| Autism |
What is autism?
Autism (sometimes called “classical autism”) is the most common condition in a group of develop-
mental disorders known as the autism spectrum disorders (ASDs). Autism is characterized by
impaired social interaction, problems with verbal and nonverbal communication, and unusual,
repetitive, or severely limited activities and interests.
Other ASDs include Asperger syndrome, Rett syndrome, childhood disintegrative disorder, and
pervasive developmental disorder not otherwise specified (usually referred to as PDD-NOS).
Experts estimate that three to six children out of every 1,000 will have autism. Males are four times
more likely to have autism than females.
Autism is a developmental disability of the brain, much like dyslexia, mental retardation, or attention
deficit disorder. Autism is not a form of mental retardation, and though many autistic people appear
to function as retarded, they are frequently quite intelligent. According to the Autism Society of
America, "autism...occur[s] in approximately 15 of every 10,000 individuals...[and]...nearly 400,000
people in the U.S. today have some form of autism."
Some Things Autism is Not
1. Autism is not mental retardation. Some autistic people may be very
intelligent — there is a lot of evidence that Albert Einstein may have been
autistic.
2. Autism is not "savant" syndrome. Some autistic people are "savants," (e.g., instant
calculator, etc.) but most are not. Other autistic people are "gifted," however, and have high
"general" intelligence. Many autistic people have normal intelligence, and some may be retarded.
3. Autism is not an emotional problem. Autism is a neurological condition which people are usually
born with. Psychological trauma doesn't cause it.
4. Autism is not a psychosis or lack of reality contact.
5. People do not choose to be autistic.
6. Autism is not "a fate worse than death." Autistic people have some disadvantages, but some
live very happy and rewarding lives. Many autistic people wouldn't want to be "cured," as this would
be like erasing them and replacing them with different people.
What are some common signs of autism?
There are three distinctive behaviors that characterize autism. Autistic children have difficulties
with social interaction, problems with verbal and nonverbal communication, and repetitive behaviors
or narrow, obsessive interests. These behaviors can range in impact from mild to disabling.
The hallmark feature of autism is impaired social interaction. Parents are usually the first to notice
symptoms of autism in their child. As early as infancy, a baby with autism may be unresponsive to
people or focus intently on one item to the exclusion of others for long periods of time. A child with
autism may appear to develop normally and then withdraw and become indifferent to social
engagement.
Children with autism may fail to respond to their name and often avoid eye contact with other people.
They have difficulty interpreting what others are thinking or feeling because they can’t understand
social cues, such as tone of voice or facial expressions, and don’t watch other people’s faces for clues
about appropriate behavior. They lack empathy.
Many children with autism engage in repetitive movements such as rocking and twirling, or in self-
abusive behavior such as biting or head-banging. They also tend to start speaking later than other
children and may refer to themselves by name instead of “I” or “me.” Children with autism don’t
know how to play interactively with other children. Some speak in a sing-song voice about a narrow
range of favorite topics, with little regard for the interests of the person to whom they are speaking.
Many children with autism have a reduced sensitivity to pain, but are abnormally sensitive to sound,
touch, or other sensory stimulation. These unusual reactions may contribute to behavioral symptoms
such as a resistance to being cuddled or hugged.
Children with autism appear to have a higher than normal risk for certain co-existing conditions,
including fragile X syndrome (which causes mental retardation), tuberous sclerosis (in which tumors
grow on the brain), epileptic seizures, Tourette syndrome, learning disabilities, and attention deficit
disorder. For reasons that are still unclear, about 20 to 30 percent of children with autism develop
epilepsy by the time they reach adulthood.
While people with schizophrenia may show some autistic-like behavior, their symptoms
usually do not appear until the late teens or early adulthood. Most people with schizophrenia
also have hallucinations and delusions, which are not found in autism.
How is autism diagnosed?
Autism varies widely in its severity and symptoms and may go unrecognized, especially in mildly
affected children or when it is masked by more debilitating handicaps. Doctors rely on a core group
of behaviors to alert them to the possibility of a diagnosis of autism. These behaviors are:
Doctors will often use a questionnaire or other screening instrument to gather information about a
child’s development and behavior. Some screening instruments rely solely on parent observations;
others rely on a combination of parent and doctor observations. If screening instruments indicate the
possibility of autism, doctors will ask for a more comprehensive evaluation.
Autism is a complex disorder. A comprehensive evaluation requires a multidisciplinary team
including a psychologist, neurologist, psychiatrist, speech therapist, and other professionals who
diagnose children with ASDs. The team members will conduct a thorough neurological assessment
and in-depth cognitive and language testing. Because hearing problems can cause behaviors that
could be mistaken for autism, children with delayed speech development should also have their
hearing tested. After a thorough evaluation, the team usually meets with parents to explain the
results of the evaluation and present the diagnosis.
Children with some symptoms of autism, but not enough to be diagnosed with classical autism, are
often diagnosed with PDD-NOS. Children with autistic behaviors but well-developed language skills
are often diagnosed with Asperger syndrome. Children who develop normally and then suddenly
deteriorate between the ages of 3 to 10 years and show marked autistic behaviors may be diagnosed
with childhood disintegrative disorder. Girls with autistic symptoms may be suffering from Rett
syndrome, a sex-linked genetic disorder characterized by social withdrawal, regressed language skills,
and hand wringing.
What causes autism?
Scientists aren’t certain what causes autism, but it’s likely that both genetics and environment play a
role. Researchers have identified a number of genes associated with the disorder. Studies of people
with autism have found irregularities in several regions of the brain. Other studies suggest that
people with autism have abnormal levels of serotonin or other neuro-transmitters in the brain. These
abnormalities suggest that autism could result from the disruption of normal brain development early
in fetal development caused by defects in genes that control brain growth and that regulate how
neurons communicate with each other. While these findings are intriguing, they are preliminary and
require further study. The theory that parental practices are responsible for autism has now been
disproved.
The largest study of the genetics of autism ever conducted, involving DNA from almost 1,200
affected families worldwide, has already yielded two important clues to the poorly understood
disorder, scientists say. Discoveries in two areas of the genome -- a region on chromosome 11
suspected of having links to autism, and aberrations in a brain-development gene called neurexin
1 -- could spur more targeted research, the experts noted.
What role does inheritance play?
Recent studies strongly suggest that some people have a genetic predisposition to autism. In families
with one autistic child, the risk of having a second child with the disorder is approximately 5 percent,
or one in 20. This is greater than the risk for the general population. Researchers are looking for
clues about which genes contribute to this increased susceptibility.
In some cases, parents and other relatives of an autistic child show mild impairments in social and
communicative skills or engage in repetitive behaviors. Evidence also suggests that some emotional
disorders, such as manic depression, occur more frequently than average in the families of people with
autism.
Do symptoms of autism change over time?
For many children, autism symptoms improve with treatment and with age. Some children with
autism grow up to lead normal or near-normal lives. Children whose language skills regress early
in life, usually before the age of 3, appear to be at risk of developing epilepsy or seizure-like brain
activity. During adolescence, some children with autism may become depressed or experience
behavioral problems. Parents of these children should be ready to adjust treatment for their child
as needed.
How is autism treated?
There is no cure for autism. Therapies and behavioral interventions are designed
to remedy specific symptoms and can bring about substantial improvement. The
ideal treatment plan coordinates therapies and interventions that target the core
symptoms of autism: impaired social interaction, problems with verbal and non-
verbal communication, and obsessive or repetitive routines and interests. Most
professionals agree that the earlier the intervention, the better.
· Educational/behavioral interventions: Therapists use highly structured and intensive skill-
oriented training sessions to help children develop social and language skills. Family counseling for
the parents and siblings of children with autism often helps families cope with the particular
challenges of living with an autistic child.
· Medications: Doctors often prescribe an antidepressant medication to handle symptoms of
anxiety, depression, or obsessive-compulsive disorder. Anti-psychotic medications are used to treat
severe behavioral problems. Seizures can be treated with one or more of the anticonvulsant drugs.
Stimulant drugs, such as those used for children with attention deficit disorder (ADD), are sometimes
used effectively to help decrease impulsivity and hyperactivity.
· Other therapies: There are a number of controversial therapies or interventions available for
autistic children, but few, if any, are supported by scientific studies. Parents should use caution before
adopting any of these treatments.
Treatment approaches are evolving as more is learned about autism. There are many therapeutic
programs, both conventional and complementary, that focus on replacing dysfunctional behaviors and
developing specific skills.
As a parent, it's natural to want to do something immediately. However, it is important not to rush
in with changes. Your child may have already learned to cope with his or her current environment
and changes could be stressful. You should investigate various treatment approaches and gather
information concerning various options before proceeding with your child's treatment.
You will encounter numerous accounts from parents about successes and failures with many of the
treatment approaches mentioned. You will also discover that professionals differ in their theories of
what they feel is the most successful treatment for autism. It can be frustrating! But you will learn to
sift through them and make rational, educated decisions on what is appropriate for your child. You
live with your child every day and you know his/her needs. And in time, you will come to know
his/her autism. Trust your instincts as you explore various options.
Again, please keep in mind that the descriptions of treatment approaches provided here are for
informational purposes only. They are meant to give you an overview of an approach. The Autism
Society of America does not endorse any specific treatment or therapy.
During your research, you will hear about many different treatments approaches, such as auditory
training, discrete trial training, vitamin therapy, anti-yeast therapy, facilitated communication, music
therapy, occupational therapy, physical therapy, and sensory integration. These approaches can
generally be broken down into three categories:
Some of these treatment approaches have research studies that support their efficacy; others may
not. Some parents will only want to try treatment methods that have undergone research and testing
and are generally accepted by the professional community. But keep in mind that scientific studies are
often difficult to do since each individual with autism is different.
For others, formal testing might not be a pre-requisite for them to try a treatment with their child.
Even for those with "scientific" proof, we recommend that the family or caregiver investigate all
options available to determine the appropriateness to their child.
Experts agree though, that early intervention is important in addressing the symptoms associated
with autism. The earlier treatment is started, the better the chance the child will reach normal
functioning levels. Many of the approaches described can be used on children as young as age 2 or 3.
They may also continue to be used in conjunction with special education programs or traditional
elementary school for children who are mainstreamed.
What About School?
Early diagnosis and appropriate educational programs are very important to children with autism or
PDD. The Individuals with Disabilities Education Act (IDEA) includes autism as a disability category.
Children with autism and PDD are eligible for an educational program appropriate to their individual
needs. Educational programs for students with autism or PDD focus on improving communication,
social, academic, behavioral, and daily living skills.
Behavior and communication problems that interfere with learning sometimes require the assistance
of a professional who is particularly knowledgeable in the autism field, who develops and helps to
implement a plan which can be carried out at home and school.
The classroom environment should be structured so that the program is consistent and predictable.
Students with autism or PDD learn better and are less confused when information is presented
visually as well as verbally. Interaction with non-disabled peers is also important, for these students
provide models of appropriate language, social, and behavioral skills. To overcome frequent problems
in generalizing skills learned at school, it is very important to develop programs with parents, so that
learning activities, experiences, and approaches can be carried over into the home and community.
With educational programs designed to meet a student’s individual needs and specialized adult
support services in employment and living arrangements, many children and adults with autism
or PDD grow up to live and work successfully in the community.
Tips for Parents
Learn about autism/PDD. The more you know, the more you can help yourself and your child.
Be mindful to interact with and teach your child in ways that are most likely to get a positive
response. Learn what is likely to trigger melt-downs for your child, so you can try to minimize
them. Remember, the earliest years are the toughest, but it does get better!
Learn from professionals and other parents how to meet your child’s special needs, but try not to
turn your lives into one round of therapy after another.
If you weren’t born loving highly structured, consistent schedules and routines, ask for help from
other parents and professionals on how to make it second nature for you.
Behavior, communication, and social skills can all be areas of concern for a
child with autism and experience tells us that maintaining a solid, loving,
and structured approach in caring for your child, can help greatly.
Learn about assistive technology that can help your child. This may include
a simple picture communication board to help your child express needs and
desires, or may be as sophisticated as an augmentative communication
device
Work with professionals in early intervention or in your school to develop
an IFSP or an IEP that reflects your child’s needs and abilities. Be sure to
include assistive technology, related services, and supplementary aids and supports, if your child
needs these. Don’t forget about a positive behavior plan, if needed. Also, check out the eBook above.
Autism (sometimes called “classical autism”) is the most common condition in a group of develop-
mental disorders known as the autism spectrum disorders (ASDs). Autism is characterized by
impaired social interaction, problems with verbal and nonverbal communication, and unusual,
repetitive, or severely limited activities and interests.
Other ASDs include Asperger syndrome, Rett syndrome, childhood disintegrative disorder, and
pervasive developmental disorder not otherwise specified (usually referred to as PDD-NOS).
Experts estimate that three to six children out of every 1,000 will have autism. Males are four times
more likely to have autism than females.
Autism is a developmental disability of the brain, much like dyslexia, mental retardation, or attention
deficit disorder. Autism is not a form of mental retardation, and though many autistic people appear
to function as retarded, they are frequently quite intelligent. According to the Autism Society of
America, "autism...occur[s] in approximately 15 of every 10,000 individuals...[and]...nearly 400,000
people in the U.S. today have some form of autism."
Some Things Autism is Not
1. Autism is not mental retardation. Some autistic people may be very
intelligent — there is a lot of evidence that Albert Einstein may have been
autistic.
2. Autism is not "savant" syndrome. Some autistic people are "savants," (e.g., instant
calculator, etc.) but most are not. Other autistic people are "gifted," however, and have high
"general" intelligence. Many autistic people have normal intelligence, and some may be retarded.
3. Autism is not an emotional problem. Autism is a neurological condition which people are usually
born with. Psychological trauma doesn't cause it.
4. Autism is not a psychosis or lack of reality contact.
5. People do not choose to be autistic.
6. Autism is not "a fate worse than death." Autistic people have some disadvantages, but some
live very happy and rewarding lives. Many autistic people wouldn't want to be "cured," as this would
be like erasing them and replacing them with different people.
What are some common signs of autism?
There are three distinctive behaviors that characterize autism. Autistic children have difficulties
with social interaction, problems with verbal and nonverbal communication, and repetitive behaviors
or narrow, obsessive interests. These behaviors can range in impact from mild to disabling.
The hallmark feature of autism is impaired social interaction. Parents are usually the first to notice
symptoms of autism in their child. As early as infancy, a baby with autism may be unresponsive to
people or focus intently on one item to the exclusion of others for long periods of time. A child with
autism may appear to develop normally and then withdraw and become indifferent to social
engagement.
Children with autism may fail to respond to their name and often avoid eye contact with other people.
They have difficulty interpreting what others are thinking or feeling because they can’t understand
social cues, such as tone of voice or facial expressions, and don’t watch other people’s faces for clues
about appropriate behavior. They lack empathy.
Many children with autism engage in repetitive movements such as rocking and twirling, or in self-
abusive behavior such as biting or head-banging. They also tend to start speaking later than other
children and may refer to themselves by name instead of “I” or “me.” Children with autism don’t
know how to play interactively with other children. Some speak in a sing-song voice about a narrow
range of favorite topics, with little regard for the interests of the person to whom they are speaking.
Many children with autism have a reduced sensitivity to pain, but are abnormally sensitive to sound,
touch, or other sensory stimulation. These unusual reactions may contribute to behavioral symptoms
such as a resistance to being cuddled or hugged.
Children with autism appear to have a higher than normal risk for certain co-existing conditions,
including fragile X syndrome (which causes mental retardation), tuberous sclerosis (in which tumors
grow on the brain), epileptic seizures, Tourette syndrome, learning disabilities, and attention deficit
disorder. For reasons that are still unclear, about 20 to 30 percent of children with autism develop
epilepsy by the time they reach adulthood.
While people with schizophrenia may show some autistic-like behavior, their symptoms
usually do not appear until the late teens or early adulthood. Most people with schizophrenia
also have hallucinations and delusions, which are not found in autism.
How is autism diagnosed?
Autism varies widely in its severity and symptoms and may go unrecognized, especially in mildly
affected children or when it is masked by more debilitating handicaps. Doctors rely on a core group
of behaviors to alert them to the possibility of a diagnosis of autism. These behaviors are:
- impaired ability to make friends with peers
- impaired ability to initiate or sustain a conversation with others
- absence or impairment of imaginative and social play
- stereotyped, repetitive, or unusual use of language
- restricted patterns of interest that are abnormal in intensity or focus
- preoccupation with certain objects or subjects
- inflexible adherence to specific routines or rituals
Doctors will often use a questionnaire or other screening instrument to gather information about a
child’s development and behavior. Some screening instruments rely solely on parent observations;
others rely on a combination of parent and doctor observations. If screening instruments indicate the
possibility of autism, doctors will ask for a more comprehensive evaluation.
Autism is a complex disorder. A comprehensive evaluation requires a multidisciplinary team
including a psychologist, neurologist, psychiatrist, speech therapist, and other professionals who
diagnose children with ASDs. The team members will conduct a thorough neurological assessment
and in-depth cognitive and language testing. Because hearing problems can cause behaviors that
could be mistaken for autism, children with delayed speech development should also have their
hearing tested. After a thorough evaluation, the team usually meets with parents to explain the
results of the evaluation and present the diagnosis.
Children with some symptoms of autism, but not enough to be diagnosed with classical autism, are
often diagnosed with PDD-NOS. Children with autistic behaviors but well-developed language skills
are often diagnosed with Asperger syndrome. Children who develop normally and then suddenly
deteriorate between the ages of 3 to 10 years and show marked autistic behaviors may be diagnosed
with childhood disintegrative disorder. Girls with autistic symptoms may be suffering from Rett
syndrome, a sex-linked genetic disorder characterized by social withdrawal, regressed language skills,
and hand wringing.
What causes autism?
Scientists aren’t certain what causes autism, but it’s likely that both genetics and environment play a
role. Researchers have identified a number of genes associated with the disorder. Studies of people
with autism have found irregularities in several regions of the brain. Other studies suggest that
people with autism have abnormal levels of serotonin or other neuro-transmitters in the brain. These
abnormalities suggest that autism could result from the disruption of normal brain development early
in fetal development caused by defects in genes that control brain growth and that regulate how
neurons communicate with each other. While these findings are intriguing, they are preliminary and
require further study. The theory that parental practices are responsible for autism has now been
disproved.
The largest study of the genetics of autism ever conducted, involving DNA from almost 1,200
affected families worldwide, has already yielded two important clues to the poorly understood
disorder, scientists say. Discoveries in two areas of the genome -- a region on chromosome 11
suspected of having links to autism, and aberrations in a brain-development gene called neurexin
1 -- could spur more targeted research, the experts noted.
What role does inheritance play?
Recent studies strongly suggest that some people have a genetic predisposition to autism. In families
with one autistic child, the risk of having a second child with the disorder is approximately 5 percent,
or one in 20. This is greater than the risk for the general population. Researchers are looking for
clues about which genes contribute to this increased susceptibility.
In some cases, parents and other relatives of an autistic child show mild impairments in social and
communicative skills or engage in repetitive behaviors. Evidence also suggests that some emotional
disorders, such as manic depression, occur more frequently than average in the families of people with
autism.
Do symptoms of autism change over time?
For many children, autism symptoms improve with treatment and with age. Some children with
autism grow up to lead normal or near-normal lives. Children whose language skills regress early
in life, usually before the age of 3, appear to be at risk of developing epilepsy or seizure-like brain
activity. During adolescence, some children with autism may become depressed or experience
behavioral problems. Parents of these children should be ready to adjust treatment for their child
as needed.
How is autism treated?
There is no cure for autism. Therapies and behavioral interventions are designed
to remedy specific symptoms and can bring about substantial improvement. The
ideal treatment plan coordinates therapies and interventions that target the core
symptoms of autism: impaired social interaction, problems with verbal and non-
verbal communication, and obsessive or repetitive routines and interests. Most
professionals agree that the earlier the intervention, the better.
· Educational/behavioral interventions: Therapists use highly structured and intensive skill-
oriented training sessions to help children develop social and language skills. Family counseling for
the parents and siblings of children with autism often helps families cope with the particular
challenges of living with an autistic child.
· Medications: Doctors often prescribe an antidepressant medication to handle symptoms of
anxiety, depression, or obsessive-compulsive disorder. Anti-psychotic medications are used to treat
severe behavioral problems. Seizures can be treated with one or more of the anticonvulsant drugs.
Stimulant drugs, such as those used for children with attention deficit disorder (ADD), are sometimes
used effectively to help decrease impulsivity and hyperactivity.
· Other therapies: There are a number of controversial therapies or interventions available for
autistic children, but few, if any, are supported by scientific studies. Parents should use caution before
adopting any of these treatments.
Treatment approaches are evolving as more is learned about autism. There are many therapeutic
programs, both conventional and complementary, that focus on replacing dysfunctional behaviors and
developing specific skills.
As a parent, it's natural to want to do something immediately. However, it is important not to rush
in with changes. Your child may have already learned to cope with his or her current environment
and changes could be stressful. You should investigate various treatment approaches and gather
information concerning various options before proceeding with your child's treatment.
You will encounter numerous accounts from parents about successes and failures with many of the
treatment approaches mentioned. You will also discover that professionals differ in their theories of
what they feel is the most successful treatment for autism. It can be frustrating! But you will learn to
sift through them and make rational, educated decisions on what is appropriate for your child. You
live with your child every day and you know his/her needs. And in time, you will come to know
his/her autism. Trust your instincts as you explore various options.
Again, please keep in mind that the descriptions of treatment approaches provided here are for
informational purposes only. They are meant to give you an overview of an approach. The Autism
Society of America does not endorse any specific treatment or therapy.
During your research, you will hear about many different treatments approaches, such as auditory
training, discrete trial training, vitamin therapy, anti-yeast therapy, facilitated communication, music
therapy, occupational therapy, physical therapy, and sensory integration. These approaches can
generally be broken down into three categories:
- Learning Approaches
- Biomedical & Dietary Approaches
- Complementary Approaches
Some of these treatment approaches have research studies that support their efficacy; others may
not. Some parents will only want to try treatment methods that have undergone research and testing
and are generally accepted by the professional community. But keep in mind that scientific studies are
often difficult to do since each individual with autism is different.
For others, formal testing might not be a pre-requisite for them to try a treatment with their child.
Even for those with "scientific" proof, we recommend that the family or caregiver investigate all
options available to determine the appropriateness to their child.
Experts agree though, that early intervention is important in addressing the symptoms associated
with autism. The earlier treatment is started, the better the chance the child will reach normal
functioning levels. Many of the approaches described can be used on children as young as age 2 or 3.
They may also continue to be used in conjunction with special education programs or traditional
elementary school for children who are mainstreamed.
What About School?
Early diagnosis and appropriate educational programs are very important to children with autism or
PDD. The Individuals with Disabilities Education Act (IDEA) includes autism as a disability category.
Children with autism and PDD are eligible for an educational program appropriate to their individual
needs. Educational programs for students with autism or PDD focus on improving communication,
social, academic, behavioral, and daily living skills.
Behavior and communication problems that interfere with learning sometimes require the assistance
of a professional who is particularly knowledgeable in the autism field, who develops and helps to
implement a plan which can be carried out at home and school.
The classroom environment should be structured so that the program is consistent and predictable.
Students with autism or PDD learn better and are less confused when information is presented
visually as well as verbally. Interaction with non-disabled peers is also important, for these students
provide models of appropriate language, social, and behavioral skills. To overcome frequent problems
in generalizing skills learned at school, it is very important to develop programs with parents, so that
learning activities, experiences, and approaches can be carried over into the home and community.
With educational programs designed to meet a student’s individual needs and specialized adult
support services in employment and living arrangements, many children and adults with autism
or PDD grow up to live and work successfully in the community.
Tips for Parents
Learn about autism/PDD. The more you know, the more you can help yourself and your child.
Be mindful to interact with and teach your child in ways that are most likely to get a positive
response. Learn what is likely to trigger melt-downs for your child, so you can try to minimize
them. Remember, the earliest years are the toughest, but it does get better!
Learn from professionals and other parents how to meet your child’s special needs, but try not to
turn your lives into one round of therapy after another.
If you weren’t born loving highly structured, consistent schedules and routines, ask for help from
other parents and professionals on how to make it second nature for you.
Behavior, communication, and social skills can all be areas of concern for a
child with autism and experience tells us that maintaining a solid, loving,
and structured approach in caring for your child, can help greatly.
Learn about assistive technology that can help your child. This may include
a simple picture communication board to help your child express needs and
desires, or may be as sophisticated as an augmentative communication
device
Work with professionals in early intervention or in your school to develop
an IFSP or an IEP that reflects your child’s needs and abilities. Be sure to
include assistive technology, related services, and supplementary aids and supports, if your child
needs these. Don’t forget about a positive behavior plan, if needed. Also, check out the eBook above.
David Ayoub, M.D. goes through the relations of Mercury to Autism as
well as its connections to “National Security Study Memorandum 200”.
This is an upsetting video, so brace yourself.
well as its connections to “National Security Study Memorandum 200”.
This is an upsetting video, so brace yourself.
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