We called it mental retardation and childhood schizophrenia. I saw thousands of autistic children and adults in our psychiatric hospitals and our developmental centers in the 1960s and 1970s. Did you know that Pilgrim State Psychiatric Hospital on Long Island was at one time the largest hospital in the world? We used to shut away people who did not fit in with societal norms. Some of those people were hopelessly psychotic, some were autistic, some had postpartum depression and some were actually committed by their families because of menopausal changes. Some had undiagnosed thyroid problems, some had Huntington's disease. Our state hospitals were overflowing.

What I am saying is that to lay people, it seems as if there is an epidemic of autism. There isn't. Autistic people have always been with us. But you didn't see them in the 1920s, 1930s, 1940s, 1950s, 1960s and 1970s because the norm at that time was to institutionalize children who required so much attention from their families. Parents were convinced by physicians, by clergy (and by themselves) that their other children would suffer because parents would be unable to give them the attention they needed due to the attention needed to watch an autistic child who may engage in headbanging behavior, or make the same noise all the time. There was no home care. There were no educational opportunities for autistic people, no mainstreaming in public schools, no treatment at all. I saw middle-aged people who had been institutionalized for their entire lives.

In the 1980s, autism was named and made a separate diagnosis from retardation and schizophrenia. Since then, more and more parents opted to keep their children at home. State psychiatric hospitals and developmental centers have closed down. Nowadays, you see the people who would have been shut away 20-70 years ago and you think there is an epidemic. There isn't. They have always been with us; they were behind brick walls in state institutions, virtually imprisoned for life because of a lack of understanding and a lack of treatment.

It isn't vaccines. It isn't thimerosal (which has been banned in Denmark since the 1990s, yet the number of children diagnosed with autism has continued to rise). It's because our state hospitals and developmental centers have been closed down and autistic people are now visible in our families and in our communities. They can't be shut away anymore. Now they are here with us in the larger world and they are receiving treatment, education and the love that they did not get before.

I grew up with a lot of health food freaks. They want to believe anything the alternative medicine/food gurus tell them and prefer to think that doctors are deceiving them and are in cahoots with the pharmaceutical industry to cheat you and make you more sick so that they can make even more money off you and your insurance company. There was a while at least 40 years ago that these people were warning their little 'dittoheads' that vaccines were 'spawned by the devil' (I can't really remember what they said) and they were bad for your children. Then it was the electrical power lines that were going to give you cancer and the cell phones that caused brain cancer. The naysdayers get a lot more press than the boring old doctors telling you to get your child protected. But I think that you're right, the alternative medicine people have a nutritional supplement that you can buy at a high price from them that will make everything better. But, the sad thing is that many people have quite getting their children vaccinated because the face of autism seems worse than the disease that they have never seen in their lifetime.

BERN, your reply is both thoughtful and in my opinion, right on target. The Education for the Handicapped Act of 1975 guarantees free and appropriate public education for all children with disabilities (up to age 21). Until 1975 schools had no obligation to provide any services for exceptional students. As such, families with little support from the medical and education communities often felt that there was little choice but to institutionalize children who were not well served by the standard educational programs available. Post-1975, special education was no longer optional in public schools, but rather federally mandated. This fundamental shift allowed parents of children with special educational needs to enroll those children in local public schools, keeping them at home and out of institutions. As a result, we've seen an increase in the number of children with autism in our communities.

My mother has been an elementary school teacher, and now principal, since the late 1960s. She's experienced public education both pre-and post-1975 and believes autism was no less prevalent in 1968, than it is today. Rather, she's seen a total increase in the number of students with special needs (presumably from sending children with behavioral or cognitive impairments to public schools rather than institutionalizing them) but reduction in students with "developmental delay," "mental retardation," and "developmental disability" diagnoses and an increase in students with autism spectrum disorder diagnoses. In her experience, the apparent increase in autism is, as you point out, a change in the convention of diagnosing and labeling children who exhibit a broad range of behaviors.

Bern, what a wonderful explanation of the "epidemic" we have now identified. I am so inclined to agree. However, there are always "artifacts" that impact the way we perceive explanations, both what we believe and what we want to believe. The article to which you responded so wonderfully ... actually was so absent of the very essence of healing ... that being HOPE. Often hope and belief in alternative processes is not only healing in and of itself, but opens up new arenas of investigation for "hard" science and research. Again thanks for such a concise and appropriate response to this rather dower and hopeless article. By the way, I totally agree that we have begun to identify (DSM4) many more as autistic because of some of the reclassification that has been changed as well as the closing down of institutions. HOWEVER, I am still in favor of any theory that will give a family that is so heavily burdened ... a lifeline of hope for healing in the future .... As well as medicine and diagnostic labeling has changed .. so has physics, biology and chemistry ... what we "believed" to be the "it" and essence of truth about physical reality 50 years ago has been literally spun on its axis ... likewise I thing that practitioners out there who are on the edge have as much to offer as those who offer little but drugs. M

I do not agree that all alternative practices are nothing but efforts on the part of crackpots or charlatan's to take money. Anyone who has gone on a serious and well studied vitamin