Autism is a common disorder, apparently affecting around one percent of people, yet much about it remains puzzling. Now two top Israeli institutions, the Hebrew University of Jerusalem and the Hadassah Medical Center, are forging a groundbreaking interdisciplinary collaboration to advance the study and treatment of the neurodevelopmental condition.
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Collaborative stabs so exist between basic researchers and clinicians of Autism Spectrum Disorder around the world. But the joint Autism Research Center is apparently a first effort, certainly in the Middle East, to institutionalize the collaboration.
Although definitions have been converging, so much remains unclear that nobody actually knows the incidence of ASD, which is the general term for all forms of autism.
"Figures differ between different countries because different countries count it in different ways," Prof. Cory Shulman Brody of the Hebrew University of Jerusalem's Paul Baerwald School of Social Work & Social Welfare told Haaretz.
Some countries count only within certain age groups, for instance. So for instance while Israel and the U.S. health authorities agree with that roughly 1% incidence, the figure for South Korea is over 2.5%, but the difference is probably a counting artifact.
What is autism, anyway? That depends who you ask. "Some people will emphasize this aspect or that aspect. But, generally, it is a phenomenological syndrome based on the absence or presence of certain characteristics," says Shulman Brody.
The spectrum starts with mild forms of social discomfort, known as Asperger syndrome, to severe developmental disorders. In many cases the condition can be diagnosed from infancy, when social interaction should begin.
Symptoms may include an indifference to social engagement and a lack of interest in eye contact. As the child develops, additional symptoms include an inability to comprehend signals from other people – to read social cues. In more severe cases, other typical behaviors may include "soothing" repetitive movements such as rocking, or even self-inflicted painful movements such as head-banging, and impaired communication.
Either sex can get it, and all races – but men are four times more likely than women to be diagnosed with autism - and other neuro-developmental diseases. Some scientists suspect may be due to an inherent weakness in the Y-chromosome, which only men have, but we don't actually know if that's true.
Happily, even if doctors can't agree on the evolutionary status of the Y chromosome, or how many people ASD affects on their turf, they have agreed on the symptoms to look for. The list appears in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which was issued in 2013.
Autism, fact or fad?
Is the incidence of autism really increasing – or is that perception an artifact of diagnostics, or even a "fad"? Probably, about all of the above.
"A lot more children are getting diagnosed with autism than used to be," says Shulman Brody. "But I will say that a lot more kids are getting diagnosed with HDD and ADHD too. Neuro-developmental issues are being checked more because there's more awareness in the community, and there's more acceptance that there's no stigma in diagnosis," she adds.
Adding to which, diagnoses of ASD have become broader. Some people not considered autistic in the 1970s might be considered just that now, especially as we have better diagnostic instruments now, explains the professor.
So there's no one answer, which is all too typical of autism. That in and of itself also and underscores the crying need for the collaborative center, which will uniquely match basic research with clinical work and social work as well, the institutions explain. Aside from research and clinical services, the center is also slated to provide training and education for professionals and parents. The hope is that the collaboration will create additive value – "The more we share, the more we know," says Shulman Brody. "No single discipline owns autism."
"By bringing together the relevant disciplines at the Hebrew University, including medicine, social work and education, and combining them with the clinical excellence of the Hadassah Medical Center, the Autism Center will be positioned to achieve important breakthroughs in the research, diagnosis and treatment of autism," stated Prof. David Lichtstein, dean of medicine at Hebrew University. And hopefully, basic scientists and doctors and "stakeholders" – people with the condition and their caretakers – can foster a dialog under this one roof that will change the state of the art of autism treatment.