Mama Gaia thank you for lending me this book❥
This intelligence nevertheless succeeds in eventually solving numerous problems of action (reaching hidden objects, reaching hidden objects …) by constructing a complex system of action-schemes (the structure/organisation of actions as they are transferred/generalised by repetition in similar/analogous circumstances) and organising reality in terms of spatio-temporal and casual structures. In the absence of language or symbolic function, however, these constructions are made with the sole support of perceptions and movements and thus by means of a sensori-motor coordination of actions, without the intervention of representation or thought.
1. Stimulus-Response and Assimilation
It is difficult to specify when sensori-motor intelligence appears. The
question actually makes no sense as the answer always depends on an arbitrary
choice of criterion. What actually happens is a remarkably smooth succession
of stages, each marking a new advance, until the moment when the acquired
behavior presents characteristics that one or another psychologist recognizes
as those of "intelligence." There is a continuous progression from spontaneous
movements and reflexes to acquired habits and from the latter to intelligence.
The real problem is not to locate the first appearance of intelligence but rather to understand the mechanism of this progression.
It can be argued that this mechanism consists in assimilation (comparable to biological assimilation in the broad sense): meaning that reality data are treated or modified in such a way as to become incorporated into the structure of the subject. In other words, every newly established connection is integrated into an existing schematism. According to this view, the organizing activity of the subject must be considered just as important as the connections inherent in the external stimuli, for the subject becomes aware of these connections only to the degree that he can assimilate them by means of his existing structures.
In other words, associationism conceives the relationship between stimulus and response in a unilateral manner: S → R; whereas the point of view of assimilation presupposes a reciprocity S←→R; that is to say, the input, the stimulus, is filtered through a structure that consists of the action-schemes (or, at a higher level, the operations of thought), which in turn are modified and enriched when the subject's behavioural repertoire is accommodated to the demands of reality. The filtering or modification of the input is called assimilation; the modification of internal schemes to fit reality is called accommodation.
2. Stage 1
On the one hand, it has been shown by the study of animal behaviour as well as by the study of the electrical activity of the nervous system that the organism is never passive, but presents spontaneous and global activities whose form is rhythmic
On the other hand, embryological analysis of the reflexes (G. E. Coghill and others) has enabled us to establish the fact that reflexes are formed by differentiation upon a groundwork of more global activi-ties. In the case of the locomotive reflexes of the batra-chains, for example, it is an overall rhythm which culminates in a succession of differentiated and coordinated reflexes, and not the reflexes which lead to that rhythm.
As far as the reflexes of the newborn child are concerned, those among them that are of particular importance for the future (the sucking reflex and the palmar reflex, which will be integrated into later intentional grasping) give rise to what has been called a "reflex exercise"; that is, a consolidation by means of functional exercise. This explains why after a few days the newborn child nurses with more assurance and finds the nipple more easily when it has slipped out of his mouth than at the time of his first attempts.* The reproductive or functional assimilation that accounts for this exercise also gives rise to a generalising assimilation (sucking on nothing between meals or sucking new objects) and a recognitive assimilation (distinguishing the nipple from other objects).
*Similar reflex exercises are observed in animals too, as in the groping that characterizes the first efforts at copulation in Lymneae.
3. Stage 2
A conditioned reflex is never stabilized by the force of its associations alone, but only by the formation of a scheme of assimilation: that is, when the result attained satisfies the need inherent in the assimilation in question (as with Pavlov's dog, which salivates at the sound of the bell as long as this sound is identified with a signal for food, but which ceases to salivate if food no longer follows the signal).
4. Stage 3
Thus after the reflex stage (Stage 1) and the stage of the first habits (Stage 2), a third stage (Stage 3) introduces the next transitions after the beginning of coordination between vision and pre-hension.
The baby starts grasping and manipulating everything he sees in his immediate vicinity. For example, a subject of this age catches hold of a cord hanging from the top of his cradle, which has the effect of shaking all the rattles suspended above him.
Each time the interesting result motivates the repetition. This constitutes a "circular reaction" in the sense of J. M. Baldwin, or a new habit in the nascent state, where the result to be obtained is not differentiated from the means employed.
Later you need only hang a new toy from the top of the cradle for the child to look for the cord, which constitutes the beginning of a differentiation between means and end.
Although the child's actions seem to reflect a sort of magical belief in causality without any material connection, his use of the same means to try to achieve different ends indicates that he is on the threshold of intelligence.
5. Stages 4 and 5
In a fourth stage (Stage 4), we observe more complete acts of practical intelligence. The subject sets out to ob tain a certain result, independent of the means he is going to employ: for example, obtaining an object that is out of reach or has just disappeared under a piece of cloth or a cushion.
In the course of this fourth stage, the coordination of means and ends is new and is invented differently in each unforeseen situation (otherwise we would not speak of intelligence), but the means employed are derived only from known schemes of assimila-tion.
In the course of a fifth stage (Stage 5), which makes its appearance around eleven or twelve months, a new ingredient is added to the foregoing behavior: the search for new means by differentiation from schemes already known.
An example of this is what we call the "behavior pattern of the support." An object has been placed on a rug out of the child's reach. The child, after trying in vain to reach the object directly, may eventually grasp one corner of the rug (by chance or as a substitute), and then, observing a relationship between the movements of the rug and those of the object, gradually comes to pull the rug in order to reach the object.
6. Stage 6
Finally, a sixth stage marks the end of the sensori-motor period and the
transition to the following period. In this stage the child becomes capable of
finding new means not only by external or physical groping but also by
internalized combinations that culminate in sudden comprehension or insight.
For example, a child confronted by a slightly open matchbox containing a
thimble first tries to open the box by physical groping (reaction of the fifth
stage), but upon failing, he presents an altogether new reaction: he stops the
action and attentively examines the situation (in the course of this he slowly
opens and closes his mouth, or, as another subject did, his hand, as if in
imitation of the result to be attained, that is, the enlargement of the
opening), after which he suddenly slips his finger into the crack and thus
succeeds in opening the box.
…None of these categories is given at the outset, and the child's initial universe is entirely centered on his own body and action in an egocentrism as total as it is unconscious (for lack of consciousness of the self). In the course of the first eighteen months, however, there occurs a kind of Copernican revolution, or, more simply, a kind of general decentering process whereby the child eventually comes to regard himself as an object among others in a universe that is made up of permanent objects (that is, structured in a spatio-temporal manner) and in which there is at work a causality that is both localized in space and objectified in things.
1. The Permanent Object
The universe of the young baby is a world without objects, consisting only of shifting and unsubstantial "tableaux" which appear and are then totally reabsorbed, either without returning, or reappearing in a modified or analogous form. At about five to seven months (Stage 3 of Infancy), when the child is about to seize an object and you cover it with a cloth or move it behind a screen, the child simply withdraws his already extended hand or, in the case of an object of special interest (his bottle, for example), begins to cry or scream with disap-pointment. He reacts, therefore, as if the object had been reabsorbed.
^ H. Gruber has made a study of the same problem in kittens. Kittens pass through approximately the same stages but reach a beginning of permanence as early as three months. The human infant, on this point as on many others, is backward in comparison to the young animal, but this backwardness bears witness to more complex assimilations, since later the human infant is able to go far beyond the animal.
2. Space and Time
3. Causality
In the observation of the cord hanging from the top of the cradle, the baby does not locate the cause of the movement of the dangling rattles in the connection between the cord and the rattles, but rather in the global action of "pulling the cord," which is quite another thing. The proof is that he continues to pull the cord in an attempt to act upon objects situated two yards away, or to act upon sounds, etc.
This early notion of causality may be called magical-phenomenalist: "phenomenalist" because the phenomenal contiguity of two events is sufficient to make them appear causally related, and "magical" because it is centered on the action of the subject without consideration of spatial connection between cause and effect.
However, as the universe is increasingly structured by the sensori-motor intelligence according to a spatio-tem-poral organization and by the formation of permanent ob-jects, causality becomes objectified and spatialized: that is, the subject becomes able to recognize not only the causes situated in his own actions but also in various ob jects, and the causal relationships between two objects or their actions presuppose a physical and spatial connection.
In the behavior patterns of the support, the string, and the stick (Stages 5 and 6), for example, it is clear that the movements of the rug, the string, or the stick are believed to influence those of the object (independently of the author of the displacement), provided there is contact. If the object is placed beside the rug and not on it, the child at Stage 5 will not pull the supporting object, whereas the child at Stage 3 or even 4 who has been trained to make use of the supporting object (or who has discovered its role by accident) will still pull the rug even if the object no longer maintains with it the spatial relationship "placed upon."
1. The Initial Adualism
The affects peculiar to the first two stages (Stages 1 and 2 of infancy) occur within a context already described by Baldwin under the name of "adualism," in which there does not yet exist any consciousness of the self; that is, any boundary between the internal or experienced world and the world of external realities. Freud talked about narcissism but did not sufficiently stress the fact that this was narcissism without a Narcissus. Anna Freud has since clarified the concept of "primary narcissism" as an initial lack of differentiation between the self and the other. H. Wallon describes this same undifferentiation in terms of symbiosis. Insofar as the self remains undifferentiated, and thus unconscious of itself, all affectivity is centered on the child's own body and action, since only with the dissociation of the self from the other or non-self does decentration, whether affective or cognitive, become possible. The root notion contained in the term "narcissism" is valid provided we make it clear that an unconscious centering due to undifferentiation is not at all like a conscious centering of one's emotional life upon the self which can occur in later life.
The affects observable in this adualistic period are at first dependent upon general rhythms corresponding to the rhythms of the spontaneous global activities of the organism; namely, alternations between states of tension and relaxation, etc. These rhythms are differentiated into a search for agreeable stimuli and a te
1. Constancy of Form
One of us has observed a relationship between certain constancies of form and the permanence of the object.
When he handed a baby of seven or eight months its bottle backwards, he observed that the infant turned the bottle around easily if it noticed part of the red rubber nipple in the background, but that it did not succeed in making this correction if it did not see any part of the nipple and only the white base of the milk-filled bottle was visible. This child, then, did not attribute a constant form to the bottle. However, as soon as he began to look for objects behind screens (at the age of nine months), he readily turned the bottle around no matter how it was pre-sented, as if the permanence of the object and the constant form of the object were related. One can assume that in this case an interaction occurs between perception and the sensori-motor scheme, for the first is not sufficient to explain the second (the search for an object that has disappeared is not dependent on its shape alone), nor the second sufficient to explain the first.
3. The Permanent Object and Perception
Suppose you show a child a moving object following a course ABCD. It appears from under a screen at A, is visible from A to B, is hidden by a screen from B to C, is visible from C to D and finally disappears again at D. A child of five to six months follows the path AB with his eyes and, when the object disappears at B, looks for it at A; then, amazed to see it at C, he follows it with his eyes from C to D, but when the object disappears at D, looks for it at C and then at A! In other words, there is no "tunnel effect" at that age; in fact, it does not appear until the permanence of the object has been established. In this case a perceptual effect is clearly determined by sensori-motor schemes, rather than explaining them.
III. The Perceptual activities
perceptual activity can be directed by an intelligence that has a better grasp of the problems.
Not, of course, that intelligence at this stage replaces per-ception, but by structuring reality it helps to program the way perceptual data are collected; that is, it helps indicate where to concentrate the attention. Even in simple linear comparisons, this programming plays an important role, substituting a science of measurement for global or simply ordinal evaluations (see Chapter 4, pages 106-107).
5. Conclusion
Logico-mathematical concepts presuppose a set of operations that are abstracted not from the objects perceived but from the actions performed on these objects, which is by no means the same.
3 The Semiotic Function
AT THE END of the sensori-motor period, at about one and a half to two years, there appears a function that is fundamental to the development of later behavior patterns. It consists in the ability to represent something (a signified something: object, event, conceptual scheme, etc.) by means of a "signifier" which is differentiated and which serves only a representative purpose: language, mental im-age, symbolic gesture, and so on. Following H. Head and the specialists in aphasia, we generally refer to this function that gives rise to representation as "symbolic." How-ever, since linguists distinguish between "symbols" and
"signs," we would do better to adopt their term "semiotic function" to designate those activities having to do with the differentiated signifiers as a whole.
III. Drawing
• In addition to this "transparency," one observes that children draw configurations as if seen from different angles and as if a three-dimensional object were flattened out (pseudo-rabatment). Luquet mentions a drawing of a cart in which the horse is seen from the side, the inside of the cart is seen from above, and the wheels are flattened out into a horizontal plane. A similar procedure is used to represent a narrative. Whereas adult imagery conventionally presents only one segment of many simultaneous events per drawing, without introducing, within the same drawing, actions that are chronologically successive, the child, like some primitive painters, uses one drawing to present a chain of chronological events. Thus one will see a mountain with five or six figures on it, each of which represents the same person in successive positions.
At about eight or nine, "intellectual realism" is succeeded by "visual realism," which presents two new fea-tures. First, the drawing now represents only what is visible from one particular perspective. A profile now has only one eye, etc., as would be seen from the side, and the concealed parts of objects are no longer visibly repre-sented. (Thus, one sees only the top of a tree behind a house, and no longer the whole tree.) Also, objects in the background are made gradually smaller (receding lines) in relation to objects in the foreground. Second, the objects in the drawing are arranged according to an overall plan (axes of coordinates) and to their geometrical pro-portions.
Another experiment gives parallel results. A child of five or six places twelve red counters opposite twelve blue ones to make sure there is an equal number of each. Yet if you space out either the blue or the red counters, he concludes that the longer row contains more elements. The question arises whether this lack of conservation is due to a difficulty in imagining these displacements and a possible return of the displaced elements to their original positions.
2. Language and Thought
As to the increasing range and rapidity of thought, thanks to language we observe in fact three differences between verbal and sensori-motor behavior. (1) Whereas sensori-motor patterns are obliged to follow events without being able to exceed the speed of the action, verbal pat-terns, by means of narration and evocation, can represent a long chain of actions very rapidly. (2) Sensori-motor adaptations are limited to immediate space and time, whereas language enables thought to range over vast stretches of time and space, liberating it from the immedi-ate. (3) The third difference is a consequence of the other two. Whereas the sensori-motor intelligence proceeds by means of successive acts, step by step, thought, particularly through language, can represent simultaneously all the elements of an organized structure.
These advantages of representative thought over the sensori-motor scheme are in reality due to the semiotic function as a whole. The semiotic function detaches thought from action and is the source of representation.
Language plays a particularly important role in this formative process. Unlike images and other semiotic instruments, which are created by the individual as the need arises, language has already been elaborated socially and contains a notation for an entire system of cognitive instruments (relationships, classifications, etc.) for use in the service of thought. The individual learns this system and then proceeds to enrich it.
3. Language and Logic
Must we then conclude, as has been suggested, that since language possesses its own logic, this logic of language constitutes not only an essential or even a uníque factor in the learning of logic (inasmuch as the child is subject to the restrictions of the linguistic group and of society in general), but is in fact the source of all logic for the whole of humanity?
II. The Genesis of the "Concrete" Operations
1. Notions of Conservation
The clearest indication of the existence of a preopera-tory period corresponding to the second of the levels distinguished in the preceding section is the absence of notions of conservation until about the age of seven or eight. Let us reexamine the experiment relating to the conservation of liquids' in which the contents of glass A were poured into a narrower glass B or a wider glass C. Two facts are particularly noteworthy in the judgments of four- to six-year-olds who think that the liquid increases or decreases in quantity. First, the young subjects seem to reason only about states or static configurations, overlooking transfor-mations: the water in B is higher than it was in A; therefore it has increased in quantity, regardless of the fact that it is the same water that has merely been poured from one container to another. Second, the transformation, although the child is perfectly well aware of it, is not conceived as a reversible movement from one state to another, changing the form but leaving the quantity constant. It is viewed as a particular action, a "pouring," situated on a level other than that of physical phenomena and assumed to have results that are literally incalculable, that is, non-deduc-tible in their external application. However, at the level of concrete operations, after seven or eight, the child says: "It is the same water," "It has only been poured," "Nothing has been taken away or added" (simple or additive identi-ties): "You can put the water in B back into A where it was before" (reversibility by inversion); or, particularly,
"The water is higher, but the glass is narrower, so it's the same amount® (compensation or reversibility by reciprocal relationship).
5. Number
The construction of whole numbers occurs in the child in close connection with the construction of seriations and class inclusions. One must not think that a young child understands number simply because he can count verbally.
In his mind numerical evaluation is for a long time linked with the spatial arrangement of the elements, in close analogy with "figural collections" (see the preceding sec-tion). The experiment described in Chapter 3, pages 78-79, shows this clearly: if you space out the elements of one of two rows initially aligned optically, the subject ceases to accept their numerical equivalence. Naturally, there can be no question of operatory numbers before the existence of a conservation of numerical groups independent of spatial arrangement.
III. Representation of the Universe: Causality and Chance
One of us once tried to describe the principal character. istics of this infantile preoperatory precausality. * In addition to an almost universal finalism, he found a "realism" due to a lack of differentiation between the psychical and the physical. Names are attached physically to things; dreams are little material tableaux which you contemplate in your bedroom; thought is a kind of voice ("the mouth in the back of my head that talks to the mouth in front").
Animism springs from the same lack of differentiation, but in the opposite direction: everything that is in movement is alive and conscious, the wind knows that it blows, the sun that it moves, etc. To questions of origin, so important to children in that they are related to the problem of the birth of babies, the young subjects reply with a systematic artificialism: men dug the lake, put water into it, and all this water comes from fountains and pipes. The stars "were born when we were born," says a boy of six, "because before that there was no need for sunlight," and the sun started as a little ball which somebody threw into the air and which grew, for it is possible to be both living and manufactured, as babies are.
Interestingly enough, this precausality is close to the initial sensori-motor forms of causality which we called "magical-phenomenalist in Chapter 1. Like those, it results from a systematic assimilation of physical processes to the child's own action, an assimilation which sometimes leads to quasi-magical attitudes (for instance, many subjects between four and six believe that the moon follows them or even that they force it to follow them). But, just as sensori-motor precausality makes way (after Stages 4 to 6 of infancy) for an objectified and spatialized cau-sality, so representative precausality, which is essentially an assimilation to action, is gradually, at the level of concrete operations, transformed into a rational causality by assimilation no longer to the child's own actions in their egocentric orientation but to the operations as general coordinations of actions.
Helen thank you for telling me to read this book!
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The problem is, most people believe that real science is too difficult and complicated for them to understand. But I don't think this is the case. But most people can understand and appreciate the basic ideas if they are presented in a clear way without equations, which I believe is possible and which is something I have enjoyed trying to do throughout my life. …
I told him never to be afraid to come up with an idea or a hypothesis no matter how daft (his words not mine) it might seem. …
fight for every woman and every man to have the opportunity to live healthy, secure lives, full of opportunity and love. We are all time travellers, journeying together into the future. But let us work together to make that future a place we want to visit. Be brave, be curious, be determined, overcome the odds. It can be done.
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I wanted to be a great scientist. However, I wasn't a very good student when I was at school, and was rarely more than halfway up my class. My work was untidy, and my handwriting not very good. But I had good friends at school. And we talked about everything and, specifically, the origin of the universe.
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Second law of thermodynamics- the total amount of disorder, or entropy, in the universe always increases with time. However the law only refers to the total amount of disorder. The order in one body can increase provided that the amount of disorder in its surroundings increases by a greater amount.
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intuition, originality, brilliance. Einstein had the ability to look beyond the surface to reveal the underlying structure. He was undaunted by common sense, the idea that things must be the way they seemed. He had the courage to pursue ideas that seemed absurd to others. And this set him free to be ingenious, a genius of his time and every other. A key element for Einstein was imagination. Many of his discoveries came from his ability to reimagine the universe through thought experiments. At the age of sixteen, when he visualised riding on a beam of light, he realised that from this vantage light would appear as a frozen wave. That image ultimately led to the theory of special relativity.
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we never really know where the next great scientific discovery will come from, nor who will make it. Opening up the thrill and wonder of scientific discovery, creating innovative and accessible ways to reach out to the widest young audience possible, greatly increases the chances of finding and inspiring the new Einstein. Wherever she might be.
Page 7 One fundamental characteristic of ASD is a difficulty socializing with, and being accepted by, peers. Another characteristic of ASD in adolescence is the tendency to be rejected by peers, engendering feelings of not belonging to any specific group or culture. The acquisition and consumption of alcohol and drugs-easily available and the "currency" of popularity and status-can provide membership of a sub-culture composed of others who also do not fit into conventional society. However, they do accept those who are different and marginalized. This sub-culture has clear rules and expectations in how to dress, talk and behave, and has its own language and rituals, "friendships" are formed, and the person is warmly welcomed, especially he or she becomes a drug courier or supplier. Thus, for the wrong reasons, the person with an ASD belongs to a group and is accepted and valued by peers.
Page 56 Although this example may seem extreme, Robertson and MacGillivay (2015) suspect there is an overrepresentation of individuals with an ASD in prison settings.
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Sometimes stereotypic behavior in autism can be seriously self-harming such as head banging. Ghaziuddin (2005) posits that there are two main theories pain or addiction to explain why individuals with autism may engage in repetitive self-harming behaviors, and interestingly, both center round the brain's production and release of its owin opiates, endorphins (Widmaier, Raff, and Strang 2006). The pain theory suggests that there are a significant amount of the brain's opioids creating a natural analgesic so that the individual does not feel the pain of their behaviours. The addiction theory proposes that the self-injurious behaviors stimulate the brain to produce endorphins, and then the brain becomes addicted and the behaviors persist in order to maintain the brains opiate production (Ghaziuddin, 2005). Interestingly, we find that this self-harming repetitive behavior is an eerie equivalent to the repetition of drug or alcohol abuse in that the immediate rewards offered by drugs/alcohol can trump the dire consequences of repeated use.
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Epigenetics is the intersection of science and social science, and is directly related to autism and addiction. Epigenetic flags are responsible for turning on or off certain genes. So, though one may carry a particular genetic code, it is not a forgone conclusion that a particular gene will be expressed.
There has been a surge of studies in the ASD and SUD fields targeting oxytocin. Why autism and substance use? Research focusing on those with ASD indicates that oxytocin might improve social function and empathy (Anagnostou et al. 2014). Studies suggest that some individuals with a diagnosis of autism have a variant in the oxytocin receptor gene that could impact social bonding (LoParo and Waldman 2015). Research indicates that something similar may impact the brains of individuals with an SUD, affecting their social connections and making them more vulnerable to seek pleasure through drugs, since social bonding offers minimal rewards (Szalavitz 2017). There is also evidence that the prosocial aspects of a drug like Ecstasy might be due to the stimulation of the brain's oxytocin systems (Dumont et al. 2009).
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Slayter 2007, in her article addressing substance abuse and treatment for those who have an intellectually challenged diagnosis (ICD), goes on to cite Deborah Stone (1997), who, in Policy Paradox: The Art of Political Decision Making, addresses the balance between liberty, equality, and security. Slayter (2007) recommends trying to find the best blend on a case-by-case basis in order to assure that an individual isn't forced to sacrifice liberty for the sake of security, or to sacrifice equality for the sake of liberty. What further complicates this approach is that once an individual is receiving, say, disability benefits, the government will add restrictions that could compromise a person's liberty, and so self-determination may no longer be in play (Slayter 2007).
As mentioned earlier, some individuals with autism have co- occurring intellectual challenges and some do not. Much of what Slayter addresses could easily apply to anyone with a developmental delay including autism. But autism, with or without a co-occurring ICD, can have a particular component that cannot be generalized: lack of social connectedness. Several studies of substance use among individuals with autism without a co-occurring ICD addressed two types of individuals with autism: those who want to socialize and those who do not. Though both groups may have impaired social communication due to autism, the impairment does not necessarily determine an individual's desire to socialize. As Clarke et al. (2016, p.156) note: ...studies have assumed that participants' diagnosis of Asperger syndrome, SUD and their interaction are solely located "within" the individual. As a result, these studies do not acknowledge, nor explore the impact of interpersonal, social, cultural and societal influences on how participants' make sense of their substance use in relation to their diagnosis.
The differences are illustrated by one adult on the spectrum who drank in order to facilitate socializing versus another individual who used substances to escape from socializing: "I have decided that I won't be quitting drinking fully because I noticed a great part of my social life will be gone and to me that's not worth it, and I don't know how it could be done without the booze" (Kronenberg et al. 2014, p.5); "Carl spoke of how at times he used... tobacco....as an escape from social settings: I start smoking. Smoking is an excuse to get out of it all. So I wind up outside with a cigarette in my mouth" (Clarke et al. 2016, p.159).
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EXPANDING ON SELF-MEDICATION
Earlier in this book we explored self-medication and raised questions as to whether it is always the wrong choice. Self-medication in the autism world is particularly controversial. Often children are accused of self-medicating simply by enacting certain behaviors or craving certain foods. One parent shared: " ...his addiction is to sugar, and there has been speculation about the similar addictive qualities of alcohol and sugar" (Anonymous, family member survey, December 5, 2016).
There are many theories and ASD treatments that target the "addictive" behaviors of children with an ASD. In the autism literature, children with a diagnosis are often suspected of self-medicating; not with alcohol or drugs, but instead, with gluten and/or casein. Books fill the autism section of bookstores addressing leaky gut and food allergies and other possible links between certain foods exacerbating or even causing autism. These books address the addictive nature of certain foods and revolve around the theory that these foods create a cycle of addiction: for example, ingredients in cheese and bread might increase autistic behaviors, and then these increased symptoms of autism trigger the child's brain to crave the very foods that might harm them most (Kuzemchak 2012). There are a number of parents and some professionals who refer to this cycle of impairment as leaky gut, a condition related to the gut-brain connection. The differences between leaky gut and gut-brain are important: leaky gut refers to particular food allergies, whereas gut-brain targets the bacteria and digestive complications that often accompany autism (Autism Speaks 2017b).
Many people directly connect leaky gut/ gluten and casein allergies to addiction. One parent's website explains this theory:
Our kids with autism-and hyperactivity-are extremely vulnerable to environmental toxins, and the toxins of its metabolism. There are certain elements in diet, specifically gluten and casein (dairy) that are not completely digested by many children with autism and hyperactivity. Due to insufficient digestion, gluten and casein eventually produce endogenous opioids, components of brain activity similar to morphine. Thus, the diet can have a profound effect on the brain of these children. In other words, it is as if they were "high."
I know it is shocking to many, but it's true. Homeopathic doctors and nutritionists report that some autistic children when they arrive at their offices, have a vacant stare, dilated pupils, do not interact and exhibit inappropriate behavior. Moreover they seem to have an incredible craving for foods containing gluten and diary, such as chicken nugget, macaroni and cheese, ice cream, etc. (de Kwant 2016) The purpose of this book is not to dispel or support such theories (though for those who trust the medical community, there is no empirical evidence that leaky gut is the cause of autism), but what is of interest is the perception that a child with autism could be grappling with addictions as soon as they begin to ingest solid foods. The celebrity Jenny McCarthy, who has a child diagnosed with autism, has championed diets that target leaky gut:
I explained to Oprah that with the proper diet, kids were getting better. I talked about the gut-brain connection... A doctor once said to me that if people don't believe in the gut-brain connection, then tell them to go try that theory in a bar. Order a drink and see what happens. (McCarthy 2008, p.10)
The doctor is right, something does happen, but what happens is complex and nuanced. Some might say it depends on the drink, or how much is consumed; others might say it depends on who's drinking; and still others might conclude it is a combination of a variety of environmental and biological factors. Ultimately, McCarthy's docto's analogy to alcohol's impact is not so simple. Most individuals working in the field of substance abuse would say that it really depends on a particular individual's gut and brain. Many children with an autism diagnosis have frustratingly limited diets- —one mother told
me that for several months her toddler would only eat fish sticks: "fish-sticks for breakfast, lunch and dinner" (Anonymous communication, September 12, 2016). Her pediatrician considered this a sensory issue, and recommended the mother just wait it out, continue to serve the child what the rest of the family was eating, occasionally introduce new foods, and eventually the child would change on his own. But when the mother mentioned her son's extreme dietary limitations to an occupational therapist, the therapist agreed it was a sensory issue, and told the mother that she had to break this habit immediately or the child would always have problems. These two different recommendations by professionals are reminiscent of the theories of harm reduction versus abstinence.
PARENTS' TREATMENT CHOICES
There are well over 100 documented treatments for autism, though few have been studied thoroughly enough to prove their efficacy (Goin-Kochel, Myers, and Mackintosh 2007; Green et al. 2006). Along with treatments such as chelation (a detoxification treatment), aromatherapy and Interactive Metronome (a physiological treatment) are pharmacological options that include Ativan, Xanax, Clonopin, Ritilan, and Adderall (all of which have the potential for being abused) (Goin-Kochel et al. 2007; Green et al. 2006). We can add MDMA (Ecstasy) and marijuana treatments to the list, given their recent popularity. When it comes to treatment, the famous adage seems to apply: "If you've met one person with autism, you've met one person with autism." Unlike some therapies such as aromatherapy or baby massage, which appear to be relatively benign, other interventions (often endorsed by parents) might seem risky or even dangerous. In the autism community, it is not unusual to read or hear comments from parents accusing other parents of child abuse, for either recommending or avoiding particular interventions:
I came home one day a few months after my child had been diagnosed and in my mailbox was an article about how a certain diet would cure my child's autism. No note or name on it. Not many people knew about the diagnosis yet. Not many people had a clue of all the treatments (speech and occupational therapy, social skills, a special preschool etc.) we were already trying. My son was very underweight and a picky eater. The diet in that article seemed impossible to implement. I believe whoever left it meant to help but it made me feel helpless, horrible and angry. (Anonymous communication, December 11, 2016)
Why address parents' treatment choices for their children with an ASD?
There appears to be a parallel to individuals with an ASD making choices for themselves. In both cases, treatment choices are nuanced and complicated, and the burden on parents to determine what is best for their child appears particularly fraught. To some of us, a parent not implementing a recommended diet that could improve the child's outcome may be viewed as a crime; to others, implementing it and not letting the child enjoy foods he likes, especially if he's underweight, could seem equally criminal. Balancing the risks and outcomes are particularly tricky.
The ethics of making choices on behalf of children, the differently-abled, the intoxicated, or impaired are messy and complicated. When an adult with autism states: so why not use marihuana in the same way? i can confirm that in my case, it helps calm me down after overload, it has prevented complete meltdowns, it's more efficient than alcohol in letting me cope with social situations such as parties (especially with loud music) because i'm not as proned to make a fool of myself seeing as my awareness is higher on marihuana than alcohol. sometimes it also helps me to stop my brain from rambling when i'm trying to get to sleep. although i'm fairly sure there are many alternatives out there (Rachel's weighted blanket as an example probably does pretty much the same job for her as a small joint for me) when it comes down to it, i think people should do whatever works for them, as long as nobody - including themselves - gets harmed in the process. (Anonymous communication, November 29, 2009)
Who is to say this adult is wrong? And though this individual's declaration may seem reasonable and rational, it may read differently when juxtaposed to the worries of the parents of a teen with autism whose marijuana use appears less benign: "The scary thing is that I fear that marijuana has become his new 'obsession.' He admitted to daily use and has told me on more than one occasion that he has no intentions of stopping. He sees it as a harmless, 'natural' substance" (Hutten 2010). Putting aside the fact that marijuana is not harmless where it is illegal and can do great harm if a teen is arrested, how can we judge what therapy may be working? Do we find alternatives?
And what alternatives are viable? As one parent of a child with autism suggested, the drugs they have been prescribed sometimes seem more dangerous than alcohol or marijuana:
Having spent half the night looking into this subject I see now that scientists are coming to the realization that marijuana might be useful in treating autism. My son was taking zoloft. We looked it up after our doctor told us there are no studies on how these drugs affect kids. They do know it causes cellular changes in the young brain, but do not know what harm these changes can cause over time. Nice huh... Yeah let's stick with what's legal. What a joke. (Smith 2011)
This father has a point since recent studies suggest that though there may be some benefit of prescribing SSRIs (selective serotonin reuptake inhibitors) such as Zoloft, there are not enough robust studies to prove the benefits of SSRIs outweigh the negative impact (Kolevzon, Mathewson, and Hollander 2006; McPheeters et al. 2011).
ALCOHOL AND RECREATIONAL DRUGS AS TREATMENT FOR AUTISM
There is no easy answer to the questions raised addressing a parent's choices or a self-advocate's self-determination in relation to using illegal drugs or alcohol to informally "treat" the symptoms of autism.
Searching the internet yields an array of iffy treatments that may or not be beneficial. There are apparently legitimate clinical trials now underway researching the impact of MDMA (known as Ecstasy or Molly on the street):
There are currently no FDA-approved pharmacological treat-ments for autistic adults with social anxiety, and conventional anti-anxiety medications lack clinical effectiveness in this population. Based on anecdotal reports, MDMA-assisted therapy may be a suitable intervention for the treatment of social anxiety in autistic adults and warrants further investigation in a randomized controlled clinical trial. (MAPS 2015)
A search of the internet finds a wealth of sites and postings dedicated to cannabis as an effective treatment for autism, despite few, if any, clinical trials:
With regard to human data on use of cannabis for developmental and behavioral conditions, to our knowledge, the only available data are from small case series [small descriptive studies that track patients] or single studies... In sum, none of these studies provide sufficient, high-quality data to suggest that cannabis should be recommended for treatment of ASD or ADHD at this time... …Even if and when studies on cannabis for developmental and behavioral conditions are conducted, they will likely use formulations of oral dronabinol or cannabidiol, both of which can be administered with a known dose and predictable schedule; at this time, the bulk of medical marijuana is sold in plant form, which results in a highly variable dose of active compound and with less predictable onset of effect based on whether it is inhaled or ingested. (Hadland, Knight, and Harris 2015, p.8) For self-advocates and family members, it is hard to know which treatments are healthy and which are harmful. For some with autism, psychedelics may seem like an ideal treatment: I also have the super-fun Aspergers/ADHD/Depression/Anxiety cocktail. Magic mushrooms have given me the ability to help me identify certain problems in my life and then take the steps towards fixing them. They have also pulled me out of suicidal depression more than once, quite literally saving my life. I also find that when I am tripping, or right after, I can understand people's emotions in a way that I normally can't access-almost like the veil of autism is being peeled away for a few hours. (Shroomery.org January 24, 2017) But others may take the same drug and find it extremely detrimental and even dangerous: Aspies often get overwhelmed by too much stimulation and Mushrooms was WAAAAAAYYYYYY too much stimulation for me to handle. On a bad trip, I couldn't look anyone in the face. I couldn't put sentances [sic] together. I would see screaming faces coming at me that werent' Isic] there. Strange (seemingly random) patterns appeared [sic] to be engraved on every surface (even my skin!). Some trips hit me so hard that I would collapse (even though I was on a VERY low dose). I didn't want to be around anyone, and if I was around anyone, they had to speak slowly and softly to me otherwise I felt very afraid. I do not recommend mushrooms for Aspies unless you intend to tackle your darkest inner demons. (Shroomery.org April 10, 2014)
How does a loved one or professional value the person's autonomy and at the same time, keep them safe? Searching autism forums such as Wrong Planet and Reddit, there is a great deal of discussion among individuals on the autism spectrum regarding (mostly the benefits of) alcohol, benzodiazepines (Xanax, Valium, Ativan, Klonopin), cannabis (marijuana, hashish), MDMA (Ecstasy), and LSD and other hallucinogens and opioids. As mentioned earlier, some individuals with autism say these substances have significantly improved functioning, while others share that these drugs caused debilitating dysfunction; and then there are those who find drugs or alcohol have had little impact one way or the other.