Martha Herbert, MD, PhD, is a pediatric neurologist who walked away from her private practice to immerse herself full-time in autism research. She found that under the time constraints of third party care in metro Harvard Yard, she was unable to spend the time necessary to give proper care to the increasingly challenging population with whom she was dealing. The alternative of course is to establish a practice in which patients pay the doctor fees commensurate with the time required, a revolutionary concept in its own right. But Dr. Herbert speaks to a revolution in medical thinking about autism, one that conceptualizes it as a whole body issue, not just a genetic/neurological problem isolated to modules in the brain. Here’s a great quote from Dr. Herbert:
“The more I worked with my patients, the more I realized I had a choice: to ‘see what I believed,’ or to ‘believe what I see.’ If I believed that autism was a genetically determined, lifelong brain impairment, then I would have to deny to myself the extraordinary capabilities and changes I saw in my patients. If I believed what I saw, then I would have to re-think everything I knew about autism.”
In and of itself this isn’t so revolutionary. Individuals like Patty Lemer have been championing this whole body approach to Autism for many years. But what is new is the admission, more like an admonition from a clinician/researcher with the stature of Dr. Herbert to say that we have to look at Autism research in a very different way, as she does in this video clip. In essence Dr. Herbert is saying that Autism represents such a heterogeneous population that we have to learn to study each child individually rather than rely on traditional large scale trials on any particular interventions. There are ways to do this with rigor, but more on that in Part 2.
This PBS interview with Dr. Herbert also helped me understand something about physicians that is an enigma of sorts. I love the question posed by the interviewer:
“How do you explain the hostility in a lot of the medical community to the treatments that parents of autistic children are using to treat these biomedical conditions?”
At first Dr. Herbert seems taken aback by the term “hostility” but any of us who have dealt with pediatricians or pediatric ophthalmologists hostile to our approach can certainly identify with the question. Dr. Herbert’s response is marvelous, and essentially points out that while many physicians feel that what parents are doing is insane or incongruous, parents are actually practicing good systems biology in pursuing head to toe treatments.
Even though it’s a back-handed compliment, I like what Dr. Herbert has to say about developmental optometry on p. 152 of her book:
“If reading problems emerge later, they may have roots in earlier sensory, speech, or language problems. They may also have roots in visual problems. A child may have trouble getting the images from each eye to converge into one image, and his may slow him or her down. An assessment by a developmental optometrist may identify visual problems interfering with reading or learning. While many doctors consider those professionals to be controversial, they do offer a program to address use of the eyes and not just acuity of vision. For children with autism, the brain and motor system may create a lot of problems with the use of the eyes as well as other senses. Visual problems can also contribute to learning problems earlier in life.”
At one point in my career I would have been bothered by being painted as “controversial”. Now I view it more in the context of Dr. Herbert’s message. We, along with the parents of the thousands of children we help to rise above an artificially imposed genetic ceiling, are simply practicing good systems biology, and pity the pediatricians and pediatric ophthalmologists who just don’t get it. It’s all part of the hostility hypothesis, and positions us squarely in the center of The Autism Revolution.