any type of treatment program During the 1960s there was an increasing number of reports of the successful use of behavioral techniques in alleviating these many and various problems in individual children Operant approaches were employed to aid the development of positive or normal features such as imitation, eye contact, social skills, speech usage and communication (Hingtgen et al, 1965, 1967; Hingtgen & Trost, 1966; Lovaas, 1966, 1967; Lovaas et al, 1965b, Metz 1965; McConnell, 1967; Halpern, 1970; Mathis, 1971; Risley & Wolf, 1967; Sloane et al, 1968) Operant procedures were also used to eliminate a wide range of deviant behaviors including self-injury, temper tantrums, aggressive behavior, hyperactivity, encopresis, and negativism (Lovaas et al, 1965a, b, 1966; Tate & Baroff, 1966; Graziano, 1970; Wetzel et al, 1966; Wolf et al, 1964, 1967; Maier, 1971; Marshall, 1966; Sulzbacher & Costello, 1970; Brown & Pace, 1969) It became clear that operant approaches provided a useful set of therapeutic interventions which could achieve fairly rapid results in terms of alteration of specific behaviors, if the child was treated daily by skilled professionals on a one-to-one basis in a well-controlled inpatient setting

A Twin Study of Individuals with Infantile Autism

Abstract: In his original description of the syndrome of infantile autism, Kanner (1943) noted that the condition was distinctive in that in most cases the children’s behavior had appeared abnormal right from early infancy. He suggested the presence of an inborn defect of presumably constitutional origin. Since then there have been numerous hypotheses concerning the possible nature and origins of this defect (see Ornitz, 1973; Rutter, 1974). However, in spite of the supposition that the disorder is inborn there have been surprisingly few attempts to investigate possible genetic influences (see Rutter, 1967; Hanson & Gottesman, 1976).

Etiology and Treatment: Cause and Cure

Abstract: Both Berlin and DesLauriers in the preceding chapters have urged the importance of planning treatment on the basis of what is known about the nature of autism and about its etiology. Berlin (Chapter 20) draws attention to the growing evidence on how early life experiences can shape later development and on how stresses and deprivation in infancy can cause persisting and serious disorders. He suggests, as does Szurek (1973), that a failure in initial bonding may be one cause of autism. It is argued that this bonding failure may often stem from parental difficulties or inadequacies and, therefore, that psychotherapy with the parents constitutes a crucial part of treatment in many cases. In his early writings (e.g., Szurek & Berlin, 1956) he stated that his therapeutic approach to autism was based on the hypothesis that the disorder was “entirely psychogenic.” Berlin now recognizes that there may be constitutional components (Berlin & Szurek, 1973) but still argues (Berlin, 1973) that “a prime etiologic element is the interpersonal one” and that “the child’s reactions usually result from the conflicted amalgam of the parents’ feelings and behavior toward him.”

Subgroups Vary with Selection Purpose

Abstract: The work on autism, brought together in this volume, is not complete. The search for causal factors continues. New ground has been broken in the field of genetics. The focus on physiological, neurological, and biochemical factors is being sharpened. Blind alleys followed in the search for social and family contributions to the disorder are gradually being replaced by data and rational inferences. The efficacies of different treatments are still being tested, and optimum educational strategies are evolving. However, while some clear steps toward enlightenment have been taken, this devastating disorder is still shrouded in too much darkness.