978-1572305441

180 A MIND APART
and social interaction or whether something else was standing in the
way of her progress.
“Did you ever hear the word ‘autism’?” her pediatrician asked one
day. “I am not saying she is autistic; only that we should consider it as a
possibility. Sophie is still not talking and not relating to other people.”
Marianne knew next to nothing about autism and asked if autism could
be caused by the experiences in the orphanage. If so, surely it could be
resolved? Love and support could overcome any obstacle, couldn’t
they?
* * *
I was asked to see Sophie at this point to try to determine whether
her poor communication skills and her lack of social interaction were
due to the deprivation or whether she might have autism. This was a
difficult issue to resolve, and it meant sorting out which behavioral
characteristics could be explained by living without proper nutrition
and stimulation for the first three years of life and which, if any, could
be due to autism. Before the appointment, I reviewed the literature on
early deprivation and its effect on child development. There were some
interesting and informative case reports of children who had experienced
terrible deprivation in their formative years. When these children
were released from these appalling conditions, they did indeed have
many “autistic” characteristics. They were often speech delayed, showed
little social interaction, were extremely withdrawn, and demonstrated
little capacity for play. However, these autistic-like behaviors attenuated
with the provision of a loving environment. It was true that some of the
symptoms never completely disappeared. Speech certainly improved,
but some of the social oddities persisted. Their social and communication
skills seemed to approximate those of younger children, consistent
with their overall developmental level. My task was to see if Sophie’s
social interaction was even more severely delayed than her overall cognitive
development. If it was, it would be hard to argue that early deprivation
was the only cause of her current difficulties. Social and nutritional
deprivation do not cause such uneven development, where some
skills are almost age appropriate (like walking and feeding) whereas
others (like social–communication) are so delayed.
When I saw Sophie, she was dressed all in red, wore eyeglasses, and
darted around the room. She was certainly tiny for her age, and her
thick curly brown tresses cascaded onto her shoulders. Her parents car-