| Eureka!
Shortly after I had written back to the parent, I went to the annual meeting of the Teratology Society ("teratology" means birth defects). Usually I don't go to the clinical talks because they are rarely about the nervous system, which is what I study. (Clinical presentations in teratology often focus on heart defects, limb defects and other structural malformations. Not defects of the brain.) That day a clinical talk called, "Thalidomide embryopathy: An insight into autism?" was scheduled for 4:30 in the afternoon. Unexpectedly, the speakers were two pediatric ophthalmologists. I was sleepy, and I remember debating whether to go to the talk or take a nap-and since I couldn't imagine what an ophthalmologist would have to say about autism the nap seemed like the better idea.
Today I am very happy I decided to skip the nap. The presenters, Marilyn Miller and Karin Strömland, were discussing eye motility in thalidomide babies-all of whom were now of course grown to adulthood. I was dumbfounded when Miller described her data. In fact, as I have told many people, I felt as though a curtain were being lifted, allowing me to "see" the disorder at last! I was literally hyperventilating.
What Miller and Strömland had discovered was that a large and significant number of thalidomide babies also had autism. As many readers will recall, thalidomide, which women were prescribed by their physicians for morning sickness, caused an epidemic of birth defects in Europe in the 1960s. Of course as a scientist studying birth defects, I was familiar with thalidomide (many readers over 40 will remember the LIFE magazine photographs of tiny children with terribly stunted limbs). But until that instant I had had no idea that these children also had extremely high rates of autism.
It was a Eureka moment. Because the researchers knew when the mothers of these babies had taken thalidomide, they had for the first time ever conclusively identified the time or origin for some cases of autism.
The story of how Miller and Strömland made this discovery is a fascinating case history of serendipity's role in the progress of knowledge. There they were, investigating eye motility in thalidomide adults, when they began to notice that a number of these subjects also had an obvious "mental" syndrome involving deficits in language, social skills, and other areas. This came as a surprise to them; they hadn't been aware that thalidomide victims had behavioral problems in addition to their obvious physical issues.
But they didn't know what they were looking at. They knew they were seeing something, but since neither of them had been trained to diagnose any kind of brain disorder, they had no idea what it was. So they called in Christopher Gilberg, a Swedish psychiatrist who also just happened to be the author of a well-known textbook on autism, to take a look. Of course Gilberg saw at once that in addition to having defects in eye motility, these thalidomide victims also had autism. In my view this story makes Marilyn Miller and Karin Strömland pretty special clinicians since very few physicians can pick up on a syndrome in which they have received no training at all. Miller and Strömland certainly were not looking for autism, and yet they found it. Many researchers would not have.
Continue to page 3 . . .
NAARATIVE, Number 1, Summer 1997 Newsletter of the National Alliance for Autism Research 1-888-777-NAAR
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