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Autism should be treated as multiple disorders: researchers

Jennifer Macey reported this story on Tuesday, April 2, 2013 12:42:00

ELEANOR HALL: Researchers from the University of Western Australia are calling for autism to be treated as a syndrome of multiple disorders.

Writing in the Medical Journal of Australia, they highlight that the causes of the disorder are not fully identified, and they argue that redefining autism would help tailor intervention programs to individual children.

Professor Andrew Whitehouse is the head of autism research at the University of Western Australia, and he spoke to Jennifer Macey.

ANDREW WHITEHOUSE: We've been trying for 70 years to identify a single cause for autism. We've tried all sorts of techniques to try and find that one defining cause of autism, and the fact remains is that we just cannot find it.

What we're saying is that actually it's probably time to start looking at autism not just as a single disorder with a single cause, but as many different disorders with many different causes. Which means that if we have two, three, four children or adults with autism in front of them, each of their autisms will be caused by different things.

JENNIFER MACEY: What are the potential different causes?

ANDREW WHITEHOUSE: Well, we know that autism is a strongly heritable disorder, which means that the genetic factors play a very large role. But the fact remains is that we can't find any single genetic variant that accounts for a large amount of cases of autism.

So what we actually think is that there is a very strong interplay between the genetic profile of an individual and also the environment, and the way that these interact actually may play a large role in autism.

JENNIFER MACEY: What are the environmental causes, and are you still looking for more?

ANDREW WHITEHOUSE: Absolutely. At this stage we haven't identified many of them at all. What we do know is that certain risk factors during pregnancy - such as exposure to maternal use of certain anti-depressants, as well as mothers' exposure to traffic pollution can actually increase... slightly increase risk for autism - but the fact is that we still don't know anywhere near enough about how the environment may interact with genes to cause autism, and this is a huge area of research right now.

JENNIFER MACEY: You've mentioned that you can make a comparison to cerebral palsy. How?

ANDREW WHITEHOUSE: People with cerebral palsy, their difficulties can be caused by many different things - for example, lack of oxygen at birth, or pregnancy complications earlier during the pregnancy. And so what we know now is that cerebral palsy is just a term that incorporates many, many, many different disorders. There is not one cause for autism, there are many different causes to all the different autisms - plural - and I think it's about time we started viewing autism like that.

JENNIFER MACEY: And how would that then affect treatment or intervention strategies?

ANDREW WHITEHOUSE: It's to do with the brain. What we need to do is actually identify: is there one area of the brain that causes all different forms of autism, or is there multiple areas of the brain that causes different cases of autism? What we are saying is that we actually think there are multiple different areas in the brain that may cause autism, and what we need to do is really hone in on those different areas. And so once we have identified those different areas we can home in on them and actually tailor our behavioural intervention to them. It's a very exciting thing, but what we do know is that certain inventions can change the way that our brain functions, and once we identified those different areas, we can actually home in on that.

ELEANOR HALL: Andrew Whitehouse is the professor of the Telethon Institute for Child Health Research at the University of Western Australia. He was speaking to Jennifer Macey.

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