ObituaryBernard Rimland
Parent and practitioner revolutionising the treatment of autismBernard Rimland, who has died from cancer aged 78, was an unknown US navy psychologist from San Diego when he published in 1964 Infantile Autism: the Syndrome and Its Implications for a Neural Theory of Behaviour. The book followed the birth in 1956 of his first son, who had developmental problems which were later diagnosed as autism.
Until then, autism had been regarded as withdrawal of a child into itself as a consequence of a lack of bonding with parents. Treatment methods were based upon psychoanalytical principles established by Bruno Bettelheim. Therapy would include kicking and spitting at statues representing their mothers. Such interventions were ineffective and cruel to parents. Autism was considered to be a very rare disorder, so parents were isolated and in no position to challenge accusations of inadequacy.
In his book, Bernie, as he was known, prepared and fired the first mighty shots against these theories. His arguments were backed by astute observation and advanced interpretation of all that was known about autism. He had taken a PhD in experimental psychology at Pennsylvania State University in 1953, after undergraduate studies at San Diego State University.
Bernie's deeply insightful book had profound effects upon the development of educational and medical programmes for children with autism worldwide. Yet, psychoanalytical treatments remain "orthodox" in much of Europe, and parents still struggle against noxious allegations.
Bernie devised practical solutions to problems as they developed. He was a founder of what became the Autism Society of America, which is still powerful after 40 years. The key to appropriate help is diagnosis and there were very few people competent to diagnose in the 1960s. Bernie's solution was to create autism checklists. Questionnaires were mailed to parents and returned for assessment and scoring. This was a crude but practical and surprisingly effective method when expertise was very scarce.
At that time, no specific educational programmes existed and Bernie was supportive of the young Ivar Lovaas, who was developing systems based upon strict behavioural techniques. Early programmes were very intensive and would be unacceptable today, but they have evolved considerably. There was no repository for information about autism, so Bernie established the Autism Research Institute, in 1967, and produced bulletins disseminating latest findings. In 1995, Bernie established the Defeat Autism Now! group of clinicians and researchers to explore and establish effective biomedical interventions.
Bernie was, from the outset, convinced that autism results from biochemical disturbances and that appropriate biomedical interventions could ameliorate many problems. Mechanisms underpinning some proposed interventions were poorly understood. His advocacy for high doses of vitamin B6 (pyridoxine) was seen as foolhardy in some quarters even though controlled studies did demonstrate efficacy in some (but not all) cases. It was a further 30 years before published research demonstrated that people with autism have difficulty in converting pyridoxine into the active form (P5P) and that, as a consequence, some children with autism do need substantial vitamin supplementation. This was the essential dilemma for Bernie and others using such techniques.
Bernie attracted criticism for advocating interventions including exclusion diets, supplements, and chelation techniques that, critics said, had not been subjected to appropriate tests for safety or efficacy. He argued that in the absence of proven remedies it is appropriate to experiment with interventions with considerable anecdotal supportive evidence yet minimal potential for harm. He attracted the odium of the medical establishment by his support for suggestions that vaccines could trigger autism in some individuals, and he supported suspicions about MMR vaccination as well as the mercury component in other vaccines.
For such a dynamic individual, Bernie was surprisingly modest and unassuming. Affection for him results as much from the hours he spent reassuring distraught parents on the phone as it does for his political and scientific achievements. Not everyone would agree with or support all of his ideas or methods, but he was loved by parents and revered by many professionals the world over.
He is survived by Gloria, his wife for more than 50 years, two sons and a daughter.
ยท Bernard Rimland, psychologist and autism campaigner, born November 15 1928; died November 21 2006
ncG1vNJzZmivp6x7tbTEoKyaqpSerq96wqikaKaVrMBwfo9pbWiclZh8cYKOoKyaqpSerq%2B7waKrrpminrK0esyaoKerlZjBqrvN