A while ago, I received a family of three: the father, mother, and their daughter. The child had just turned 3 years old and was very thin and small. If it weren’t for the age on the assessment form, one would think she was no more than 2 years old just by looking at her physique. As soon as the child entered the room, she glanced at me, didn’t linger, and knelt down on the floor because she saw a little car there. As soon as she picked it up, she began to slide it back and forth repeatedly. I called the child’s name several times, but there was no response, not even a pause in playing with the car.
The mother looked very worried and anxious about what was wrong with her child. After the father entered the room, he sat silently on a chair in the corner of the clinic, seeming preoccupied throughout the entire conversation between the mother and me.
The child continued to play with the toy car, sometimes sliding it and sometimes spinning the wheels, never tiring of it. The mother mentioned that the child was supposed to start kindergarten in the second half of the year, but she had not spoken a word yet, which is why they brought her in for a check-up.
I continued to try to interact with the child, saying, “What kind of car is this, XX?” “This car runs so fast!” “Oops, it hit the wall.”
But still, there was no response from the child.
After a detailed conversation with the mother, I learned that the child had not spoken a word, not even calling her parents. Occasionally, when excited, she would make a series of repeated sounds, but not directed at anyone, clearly an unconscious articulation.
When she needed something, she would either place her parents’ hands on the desired object or cry out towards the item, rarely making eye contact; when her parents asked her to do something, there was basically no response.
The child was fond of spinning objects, including wheels, fans, traffic lights, LED screens, and could stare at them for a long time.
The child’s narrow interests also manifested in her picky eating habits. It might be hard to believe, but she only ate white rice and leafy vegetables, rejecting any animal-based food, whether it was made into slices, meatballs, or fillings, all were refused. So even though the child was eating normally, she was still anemic because there was no food source at all, which was also a significant reason for her being so thin and small.
The child had a high tolerance for pain and did not seem to be afraid of it. There were several instances where she fell and scraped her knees bleeding, but the child did not cry.
I told the mother, “Considering the child’s various behaviors, we may need to consider a preliminary diagnosis of autism.”
The mother said this was her first visit to the clinic. She had noticed something off about the child when she was 2 years old and not speaking much, and she had thought about taking her to the hospital. But family members said the child could eat, sleep, and play by herself, so where was the problem? The child’s father had expressed his worries more than once: “Look at her playing by herself just fine, it’s you who are too anxious. You need to be more patient with the child, read her more picture books…”
“Actually, I am not impatient. I am a full-time homemaker, taking care of the child and doing household chores. Recently, I just gave birth to our second child, and there is no one to help. The child’s father works away from home all year round, and although he supports us financially, I handle all the major and minor matters at home, and I am also very tired. So, sometimes I am indeed impatient with the child, but I do take her out to play when I have time; it’s not that I haven’t read her picture books, it’s just that she doesn’t listen and runs off to play by herself, as if she is not interested in the content at all.” As she spoke, the mother felt wronged, lowered her head, and tightly closed her lips, stubbornly not letting the tears fall.
“Doctor, I want to know, is the child’s current situation really because I was not patient with her?”At that moment, I knew I must first relieve them of the “guilt of parenting” to talk about the science and hope that follow.
So, here comes the question, is it really the lack of parental companionship and improper upbringing that causes a child to have autism?
There are still many parents who attribute their child’s autism to problems with parenting methods. Source: Science and Technology Daily ▲
What causes autism?
The causes of autism have been a subject of ongoing debate, with the most widely circulated theory being the ‘refrigerator mother’ theory. The scientific community’s rejection of the ‘refrigerator mother’ theory has been a continuous process.
Although this erroneous view existed in the early days, subsequent extensive research, especially breakthroughs in genetic studies(for example, based on the foundation laid by the Human Genome Project, studies have found that regions such as 7q31-32 on chromosomes are significantly associated with the risk of autism[1]), provided conclusive evidence, completely overturning the view that parenting methods are the main cause of autism, and vindicating parents (especially mothers).
In simple terms,the core cause of autism is not improper parenting, but a complex neurodevelopmental disorder, with its roots mainly in genetic factors(genes)and certain non-parenting environmental risk factors(such as prenatal environment) in complex interactions.
Existing scientific evidence indicates that the way parents raise their children(such as patience or amount of companionship)is not the cause of autism. The risk of autism mainly stems from the genetic traits that an individual carries early in development(including before conception and during pregnancy)and their interaction with specific biological environmental factors. These factorsalready exist or begin to play a role before parents start specific parenting behaviors[2].
Indifferent parents can indeed cause their children to develop ‘Reactive Attachment Disorder‘, but that is a completely different condition: the child will improve rapidly once they receive warmth. However,the core symptoms of autism will not disappear just because of a few more hugs.
To illustrate with a metaphor: The neural connections in a typically developing child’s brain are like highways, allowing information to travel directly from the frontal lobe to the amygdala.
For example, a typically developing 2-year-old who sees “Mommy crying” will naturally react with “I should comfort my mommy.” In contrast, a child with autism has neural pathways akin to a highway collapse, with signals taking detours, getting stuck in traffic, or even breaking off entirely, which is why they cannot interpret any non-verbal communication signals, nor can they interact with others through non-verbal communication.
When a typically developing child sees a photo of “Mommy smiling,” their brain lights up like fireworks with dozens of bright spots; while the activation map of a child with autism only has a few scattered points, like a matchstick doused in water.
More brutally,these “breaks” begin to appear as early as the 20th week of pregnancy. Genetic factors may lead to abnormalities in the brain development of the fetus, such as deviations in neuronal migration, connection establishment, or pruning,like subtle but critical errors in a building blueprint.
Parents’ companionship and scientific early intervention(such as behavioral therapy), while unable to completely “repair” the initial developmental differences(blueprint errors), can act like skilled engineers, “strengthening” and “optimizing wiring” on the existing foundation, “creating efficient auxiliary roads,” significantly improving the efficiency and adaptability of the brain’s information processing, and helping children learn and develop key skills.
Parents may ask, are there any early warning signs to detect autism in children?
Are there any early warning signs to detect autism in children?
Of course, such as the most easily observable, core, and widely recognized early warning signs by parents, like: ● Lack or reduction of eye contact; ● Poor response to their name; ● Lack of joint attention( pointing, showing interest).
I previously wrote an article that详细介绍了 this in detail; if needed, you can read it here:《Can a child who can speak and chat have autism?》
It needs to be emphasized thatautism manifests in various ways, and every child is unique, ranging from those with intellectual disabilities and severe language delays to those who are fluent in language but have significant differences in social communication(such as Asperger’s Syndrome).
So, when a child is diagnosed with autism, parents should stop blaming themselves for not spending enough time with the child or improper parenting; that is not science, it’s superstition.
The real science is—to build a new auxiliary bridge where the bridge has collapsed:
The outcome of autism intervention in children is full of uncertainty, and self-care for parents is very important. The reason for self-blame still stems from the parents’ love for their children, but science can turn “self-blame” into “resources,” and truly help the child.
So, when a child is diagnosed with autism, parents, please keep this “energy replenishment package”:
using behavioral intervention during the most plastic 0-6 years of a child’s brain to train the “detour” into a “shortcut”.
What can parents do for themselves when they have a child with autism? 01 Set aside a fixed “adult breather time” every week Have a fixed time every week as the“primary caregiver rotation break” period, hand the child over to other trusted family members, friends, or professional temporary caregivers, and go to a nearby coffee shop or movie theater to be alone, even if it’s just to daydream. Research shows that“parental emotion relief” for 12 weeks can increase the efficiency of family intervention by 34%[3]
02 Do not over-explain your child’s condition to others Block out all inquiries that ask, “Why isn’t he talking?”
03 Keep a “progress passbook” for your child Buy a small notebook and record the child’s minor changes every day as their “progress passbook”—even if it’s just looking back at the parent for 0.5 seconds. After three months, this passbook will be a better proof than any assessment report:You are moving forward.
Autism is not a flood or a beast; it is more like a test paper with difficult questions, but the answer is not “who is right or wrong,” but “solving the problem together.” Every bit of energy that parents save from self-blame today will become a stepping stone for the child’s progress tomorrow.
You need to be seen, not interrogated.
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