Intialaisen Kiran Desain teos Hulabaloo hedelmätarhassa (1999) kuvaa autististista kommunikaatiota itämaisessa kulttuurissa. Intialaisessa yhteisössä ymmärretään poikkeavaa viestintää toisin kuin lännessä, jossa poikkeaviltakin vaaditaan yhteisten sääntöjen noudattamista. Elämä kääntyy päälaelleen, kun Sampath- poika kiipeää puuhun ja alkaa jakaa viisauksiaan:"Joka luumulla on alkunsa." Erakoituneesta, autistisesta pojasta tulee Shahkotin pikkukaupungin Baba, tietäjä-pyhimys. Autistisen neron viisaus vetää puoleensa muita omantakeisia ihmisiä - eläimistä puhumattakaan. Guavapuussa asuvasta pojasta tulee samalla myös kaupunkia terrorisoivan apinajoukon suosikki.
Erilaisuus on suvussa. Sampathin sisar Pinky viestii myös poikkeuksellisella tavalla. Ihastuessaan jäätelömyyjään hän osoittaa huomionsa puremalla irti tämän korvalehden. Myöhemmin tyttö sitoo rakkauskirjeensä kivenmurikkaan. Pahaa aavistamattoman pojan leukaan osuessaan se aiheuttaa verisen tilanteen, joka johtaa uhrin rakastumaan ärsyttäjäänsä. "Jos raketti on sytytetty, niin se kohta räjähtää, halusit tai et " – toteaa neropatti Sampath.
"Ei pidä niellä mitä tahansa jos tahtoo säästyä mahanpuruilta." Näitä elämäntotuuksia ihmiset tulevat kuuntelemaan ja jopa maksua vastaan - ja Sampathin pikkuvirkamies isä kerää kolehdin. Sampathille puusta tulee uusi koti, jossa kännäävät apinat hyväksyy oudosti käyttäytyvän nuorukaisen naapurikseen. Myös itämainen kulttuuri on valmis hyväksymään erilaisuuden ja löytää tarkoituksen oudolle käytökselle. Näin myös autistinen ihminen saa oman paikkansa, arvokkaan tehtävän ja ympäristönsä kunnioituksen. Yhteiskunnan patriarkaalisuutta ja naisten asemaa, köyhyyttä ja erilaisuutta käsitellään huumorin siivin. Lahjattomasta nahjuksesta nousee hengellinen johtaja.
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Äskettäin Yhdysvaloissa on huomattu, että autismia diagnosoidaan enemmän pohjoisissa kuin eteläisissä osavaltioissa. Onkin epäilty ilmaston tai saasteiden vaikutusta.
Mutta syynä saattaa olla diagnoosin tarve. Etelässä ja kehitysmaissa autistinen henkilö tulee toimeen ilmaston ansiosta ilman erityistukeakin. Siitä esimerkkinä tämä puussa asuva erakko Intiasta. Tämä tarina, tuskin olisi mahdollista täällä kylmässä pohjolassa.
Somalialaisella paimentolaispojalla ei ollut vaikeuksia paimentaa vuohia kotimaassaan, mutta tultuaan vanhempiensa kanssa pakolaisena Ruotsiin, hänet todettiin tuen tarpeessa olevaksi autistiseksi henkilöksi.
Sharp rise in autism is real, UC Davis researchers report
UC Davis researchers who analyzed 16 years of records concluded that California's dramatic rise in autism cases since 1990 cannot be blamed on population increases or the way the disability is classified or diagnosed.
The study's authors, from the university's MIND Institute, called for a switch in research emphasis from a genetic cause to possible environmental triggers including chemicals, medications, fertility treatments and childhood vaccines.
The incidence of autism in children 6 or younger increased from less than nine per 10,000 children born in California in 1990 to more than 44 in 10,000 children born in 2000.
Many experts contend that other factors account for the increase, such as greater awareness among parents and pediatricians, and therefore a greater likelihood of a diagnosis.
But that accounts for only a fraction of the more than 600 percent jump, said Irva Hertz-Picciotto, whose work was published this month in the journal Epidemiology.
"It's still climbing. Five years from now it's going to be even higher than that," Hertz-Picciotto said in a telephone interview Friday. "Once you're left with this idea that part of this is due to a true increase, it has to have something to do with the environment because genetics don't change that quickly."
Looking at birth records from 1990 through 2006, the researchers excluded children not born in California, thus eliminating migration as a possible cause for the increase. They also used census data to calculate incidence of autism over time and the age at diagnosis.
Hertz-Picciotto and her colleague, Lora Delwiche, found that less than 10 percent of the estimated increase could be attributed to the inclusion -- after 1993 -- of milder forms of autism, and about 4 percent of the increase was attributed to a trend toward earlier diagnosis.
"These are fairly small percentages compared to the size of the increase that we've seen in the state," said Hertz-Picciotto, a professor of environmental and occupational health and epidemiology.
Many scientists think people have a genetic predisposition to autism that is triggered by some environmental factor. Hertz-Picciotto believes it's probably multiple genetic susceptibilities and more than one environmental trigger.
People with autism have trouble with communication and social interaction. They often play with toys in unusual ways and have repetitive patterns of behavior such as hand flapping and spinning.
Stanley Swartz, an autism researcher and professor of special education at Cal State San Bernardino, said it will be hard to get a consensus on causes for the increase.
"The problem is we're operating almost completely on theories," he said. "What we have to consider is that this is not a single syndrome with a single cause. ... There's more going on than just one thing because you do see such a wide variety of cases of autism."
Becky White, of Riverside, agreed. Her 14-year-old son Cameron, a triplet, has such severe autism that she had to put him in a group home full time last spring. Cameron speaks little and is prone to aggressive behaviors. Even before he was diagnosed at age 3, White knew he was different from his brothers, especially with his lack of eye contact.
A deeply devout woman, White said she doesn't waste time or energy figuring out where to place blame for Cameron's autism. She believes it was God at work and not environment, since her other sons are developing normally.
"It lessens the odds (of it being an environmental trigger) when you have multiples raised in the same place, exposed to the same things, the same food, and one of them isn't just a little different, but profoundly different," she said.
Reach Janet Zimmerman at 951-368-9586 or jzimmerman@PE.com
New Study: Autism Linked to Environment
or years, many medical officials have suspected that the trend is artificial--due to changes in diagnoses or migration patterns rather than a real rise in the disorder.
But the new study concludes that those factors cannot explain most of the increase in autism.
Hertz-Picciotto and Lora Delwiche of the UC Davis Department of Public Health Sciences analyzed 17 years of state data that tracks developmental disabilities, and used birth records and Census Bureau data to calculate the rate of autism and age of diagnosis.
The results: Migration to the state had no effect. And changes in how and when doctors diagnose the disorder and when state officials report it can explain less than half of the increase.
Dr. Bernard Weiss, a professor of environmental medicine and pediatrics at the University of Rochester Medical Center who was not involved in the new research, said the autism rate reported in the study "seems astonishing." He agreed that environmental causes should be getting more attention.
The California researchers concluded that doctors are diagnosing autism at a younger age because of increased awareness. But that change is responsible for only about a 24 percent increase in children reported to be autistic by the age
"A shift toward younger age at diagnosis was clear but not huge," the report says.
Also, a shift in doctors diagnosing milder cases explains another 56 percent increase. And changes in state reporting of the disorder could account for around a 120 percent increase.
Combined, Hertz-Picciotto said those factors "don't get us close" to the 600 to 700 percent increase in diagnosed cases.
That means the rest is unexplained and likely caused by something that pregnant women or infants are exposed to, or a combination of genetic and environmental factors.
"There's genetics and there's environment. And genetics don't change in such short periods of time," Hertz-Picciotto, a researcher at UC Davis' M.I.N.D. Institute, a leading autism research facility, said in an interview Thursday.
Many researchers have theorized that a pregnant woman's exposure to chemical pollutants, particularly metals and pesticides, could be altering a developing baby's brain structure, triggering autism.
Many parent groups believe that childhood vaccines are responsible because they contained thimerosal, a mercury compound used as a preservative. But thimerosal was removed from most vaccines in 1999, and autism rates are still rising.
ws. Mercury, polychlorinated biphenyls, lead, brominated flame retardants and pesticides are examples.
While exposure to some--such as PCBs--has declined in recent decades, others--including flame retardants used in furniture and electronics, and pyrethroid insecticides--have increased.
Mothers of autistic children were twice as likely to use pet flea shampoos, which contain organophosphates or pyrethroids, according to one study that has not yet been published. Another new study has found a link between autism and phthalates, which are compounds used in vinyl and cosmetics. Other household products such as antibacterial soaps also could have ingredients that harm the brain by changing immune systems, Hertz-Picciotto said.
In addition, fetuses and infants might be exposed to a fairly new infectious microbe, such as a virus or bacterium, that could be altering the immune system or brain structure. In the 1970s, autism rates increased due to the rubella virus.
The culprits, Hertz-Picciotto said, could be "in the microbial world and in the chemical world."
"I don't think there's going to be one smoking gun in this autism problem," she said. "It's such a big world out there and we know so little at this point."
But she added, scientists expect to develop "quite a few leads in a year or so."
The UC Davis researchers have been studying autistic children's exposure to flame retardants and pesticides to see if there is a connection. The results have not yet been published.
"If we're going to stop the rise in autism in California, we need to keep these studies going and expand them to the extent possible," Hertz-Picciotto said.
Funding for studying genetic causes of autism is 10 to 20 times higher than funding for environmental causes, she said. "It's very off-balance," she said.
Weiss agreed, saying that "excessive emphasis has been placed on genetics as a cause. "The advances in molecular genetics have tended to obscure the principle that genes are always acting in and on a particular environment. This article, I think, will restore some balance to our thinking," he said.
Some issues related to whether the increase is merely a reporting artifact remain unresolved. There could be other, unknown issues involving diagnosis and reporting, scientists say.
The surge in autism is similar to the rise in childhood asthma, which has reached epidemic proportions for unexplained reasons. Medical officials originally thought that, too, might be due to increased reporting of the disease, but now they acknowledge that many more children are asthmatic than in the past. Experts suspect that environmental pollutants or immune changes could be responsible.
Autism has serious effects, not just on an individual child's health but on education, health care and the economy "Autism incidence in California shows no sign yet of plateauing," Hertz-Picciotto and Delwiche said in their study.
This article originally ran at Environmental Health News, a news source published by Environmental Health Sciences, a nonprofit media company.
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