WEBINAR ABOUT AUTISM.

Janet Doman answers questions from parents about autism, director of the Institutes for the Achievement of Human Potential.

Why do specialists of the Institutes consider autism"symptomatic label" and not a diagnosis at all? Why is it important to give Special attention not only intellectual but also physical development a child with autism? How are nutrition and behavior related?

Janet Doman:
-First of all, I want to say that it is a great pleasure for me that I have such an opportunity, being here, on the territory Institutes for the Achievement of Human Potential, chatting with you to answer your questions is a very pleasant moment and I hope that in the future we will be able to hold many more such webinars.
First of all, I would like to in general terms talk about autism and about damage brain, because many of the questions that mothers asked, they overlap and some of them can be given general answers.

Parents are not told that their children have brain damage, in fact it is a label that is stuck on their children. This label primarily reflects the symptomatology. Those. the label is more aimed at describing the symptoms, but not the cause. Parents do not understand what the child has brain damage. Autism, if you look it up in a dictionary, is in some sense one of those words that doesn't have any meaning at all. The dictionary definition of this word cannot satisfy the person who wishes to understand the meaning of this word.

These labels have a very big influence, a very big power on parents and their children. Good news is that children with a diagnosis "autism" it's simple children with brain damage. Of course there is nothing good in the fact that a child brain damage, it's better not to have brain damage. On the brain damage you can influence, you can improve the condition of a person with brain damage, this is not some kind of incurable, incurable disease. Therefore, parents of children with brain damage, parents of children who have been given such labels - it is very important to realize that the problem of the child is precisely in brain.

Very often, parents think about why these children are so different - because each of them manifests itself differently. brain damage. Children who cannot speak, walk, or use their arms or legs simply have more severe brain damage. There are children who work well with their hands - they have less severe brain damage. Children who have been labeled with this symptom "autism"- their main problem is localized in the areas of the brain that are responsible for integrative functions. Those. this is the part of the brain where the average functions and functions of the cerebral cortex intersect, connect together, overlap each other.

In traditional medicine, it is believed that this disease is associated with mental development, intellectual development, very often here it is said about behavioral problems and doctors believe that in such situations it is necessary to give children medicines, but from our point of view, these are generally some kind of medieval approaches, we have a completely different attitude to this problem. The main problem of these children is related to sensory areas of the brain, with vision, with tactility, with hearing, i.e. with the lower parts of the brain. Thus, these problems translate into behavioral difficulties. The problem is also related to the release of information through the motor pathways, precisely because the child has a real chaos in his head, the child cannot perceive visual, tactile, sensory information. The motor response to such chaos turns out to be behaviorally complex, so people often, looking at all this, conclude that the child has problems with intelligence. But in fact, these children can function at a very high intellectual level.

Many of these children have trouble concentrating and find it difficult to focus because they are bombarded with a huge amount of sensory information. Therefore, children often appear uninterested in what is happening around them. And very often it seems to others that this child is simply abnormal, his behavior is too strange.

What happened is that we turned into a rehabilitation center, one of the very first in the country.

We had a lot of problems, and as a director, these problems weighed heavily on me. First, the buildings and land were inadequate for the task before us. Since most of the buildings and land belonged to the nursing home, we couldn't change things the way we wanted. And because the purpose of the nursing home and its owners was to make money, not solve problems, which was their right, we were defeated in our attempts to research or educate.

We began to receive inquiries from methodologists and physicians, local and foreign, who would like to visit our "institute" to study the work we were doing. We had neither the time, nor the money, nor the means to conduct such training.

What was necessary was crystal clear, but how to get there was much less clear. What was needed was a non-profit organization organized to research, educate and treat patients with brain damage. It should have been organized like an ordinary hospital or university. Such an organization must have buildings, land and staff adequate to treat patients, conduct clinical research and educate other professionals about what we do, how we do it and why we do it.

A reasonable amount of land would be required, no less than a few acres, of course, and on Chestnut Hill land was sold by the foot. Of course, the land would be worth $25,000.

A minimum of forty beds would also be needed, plus places for treatment, etc. In those days, one bed (a bed for a patient) was valued at about $10,000, which meant the building would cost about half a million dollars.

In addition, a minimum staff of about ten first-class specialists would be needed, as well as about ten service personnel such as cooks, laundresses, engineers, etc. With the strictest economy, the total salary would be no less than $150,000 a year.

Food, building heating, electricity, telephones, etc., of course, would cost no less than a hundred thousand dollars during the first year.

In short, we needed almost a million dollars to get started.

Dr. Fay, although he could charge huge fees for surgery, rarely did so, and he had yet to recover from the financial collapse of the Neurological Rehabilitation Center. Bob, Carl and Claude were even younger than me, recent high school graduates. Only I remained and everyone looked at me, waiting for a decision. I needed a million dollars, but I knew where I could get about forty-three dollars.

Around that time, events began that led me to feel that I was being pushed by external forces beyond my control.

The very day I decided that there was simply no way to solve the problem, the first event happened. Betty Marsh came to see me. Betty Marsh was a very pretty, red-haired, middle-aged Irish nurse intern. She worked in a private sanatorium and often brought patients to my office in wheelchairs at my call. Although she and I often exchanged jokes, I did not remember her name. Although she was a registered nurse practitioner, everything she had to tell me was as impractical as anything I'd ever heard - and frighteningly insightful.

She said that she saw the results of the work of the Rehabilitation Center and thought that this is the most noble work that she has ever seen. She thought that if people were that kind to each other, then perhaps there would be some hope for all of us. She noticed how extremely busy I was, and lately she felt that perhaps I was not completely satisfied with all the circumstances in the nursing home.

She then dropped her bomb. She said that she thought it was very important for the people of the world that my work should continue. Although she did not know anything about the situation, she wanted me to know that she had lived her life very frugally and that she had saved six thousand dollars. That six thousand dollars was in the bank and I can take it out any time and I can pay it back later if I ever am able to do so. At the same time, she announced that she would not take any receipt (she does not trust them) and no interest, which deprive all good of any good motive.

I mumbled that I appreciated her good intentions and sat stunned as she nonchalantly walked out the door, pushing her empty wheelchair in front of her.

What the hell did that mean?

How did she even guess that there was a problem?

Why, in the name of all that's holy, is this lonely little woman offering me the savings of her life without any guarantees when I'm almost a stranger to her?

What the hell is her name?

Although I had no intention of accepting her offer, I was completely captivated by her incredible generosity to a man who did not even know her name. I was seething with conflicting emotions.

On the one hand, her extremely strange insight and incredible generosity brought me to tears. On the other hand, she made me feel extremely selfish and rather cowardly and, in general, unworthy of the work that I did. I was overwhelmed by this need for hundreds of thousands of dollars and decided to give up this pipe dream without even discussing it. And yet, it was obvious to me that six thousand dollars must represent much more money for this woman than hundreds of thousands of dollars for me. And despite everything, she offered them all. While it was undeniable that six thousand dollars was more money to her than hundreds of thousands to me, it was also clear that this amount of money was worth less to her than it was to me. I was ashamed.

I worked all that day in a purely mechanical way (which was unlike me) and I was greatly distracted by what had happened. I was not even allowed to recover during that day.

When I finished my work, Mae Blackburn suggested we sit down and talk.

May worked as a clerk in the US Navy during the First world war and, I was told, was an excellent secretary. I met May first as a patient three or four years ago. She weighed eighty-eight pounds, was several years older than my mother, and looked like my grandmother.

It didn't take any psychiatrist to understand her problem. Mei was in her early 60s, but very young at heart. Her husband died, as did most of her friends, and those who did not age much more readily than May did. Her son was married and moved away, leaving Mei alone. Mei didn't take care of herself, and when I first saw her, she didn't have the strength to walk. good food, a regimen, no company, and a sensible exercise program got her in shape within a few months, and she was discharged. She returned six months later and the whole process was repeated. Then she returned a third time.

It was then that I implemented one combination, which then had consequences. Until that time I had been a secretary for myself (my advantages were cheapness and attentiveness). When Mae Blackburn returned for the third time, painfully thin, emaciated, and so wobbly that she couldn't light her own cigarette, I suggested that she might be able to help me by typing a couple of letters. Although the thought obviously terrified her, she agreed to try. Her letters were absolutely terrible at the beginning, and I took them home at night and retyped them with two fingers. Since I had to do it one way or another, there was no extra work for me in it, and it was clearly useful for her. Very soon, her letters began to get better, until they were completely perfect, just like herself. Obviously it was time for her to check out, as she no longer needed me. However, my cunning game had consequences, because now I needed in her.

So Mae started working for me for a woefully inadequate salary, becoming my secretary, my accountant, my second mother, my boss, and my friend.

I sat on the bench and listened in amazement as May offered me her saving. May had saved $3,000 since her tiny payday, and it was mine.

I saw some kind of conspiracy and accused her of collaborating with what-her-name, a red-haired Irish nurse. She obviously didn't know what I was talking about, but she did know that the red-haired Irish nurse's name was Betty Marsh. I told her with surprise what had happened that morning. She did not know anything about it, but she did not see anything unusual in this story, since she also thought that the work was noble and wonderful. She believed that everyone should help. She was surprised that not everyone offered to help, and the fact that no one knew about the problem did not seem like a good reason for her not to help. No one had told her or Marsh about it, but they knew, didn't they? I agreed, being in some trance.

Even today I have a hard time believing my own story, and it might be even harder to believe now that so many years have passed if I didn't look daily from my office window across the beautiful green lawn at the May Blackburn Building. It helps me remember this amazing woman. It will also help me remember Betty Marsh when I look out of my office window at the May Blackburn building because my office is in the Betty Marsh building.

Mae Blackburn also insisted, in addition to the $3,000 she had given me, that she could, would, and would work for free wherever the "new place" was.

I didn't sleep well that night because I didn't know what the "new place" was. I had the feeling that I was being pushed by external factors beyond my control. This feeling has visited me since then many, many times, and I learned to relax and not resist, even when I did not understand everything.

Both of these women, I thought that night, are much older than me. They don't have any guarantees. And yet, using some foresight that I did not understand, they both insisted on giving everything they had. What about me? What do I have is all I have? Do I want to give it away?

Well, I had the equipment and everything I needed in my big house. All of this could be donated for use in the "new place", whatever that means. This is equivalent to nine or ten thousand dollars.

Then there was the house itself. Although there was still a large deposit left, I could sell it and get fourteen thousand dollars, and that could also be donated.

All in all, I could scrape together about thirty-two thousand dollars. A drop in the sea. It's impossible, and that's what I should say to these two crazy women tomorrow. How could I tell them? They just wouldn't understand.

Although, maybe with May's idea of ​​free working time... Assuming that all specialists would work for free for a while, until we got off the ground? I got out of bed and took a pencil and paper.

Suppose we miraculously got a place to work. Maybe we could rent something or do something like that. Could we then start working? If there was a place to work, we could miraculously last a couple of months if we had forty thousand dollars instead of thirty-two.

Two nights later, Mr. Massingham, my father-in-law, offered me eight thousand dollars. It was clear how he knew about the problem. I told him about it, but not even suspecting that he would decide to help. Both he and his mother were very poor in England as children. And although dad did well in America, he could not forget the poverty of his childhood and was extremely careful with money. I didn't even think of it as a money resource.

Dr. Fei agreed to work for free. My brother did the same. And, of course, my wife.

It was then that Miss Galbraith asked me to meet. I was beginning to get used to people wanting to meet me, and I went to her half expecting her to offer help. Libbeth Galbraith was a patient. She was a fifty-year-old brain-damaged child with what most people call cerebral palsy. Such people when they are seriously ill. are in constant writhing motion. These people look so terrifying (when they are seriously ill).

Most people think of them as mentally retarded, when in fact they are very, very, very smart.

Libbet's condition was not the same as in people with severe athetoid cerebral palsy. She did not squirm, although she could not walk, but like other athetoid patients, she was very, very, very smart. She was also very perceptive. Although we spent some of our daily time together, when she got out of her wheelchair and learning to walk for the first time in fifty years, we never discussed my problem.

This evening we discussed it. We headed towards Fairmount Park, and as we got there, Libbet was talking. She thought I should go talk to her brother-in-law, A. Wynton Clark, and her sister, Helen Clark.

I've only met Mr. Clark once before, and that was quite by accident. I was sure he wouldn't even remember me, and when I called to make an appointment, it turned out to be true. He didn't remember me. However, he invited me to his house the next evening.

He listened carefully as I talked about our hopes and dreams. Taking a deep breath, I told him that in order to get started, I needed what I thought was about twenty-five thousand dollars. He shook his head slowly. You'll need more, he told me, about eighty thousand dollars. With that, he handed me a check for eighty thousand dollars. Although I had never seen so much money and was extremely grateful, I was no longer surprised.

I was not surprised when I found a "new place". It was an excellent estate in Chestnut Hill. Eight acres of original land with two superb buildings, as well as beautiful greenhouses and a barn. More than a quarter of a million dollars were worthy of beautiful trees and shrubs. The place was undoubtedly worth millions of dollars and was absolutely perfect for our purposes. I was not surprised to find the perfect place for us.

I wasn't even surprised when I called the agent to find out how much the estate would cost. The sale price was exactly eighty thousand dollars.

And what do you think about pushing from outside?

The only friends I had outside of my job were my military friends.

After the war, I decided that the world was far from complete peace, and I remained in the primary reserve. I was enrolled in the old Philadelphia 111th Infantry Regiment of the Pennsylvania National Guard. The commander of this regiment was Colonel Jay Cooke, a distinguished citizen of Philadelphia whose great-grandfather, Jay Cooke, financed Civil War side of the Union.

It was he who raised me to the rank of captain when I joined the regiment, and it was his former estate that we bought. Since I was visiting him there, I knew about it. He lived there with his wife and two daughters, and when he found himself there alone with a huge staff of servants after the death of his wife and the marriage of his daughters, he put the estate up for auction. The very rich man who bought it quickly realized that even a rich man could not afford to maintain such an estate, and he sold it to us.

Jay Cook served as a member of the board of directors of the "new place" until the day he died in 1963.

On July 22, 1955, after months of deliberations, Judge Emeritus William F. Dannhauer of the Montgomery County Court of Civil Claims, Pennsylvania ruled that the Philadelphia Rehabilitation Center should be considered a non-profit organization.

The directors were Glenn Doman, Robert Doman, Frank D. McCormick (military friend), Temple Fay, Claude Cheek, and Martin Palmer.

Thomas R. White, Jr. (a prominent Philadelphia lawyer and senior officer in my regiment) served as an attorney at the institutes until his death. He did his job for free.

Robert Magee, one of my oldest and closest friends, served as the first president of the board of governors.

Major General Arthur D. Kemp served as a member of the board of governors from the first day of the body's existence and later became its president until he retired from service many years later.

Bob Magee's wife, Doris, served several terms as President of the Women's Council and is still an active part of the group.

They all served because they were personal friends, and for the love of their children, which they considered a sufficient reward for their work.

The Philadelphia Rehabilitation Center later changed its name to the Institutes for the Achievement of Human Potential.

Thus - by numerous pushes - the Institutes for the Achievement of Human Potential were born - and just in time.

SENSITIVITY AND

ITS IMPORTANCE FOR MOVEMENT

We noted that without input (sensory or perceptual) factors, any normal adult human brain would not be able to function even in a situation as simple as picking up a paper clip. One can imagine what such a loss in perception would mean for much more complex activities like walking and talking in a brain-damaged child who originally never knew about such things.

Now we had to determine where the brain-damaged children suffered such losses and to what extent. If they have such losses, then we had to find out if something can be done about it, for these losses may prevent not only walking and speaking, but even simpler actions.

We have established that there are five human perceptual abilities that allow a person to receive information of any kind, from the most complex (understanding nuclear physics) to the simplest (understanding that a radiator burns a leg that lies nearby). These five areas of perception are: (1) sight, (2) touch, (3) hearing,

(4) smell, (5) taste.

Smell and taste are extremely recessive traits in humans, and our dogs have more skill in these areas than we do. In healthy adults, these characteristics exist mainly for pleasure seeking. They are extremely important to some professionals such as wine tasters and perfume sniffers. Adults receive most of their operational information through the other three organs of perception.

This chapter will deal with sight, hearing and touch.

We have begun to feel that we understand how a child learns to see, hear, and touch in a broad sense, but we have not yet spent much time understanding how a child learns to smell and taste.

We again turned first to healthy children to study how they learned to see, and found that they passed through four important stages which, broadly speaking, corresponded to the four stages we saw in locomotion, stages which usually ended at age twelve months. We were struck by this coincidence, and later events proved that we were very wise to point out what was most important.

A great deal of ingenuity was required to test these children and determine what they saw, since the eye test is usually based on the patient's verbal responses about what he sees. None of the children less than a year old could answer such questions, and many of the brain-damaged children over a year old had speech problems. New methods had to be developed and new equipment had to be developed by which we could come to understand what the child was seeing without asking him to answer questions. It wasn't easy, and even the methods we developed didn't give us everything we wanted to know. However, we have learned a lot.

The four stages healthy children go through in learning to see are:

Stage 1- in the first days, immediately after birth, the child reacts reflexively to light and darkness. This is called the "light reflex". It is not possible to say with certainty whether he feels the light or understands it, since such an assessment is not possible until the higher stages come. His reaction is completely reflex in nature. When light falls on the eye, the pupil contracts; when the light is removed the pupil dilates.

Stage 2 - during this stage healthy child begins to perceive contours and differentiate different degrees of light; that is, he can see a human silhouette if the person is between him and the light source and he will react to a less bright light directed at his face. He can follow a person around the room with his eyes, if this person is between him and the light source.

Stage 3- during this stage, he begins to see the details when the light falls on the object directly and appreciate the differences in the details of this object. Now he can see the object within the larger configuration. Vision takes on additional importance. (He can tell the buttons on his mother's blouse from the blouse itself directly.)

Stage 4- during this stage, which begins at about the age of one, and which will not be fully completed in all its human details until almost six years of age, a great many important things happen. The most important thing is "convergence", which leads to a comprehensive perception. In humans, this is another function of the bare brain cortex. (Which again became a confirmation of our initial ideas.)

We have come to understand that a very high percentage of children with brain damage have vision problems. Indeed, we were becoming more and more convinced every day that virtually all brain-damaged children had some kind of vision problem, despite the fact that some of them had eyes that seemed to be superficially normal and did not show any obvious signs that there are vision problems.

We have also seen many seriously ill children who did not react, consciously or reflexively, even to strong light directed into the eyes. It was blindness. For many years we felt that this was a situation where we could only pray, because if the child is blind, what else can be done? But as the years went on, we began to notice an amazing phenomenon that we did not even try to explain, perceiving it as a happy coincidence. Many of the children who appeared to be blind in the beginning began to see a little. Others who saw a little began to see better. This was extremely strange, since we did not do anything at all that could be attributed in nature to the treatment of vision.

As more and more children began to show improvements in their vision, it became necessary to ask ourselves if this was actually a coincidence or if it was the result of something that was happening to the children.

Up to this time, we had not kept a record of children's vision, only carefully examined it completely at the beginning of treatment, since we considered vision as a static area - something that will not improve. Now we've started keeping records.

We began to notice that these vision improvements were more than a coincidence, because it was obvious that the children who improved their vision were the same children who made progress in movement. If the treatment was stopped for any reason, and the progress in movement stopped, then the progress in vision also stopped. If the treatment was restarted again and the mobility improved again, we began to see improvements in vision again. What contributed to the success in the field of vision?

I seem to have shown repeatedly in this book that there is always a price to pay for inattention. Now, looking back, these startling facts are clear. Indeed, it is rather ironic that, in light of the ideas that our group held, we were surprised to see progress in the field of vision. It is surprising that people who have devoted most of their lives to establishing the fact that brain damage is within the brain have overlooked this point. We ourselves have said many times: If the problem is within the brain, then there will be no success if the elbows, nose, ears and eyes are treated - places where only symptoms of the problem exist.

We ourselves fell into that very trap, for the inattention to which we criticized others. We thought of blindness as an eye problem, not as a symptom of a problem within the brain. Indeed, why should it be strange that vision improved, if we really, as intended, were treating the brain? If the disorder that caused the paralysis of the leg existed within the brain, as we said, then why couldn't the disorder that affected vision also exist within the brain? It was a matter of great importance.

Why is it that such a high percentage of people with brain injury have a variety of vision problems? Did we have any right to suspect that brain-damaged children also experienced something else that happened to their eyes and that caused vision problems? It seemed unlikely. Wasn't it much more likely that children who had a brain injury had vision problems because of that injury? Couldn't we say that if the problem exists within the brain, then there is a strong possibility that a brain-damaged child will also have a visual impairment for the same reason as a motor impairment in a leg or arm?

After all, there has been plenty of evidence that a person can have vision problems, and these problems are not directly in the eye. This happens quite often. We have repeatedly observed vision problems in adults with brain injury after a stroke. We knew about the visual problems that affect the adult brain in Parkinson's disease. We knew about vision problems that an adult could develop when their adult brain was damaged in a car accident or a diving accident.

We did not observe some strange miracle when we saw blind children who could now see contours or details for the first time, but rather we observed the only possible logical phenomenon that we could expect if we really treated the brain and not the elbow or the eye.

With renewed vigor, we set out to investigate the vision problems these children have.

In short, we came to the conclusion that these children had all the vision problems that an adult would experience with a brain injury.

In these children, we saw exactly the same kind of vision problems that we saw in adult patients after a stroke. Some of these children saw nothing to the left of the nose, or nothing to the right of the nose, or nothing above the horizontal plane, or nothing below it. Some had the problem of compressed visual fields, where the child's entire cone of vision was greatly reduced, allowing them to see a little to the side and a little up and down.

We also found white spots in the visual field of some of these children, although these were difficult to detect because the children could not communicate their problems to us, and such a complex test as determining the presence of a white spot was difficult to perform.

Some of the children could see near (within an arm's length) but not far (above arm's length), while others did the opposite. Some children could see quite well but could not detect details.

We have found that the most common problem in our children is blurring of objects. This problem was very easy to detect as it was usually accompanied by a noticeable strabismus (strabismus).

The word "strabismus" to remember is the medical term for what is commonly referred to as "strabismus" or "squint". If one eye squints, it is called "converging unilateral strabismus." If one eye looks to the side, then this is called "divergent unilateral strabismus." If one eye looks up, then this is called "ascending unilateral strabismus." If one eye looks down, then it is called "descending unilateral strabismus". If both eyes squint, then “one-sided” is simply replaced by “two-sided”, that is, if we see a child in whom both eyes converge, then this child will have “converging bilateral

strabismus".

These problems are extremely common, especially in those children who have problems in the midbrain and subcortical areas that occurred at the time of birth or before birth. While a marked strabismus is fairly easy to detect even for the uninitiated, very slight strabismus is not easy to detect and requires careful evaluation. This examination, however, can be done by the parents themselves by simply observing the child's eyes and how they move.

If a child has strabismus, it is quite obvious that his eyes cannot converge on the object seen. This can often be seen in a child who has been diagnosed with squint until he looks definitely at an object - for a while the squint may disappear and he can actually see the object in the proper depth. If a child has a permanent squint, or a squint that goes from eye to eye, then he certainly cannot see in depth.