In 2010, the creators of Sesame Street began researching for the creation of the character who would eventually become the first autistic Muppet, Julia. They interviewed parents, experts, and kids in order to create an accurate and compassionate depiction of a child with autism spectrum disorder (ASD). In her 2017 debut online, she is shown to be sweet and creative, a full person. She loves to paint. Her preferences are shown: she doesn’t like the texture of paint on her hands, so unlike the other kids who are finger painting, she uses a brush. With this brush, she creates a beautiful picture of a flying winged rabbit. Her non-neurotypical behaviors are also addressed head-on. She flaps her hands when she gets excited. Big Bird, who has never heard of autism, has his feelings hurt when she doesn’t talk to him or give him a high-five. But it is explained to Big Bird that she doesn’t greet him not because she dislikes him but rather because she’s focusing on her painting. Also, a loud siren causes Julia to get very upset, and she takes some time to do deep breathing exercises before rejoining the group. The webisode culminates in a song and a round of “boing tag,” a game of Julia’s invention. Early on in the webisode, when Big Bird asks what autism is, his friends give a clear, informative answer:
Alan: For Julia, it means she might not answer you right away.
Abby: She doesn’t say a lot.
Alan: And she might not do what you expect, like give you a high five.
Elmo: Yeah, she does things just a little differently.
Perhaps the most insightful detail here is Alan’s important inclusion of the introductory phrase “for Julia.” Many users who commented on the YouTube video praised the line These viewers felt that the phrase “for Julia” touched on the important fact that every person with autism is different and echoed the theme of Dr. Stephen Shore’s oft-quoted line: “If you’ve met one person with autism, you’ve met one person with autism.”
This is a key point in understanding autism: every person with autism is different, not least because ASD is an umbrella category including autistic disorder, Asperger syndrome, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified (PDD-NOS, also known as atypical autism). Some autistic people are high-functioning. They can communicate quite well, have healthy friendships, date, marry, and pursue education and fulfilling careers. Then there are those who are entirely non-communicative and get overwhelmed by the sensory overload of the world, retreating into their routines.
The culture of autism is also more complicated than just understanding the various conditions that fall within the spectrum. There is a whole lexicon to dive into, with terms like “neurodivergent,” “neurodiversity,” “neurotypical,” and others that can be hard for the uninitiated to sort through.
Medical cannabis is also widely misunderstood because of most countries’ tragically misguided (not to mention discriminatory) criminalization of the substance. However, there is a growing body of encouraging scientific evidence for the possibility of cannabis being able to play a future role in treatment and compassionate care of people with autism spectrum disorder (ASD) and many other conditions.
The purpose of this article is twofold: to help you understand autism spectrum disorder and to outline some of the latest and most promising research in how the endocannabinoid system of the body is involved in ASD.
Autism’s Many Faces
First things first: Autism is not caused by vaccines. Here is a source. The original fraudulent study that claimed a link between vaccines and autism involved only involved 12 subjects (not a proper sample size) and deliberately falsified data. It was later revealed that Mr. Andrew Wakefield, the author of the fraudulent study, had multiple conflicts of interest and broke several ethical codes. According to Dennis K. Flaherty, Ph.D., Wakefield was found guilty of “ethical, medical, and scientific misconduct,” caused a public health disaster in the UK, and wrongly undermined public trust in doctors in the UK and US. According to Flaherty, “The alleged autism-vaccine connection is, perhaps, the most damaging medical hoax of the last 100 years.” Don’t fall for this hoax. Please vaccinate your kids.
So what does cause ASD? The answer is still unclear, but the generally accepted theory is that genes are involved. The following risk factors are indicative of autism:
Autism should be diagnosed as early as possible, but unfortunately it is often missed at first. It can be reliably diagnosed as early as two years old. Although, as I wrote above, there is no typical case of autism, there are some common threads between many cases:
Children with autism often line up their toys in straight lines instead of playing with them as most children do. They may not play make-believe, unlike other children. Many children with autism don’t speak until a much later age–or never speak at all. Children and adults with autism generally have difficulties adapting to even minor changes in their routines. They often have trouble connecting with other people and sometimes avoid eye contact. This is frustrating for many of them who are genuinely interested in people but have trouble expressing themselves.
A high-functioning form of ASD is Aspergers Syndrome (AS), which until the 2013 publication of the DSM-5 (the psychological community’s standard of diagnosis) was considered a separate condition. Some treatments and interventions include the following:
Because many people with Aspergers live healthy, fulfilling lives, many are beginning to see it as a difference rather than a disease or disorder. One meta-analysis of blogs written by people with Aspergers found major differences between institutional discourse and the experiences of people who live with Aspergers. According to the author:
The organizations’ website descriptions of AS were based on the premise that AS is a medical disorder and a deficit. The individual bloggers, in contrast, called themselves Aspies and indicated that they were happy with themselves but angry and disappointed with those who tried to change them.
It should be noted that some people with Aspergers use the term “Aspie,” and others don’t. Some consider it infantilizing. It would not be used by a neurotypical person. The term and other issues are hotly debated on sites, forums, subreddits, and blogs. Even the term “neurotypical” is not without controversy. Some prefer the term “allistic.” In my relatively limited exposure to autism issues, I have found that the best approach to disagreements like this should be one based in compassion and open-mindedness.
The main difference between Aspergers and other forms of autism is in language development. Children with Aspergers tend to have no delay in language development compared to neurotypical children, whereas language development in PDD-NOS is delayed.
The Endocannabinoid System and Autism
The cannabis plant contains a number of chemical substances known as cannabinoids. Similar substances occur naturally in humans and other animals. When they are found within the human body, they are known as endocannabinoids. When they are found in plants, they are known as phytocannabinoids. They can also be synthesized. The runner’s high, or exercise-induced euphoria, is created in part by endocannabinoids working alongside endorphins. How it works is that you have cannabinoid receptors throughout your body, in both the central nervous system (CB1) and elsewhere (CB2) that interact with cannabinoids in special ways.
These CB1 and CB2 receptors are protein receptors that make up the endocannabinoid system (ECS), which performs balancing and regulatory function in the body and helps to maintain homeostasis. This endocannabinoid system is being recognized as a target for a wide variety of treatments for a wide variety of ailments, especially those involving inflammation.
A 2015 study published in Neurotherapeutics found evidence for “a strong role for the eCB [endocannabinoid] system in social play behavior, which is a proxy measure for social reward responsivity.” This means chemicals similar to CBD and THC are involved in how our brain rewards us for positive social interactions–and remember, these chemicals are naturally occurring in our brain and body. Recall also that people with autism tend to have difficulty with social interaction. The authors of the study conclude that future treatments of autism should focus on ECS-related processes that involve “1) social reward responsivity; 2) neural development; 3) circadian rhythm [sleep patterns]; and 4) anxiety-related symptoms.” The study predicts “immense” “potential therapeutic exploitation” of parts of the ECS in the future.
A 2013 study published in Neuron reported an “unexpected link between a protein implicated in autism and a signaling system that previously had not been considered to be particularly important for autism.” These findings are considered significant because they open up a new avenue for research between the link between the ECS and autism.
In the same year, a study published in the Journal of Autism and Developmental Disorders found that CB2 receptors may be a potential therapeutic target for future treatments in autism care and management. Since CBD interacts primarily with CB2 receptors, I would speculate that this points to CBD potentially playing a role somewhere down the road in autism treatment.
In 2017, the authors of a review of animal models concluded that “preclinical findings seem to suggest that pharmacological interventions aimed at modulating the EC system could be beneficial for relieving symptoms associated with ASD,” which means treating the endocannabinoid system (perhaps through cannabis) might very well treat autism symptoms. Responsible scientists that they are, the writers of made it clear that the findings were preliminary.
Another study from the same year looked into neuroinflammation’s role in ASD and the role of the endocannabinoid system in ASD and theorized that future treatments may involve the endocannabinoid system.
A 2011 study found that THC enhanced motor functioning in mice that had been modified to express traits similar to autism. A 2013 rodent study found that “blockade of ECS is a potential therapeutic approach to normalize specific alterations in FXS.” FXS (fragile X syndrome) is a common precursor to autism and causes mental impairment. The treatment “normalized cognitive impairment” in mice with FXS. A 2016 study found that neuroinflammation in early life contributes to the development of autism and that altering ECS signaling (perhaps through cannabis) may normalize cognitive development.
Here are a few disorders other than ASD in which CBD or medical cannabis has shown promise:
Unfortunately, it is difficult for researchers in the United States to obtain approval to research cannabis treatments. Proponents of medical marijuana research can support more reasonable medical cannabis research policies. One organization that advocates for reasonable marijuana policy, including legalization of medical and marijuana, is NORML, which has done work in this area for four decades. If you are interested in this issue, I highly recommend supporting NORML’s legalization efforts.
Autism Treatment: Questions of Autonomy and Respect
The question of treating and attempting to cure autism is highly controversial. The most well-known group advocating the curing of autism is Autism Speaks. On the opposing side, activists have formed the Autism Rights Movement (ARM), which is for societal acceptance of neurodiversity. Their claim is that autism is a neurological difference rather than a disease, that the condition of autism cannot be separated from the person who lives with it, and that many medical and behavioral treatments of autism, including those recommended by Autism Speaks, tend to be abusive. Pro-cure advocates, on the other hand, call ARM activists deluded and say autism should be cured if possible to make life easier for people who don’t want to have to live with autism. Only one person with ASD, John Elder Robison, has ever served in a leadership position of Autism Speaks, and he resigned in 2013 because he felt the organization dehumanized autistic people. The focus of this article is on medical treatments of ASD and its symptoms.
There is no known medication that cures ASD or treats the core symptoms, but the CDC lists the following treatments as potentially helpful to people living with ASD:
More about Cannabidiol
Cannabidiol (CBD) is a non-psychoactive derivative of the Cannabis sativa or marijuana plant. This means that unlike its more famous (or infamous) cousin delta-9-tetrahydrocannabinol (THC), it cannot get you or your kid high, no matter how much is taken. Until just a few years ago, marijuana growers tended to maximize the amount of THC in their crops at the expense of CBD because the medicinal properties of CBD were not yet well-known. But with more and more evidence that CBD can treat various ailments, CBD has now become a hot topic. Even my home state of Indiana, otherwise a stronghold of regressivism, has made baby steps in liberalization of its generally wrongheaded approach to CBD by legalizing CBD for patients with a rare form of epilepsy.
How CBD works is that unlike THC, which interacts with the above-mentioned CB1 receptors in the central nervous system to produce the well-known euphoria for which marijuana is famous, CBD interacts with CB2 receptors in other cells in the body, most notably in the immune system and peripheral nervous system.
Whether you’re an expert, a family doctor, a person living with autism, or parent–or even just an enthusiast like me, the growing body of research should give reason for optimism. Nearly 40 percent of parents of preschoolers with autism have tried some form of alternative therapy, and no medication is specifically approved for autism. If you live in an area where medical cannabis is available and other treatments for symptoms of autism have not worked, you may want to try cannabis under the supervision of your doctor or pediatrician.
Whether or not you try cannabis for autism, take heart in the fact that our culture is changing to become more accepting and inclusive of people with autism. And if you still haven’t seen the video I mentioned above (Julia’s Sesame Street debut), I can’t recommend it enough. Click here and prepare to have your heart warmed.