Quack Myth: Autism is a Brain Injury


A very common myth, not just around quacks, is that autism is a traumatic brain injury or TBI for short. Autism and TBI can have similar signs and both disabilities are developmental disabilities but a TBI is the only developmental disability that can be acquired later in life. All other developmental disabilities originate before and during birth. 

What is TBI

TBI is an injury that affects how the brain works. TBI is a major cause of death and disability in the United States. Anyone can experience TBI but there are some groups that are at a greater risk for it. 

Causes of TBI

  • Falls
  • Vehicle related collisions
  • violence
  • sports injuries
  • explosive blasts or other combat injuries
  • lack of oxygen to the brain 

The Types of TBI and Signs

There are three main types of TBI:

  • Mild TBI or Concussion
    • Headache
    • nausea or vommitting
    • fatigue or drowsiness
    • problems with speech
    • dizziness or loss of balance
    • sensory problems, such as blurred vision, ringing in ears, bad taste in the mouth or changes in the ability to smell
    • sensitive to light or sound
    • loss of consciousness for a few seconds to a few minutes
    • no loss of consciousness, but state of being dazed, confused or disoriented
    • memory or concentration problems
    • mood changes or mood swings
    • feeling depressed or anxious
    • difficulty sleeping
    • sleeping more than usual
  • Moderate and Severe (two different types but same signs) TBIte
    • loss of consciousness from several minutes to hours
    • persistent headache or headache that worsens
    • repeated vomiting or nausea
    • convulsions or seizures
    • dilation of one or both pupils of the eyes
    • clear liquids draining from nose or ears
    • inability to awaken from sleep
    • weakness or numbness in fingers and toes
    • loss of coordination
    • profound confusion
    • agitation, combativeness or other behavior that isn't typical for the individual
    • slurred speech
    • coma or unconscious state
  • Severe TBI
    • see signs of Moderate TBI

Complications from TBI

  • Altered consciousness
    • coma
    • vegetative state
    • minimally conscious state
    • brain death
  • Physical complications
    • seizures
    • fluid buildup in the brain
    • infectoins
    • blood vessel damage
    • headaches
    • vertigo
  • Cranial nerve damage
    • paralysis of facial muscles or losing sensation in the face
    • loss of altered sense of smell or taste
    • loss of vision or double vision
    • swallowing problems
    • dizziness
    • ringing in the ear
    • hearing loss
  • cognitive complications
    • memory
    • learning
    • reasoning
    • judgement
    • attention or concentration
  • executive functioning complications
    • problem solving
    • multitasking
    • organization
    • planning
    • decision making
    • bringing or completing tasks
  • communication complications
    • difficulty understanding speech or writing
    • difficulty speaking or writing
    • inability to organize thoughts and idea
    • trouble following and participating in conversations
    • trouble taking turns or topic selection in conversation
    • problems with changing tone, pitch or emphasis to express emotions, attitudes or subtle difference with meaning
    • trouble reading cues from listeners
    • trouble starting or stopping conversations
    • inability to use the muscles needed to form words verbally
  • Behavioral changes
    • difficulty with self control
    • lack of awareness of abilities
    • risky behavior
    • difficulty in social situations
    • verbal or pshycal outburst
  • Emotional changes
    • depression
    • anxiety
    • mood swings
    • irritability
    • lack of empathy
    • anger
    • insomnia
  • Sensory changes
    • persistent ringing in the ears
    • difficulty recognizing objects
    • impaired hand eye coordination
    • blind spots or double vision
    • a bitter taste, a bad smell or difficulty smelling
    • skin tingling, pain or itching
    • trouble with balance or dizziness

Degenerative Brain Diseases

The relationship between TBI and degenerative brain diseases is unclear. There is some research that suggests that repeated or severe TBI may increase the risk of degenerative brain diseases. The risk cannot be predicted individually. Researchers are still investigating why and how TBI might be related to these disease. Some examples of these diseases are Alzheimers Diseases, Parkinson's Diseases and dementia. 

Deaths Relating to TBI

There were 61,0000 TBI related deaths in the United States in 2019. That is equal to 166 TBI deaths per year. There is no age limit to this type of injury, it can affect anyone of any age. 

Who is at Greatest Risk

The groups that are a greatest risk of TBI are:
  • racial and ethnic minorities
  • service members and veterans
  • the homeless
  • inmates in correctional and detention facilities
  • survivors of domestic violence
  • people who live in rural areas
  • children, especially newborns to 4 year olds
  • Young adults, especially ages 15-24
  • adults 60 and older
  • males of any age group (this is the statistic, not me making this assumption)

TBI Can be Short Term or Long Term

It depends on the severity of the injury. Those who have TBI can face some challenges that last a few days or the rest of their lives. A person who has possible TBI needs to be seen by a healthcare provider. Most people at home can recover safely at home following a medical checkup. People who have moderate to severe TBI may need long term care. 

TBI During Childhood

TBI does effect children differently than adults. Any injury to the developing brain has the potential to:

  • disrupt a child's development
  • limit their ability to participate in school and other activities

Signs in Children with TBI

  • change in eating or nursing habits
  • unusually or easily irritable
  • persistent crying and inability to be consoled
  • change in ability to pay attention
  • change in sleep habits
  • seizures
  • sad or depressed mood
  • drowsiness
  • loss of interest in favorite toys or activities

TBI is Often Missed in Older Adults

While older adults are more likely to be hospitalized and die from a TBI complication compared to other age groups, it may be missed or misdiagnosed. This is because signs of TBI overlap with other conditions that are common in older adults like dementia.  Further TBI screening should be done if the person is on anticoagulants and antiplatlet drugs. These type of medications increase the risk for bleeding following a TBI. Bleeding in the brain after a TBI puts the person at risk for severe injury or death. 

Pediatric TBI Differs from Autism

In children who suffer from a brain injury, some complications can look like autism signs. According to a study published in the journal Behavioral Neurology, "Pediatric Traumatic Brain Injury and Autism: Elucidating Shared Mechanisms," they prove that autism is not a brain injury. They highlight the overlapping signs of autism and TBI in children. There may be overlapping signs but they are not the same. Please excuse the ableist language of the chart, it was taken directly from the study. 



Science Proves Autism is Not a Brain Injury

Autism haČ™ been proven time and time again that it is genetic, not a brain injury. A study that was published in the New England Journal of Medicine analyzed brain tissue in deceased autistic children. The researchers were from the University of California, San Diego School of Medicine and the Allen Institute for Brain Science in Seattle, Washington. They examined 25 genes in postmortem brain tissue of autistic children and neurotypical children. These genes included biomarkers for brain cells in different layers of the cortex, genes that have been linked to autism and several control genes. 



Someone with A TBI

As some of you might know, my husband Nick has a TBI from when he was five. This is written with consent. He was playing in his back yard as a child in the back yard and his neighbor threw a brick over the fence and hit him in the head. After a few days in the hospital, MRI, CT scans and stitching him up, he was very lucky. All he has from it is a soft spot on his head and some short term memory loss. 

When they returned home from the hospital, the neighbors fled and moved. 

After I told him about this myth, he was understandably angry. People with a TBI go through some tremendous pain. It belittles what he went through as a child. I cannot imagine being hit with something like that as a child and living to tell the story. "Autism is a different way of being, TBI was painful."

To leave you with something good, TBI actually stumped his police academy professor. His instructor was trying to demonstrate the pressure point on top of the head. Because of his injury, it didn't work. If you hit someone on top of the head they are supposed to fall but it did not work with him. He had to hold in his laughter until I picked him up. Only one of his friends knew about his injury and he was twitching while Nick was fine. 

Sources:
https://www.cdc.gov/traumaticbraininjury/get_the_facts.html
https://www.mayoclinic.org/diseases-conditions/traumatic-brain-injury/symptoms-causes/syc-20378557
https://www.hindawi.com/journals/bn/2016/8781725/tab1/
https://www.medicalnewstoday.com/articles/274655#Study-finding-an-in-utero-basis-for-autism-is-the-first-to-do-so-

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