Natalie Williams and Dr. John Seggar, Sociology
Orphans in developing countries raised in social institutions often manifest extreme developmental delays. Autism is a common layman diagnosis for such children due to the pattern of their developmental delays. Most orphans raised in such situations show severe delays in language skills, social interaction, and play behavior. All three of these delays are very characteristic of the Autism Spectrum Disorder. However, deeper investigation shows autism to be a more intricate and pervasive disorder.
The general population sees autism as being manifest by a lack of social and verbal interaction and extremes in skill levels (above average proficiency in some areas and severely inadequate skills in other areas) as was manifest by Dustin Hoffman’s character in the popular movie “Rain Man.” While this is true, the general population fails to see the neurological cause behind such delays. A closer study shows that such symptoms of autism are most likely due to a failure to processes neurological signals the same as the average individual. For example, social cues are often misread or unrealized. Someone with autism may also interpret sounds and sensations differently.
The fact that autism is strictly a biological disorder is also often misunderstood. There are no known environmental causes that can trigger autism in a child once it is outside the womb. Researchers first believed autism to result from neglect, abuse, or tragedy during early childhood.1 Although scientists have discovered some of the biochemical and physical causes of autism, most of the general population still believes the first assumptions of environmental factors during early childhood to be the cause of autism.
I spent time with Dr. Sally Ozonoff, the director of the autism clinic at the University of Utah, and read many research articles on autism prior to leaving for Romania. I even found research by Dr. Michael Rutter, an autism specialist, on the presence of “quasi-autistic patterns” in orphans from Romania.2 All of this knowledge helped me to take a more informed approach to assessing the presence of autism in the orphans at the Placement Center. I agree with Rutter in that to truly assess whether or not an orphan from such a disadvantaged background really does have autism, the orphan would have to be removed from his current surroundings in order to eliminate complications of causation for his atypical development and behavior. Despite my inability to remove my subjects from their poor surroundings I still feel confident in my assessments.
The children in St. Maria’s Dystrophic Section of the Placement Center in Iasi Romania manifested many atypical characteristics. My subject base was selected from the 60 infants housed therein. I had the opportunity to work with 10 to 15 children (the number varied as children were sent to the hospital, or brought in or taken home) from ages 8 months to three years for a duration of four months. I generally worked with each child on a daily basis. My ability to regulate an exact time schedule for each child was rendered impossible by the daily variations in the operations of the Placement Center.
With my first observance and testing of the children they indeed appeared to fit the prototype of an autistic child. The children would spend hours rocking back and forth. They did so in their cribs, in the playroom while playing, and even in their sleep at times. With the definite exception of two children who had just recently come from homes, almost all of my subjects would make unusual, repetitive hand motions for hours. When given the chance to visit the playroom, about 40 to 50% of the children exhibited unusual play behavior. They would spend great amounts of time playing with unusual objects such as string, lids, etc. while more colorful appropriate toys sat untouched. Many of the children would sit isolated and spend most of their time using the toys in repetitive, unimaginative play.
The DENVER II developmental test revealed extremely severe delays in language in all of my subjects. Delays in gross motor, fine motor-adaptive, and personal-social varied in severity from child to child, but all children scored months, and sometimes even as much as a year behind the estimated developmental level for children of their age.
The probability of having so many autistic children drawn randomly from the general Romanian population is nearly impossible. The more time I spent with the children at the Placement Center the more I came to know each one individually and gain a sense of their own personal skills and the possible reasons for their delays. I noticed that the more the children came to know and trust me, the less I saw them make their repetitive hand motions. The more stimulation they were exposed to the less they rocked. The more I interacted with them the better their social skills became. Not only their social skills with me, but with other children as well. It is from these observations and experiences that I would state that most of their developmental delays actually stemmed from their physical and social neglect as well as their lack of stimulation and interaction with others.
It is sad to realize that some children spend most of the young lives in such substandard conditions, but my findings do provide hope. With a little extra time, attention, and love the quality of life for the children in the Placement Center can be drastically improved. I’m grateful for the chance I had to perform this research and be a part of such special children’s lives. My findings aren’t ground shattering, but if more people were aware of the difference they could make with such a little effort, the results would be ground shattering.
References
- Hart, C.A. (1993) A Parent’s Guide to Autism: Answers to the Most Common Questions, Pocket Books, 40 – 50.
- Rutter, M., Andersen–Wood, L., Beckett, C., Bredenkamp, D., Castle, J., Groothues, C., Kreppner, J., Keaveney, L., Lord, O’Connor, T.G. (1999) Quasi-autistic Patterns following Severe Early Global Privation, Journal of Child Psychology and Psychiatry and Allied Disciplines Vol 40 (4): 537 – 549.