35 Years After Rain Man: Our Understanding of Autism

Willem Gielen, MD
4 min readJul 29, 2023

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In 1988, audiences all over the world were introduced to a character who would forever alter our perception of autism. Dustin Hoffman’s portrayal of Raymond Babbitt, an autistic savant, in the film “Rain Man” was superb. With his extraordinary abilities and unique challenges, Raymond’s character provided a glimpse into the world of autism and sparked a global conversation about this complex condition. Rain Man not only shed light on the inner workings of an autistic mind, but it also challenged societal stereotypes and misconceptions surrounding autism. Raymond Babbitt’s character was a revelation to many, breaking away from the typical Hollywood portrayal of individuals with autism as either incapable or lacking in intelligence. Hoffman’s impeccable performance captured the intricate nuances of Raymond’s behavior, showcasing his uncanny memory and mathematical genius.

Rain Man film by Levinson [1988]

In the 35 years since “Rain Man,” our understanding of autism has vastly improved. Many mysteries, however, remain.

The Unsolved Mysteries of Autism

Extensive research on the pathophysiology of autism has been conducted now for decades. Although much progress has been made, a comprehensive understanding of the exact cause of autism remains elusive. It, however, widely accepted that autism is influenced by multiple factors, including genetics, neurological variations, and environmental elements.

Autism Spectrum Disorder (ASD) is complex and not fully understood. However, research indicates several neurotransmitters may play a crucial role in its development and manifestation.

  • Serotonin: Some studies indicate that up to a third of individuals with autism have elevated blood levels of serotonin, suggesting an imbalance in this neurotransmitter.
  • Glutamate: This excitatory neurotransmitter has been linked to autism. Too much glutamate can cause an overstimulation of nerve cells, potentially leading to cell damage or death.
  • GABA (gamma-aminobutyric acid): As the primary inhibitory neurotransmitter in the brain, GABA balances the excitatory impulses of glutamate. Some researchers believe that imbalances between GABA and glutamate signaling could contribute to the symptoms of autism.
  • Dopamine: This neurotransmitter is involved in reward and pleasure systems, and it also plays a role in motor control. Some research has suggested that abnormalities in the dopamine system could contribute to autism.
  • Oxytocin: Often referred to as the “love hormone,” oxytocin plays a crucial role in social bonding and trust. Several studies have suggested that oxytocin dysregulation may be involved in ASD, particularly in relation to social interaction difficulties.

Additionally, genetic factors may contribute to the development of autism, as studies have shown a higher likelihood of diagnosis among individuals with a family history of the disorder.

While these theories offer interesting possibilities, further in-depth research is necessary to gain a complete understanding of the complex processes underlying autism. Identifying the root causes is crucial for developing effective treatments and interventions. Despite significant progress, there are still many pieces of the puzzle yet to be discovered.

The Reluctant Treatment

There’s currently no cure for ASD, and its treatment remains as diverse as its manifestations. Therapies largely focus on managing symptoms, improving quality of life and maximizing functional independence. Applied behavior analysis (ABA) is one of the most widely used and evidence-based interventions for individuals with autism spectrum disorder (ASD). This therapy focuses on identifying and modifying specific behaviors that interfere with an individual’s daily functioning. ABA techniques are tailored to the unique needs of each person, aiming to teach new skills, reduce problem behaviors, and promote social interactions.

RPM, an acronym for Rapid Prompting Method, is a technique employed in the education and communication development of individuals with autism and similar conditions. This method utilizes prompts to elicit a response without physically guiding the student, with the goal of fostering the student’s independent thinking skills.

Another commonly employed treatment approach for ASD is speech-language therapy. Speech-language therapy is a crucial component in the comprehensive treatment plan for individuals with ASD. This therapy focuses on improving communication skills, both verbal and nonverbal, to enhance social interactions and overall quality of life. During speech-language therapy sessions, trained professionals work closely with individuals with ASD to address their specific communication challenges. These challenges may include difficulties in understanding and using language, articulation problems, or trouble with nonverbal cues such as eye contact or gestures.

Sometimes medication is given for associated conditions such as anxiety or attention deficit hyperactivity disorder (ADHD). Early diagnosis and intervention have been shown to significantly improve outcomes. In cases where individuals with associated conditions such as anxiety or ADHD are diagnosed early, the incorporation of medication into their treatment plan has proven to be beneficial. Anxiety medications can help alleviate symptoms of excessive worry, panic attacks, and social anxiety, enabling patients to engage more fully in daily activities and improve their overall quality of life.

Similarly, for individuals diagnosed with ADHD, medication can play a crucial role in managing symptoms like difficulty focusing, impulsivity, and hyperactivity.

Looking Toward the Future

Though we’ve come a long way since “Rain Man,” there’s much we still don’t know about autism. But what we can envision for the future is a world that is even more understanding and accommodating of people with ASD.

Advancements in technology may provide novel ways to aid communication and social interaction for those with ASD. Furthermore, we hope for breakthroughs in neuroscience that might shed light on the pathophysiology of autism, guiding us towards more targeted and effective interventions.

In the meantime, it’s crucial to continue fostering acceptance and understanding for people with autism on a societal level. Just like Raymond Babbitt in “Rain Man,” individuals with ASD have unique strengths and challenges that deserve recognition and respect.

Conclusion

While our understanding of autism has evolved significantly in the 35 years following “Rain Man,” there’s plenty more to learn. Autism continues to be a fascinating field of study that challenges our understanding of the brain and human behavior. And as we continue to research and learn, we inch closer to a future where everyone on the spectrum is better understood and supported.

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Willem Gielen, MD

A cardiologist, father, and husband, with a keen interest in the latest technologies, such as AI, and wearables.