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Morgan Schwartz

Mr. Martin

AP US History

11 March 2013

Autism: The Challenges and the Rewards

“Your child has autism.” Four words that every parent dreads hearing. The four words

that spark a lifetime struggle with a diagnosis that will never go away and is unlikely to be cured.

Autism effects an increasing number of families every year. They struggle with the challenge to

find therapies to help their child and themselves cope with a diagnosis that will change their

entire life. Autism Spectrum Disorder (ASD) is a developmental disorder that often causes

deficits in social skills and language, as well as numerous health issues. Each individual on the

spectrum, although sharing the same diagnosis, is a unique person requiring an individualized

treatment plan. Parents struggle to find treatments for their child because there is no set treatment

plan that is guaranteed to work for every individual. Autism is a little understood childhood

illness that greatly effects the lives of those with the diagnosis and their families. Awareness

needs to be raised so that private and government funding is available for research and so that

autistic individuals are accepted into society.

In earlier centuries, people did not have science to explain autism and other mental

disorders so they instead blamed fairies or other mystical creatures. Legends tell stories of

changeling children, newborn babies who were stolen during the night and replaced by the child

of a witch, goblin, or fairy.1 Ana Maria Rodriguez, a researcher who has examined the legends of

changelings, proposes that changelings were autistic or victims of other developmental disorders.

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Parents of “changeling children” noticed that “while human babies were affectionate and eager to

communicate, goblin babies were aloof or distant physically and emotionally.”2 This description

is similar to the common symptoms of autism that parents first notice. Misunderstood changeling

children were often killed or mistreated by their parents in hopes that the mythical parents of the

children would save them and return the original child.3 Fear of children who were different led

to the creation of the legend of changeling children.

Into the late 1900s asylums were the primary form of treatment for anyone who was

considered mentally ill, physically disabled, or possibly autistic, was placed in asylums.

Treatments were often cruel, ranging from blood letting in early asylums to lobotomies and

electroconvulsive therapy in the 1900s.4 Patients were kept in inhumane conditions and treated as

animals, some found chained to the wall with no ability to move.5 Today, in the United States,

asylums are rare and those that exist follow carefully designed treatment plans for each patient.

Those diagnosed with Autism Spectrum Disorder are rarely inducted into asylums today.

The first scientific report about autism was published in 1943 by Leo Kanner, a child

psychiatrist and physician. At Johns Hopkins Hospital, Kanner studied a group of eleven boys

and girls who had symptoms that seemed to represent a new disorder based on an inability to

interact socially.6 Kanner described the disorder as “autistic,” a term borrowed from Swiss

psychiatrist, Eugen Bleuler, who used the word to describe self-centered thinking.7 Kanner

observed that the children desired “extreme aloneness:” they preferred playing by themselves

with toys to any form of social interaction.8 Kanner also observed a number of other behaviors

and symptoms which have become part of the classic definition of autism today: difficulty with

speech and echolalia, rote memory, obsessive repetitive behaviors, and sensory issues.9 However

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despite their variety of symptoms and challenges, Kanner noticed that they possessed both

normal intelligence and severe mental retardation in different areas.10 Kanner’s observations

from his study of children with developmental issues began to raise awareness of the possible

disorder of autism.

At the same time as Kanner, Austrian psychiatrist Hans Asperger published a report in

1944 on a disorder, which he also described as autism, but later became known as Asperger

Syndrome. Asperger studied 200 children that displayed “self-absorption and isolation from

reality.”11 Although Asperger’s report described many of the symptoms that Kanner had reported,

as listed previously, the two reports also included significant differences. The children in

Asperger’s study developed normal speech and wide vocabulary with interests in specific topics,

while Kanner’s study recorded either a lack of speech or abnormal ways of using it, including

echolalia.12 The reports also differed in social skills: Asperger’s displayed social awkwardness

with a willingness to interact while Kanner’s described disinterest in any social interaction.13

These two reports of similar but different disorders became the basis of diagnosis for autism until

more research revealed the presence of a spectrum of disorders.

After the publication of Kanner’s and Asperger’s papers on autism in the 1940s, the

description and diagnosis developed into the Autism Spectrum Disorder (ASD) that is known

today. Doctors found that distinctions between autism and Asperger Syndrome were very faint

and frequently diagnosed patients with symptoms from both disorders. Today, doctors make their

diagnoses from the Diagnostic and Statistical Manual of Mental Disorders (DSM). The manual is

published by the American Psychiatric Association (APA) and serves to provide guidelines for

standard diagnoses of a variety of different psychological disorders and conditions.14 Autism was

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first added as a separate category of diagnosis to the DSM in the third edition in 1980, with

Asperger’s syndrome added to the fourth edition in 1994.15 The DSM-IV-TR, which is still in use

today, defines ASD as three things: Autism Disorder, Asperger Syndrome, and pervasive

developmental disorder—not otherwise specified (PDD-NOS).16 A complete definition of the

DSM-IV-TR diagnosis for these three disorders is available in Appendices A, B, and C.17 An

Autism Disorder diagnosis requires at least six symptoms from three categories: two in social

interaction, one in communication, and one in repetitive patterns of behavior. The diagnosis also

requires delays in development before the age of three or normal development before losing

skills which is called regressive autism.18 The diagnosis for Asperger Syndrome is similar in that

it requires two symptoms from social interaction and one from repetitive patterns of behavior;

however, it differs in that there is no delay in development of skills in communication and age-

appropriate skills.19 The diagnosis defined by the DSM is used as a reference and a standard for

the diagnosis of ASD.

Throughout the history of autism, people have blamed a variety of different causes of the

disorder, ranging from vaccinations and environmental factors to bad parenting. The “refrigerator

mother” theory was first proposed by Kanner and later popularized by Bruno Bettleheim in the

1950s and 1960s. This theory stated that autism was caused by cold and uncaring mothers.20

Today, the theory is disregarded as a potential cause for autism. Another popular theory blamed

autism on the measles-mumps-rubella (MMR) vaccine.21 This theory was first introduced in

1998 by British researcher Andrew Wakefield. He noted seeing several children that experienced

a loss in developmental skills at the same time as the MMR vaccine was given. He specifically

blamed the use of thimerosal as a preservative in vaccines.22 Thimerosal contains harmless ethyl

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mercury, different from the dangerous methyl mercury in seafood, but it was still viewed as a

possible cause of autism. Although many studies were done around the world that showed no

relation between thimerosal in the vaccine and autism, thimerosal was removed from US

vaccinations in 2001 in response to continued public concern.23 Data shows that even after the

removal of mercury from vaccines the prevalence of autism continued to rise.24 Both of these

theories on the causes of autism were widely popular but are disproved today and replaced by

many others.

Although scientists are aware that genetics is a probable cause of autism, research has

failed to reveal any clear answers. Some researchers are examining family histories to reveal

genetic conditions that might increase the risk of autism. One observation notes that a sibling of

a child with autism has a 10 percent chance of being on the spectrum.25 This statistic is

significantly higher than the Center for Disease Control’s (CDC) 2012 statistic that in 2008 1 in

88 children had autism or 1.14 percent of the population of children.26 For boys, the rate of

autism is as high as one in fifty-four.27 Researchers have also discovered that family members of

children with ASD have an increased risk for other milder forms of atypicality: nonverbal

learning disorder, language disorders, anxiety disorder, obsessive-compulsive disorder, and

depression and bipolar disorder. Scientists believe that the few dozen genes that are suspected of

causing autism also cause these other milder disorders.28 Although genetic factors may cause

autism, scientists believe that there may also be environmental components involved.29 Research

done on identical twins has shown that, although the twins have the same genes, one twin can

have more severe autism due to environmental influences. For example, two identical twins, Tom

and Jim, have different degrees of Asperger Syndrome because of birth complications. Tom had a

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normal birth, but Jim did not breathe until oxygen was provided by doctors. Doctors believe that

the brief time without oxygen may have intensified Aspergers in Jim.30 Situations like this and

many others show that the genetics of autism and the effects of the environment are currently a

little understood field that is being aggressively researched today.

At this point, autism cannot be diagnosed through any genetic testing; however, there are

other syndromes that can display autistic characteristics and can be tested on the chromosomal

level. Down syndrome, for example, is easily identified by the presence of three copies of

chromosome 21 rather than the normal two.31 Down syndrome can cause the characteristic

physical appearance as well as low muscle tone and mental retardation. A very small minority of

the Down syndrome population are also diagnosed with ASD. Another chromosomal disorder

that displays autistic characteristics is Fragile X syndrome due to a visible mutation in an X

chromosome. Fragile X is more common in males and is presented through physical features,

mental retardation, and the developmental challenges of ASD.32 Rett syndrome is also caused by

a mutation on the X chromosome although at a different location than Fragile X.33 The disorder

primarily affects girls who appear normal until the age of six months to eighteen months when

they begin to lose language and social skills.34 The deterioration of skills and physical abilities

continues into adulthood.35 Although Rett syndrome is not autism, it shares characteristics with

regressive autism. These three syndromes are all easier to diagnose than autism because they are

easily identified through a simple scientific analysis for chromosome mutation.

Although clearly labeled in the DSM, autism is a less concrete diagnosis and has been

labeled as a childhood epidemic because of the increased prevalence. However, there are many

differences in opinions on whether the epidemic is real. The CDC’s reports on the prevalence of

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autism show the rate of 1 in 150 children having autism in 2000 rising to 1 in 88 having autism

in 2008.36 The controversy over the epidemic is whether the increase in autism is due to better

diagnosis or an actual increase in numbers. Those in the scientific and academic community,

including autism author James Coplan, argue that the increased awareness of autism combined

with wider definitions for diagnosis have contributed to the increase in prevalence.37 A graph of

the increase in autism diagnoses is available in Appendix D.38 Also, doctors and parents are

motivated to seek out an autism diagnosis because it opens access to different services and

therapies for their child. Although anthropologist Roy Richard Grinker agrees with the scientific

and academic community that labeling autism as an epidemic is incorrect, he sympathizes that

“there’s something reassuring about the idea of an epidemic.”39 Organizations that work to

provide support for those with ASD benefit from the use of the label “epidemic” because it raises

awareness and adds gravity to their plight. Autism Speaks President Mark Roithmayr strongly

supports the epidemic view because he can use it to inspire political action to support research

into ASD and resources for people with autism.40 Regardless, on either side of the epidemic

argument, both agree that autism is a problem that needs to be addressed to help those that

struggle with autism every day.

One of the most prominent goals of autism organizations is to promote early diagnosis

and early intervention programs. Most doctors and researchers believe that the sooner a child can

be placed in an early intervention program the more successful he or she will be. The most

popular early intervention program is the Early Start Denver Model (ESDM) whose goal is to

affect the main symptoms of autism in toddlers: “social orientation and attention, affect sharing

and attunement, imitation, joint attention, language development, and functional and symbolic

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play.”41 Therapy is based upon activities that involve give and take between the child and the

therapist. Games will often depend on the child’s personal interests so as to foster independence

and decision making.42 ESDM also includes a parent training program that gives parents

opportunities to incorporate ESDM into their daily activities to create teachable moments for

their child. The use of ESDM with their child will also help build parent-child relations and

foster the parents’ sense of empowerment.43 Another benefit of ESDM is that it can be used with

children as young as twelve months old.44 Long-term studies done on ESDM have shown it to be

effective in alleviating the symptoms of autism and increasing a child’s chance at success. A

study published in the Pediatrics journal compares the progress of two groups of twenty-four

children ages eighteen months to thirty months who participated either in two years of ESDM

intervention or in two years of community provided intervention.45 Children who participated in

ESDM therapy achieved remarkable improvement in IQ, language, and adaptive behavior

compared to the community-based therapy group that gained little improvement. Also, in the

ESDM group thirty percent of the children had their autistic diagnosis changed to the less severe

PDD-NOS diagnosis, while in the community based intervention group only five percent of the

children had their diagnosis changed.46 The clear benefits of the Early Start Denver Model for

early intervention have created a movement to increase the number of early diagnosis and

therefore early intervention.

Applied Behavior Analysis (ABA) is one of the most popular and successful behavioral

interventions for autistic clients. ABA’s goal is to increase positive behaviors and decrease those

that are troublesome, while also teaching many different daily life skills that are necessary for a

child to function well in his or her environment.47 ABA can be used to teach many different skills

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from a very basic level such as saying hello to one’s mother or asking for food if one is hungry.

The core principles of ABA are based on the ABC’s of behavior: antecedent, behavior, and

consequence. An antecedent is the request or motivation for a behavior. The behavior is the

appropriate response to the antecedent. The consequence is the reward or praise that is given to

the child in return for an appropriate behavioral response.48 A key element of ABA is that wrong

actions on the part of the child are either ignored or redirected, never punished.49 To be effective,

ABA needs to be implemented into a child’s schedule for several hours per day with the

therapist.50 ABA can be even more powerful if the therapy is continued in the hands of the

parents. Parents often receive special training to learn how to create teachable moments and how

to respond to their child’s behavior.51 In addition to standard ABA therapy, there are many

different varieties of ABA therapy that can work better for some children. ABA and therapies in

the style of ABA are powerful tools that can be used to teach those on the spectrum skills that

they need to succeed in daily life.

Many on the spectrum can also benefit from speech-language therapy either to improve

their pronunciation and mechanical speaking of words or to teach them how to effectively use

language to communicate. Three types of speech-language therapy can be done to help autistic

clients: speech therapy, language therapy, and picture exchange communication system (PECS)

therapy. Classic speech therapy can be done to help those that can speak and communicate but

cannot pronounce their words clearly enough to be understood. This therapy will work on the

proper physical movements of the cheeks, lips, and tongue.52 On a different level, language

therapy can be done to help clients learn how to properly use language to express themselves,

which can involve exploring how the brain processes ideas and how it forms sentences. As part

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of the language therapy program, therapists will teach their client how to better communicate

with eye contact and how to engage in conversations in a variety of situations.53 In the field of

language therapy there are a variety of different techniques and styles that can work better on

some children than others. A third alternative, PECS, is available for children that have an

understanding of language but cannot communicate orally. With training from a therapist,

children can learn how to exchange a picture for an object and eventually how to express their

thoughts and desires with pictures.54 In addition to PECS, other forms of alternative

communication are available, such as gestures or sign language.55 It is important to note that the

use of PECS of other alternative communication devices will not prevent or inhibit nonverbal

children from learning how to talk. Instead, an understanding of how to communicate can

motivate the child to learn how to talk.56 With any speech-language therapies, it is only effective

if the child carries over skills learned in therapy sessions into other parts of the his or her life.

Parents, other therapists, and teachers all need to collaborate with the speech-language therapist

to best encourage a child to use speech in their daily life.57 With proper implementation, any of

these therapies can be effective for those with autism by teaching them how to effectively

communicate with their world and to manage social situations.

In addition to some of the basic social skills that can be taught through ABA or with

speech-language therapy, autistic individuals may need additional support from social skills

therapy, which can be provided through play group interactions or guided parental interactions.

The Integrated Play Group (IPG) model is used to promote socialization, communication, and

play among autistic children.58 Groups are formed of small numbers of autistic children and

neurotypical peers guided by a play guide who tailors sessions to the interests of the group.

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During play, the typical peers can teach their autistic counterparts how to properly engage in

social communication and play while the typical peers can learn how to be accepting of

differences and sensitive and inclusive of their peers.59 In addition to IPG sessions for social

skills therapy, parents can facilitate guided therapy in their own home using Relationship

Development Intervention (RDI). The RDI model works by having a therapist train and consult

with parents to help them create an environment that is conductive to the use of social inference,

where children must look to their parents for help and information in uncertain situations.60 For

example, Mom can place a child’s cup on the table upside down and wait for the child to fix the

cup before she pores the drink. The child must be aware of his or her environment and take

action to solve a problem with the guidance of his or her parent if necessary.61 Once parents have

received their training in RDI they will consult with a therapist to create a curriculum and set

goals for their child. This program is particularly effective in teaching problem solving skills and

social skills because it requires the child to interact with his or her parents and environment and

learn how to become flexible in social situations.62 The combination of the RDI model with the

IPG model can work effectively to teach autistic children the range of social skills that they need

to function in today’s dynamic world.

Occupational therapy (OT) can be done to help ASD individuals with motor skills deficits

as well as daily life skills. OT is generally considered one of the more fun therapies with

activities using therapy balls, swings, roller boards, and other fun toys.63 An occupational

therapist can help any individual with “sensory, motor, neuromuscular, and/or visual skills.”64

Daily skills, such as brushing one’s teeth or getting dressed, can be taught by an occupational

therapist, as well as the fine motor skills needed for writing or other delicate tasks.65 Activities

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introduced by the therapist are practiced and reinforced at home between sessions.66 Although

occupational therapy is not necessary for all on the spectrum, it can make a tremendous

difference in some by removing the physical limitations that keep them from functioning well in

their daily life.

Many children with autism experience sensory challenges that can be lessened through

sensory integration therapy done by occupational therapists. Sensory integration is the way the

brain intakes information from the five senses, processes it, and responds appropriately. In

addition to the five senses, our brain also receives information from the vestibular sense

(balance), which tells the brain how to orient the body in space, and the proprioceptive sense

(awareness of our body in space), which tells the brain what to do with muscles, joints, and body

parts. Individuals on the spectrum may either be hypersensitive or hyposensitive to their

surroundings.67 A hypersensitive child is sensory avoiding because of his or her state of high

arousal in their environment. This child may avoid messy play, prefer old, soft clothing, move

away from groups of people, and avoid cuddling with family members. A hyposensitive child is

sensory seeking because of his or her low arousal in their environment. This child may seek out

messy play and unfamiliar textures, be unaware of clothing twisted in an uncomfortable way, and

fidget when sitting to retain awareness of where he is in the chair.68 In sensory integration

therapy, an occupational therapist can help both hypersensitive and hyposensitive children

achieve the sensory experience that they require, as well as retrain the brain to better process

sensory information and respond to its environment.69 ASD individuals with sensory issues often

cannot learn or function in their environment until sensory issues are addressed. Once they can

appropriately process sensory information, it is easier for them to learn and deal with new

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situations.70 While sensory integration therapy may not be necessary for all individuals on the

spectrum, for some it can make an incredible difference and allow them to function normally in

their environment.

Conventional medications, although not typically effective for behavioral issues, are used

to help treat the many other health issues that can accompany an autism diagnosis. One author

estimates that nearly forty to fifty percent of children and adults with an autism diagnosis are

taking some form of medication.71 Some common reasons for taking medications are seizures,

tics, gastrointestinal problems, sleep disturbances, anxiety disorder, depression, bipolar disorder,

obsessive-compulsive disorder, and attention-deficit/hyperactivity disorder.72 By treating these

disorders and reducing their effects, therapies for behavioral issues can become more effective.

Temple Grandin, an autistic women who speaks and writes extensively on autism, offers advice

to parents on the use of medications. Because many medications can have serious side effects,

Grandin cautions that parents should make sure that there is an obvious benefit from the

medication that outweighs any risk. She also encourages parents to introduce only one

medication at a time and to use a journal to record the changes that they notice.73 Another

common warning is to confirm that all possible behavioral treatments have been exhausted

before resorting to medications.74 Many parents have found that the benefits of medications can

outweigh their side effects, but it is important to use caution with any drug.

When therapies and conventional medicine are not successful in helping a child, some

parents seek out a solution in complementary and alternative medicine (CAM). Complementary

medicine is any treatment given as a supplement to another and alternative medicine is given in

place of a conventional one.75 Some popular alternative therapies include the gluten-free/casein-

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free diet as well as a variety of other dietary supplements and vitamins.76 Temple Grandin writes

that CAM therapies are a very personalized experience, as therapies that may work for one

individual on the spectrum may not work for anyone else.77 She cautions parents to pick and

choose carefully and see what works for their child. Parents need to be aware that adding

multiple CAM therapies or conventional medications can often do more harm than good because

some medications and supplements will interact in unexpected ways.78 CAM therapies can and

have been beneficial for many ASD individuals, but they need to be treated with the same respect

and caution as conventional medications.

When parents begin to design a treatment plan for their children, they can be

overwhelmed with the variety of choices. To further complicate the matter, treatment is highly

individualized and what may work for one child will not work for another. Most intensive

programs are based around twenty-five to forty hours per week of ABA treatment. The ABA

sessions will be broken up throughout the day and interspersed with shorter sessions of

occupational, speech, or other therapies.79 When parents are selecting therapies for their child,

they should do thorough research to discover the philosophy, goals, and implementation of a new

therapy. Youtube can be an effective tool to observe therapies in action.80 Because treatment is

provided by many different therapists, parents need to create a therapy team that shares the same

philosophies and is willing to work together to best help the child.81 The most cohesive therapy

programs have weekly or monthly meetings of the child’s therapists to discuss the child’s

progress. It is also recommended that parents have independent assessments done on their child

to measure progress by someone who is not involved in the therapy process.82 Even with well-

designed therapy programs, a child’s progress may be slow and subtle and treatment will often

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continue into adulthood.83 An effective treatment program can make significant differences in a

child’s ability to function with autism, but time, effort, and patience are all required to make a

cohesive program.

With the increase in autism diagnosis, organizations such as Southwest Autism Research

and Resources Center (SARRC), have been founded to research autism and provide resources for

families affected by autism. SARRC was founded in Phoenix, Arizona in 1997 by two mothers

of autistic children and the doctor that cared for them. Their mission is to make advances in

autism research as well as providing “insight, empowerment, and comfort to parents searching

for information and hope.”84 Today, SARRC offers a variety of services, including early

intervention programs, outreach to the medical and educational community, and vocational and

life-skills training for adults with autism.85 SARRC’s work in the community has made

tremendous strides towards making this type of outreach standard for all autism families.

Similarly, Autism Speaks was founded in 2005 by grandparents of an autistic child. Their

program was jumpstarted by a twenty-five million dollar donation from a close friend.86 Their

mission is to research the causes of autism as well as raise public awareness of the challenges

that face families with autism.87 Their program Walk Now For Autism is cited as the fastest

growing charity walk. In 2008, walks around the country raised twenty-seven million dollars for

autism research and advocacy.88 The efforts of Autism Speaks has spread autism awareness

across the country.

One controversial topic in the world of autism that has caused uproar among autism

organizations is the proposed changes to the soon-to-be-released Diagnostic and Statistical

Manual-Fifth Edition (DSM-5). The change that affects autism is the combination of the three

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separate diagnoses of Autistic Disorder, Asperger’s Disorder, and PDD-NOS under one label of

Autism Spectrum Disorder. While the DSM-IV-TR lists three categories of symptoms that must

be present for diagnosis, the DSM-5 simplifies the requirements to at least three deficits in social

communication and at least two in restricted activities and repetitive behaviors. In addition, a

new diagnosis of Social Communication Disorder will be added to allow for communication

challenges without repetitive behaviors.89 The APA hopes that the new diagnostic criteria will

create more consistent diagnoses that can be tailored to fit the individual client.90 Before the final

publication date in May 2013, the APA has released a draft of the DSM-5 online for viewing by

the public. The reaction to the proposed changes ranges from praise to warnings of dire

consequences. Some critics are concerned that the new condensation of the previous three

diagnoses will exclude some people who received a diagnosis under the old criteria. When

patients who have an autism diagnosis are reevaluated under the new criteria, there is a

possibility that some will not receive an ASD diagnosis under the new criteria. Many people on

the spectrum depend on their diagnosis to help them access important services and therapies that

would not be available without their diagnosis.91 The true impact will not be revealed until the

changes go into effect in May 2013.

Rupert Isaacson’s memoir, The Horse Boy, tells of his family’s journey to Mongolia with

their autistic son and the terrible trials that motivated their trip. Isaacson describes “this weird,

irrational shame, as if I had somehow cursed this child by giving him my faulty genes.”92 Many

parents experience both a grief and a guilt cycle, convinced that they are responsible for their

child’s autistic diagnosis. This belief that parents are responsible has been encouraged by the

false “refrigerator mother” theory that was popular in the ‘60s, believing that unloving mothers

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produced the autistic symptoms.93 Rupert also struggled with the well meaning comments from

his parents and in-laws, such as, “you’re too indulgent with him.”94 In a sourcebook about coping

with an autism diagnosis, Karen Siff Exkorn, mother to an autistic son, explains that many

relatives and friends feel compelled to offer comfort and advice. The best way to deal with their

well-meant intentions is to redirect them into concrete help, such as running errands.95 Parents

also struggle to maintain the healthy relationship with each other that is necessary to parenting

even healthy children. Isaacson shares that he often found himself bickering and fighting with his

wife due to exhaustion and frustration.96 Exkorn encourages parents, in her book, to take time for

themselves and make a conscious effort to work on their relationship.97 The Isaacsons built in

one day each week for each of them to get out of the house and find relief from the constant

demands of parenting an autistic child.98 Parents also find criticism in public from strangers who

do not understand autism. Isaacson was enraged by the comment of a tourist at a wild horse park

who said, “Well, I think, if you have a child like that. With a certain…condition—by which it is

very noisy, it’s not very sensible to be around here, where a lot of people come to be in a quiet

environment.”99 The response of people such as this tourist is a major problem for parents with

autism. Isaacson’s memoir vividly recounts the misunderstandings of the challenges that parents

with an autistic child encounter on a daily basis.

The Horse Boy also reveals how the culture surrounding an autistic child can make a

significant difference in their progress. In most western nations, including America, individuals

with autism are viewed as strange because of the way they view the world. Society puts pressure

on them to change and socialize so that they can fit into society and not be a burden. In The

Horse Boy, Rupert Isaacson documents his incredible journey to Mongolia with his wife and

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autistic son, Rowan, to seek out shamans for healing. In Mongolia, the Isaacsons encountered a

completely different cultural viewpoint towards autistic individuals. When Rowan was rushing

about a park in Mongolia trailed by a film crew that was making the documentary, Isaacson was

startled by the reaction of the other people in the park. Although they were curious about the

strange spectacle:

everyone tolerated Rowan’s pushing, yelping, and joyful rushing about with a good

humor quite at odds with the more usual tut-tuttings or worse that we had come to expect

in the United States and Britain, when Rowan was at his most autistic. Here, it was if we

—he—were somehow being accommodated, not just tolerated.100

This unconditional acceptance of autism and all it encompasses does not exist in western nations

because of the mindset that individuals should adapt to society and society should not have to

adapt to them. In Mongolian society, those who are strange or see the world in a different way

often become shamans. The Isaacson’s Mongolian guide explained that “some shamans have

mental problems a bit before they start their training. It’s a sign that they are supposed to be a

shaman.”101 When Rowan was first introduced to shamans that Isaacson met while attending a

western conference as a journalist, they welcomed Rowan because “he’s one of us.”102 Rowan’s

reaction to the shamans was unusual because he did not get upset when they touched him, which

would have been his typical reaction.103 The kinship that was displayed between Rowan and the

visiting shamans, from a variety of different cultures, was also present with the Mongolian

shamans. Returning to their home in Texas, the family found Rowan better able to communicate

and manage daily life skills. Although the ceremonies and rituals that the Mongolian shamans

performed during their journey were powerful, it seems that an important part of Rowans healing

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came from spending months in a culture were he was accepted and welcomed.

What Would You Do is a popular TV series hosted by John Quinones that designs

scenarios with complex ethical issues to see how common people react. One episode examines

the challenges that families with an autistic child face when going out in public for dinner or any

other activity. When an actor taught to imitate autistic behaviors wanders around the restaurant

repeating words and knocking over his water glass, patrons react in two different ways. A rude

patron, also an actor, is offended by the parents’ inability to control their autistic child and asks

the family to leave so that he can eat in peace. Other patrons of the diner rise to the parents’

defense and loudly encourage the other rude diner to leave himself.104 The general response from

patrons shows the rising awareness and acceptance of autism, despite people who are ignorant of

the challenges of autism and believe that it is the result of bad parenting.

Autism was thrust onto the big screen in Rain Man, which followed the story of an

autistic savant, Raymond Babbitt (Dustin Hoffman). Charlie Babbitt (Tom Cruise) discovers his

brother Raymond, who he never knew, when his father died and left his $3 million dollar estate

to Raymond, instead of Charlie. Charlie kidnaps Raymond and sets off on a six day cross country

trip to Los Angeles. Raymond struggles with leaving his isolated and highly structured life in an

institution where he depends on routines and rituals to help him combat the deficits of autism.105

To accurately portray the movie character of an autistic savant, Hoffman spent time with several

savants, who display extraordinary abilities in a specific area to learn about their unique

characteristics. Raymond Babbitt was able to calculate large numbers in his head and to count

exactly the number of toothpicks that fell on the ground.106 Hoffman’s remarkable portrayal of

Raymond “upstages the work of everyone else involved,” in the film, says a New York Times

Schwartz 20

reviewer.107 For his incredible performance, Hoffman received an Academy Award in 1988 for

Best Actor.108 Tom Cruise, in the role of Raymond’s brother, also deserves commendation for

portraying the challenges of being a family member to someone with autism. Charlie is

constantly frustrated by Raymond’s seemingly irrational fears, such as of the rain that delays

their cross country drive until the weather clears.109 Rain Man has taught movie audiences the

challenges and rewards of autism as they see Charlie’s life enriched by his brother when he slows

down to appreciate small details and comes to admit that what is best for Raymond is the

structure of a group home.

The New York Times bestselling novel The Curious Incident of the Dog in the Night-

Time by Mark Haddon opens the readers eyes to the perspective of a boy with autism,

Christopher Boone, who discovers his neighbor’s dead dog and decides to find the murderer.

Christopher, who narrates the novel, almost immediately describes how he is unable to

understand complex emotions on other people’s faces.110 He also discusses his frustration with

metaphors for example, “he was the apple of her eye,” because “when I try and make a picture of

the phrase in my head it just confuses me.”111 The way one thinks is a noted difference between

neurotypical people and those with autism. Temple Grandin describes that the way that she, and

other ASD individuals, thinks in pictures can make understanding metaphors challenging.112

Christopher also follows very strict routines, which can defy logic of neurotypical individuals,

but give him comfort. For example, if he sees four red cars in a row on the way to school it is a

good day and if he sees four yellow cars in a row it is a “black” day. Christopher believes that his

system of determining a good or a bad day is more logical and dependable then the way people

base their mood on the weather or other less measurable factors.113 Although Christopher is a

Schwartz 21

high functioning autistic individual, his way of seeing and interacting with the world contrasts

that of a neurotypical person. By allowing the reader to get inside the head of someone with

autism, Haddon’s novel opens the door for the understanding of and compassion for autism.

Two influential and brilliant scientists who transformed our understanding of the physical

world, Albert Einstein and Isaac Newton, are suspected to have been on the autism spectrum. It

is not possible to make a conclusive diagnosis of autism post-mortem but some autism experts

have strong suspicions. Einstein displayed classic symptoms of autism, not speaking until the age

of three and displaying obsessive behaviors until the age of seven.114 Although he had friends

later in his life, that was contrasted by his self-described “pronounced lack of need for direct

contact with other human beings and human communities.”115 Even more so than Einstein,

Newton’s behavior describes a classic case of autism. He often became so obsessed with his

work that he would forget to eat and sleep. He was well-known for giving lectures to empty

rooms even if no one attended them.116 Glen Elliot, a psychiatrist from University of California

at San Francisco, challenges these claims pointing out that geniuses could have social challenges

without being autistic. Instead, their “impatience with the intellectual slowness of others,

narcissism and passion for one’s mission in life might combine to make such an individual

isolate and difficult.”117 Regardless of whether these men suffered from social awkwardness or

autism, their stories have served as inspiration to autistic individuals that they can still go on to

have successful careers.

Temple Grandin’s story is awe inspiring for those with and without autism because,

despite being on the spectrum, she has used her abilities from autism to build a successful career

in cattle management, as well as writing and speaking extensively on autism. Grandin credits her

Schwartz 22

mother’s conscientious but strict upbringing for giving her the tools to succeed in a social

society. In contrast to the somewhat lax standards of today, Grandin comments that in the ‘50s

when she was growing up manners and socials skills were taught and strictly enforced.118 With a

concrete foundation in social skills, Grandin went through high school and college to discover a

career as an animal scientist. She first noticed that her visual thinking made her different when

she studied feed yards where cattle were balking. Because she is a visual thinker like animals,

she could see and understand what was scaring them in ways the people in the feed yards could

not.119 Today, fifty percent of cattle in the United States and Canada are handled in the humane

slaughter systems designed by Grandin.120 Her autism has not limited her but instead has given

her the ability to make contributions where neurotypical individuals could not. Her work has

extended to include writing several books that provide unique insights into the many facets of

autism, offering inspiration and hope to those affected by autism.

Personally, my connection with autism began when I stumbled upon Hunkapi, a

therapeutic riding barn. Hunkapi offers riding lessons as a venue for therapies to people with all

types of special needs from autism to cerebral palsy to bipolar disorder. Hunkapi evolved from

research done by Debbie Crews at Arizona State University on the effects of different types of

sports and exercise on children with autism. Crew found that horse therapy, which combined

animal therapy with movement therapy, provided the most consistent positive intervention as

measured by self esteem scores and daily anxiety scores. Horses are especially good for therapy

because they mirror their riders emotions. If the rider is angry and frustrated, the horse will be

tense until the rider relaxes.121 In my four years of weekly volunteering at Hunkapi, I have come

to know a special group of autistic teenagers: Ray, Daniel, Drew, and Ethan. Through these four

Schwartz 23

boys I have come to appreciate the true diversity of the autism spectrum. At first glance, Drew

appears to be the lowest functioning of the four boys because, although he can mimic speech, he

does not form original speech. However, in my time working with Drew, I have found that

communication using my body language and single word commands can be more effective than

simply talking about lesson activities. This quiet approach to the world improves Drew’s ability

to communicate with his horse and is often more effective than my own horse training

techniques. In contrast to Drew’s quiet form of communication, Daniel rarely stops talking

showing a never ending obsession with anything to do with mind control, spy or interrogation. I

am frequently asked if Daniel can be my second-in-command in my future spy organization. This

intense focus on one topic can distract Daniel from tasks and necessitates strict routines and

supervision, a consequence of this form of autism. Ray and Ethan fall somewhere between Drew

and Daniel on the autism spectrum. Although though they both can communicate orally and have

their own particular interests, Ray, fighting “dark powers” with his horse, and Ethan, singing

Michael Jackson hits, these two boys work best when they are given clear and minimalistic

instructions. I have found that if I talk too much or try to help either Ray or Ethan they can get

easily frustrated by too much information. The extreme variation that I have observed in the

autism of these four boys makes me appreciate why it is so difficult to treat, prevent, or cure

autism as every individual presents with a unique set of challenges and abilities. Though my

regular volunteering, my relationship with these young men has become that of close friends.

These friends may look at the world differently than many neurotypical people, but these boys

are often more genuine and sincere and like Charlie, Raymond’s brother, I am reminded to

embrace and appreciate different viewpoints.

Schwartz 24

Autism is a recognized challenge of rising concern in our society. With the greater

number of children that are becoming autistic adults, there needs to be a support system in place

to help them through all states of life. While research continues into the root causes of autism,

support for individuals on the spectrum needs to begin at an early age and follow them through

to living independently, separate from their parents, and having a job if they are capable. There

needs to be homes and communities where they can live in their supported comfort when their

parents can no longer care for them. As a plan and system is developed to care for autistic

individuals, it is important to remember that it is not necessary to cure autism, only to help

alleviate some of the symptoms and challenges. Isaacson describes his wishes for his son after

their trip to Mongolia:

Rowan is still autistic—his essence, his many talents, are all tied up with it. He has been

healed of the terrible dysfunctions that afflicted him—his physical and emotional

incontinence, his neurological firestorms, his anxiety and hyperactivity. But he has not

been cured. Nor would I want him to be. To “cure” him, in terms of trying to tear the

autism out, now seems to me completely wrong. Why can’t he exist between the worlds,

with a foot in both…?122

Rupert’s wish for his son conveys the sentiment that autism is not just a disorder to be cured but

also a unique quality to be valued. Instead of autistic individuals changing for society, society

needs to welcome and value autistic individuals. Temple Grandin argues that if the genes for

autism are eliminated, then society may lose some of the greatest talents and genius since great

men such as Albert Einstein and Isaac Newton are both suspected to be on the spectrum. As

research continues, it may be found that the same genes that created their brilliant mind can also

Schwartz 25

create the most mild cases of autism to the most severe.123 As a society, people need to learn to

appreciate what people on the spectrum can do, not on what they cannot do. With this new

perception change, opportunities can be opened for thousands of autistic adults to share their

talents with the rest of society.

Schwartz 26

Appendix A

From Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-TR)

Diagnostic criteria for 299.00 Autistic Disorder

A. A total of six (or more) items from (1), (2), and (3), with at least two from (1), and one

each from (2) and (3):

(1) qualitative impairment in social interaction, as manifested by at least two of the

following:

(a) marked impairment in the use of multiple nonverbal behaviors such as

eye-to-eye gaze, facial expression, body postures, and gestures to regulate

social interaction

(b) failure to develop peer relationships appropriate to developmental level

(c) a lack of spontaneous seeking to share enjoyment, interests, or

achievements with other people (e.g., by a lack of showing, bringing, or

pointing out objects of interest)

(d) lack of social or emotional reciprocity

(2) qualitative impairments in communication as manifested by at least one of the

following:

(a) delay in, or total lack of, the development of spoken language (not

accompanied by an attempt to compensate through alternative modes of

communication such as gesture or mime)

(b) in individuals with adequate speech, marked impairment in the ability to

Schwartz 27

initiate or sustain a conversation with others

(c) stereotyped and repetitive use of language or idiosyncratic language

(d) lack of varied, spontaneous make-believe play or social imitative play

appropriate to developmental level

(3) restricted repetitive and stereotyped patterns of behavior, interests, and activities,

as manifested by at least one of the following:

(a) encompassing preoccupation with one or more stereotyped and restricted

patterns of interest that is abnormal either in intensity or focus

(b) apparently inflexible adherence to specific, nonfunctional routines or

rituals

(c) stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping

or twisting, or complex whole-body movements)

(d) persistent preoccupation with parts of objects

B. Delays or abnormal functioning in at least one of the following areas, with onset prior to

age 3 years: (1) social interaction, (2) language as used in social communication, or (3)

symbolic or imaginative play.

C. The disturbance is not better accounted for by Rett’s Disorder or Childhood

Disintegrative Disorder.

Schwartz 28

Appendix B

From Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-TR)

Diagnostic criteria for 299.80 Asperger’s Disorder

A. Qualitative impairment in social interaction, as manifested by at least two of the

following:

(1) marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye

gaze, facial expression, body postures, and gestures to regulate social interaction

(2) failure to develop peer relationships appropriate to developmental level

(3) a lack of spontaneous seeking to share enjoyment, interests, or achievements with

other people (e.g., by a lack of showing, bringing, or pointing out objects of

interest)

(4) lack of social or emotional reciprocity

B. restricted repetitive and stereotyped patterns of behavior, interests, and activities, as

manifested by at least one of the following:

(1) encompassing preoccupation with one or more stereotyped and restricted patterns

of interest that is abnormal either in intensity or focus

(2) apparently inflexible adherence to specific, nonfunctional routines or rituals

(3) stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or

twisting, or complex whole-body movements)

(4) persistent preoccupation with parts of objects

C. The disturbance causes clinically significant impairment in social, occupational, or other

Schwartz 29

important areas of functioning.

D. There is no clinically significant general delay in language (e.g., single words used by

age 2 years, communicative phrases used by age 3 years).

E. There is no clinically significant delay in cognitive development or in the development of

age-appropriate self-help skills, adaptive behavior (other than in social interaction), and

curiosity about the environment in childhood.

F. Criteria are not met for another Pervasive Developmental Disorder or Schizophrenia.

Schwartz 30

Appendix C

From Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-TR)

299.80 Pervasive Developmental Disorder Not Otherwise Specified (Including Atypical Autism)

This category should be used when there is a severe and pervasive impairment in the

development of reciprocal social interaction associated with the impairment in either verbal or

nonverbal communication skills or with the presence of stereotyped behavior, interests, an

activities, but the criteria are not met for a specific Pervasive Developmental Disorder,

Schizophrenia, Schizotypal Personality Disorder, or Avoidant Personality Disorder. For example,

this category includes “atypical autism”—presentations that do not meet the criteria for Autistic

Disorder because of late age at onset, atypical symptomatology, or subthreshold

symptomatology, or all of these.

Schwartz 31

Appendix D

From Making Sense of Autism Spectrum Disorders

Schwartz 32

Notes

1 D. L. Ashliman, “Changelings,” University of Pittsburg, 3 September 1997, accessed

February 15, 2013, http://www.pitt.edu/~dash/changeling.html#luther.

2 Ana Maria Rodriguez, Autism and Asperger Syndrome (Minneapolis, MN: Twenty-First

Century Books, 2009), 26.

3 Ashliman.

4 Allison M. Foerschner, “The History of Mental Illness: From ’Skull Drills’ to ‘Happy

Pills’,” Student Pulse 2.9 (2010), accessed February 15, 2013, http://www.studentpulse.com/

articles/283/the-history-of-mental-illness-from-skull-drills-to-happy-pills.

5 Edward R. Ritvo, Understanding the Nature of Autism and Asperger’s Disorder

(Philadelphia, PA: Jessica Kingsley Publishers, 2006), 20.

6 Rodriguez, 27.

7 Ritvo, 21.

8 Rodriguez, 28-29.

9 Ibid., 30-32.

10 Ritvo, 21.

11 Rodriguez, 33.

12 Ibid., 35.

13 Ibid.

14 “DSM-V: What Changes May Mean,” Autism Research Institute, 2013, accessed

January 1, 2013, http://www.autism.com/index.php/news_dsmV.

15 Brittney Johnson, “Some Key Dates in Autism History,” The Washington Post, 1 July

Schwartz 33

2008, accessed February 15, 2013, http://www.washingtonpost.com/wp-dyn/content/article/

2008/06/27/AR2008062703062.html.

16 Rodriguez, 36.

17 American Psychiatric Association, Diagnostic and Statistical Manual of Mental

Disorders, Fourth Edition, Text Revision (Washington, DC: American Psychiatric Association,

2000), 75-84.

18 Ibid., 75.

19 Ibid., 84.

20 James R. Laidler, “The ‘Refrigerator Mother’ Hypothesis of Autism,” Autism Watch,

15 September 2004, accessed February 16, 2013, http://www.autism-watch.org/causes/rm.shtml.

21 Rodriguez, 59.

22 James Coplan, Making Sense of Autism Spectrum Disorders (New York: Bantam

Books, 2010), 94.

23 Ibid., 99.

24 Ibid., 89.

25 Ibid., 58.

26 Center for Disease Control and Prevention, “Data and Statistics, Autism Spectrum

Disorders,” CDC, 29 March 2012, accessed February 16, 2013, http://www.cdc.gov/ncbddd/

autism/data.html.

27 “Facts about Autism,” Autism Speaks, 2013, accessed March 10, 2013, http://

www.autismspeaks.org/what-autism/facts-about-autism.

28 Coplan, 59.

Schwartz 34

29 Rodriguez, 57.

30 Ibid., 58.

31 Coplan, 60.

32 Ibid., 61.

33 Ibid., 62.

34 Ibid., 61.

35 Ibid., 62.

36 Center for Disease Control and Prevention.

37 Coplan, 89.

38 Ibid.

39 Claudia Wallis, “Is the Autism Epidemic a Myth?” Time, 12 January 2007, accessed

February 16, 2013, http://www.time.com/time/magazine/article/0,9171,1576829,00.html.

40 Mark Roithmayr, “Autism Is a National Epidemic That Needs a National Plan,”

Huffington Post, 4 April 2012, accessed February 16, 2013, http://www.huffingtonpost.com/

mark-roithmayr/autism-statistics_b_1403263.html.

41 Sally Rogers, “Early Start Denver Model,” in Cutting-Edge Therapies for Autism, ed.

Ken Siri and Tony Lyons (New York: Skyhorse Publishing, 2010), 128.

42 Alan I. Rosenblatt, Paul S. Carbone, and Winnie Yu, eds. Autism Spectrum Disorders

(Illinois: American Academy of Pediatrics, 2013), 82.

43 Rogers, 131.

44 Rosenblatt, 81.

45 Geraldine Dawson et al., “Randomized, Controlled Trial of an Intervention for Toddlers

Schwartz 35

With Autism: The Early Start Denver Model,” Pediatrics 125.1 (2009): 17, accessed February

17, 2013, http://pediatrics.aappublications.org/content/125/1/e17.full.html.

46 Ibid., 22.

47 Rosenblatt, 72-73.

48 Ibid., 72.

49 Robert W. Sears, The Autism Book (New York: Little, Brown and Company, 2010),

136.

50 Rodriguez, 86.

51 Jennifer Clark, “Applied Behavior Analysis,” in Cutting-Edge Therapies for Autism,

ed. Ken Siri and Tony Lyons (New York: Skyhorse Publishing, 2010), 39.

52 Sears, 142.

53 Ibid., 143.

54 Rosenblatt, 84.

55 Ibid., 83.

56 Ibid., 84.

57 Lavinia Pereira and Michelle Solomon, “Speech-Language Therapy,” in Cutting-Edge

Therapies for Autism, ed. Ken Siri and Tony Lyons (New York: Skyhorse Publishing, 2010), 367.

58 Pamela Wolfberg, “Integrated Play Groups (IPG) Model,” in Cutting-Edge Therapies

for Autism, ed. Ken Siri and Tony Lyons (New York: Skyhorse Publishing, 2010), 188.

59 Ibid., 189.

60 Hynes, 308.

61 Ibid., 309.

Schwartz 36

62 Ibid., 310.

63 Mitzi Waltz, Autism Spectrum Disorders (California: O’Reilly & Associates, 2002),

161.

64 Karen Siff Exkorn, The Autism Sourcebook (New York: HarperCollins, 2005), 107.

65 Rosenblatt, 85.

66 Ibid., 161.

67 Ibid., 85.

68 Markus Jarrow, “Occupational Therapy and Sensory Integration,” in Cutting-Edge

Therapies for Autism, ed. Ken Siri and Tony Lyons (New York: Skyhorse Publishing, 2010), 273.

69 Ibid., 274.

70 Sears, 145.

71 Rosenblatt, 119.

72 Ibid., 129

73 Temple Grandin, “Medication Usages: Risk versus Benefit Decisions,” The Way I See It

(Arlington, TX: Future Horizons Inc., 2008), 177.

74 Rosenblatt, 120.

75 Ibid., 140.

76 Ibid., 142.

77 Temple Grandin, “Alternative versus Conventional Medicine,” The Way I See It

(Arlington, TX: Future Horizons Inc., 2008), 173.

78 Ibid., 174.

79 Exkorn, 94.

Schwartz 37

80 Rosenblatt, 70

81 Exkorn, 96.

82 Ibid., 98.

83 Rosenblatt, 71.

84 “The History of Southwest Autism Research & Resource Center,” Outreach, 2007,

SARRC, 2013, accessed March 3, 2013, http://autismcenter.org/history.aspx.

85 Ibid.

86 “About Us: Autism Speaks History,” Autism Speaks, 2013, accessed March 3, 2013,

http://www.autismspeaks.org/about-us.

87 “Mission,” Autism Speaks, 2013, accessed March 3, 2013, http://

www.autismspeaks.org/about-us/mission.

88 “Autism Speaks Walk Now for Autism Recognized as the Nation’s Fastest Growing

Fundraising Walk Program,” Autism Speaks. 6 March 2008, accessed March 2, 2013, http://

www.autismspeaks.org/about-us/press-releases/autism-speaks-walk-now-autism-recognized-

nations-fastest-growing-fundraising.

89 “Answers to Frequently Asked Questions about DSM-5,” Autism Speaks, 2013,

accessed February 15, 2013, http://www.autismspeaks.org/science/policy-statements/statement-

revisions-dsm-definition-autism-spectrum-disorder/frequently-ask.

90 “Asperger’s, Autism & the New DSM,” Disability Services, William & Mary, 2012,

accessed December 31, 2012, http://www.wm.edu/offices/deanofstudents/services/

disabilityservices/resources/aspergersyndrome/index.php.

91 Benedict Carey, “New Definition of Autism Will Exclude Many, Study Suggests,” The

Schwartz 38

New York Times, 19 January 2012, accessed February 15, 2013, http://www.nytimes.com/

2012/01/20/health/research/new-autism-definition-would-exclude-many-study-suggests.html?

pagewanted=all.

92 Rupert Isaacson, The Horse Boy (New York: Little, Brown and Company, 2009), 7.

93 Exkorn, 183.

94 Isaacson, 13.

95 Exkorn, 189.

96 Isaacson, 48.

97 Exkorn, 252.

98 Isaacson, 48.

99 Ibid., 337.100 Ibid., 81.101 Ibid., 109.102 Ibid., 32.103 Ibid.

104 "Autistic Child Is Disruptive in Café: How Will Patrons React?" What Would You Do,

ABC, April 13, 2012.

105 Rain Man, Director Barry Levinson, United Artists, 1988.

106 Ibid., 38.

107 Vincent Canby, “Brotherly Love, of Sorts,” Review of Rain Man, New York Times, 16

December 1988, accessed March 2, 2013, http://movies.nytimes.com/movie/review?

res=940DE2D91538F935A25751C1A96E948260.

108 “Academy Awards Database: Dustin Hoffman,” The Academy of Motion Picture Arts

and Sciences, 2013, accessed March 2, 2013, http://awardsdatabase.oscars.org/ampas_awards/

Schwartz 39

DisplayMain.jsp;jsessionid=59B34B0EC0AAFC409AEBBDD4270611F3?

curTime=1362221816214.

109 Rain Man.

110 Haddon, 3.

111 Ibid., 15.

112 Temple Grandin, “Different Ways of Thinking in Autism,” The Way I See It

(Arlington, TX: Future Horizons Inc., 2008), 16.

113 Haddon, 24.

114 Temple Grandin, “The Link Between Autism Genetics and Genius,” The Way I See It

(Arlington, TX: Future Horizons Inc., 2008), 242.

115 Ibid.

116 Hazel Muir, “Einstein and Newton Showed Signs of Autism,” New Scientist, 30 April

2003, accessed March 2, 2013, http://www.newscientist.com/article/dn3676-einstein-and-

newton-showed-signs-of-autism.html.

117 Ibid.

118 Temple Grandin, “Behavior Issues,” The Way I See It (Arlington, TX: Future Horizons

Inc., 2008), 111.

119 Temple Grandin and Catherine Johnson, Animals in Translation (New York: Scribner,

2005), 19.

120 Ibid., 7.

121 Jessica McCann, “Equine Equilibrium Research,” ASU Alternative Intervention

Research Clinic, 2005, accessed March 9, 2013, http://hunkapi.org/wp/wp-content/uploads/

Schwartz 40

2013/02/Equine-Equilibrium-Research.pdf.122 Isaacson, 348-349.123 Temple Grandin, “The Link Between Autism Genetics and Genius,” 242.

Schwartz 42

CDC. 29 March 2012. Web. 16 February 2013.

Clark, Jennifer. “Applied Behavior Analysis.” Siri 35-40.

Coplan, James. Making Sense of Autism Spectrum Disorders. New York: Bantam Books, 2010.

Print.

Dawson, Geraldine et al. “Randomized, Controlled Trial of an Intervention for Toddlers With

Autism: The Early Start Denver Model.” Pediatrics 125.1 (2009): 17-23. Web. 17

February 2013.

“DSM-V: What Changes May Mean.” Autism Research Institute. 2013. Web. 1 January 2013.

Exkorn, Karen Siff. The Autism Sourcebook. New York: HarperCollins, 2005. Print.

“Facts about Autism.” Autism Speaks. 2013. Web. 10 March 2013.

Foerschner, Allison M. “The History of Mental Illness: From ’Skull Drills’ to ‘Happy Pills’.”

Student Pulse 2.9 (2010). Web. 15 February 2013.

Grandin, Temple. “Alternative versus Conventional Medicine.” The Way I See It. Arlington, TX:

Future Horizons Inc., 2008. 173-174. Print.

- - -. “Behavior Issues.” The Way I See It. Arlington, TX: Future Horizons Inc., 2008. 109-113.

Print.

- - -. “Different Types of Thinking in Autism.” The Way I See It. Arlington, TX: Future Horizons

Inc., 2008. 15-17. Print.

- - -. “The Link Between Autism Genetics and Genius.” The Way I See It. Arlington, TX: Future

Horizons Inc., 2008. 241-244. Print.

- - -. “Medication Usages: Risk versus Benefit Decisions.” The Way I See It. Arlington, TX:

Future Horizons Inc., 2008. 177-180. Print.

Schwartz 41

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