Dr. Stanley Goldstein - Author and Psychologist

A recent robust online clinical discussion concerned whether a teenager's proper diagnosis was autism or a subtype of schizophrenia despite the treatment of both conditions being the same: for the therapist to provide such a comfortable experience that the patient will eventually renounce the symptoms which keep them socially isolated and gain social skills. Both conditions reflect what has been termed Elements of a Borderline Psychotic Psychostructural Organization: the weakness of basic ego capacities which develop during the earliest years of life and control thinking, behavior, the sense of who one is, and more.

Autism is vastly diagnosed. With true autism the very young child senses the grave inadequacy of their parenting and tries to function independently. After inevitably failing because of their age and despairing they enter a personal universe to psychologically protect themselves, which is the autism. An Australian study found that when the parents of very young children with autistic features were provided extensive parenting education almost all the children were no longer diagnosable as autistic by the age of four.

An August 31, 2023 article in The Wall Street Journal ("My Son Sam Doesn't Need Special Ed - His autism demanded it, experts said.") aroused several thoughts. My first book, Troubled Children/Troubled Parents, the first chapter can be read on my website, included my lengthy treatment of an accurately diagnosed autistic child. The current frequent misdiagnoses are caused by widespread inadequate understanding of child psychological problems by school personnel and doctors. To treat an autistic child the therapist must enter their personal world, which is their protective shell but can be relinquished with proper treatment. The belief they are uncommunicative is false and as erroneous as relating to them with behavioral modification (reward-punishment) methods. These children do communicate but in their way. With rare exception, schools do a poor to disastrous job of interacting with or advising parents about their troubled children.

 

While parents rarely feel guilty when their child becomes physically ill, this is not true when they develop emotional problems. Autism is perhaps the most affected of these attitudes which, in its severest form, devastates family life.

 

Though recent infant research has confirmed what clinicians have long sensed, that the parent-child interaction plays an overwhelming role in its development, denial of this fact persists. Thus we read of continued, failed attempts to relate autism to vaccines or pollution or whatever, any cause but parenting. This is understandable since the sight of a severely autistic child horrifies and no parent would willingly accept blame for this.

 

All children have strengths and limitations, as do parents who had their own childhood struggles. A parent's personality must mesh with their unselected child and mismatches naturally occur. The unconscious is very powerful, and one must recognize its power. Thus, once a child's emotional problem is recognized and help for it is sought, any parental guilt is undeserved and counter-productive.

 

A positive thought is that autism is vastly and inaccurately over-diagnosed. In my long experience, in both medical and psychological settings, I have seen fewer than five severely disturbed, self-mutilating autistic children, and fewer than twenty diagnosable autistic children with lesser symptoms. Moreover, young children whose behavior exhibit some autistic features can have these symptoms disappear through ordinary play psychotherapy, sometimes in just a few months. And with lengthy, extensive services, major change can be made in even the most disturbed autistic child's life.

The aloofness noted in autistic children often becomes a self-fulfilling prophecy when their therapist considers it a given, something amenable only to simplistic reward/punishment behavior modification techniques. But the autistic child does have relationships though these are inadequate and require nurturing through play therapy.

No special techniques are required since the basic difficulty of autistic children is communication and play is the primary language in conducting psychotherapy with children. Thus, autistic children must be related to individually with their aloofness not being taken as a rejection of interpersonal contact but merely their inadequacy at it. A recent study found that most infants, who had communication difficulties associated with autism in their second year of life, were later no longer diagnosable as autistic when their mothers were given early intense instruction in communicating with them.

Psychologists have long known that children in every nation become capable of speaking their nation's language not by learning that one word follows another but because the mind innately inducts the grammatical structure of their nation's language. Understandably so since the purpose of all cognition is to make sense of the personal world as quickly as possible.

 

It is not true that autistic children avoid communication but rather that they try to communicate in their own way. Thus, treating them with the same behavior modification method that one would use with a dog is doomed to failure. Instead, one must enter their world and wean them into the larger world, one that is unproblematic unlike the unsatisfying, psychologically non-nourishing developmental experiences that drove them from it originally.

 

One caution: misdiagnosis of autism in children is widespread and traditional play therapy can often reduce or eliminate a few autistic symptoms in mere months.

 

An English researcher and author of The Pattern Seekers: How Autism Drives Human Invention, Dr. Baron-Cohen, has found an association between autism and the capacity for hyper-systematizing, the ability to see patterns where others cannot, which is important in creative invention. Yet it is important to keep in mind that these individuals are but a tiny minority of autistic sufferers, that autism is vastly mis-diagnosed and of a wide range and, when severe, is perhaps the most disabling of all the mental health conditions and the most resistant to healing since it originates very early in life.

Newspaper and other reports often indicate high rates of autism among children. One, in South Korea, asserted a huge rate of one in thirty-eight, it also including some "highly functioning children."
These provoke understandable alarm for autism is probably the most devastating of all the mental health disorders. It cripples childhood and later adult  Read More 

While parents rarely feel guilty when their child becomes physically ill, this is not true when they develop emotional problems.
Autism is perhaps the most affected disturbance by this attitude for, in its severest form, it devastates family life. Recent infant research has confirmed what clinicians have long known: that the parent-child interaction plays  Read More 

The aloofness noted in autistic children often becomes a self-fulfilling prophecy when their therapist considers it a given, something amenable only to simplistic reward/punishment behavior modification techniques. But the autistic child does have relationships though these are inadequate and require nurturing through play therapy.
No special techniques are required since the basic  Read More