autism be caused by trauma

Can autism be caused by trauma?

What is autism?

Autism is a neurodevelopmental disorder characterised by impaired social communication and interactions. Its aetiology appears to be congenital in origin. Autism can be identified via repetitive speech, movements and behaviours. Hyper- or hypo sensitivity to sound, light and other sensory stimuli are also common. The persistent and unrelenting hyperfocus on one particular thing at a time, to the exclusion of every other thing is characteristic of autism.

However, presenting symptoms and their severity differ among individuals.

What is trauma?

There is a great debate as to what comprises trauma.The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) defines trauma as “actual or threatened death, serious injury, or sexual violence”. Trauma is also considered to be the experience of an event rather than the traumatic event itself. This poses a question of subjectivity here. A person’s response to trauma depends on their identity, personality, conditioning and attachment type.

Research has shown that early life stressors can cause brain changes especially during the period of brain development. Birth asphyxia, preeclampsia, foetal dystocia, umbilical cord collapse, placental abruption, breech or transverse presentation can cause serious brain injury in a child if not handled quickly.

Stressors in early life and childhood have been associated with brain changes in adults notably in the caudate nucleus, hippocampus, anterior cingulate gyrus, corpus callosum, orbitofrontal cortex, insula and dorsolateral prefrontal cortex. These brain areas have been implicated in the differences we see in the autistic brain.

Irrespective of the cause of the differences, the result is the decreased capacity to self regulate, leading to prolonged stress and experiencing harmless social interactions as threatening. The bottom line is that trauma and extended periods of stress can cause brain changes that mimic autism.

Clinicians need to be aware that clients wanting assessment for autism may have been subjected to trauma. Assessing for previous history of trauma will inform the diagnosis and what treatment to offer. The clinician will need to determine if the person is really autistic, traumatised or both and then modify treatment accordingly.

There have been reports of people who seemingly developed autistic traits following traumatic events. In one case report, Ms B was born into a perfect family with no known history of mental issues. Her mother was discovered to be violently, shaking the infant in a bid to stop her from crying at night. From that time onwards, Ms B has never cried. At age 50, she feels no emotional attachment to anybody, lacks social awareness and is in a constant state of autistic hyperfocus.

In another case, 39 year old Mr T was a happy kid until his parents separated at age 4. The only male figure whom he adored at the time was his much older sister’s husband.

Unfortunately, all of that ended when the marriage failed and the brother-in-law moved out. Since that time, Mr T has never felt any emotion. He had even burst into laughter on two occasions when he was threatened at gunpoint. He is currently obsessed with inventions.

It is still uncertain whether trauma induced autism is real, rare or commonplace and clinicians might be able to help by asking for history of trauma when assessing patients for autism. The number of reported trauma-induced autism cases is still insufficient to project definite information over the entire autistic population.


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