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Old 09-17-05, 09:52 PM
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Autism FAQ

Frequently Asked Questions about Autism


Temple Grandin, Ph.D.
Assistant Professor
Colorado State University
Fort Collins, CO 80523, USA



1. How do I know if my child has problems with sensory over sensitivity?

Sounds or visual stimuli that are tolerated by normal children may cause pain, confusion and/or fear in some autistic children. Sensory over sensitivity can vary from very slight to severe. If your child frequently puts his hands over his ears, this is an indicator of sensitivity to noise. Children who flick their fingers in front of their eyes are likely to have visual sensitivity problems. Children who enjoy a trip to a large super-market or a shopping mall usually have relatively mild sensory sensitivities. Autistic children with severe sensory sensitivities will often have tantrums and other bad behavior in a shopping mall due to sensory overload. These children are the ones who will most likely need environmental modifications in the classroom. Older children and adults, who remain nonverbal and have very little language, often have more severe sensitivities than individuals with good language. Children with auditory or visual sensitivity will often have normal hearing and visual acuity tests. The problem is in the brain, whereas the ears and eyes are normal.

2. What sights and sounds are most likely to cause sensory overload or confusion in the classroom?

Every autistic child or adult is different. A sound or sight, which is painful to one autistic child, may be attractive to another. The flicker of fluorescent lighting can be seen by some children with autism and may be distracting to them. It is mostly likely to cause sensory overload in children who flick their fingers in front of their eyes. Replacing fluorescents with incandescent bulbs will be helpful for some children. Many children with autism are scared of the public address system, the school bells or the fire alarms, because the sound hurts their ears. Screeching electronic feedback from public address systems or the sound of fire alarms are the worst sounds because the onset of the sound canNOT be predicted. Children with milder hearing sensitivity can sometimes learn to tolerate hurtful sounds when they know when they will occur. However, they may NEVER learn to tolerate UNexpected loud noise. Autistic children with severe hearing sensitivity should be removed from the classroom prior to a fire drill. The fear of a hurtful sound may make an autistic child fearful of a certain classroom. He may become afraid to go into the room because he fears that the fire alarm or the public address systems may make a hurtful sound. If possible, the buzzes or bell should be modified to reduce the sound. Sometimes only a slight reduction in sound is required to make a buzzer or bell tolerable. Duct tape can be applied to bells to soften the sounds. If the public address system has frequent feedback problems, it should be disconnected.

Echoes and noise can be reduced by installing carpeting -- carpet remnants can sometimes be obtained from a carpet store at a low cost. Scraping of chair legs on the floor can be muffled by placing cut tennis balls on the chair legs.

3. Why does my child avoid certain foods or always want to eat the same thing?

Certain foods may be avoided due to sensory over sensitivity. Crunchy foods such as potato chips may be too loud and sound like a raging forest fire to children with over sensitive hearing. Certain odors may be overpowering. When I was a child I gagged when I had to eat slimy foods like jello. However, some limited food preferences may be bad habits and are not due to sensory problems. One has to be a careful observer to figure out which foods cause sensory pain. For example, if a child has extreme sound sensitivity, he should not be required to eat loud, crunchy foods; but he should be encouraged to eat a variety of softer foods. When I was a child my parents made me eat everything except the two things which really made me gag. They were under-cooked slimy egg whites and jello. I was allowed to have a grilled cheese sandwich everyday for lunch, but at dinnertime I was expected to eat everything that was not slimy.

To motivate a child to eat something he does not like, it is recommended to have a food he really likes such as pizza right in front of him along with the food he dislikes. He is then told that he can have the pizza after he eats a few bites of peas. It is important to have the pizza right there in front of him to motivate eating something he does not like.

4. How do I toilet train my autistic child?

There are two major causes of toilet training problems in children with autism. They are either afraid of the toilet or they do not know what they are supposed to do. Children with severe hearing sensitivity may be terrified of the toilet flushing. The sound may hurt their ears. Sometimes these children can learn if they use a potty chair which is located away from the frightening toilet. Due to the great variability of sensory problems, some children may like to repeatedly flush the toilet but they are still not trained. The thinking of some autistic children is so concrete that the only way they can learn is to have an adult demonstrate to them how to use the toilet. They have to see someone else do it in order to learn. Some children with very severe sensory processing problems are not able to accurately sense when they need to use the bathroom. If they are calm they may be able to feel the sensation that they need to urinate or defecate, but if they experience sensory overload they cannot feel it. This may explain why a child will sometimes use the toilet correctly, and other times he will not.

5. Why do some autistic children repeat back what an adult has said or sing TV commercials?

Repeating back what has been said, or being able to sing an entire TV commercial or children's video is called 'echolalia.' Echolalia is actually a good sign because it indicates that the child's brain is processing language even though he may not be understanding the meaning of the words. These children need to learn that words are used for communication. If a child says the word 'apple,' immediately give him an apple. This will enable the child to associate the word 'apple' with getting a real apple. Some autistic children use phrases from TV commercials or children's videos in an appropriate manner in other situations. This is how they learn language. For example, if a child says part of a breakfast cereal slogan at breakfast, give him the cereal.

Autistic children also use echolalia to verify what has been said. Some children have difficulty hearing hard consonant sounds such as "d" in dog or "b" in boy. Repeating the phrase helps them to hear it. Children who pass a pure tone hearing test can still have difficulty hearing complex speech sounds. Children with this difficulty may learn to read and speak by using flash cards that have both a printed word and a picture of an object. By using these cards they learn to associate the spoken word with the printed word and a picture. My speech therapist helped me to learn to hear speech by lengthening hard consonant sounds. She would hold up a ball and say "bbbb all." The hard consonant sound of "b" was lengthened. Some autistic children learn vowel sounds more easily than consonants.

6. How should educators and parents handle autistic fixations on things such as lawn mowers or trains?

Fixations should be used to motivate schoolwork and education. If a child is fixated on trains, use his interest in trains to motivate reading or learning arithmetic. Have him read about trains or do arithmetic problems with trains. The intense interest in trains can be used to motivate reading. It is a mistake to take fixations away, but the child needs to learn that there are some situations when talking about trains is not appropriate.

The idea is to broaden the fixation into a less fixated educational or social activity. If a child likes to spin a penny then start playing a game with the child where you and the child take turns playing with the penny. This also helps to teach turn taking. A train fixation could be broadened in studying history. A high-functioning child would be motivated to read a book about the history of the railroad. One should build and broaden fixation into useful activities. My career in livestock equipment design started as a fixation on cattle chutes. My high school science teacher encouraged me to study science to learn more about my fixation.

High functioning autistic and Asperger teenagers need mentors to help them develop their talents into a career skill. They need somebody to teach them computer programming or graphic arts. A local computer professional could serve as a mentor or the individual may be able to take a programming class at a community college. Many parents wonder where they can find a mentor for their teenager. Try posting a notice on a bulletin board at a university computer science department or strike up a conversation with the man in the supermarket checkout line who is wearing a badge with the name of a computer company on it. I found one of my mentors in the business world when I met the wife of his insurance agent.

7. What is the difference between PDD and autism?

Autism and PDD are behavioral diagnoses. At the present time there are no medical tests for autism. Autism is diagnosed based on the child's behavior. Both children diagnosed with autism and PDD will benefit from education programs designed for autistics. It is essential that children diagnosed as PDD receive the same education as children diagnosed with autism. Both autistic and PDD children should be placed into a good early education program immediately after diagnosis. Children diagnosed with PDD tend to fall into two groups: (1) very mild autistic symptoms, or (2) some autistic symptoms in a child who has other severe neurological problems. Therefore, some children diagnosed as PDD may be almost normal; and others have severe neurological problems such as epilepsy, microencephaly or cerebral palsy. The problem with the autism and PDD diagnoses is that they are NOT precise. They are based only on behavior. In the future, brain scans will be used for precise diagnosis. Today there is no brain scan that can be used for diagnosing PDD nor autism.

8. Why is Early Intervention important?

Both scientific studies and practical experience have shown that the prognosis is greatly improved if a child is placed into an intense, highly structured educational program by age two or three. Autistic children perform stereotypic behaviors such as rocking or twiddling a penny because engaging in repetitive behaviors shuts off sounds and sights which cause confusion and/or pain. The problems is that if the child is allowed to shut out the world, his brain will not develop. Autistic and PDD children need many hours of structured education to keep their brain engaged with the world. They need to be kept interacting in a meaningful way with an adult or another child. The worst things for a young two to five year old autistic child is to sit alone watching TV or playing video games all day. His brain will be shut off from the world. Autistic children need to be kept engaged; but at the same time, a teacher must be careful to avoid sensory overload. Children with milder sensory problems often respond well to Lovaas-type programs. However, children with more severe sensory processing problems may experience sensory overload. There are two major categories of children. The first type will respond well to a therapist who is gently intrusive and pulls them out of their world. I was this type. My speech therapist was able to "snap me out of it" by grabbing my chin and making me pay attention. The second type of child has more neurological problems, and they may respond poorly to a strict Lovaas program. They will require a gentler approach. Some are 'mono-channel' because they cannot see and hear at the same time. They either have to look at something or they have to listen. Simultaneous looking and listening may result in sensory overload and shutdown. This type of child may respond best when the teacher whispers quietly in a dimly illuminated room.

A good teacher needs to tailor his/her teaching method to the child. To be successful, the teacher has to be gently insistent. A good teacher knows how hard to push. To be successful, the teacher has to intrude into the autistic child's world. With some children the teacher can jerk open their "front door;" and with other children, the teacher has to sneak quietly in their "back door."

9. Why does my child want to wear the same clothes all the time?

Stiff scratching clothes or wool against my skin is sandpaper ripping off raw nerve endings. I am not able to tolerate scratching clothes. Autistic children will be most comfortable with soft cotton against their skin. New underwear and shirts will be more comfortable if they are washed several times. It is often best to avoid spray starch or fabric softeners that are placed in the dryer. Some children are allergic to them. [Note: Caretakers and teachers should also avoid the use of perfume because some children hate the smell and/or they are allergic to it.]

Even today at the age of 49, I have had to find good clothes and work clothes that feel the same. It takes me up to two weeks to habituate to the feeling of wearing a skirt. If I wear shorts during the summer, it takes at least a week before long pants become fully tolerable. The problem is switching back-and-forth. Switching back-and-forth can be made more tolerable by wearing tights with skirts. The tights make the skirt feel the same as long pants.

January, 1998




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Old 09-17-05, 09:55 PM
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"The Geek Syndrome" (A controvertial must-read!)

The Geek Syndrome


Autism - and its milder cousin Asperger's syndrome - is surging among the children of Silicon Valley. Are math-and-tech genes to blame?

By Steve Silberman

Nick is building a universe on his computer. He's already mapped out his first planet: an anvil-shaped world called Denthaim that is home to gnomes and gods, along with a three-gendered race known as kiman. As he tells me about his universe, Nick looks up at the ceiling, humming fragments of a melody over and over. "I'm thinking of making magic a form of quantum physics, but I haven't decided yet, actually," he explains. The music of his speech is pitched high, alternately poetic and pedantic - as if the soul of an Oxford don has been awkwardly reincarnated in the body of a chubby, rosy-cheeked boy from Silicon Valley. Nick is 11 years old.

Nick's father is a software engineer, and his mother is a computer programmer. They've known that Nick was an unusual child for a long time. He's infatuated with fantasy novels, but he has a hard time reading people. Clearly bright and imaginative, he has no friends his own age. His inability to pick up on hidden agendas makes him easy prey to certain cruelties, as when some kids paid him a few dollars to wear a ridiculous outfit to school.

One therapist suggested that Nick was suffering from an anxiety disorder. Another said he had a speech impediment. Then his mother read a book called Asperger's Syndrome: A Guide for Parents and Professionals. In it, psychologist Tony Attwood describes children who lack basic social and motor skills, seem unable to decode body language and sense the feelings of others, avoid eye contact, and frequently launch into monologues about narrowly defined - and often highly technical - interests. Even when very young, these children become obsessed with order, arranging their toys in a regimented fashion on the floor and flying into tantrums when their routines are disturbed. As teenagers, they're prone to getting into trouble with teachers and other figures of authority, partly because the subtle cues that define societal hierarchies are invisible to them.

"I thought, 'That's Nick,'" his mother recalls.


Asperger's syndrome is one of the disorders on the autistic spectrum - a milder form of the condition that afflicted Raymond Babbitt, the character played by Dustin Hoffman in Rain Man. In the taxonomy of autism, those with Asperger's syndrome have average - or even very high - IQs, while 70 percent of those with other autistic disorders suffer from mild to severe mental retardation. One of the estimated 450,000 people in the US living with autism, Nick is more fortunate than most. He can read, write, and speak. He'll be able to live and work on his own. Once he gets out of junior high hell, it's not hard to imagine Nick creating a niche for himself in all his exuberant strangeness. At the less fortunate end of the spectrum are what diagnosticians call "profoundly affected" children. If not forcibly engaged, these children spend their waking hours in trancelike states, staring at lights, rocking, making high-pitched squeaks, and flapping their hands, repetitively stimulating ("stimming") their miswired nervous systems.

In one of the uncanny synchronicities of science, autism was first recognized on two continents nearly simultaneously. In 1943, a child psychiatrist named Leo Kanner published a monograph outlining a curious set of behaviors he noticed in 11 children at the Johns Hopkins Hospital in Baltimore. A year later, a pediatrician in Vienna named Hans Asperger, who had never seen Kanner's work, published a paper describing four children who shared many of the same traits. Both Kanner and Asperger gave the condition the same name: autism - from the Greek word for self, aut˛s - because the children in their care seemed to withdraw into iron-walled universes of their own.

Kanner went on to launch the field of child psychiatry in the US, while Asperger's clinic was destroyed by a shower of Allied bombs. Over the next 40 years, Kanner became widely known as the author of the canonical textbook in his field, in which he classified autism as a subset of childhood schizophrenia. Asperger was virtually ignored outside of Europe and died in 1980. The term Asperger syndrome wasn't coined until a year later, by UK psychologist Lorna Wing, and Asperger's original paper wasn't even translated into English until 1991. Wing built upon Asperger's intuition that even certain gifted children might also be autistic. She described the disorder as a continuum that "ranges from the most profoundly physically and mentally retarded person ... to the most able, highly intelligent person with social impairment in its subtlest form as his only disability. It overlaps with learning disabilities and shades into eccentric normality."

Asperger's notion of a continuum that embraces both smart, geeky kids like Nick and those with so-called classic or profound autism has been accepted by the medical establishment only in the last decade. Like most distinctions in the world of childhood developmental disorders, the line between classic autism and Asperger's syndrome is hazy, shifting with the state of diagnostic opinion. Autism was added to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders in 1980, but Asperger's syndrome wasn't included as a separate disorder until the fourth edition in 1994. The taxonomy is further complicated by the fact that few if any people who have Asperger's syndrome will exhibit all of the behaviors listed in the DSM-IV. (The syn in syndrome derives from the same root as the syn in synchronicity - the word means that certain symptoms tend to cluster together, but all need not be present to make the diagnosis.) Though Asperger's syndrome is less disabling than "low-functioning" forms of autism, kids who have it suffer difficulties in the same areas as classically autistic children do: social interactions, motor skills, sensory processing, and a tendency toward repetitive behavior.

In the last 20 years, significant advances have been made in developing methods of behavioral training that help autistic children find ways to communicate. These techniques, however, require prodigious amounts of persistence, time, money, and love. Though more than half a century has passed since Kanner and Asperger first gave a name to autism, there is still no known cause, no miracle drug, and no cure.

And now, something dark and unsettling is happening in Silicon Valley.




In the past decade, there has been a significant surge in the number of kids diagnosed with autism throughout California. In August 1993, there were 4,911 cases of so-called level-one autism logged in the state's Department of Developmental Services client-management system. This figure doesn't include kids with Asperger's syndrome, like Nick, but only those who have received a diagnosis of classic autism. In the mid-'90s, this caseload started spiraling up. In 1999, the number of clients was more than double what it had been six years earlier. Then the curve started spiking. By July 2001, there were 15,441 clients in the DDS database. Now there are more than seven new cases of level-one autism - 85 percent of them children - entering the system every day.
Through the '90s, cases tripled in California. "Anyone who says this is due to better diagnostics has his head in the sand."

California is not alone. Rates of both classic autism and Asperger's syndrome are going up all over the world, which is certainly cause for alarm and for the urgent mobilization of research. Autism was once considered a very rare disorder, occurring in one out of every 10,000 births. Now it's understood to be much more common - perhaps 20 times more. But according to local authorities, the picture in California is particularly bleak in Santa Clara County. Here in Silicon Valley, family support services provided by the DDS are brokered by the San Andreas Regional Center, one of 21 such centers in the state. SARC dispenses desperately needed resources (such as in-home behavioral training, educational aides, and respite care) to families in four counties. While the autistic caseload is rising in all four, the percentage of cases of classic autism among the total client population in Santa Clara County is higher enough to be worrisome, says SARC's director, Santi Rogers.

"There's a significant difference, and no signs that it's abating," says Rogers. "We've been watching these numbers for years. We feared that something like this was coming. But this is a burst that has staggered us in our steps."

It's not easy to arrive at a clear picture of whether there actually is a startling rise in the incidence of autism in California, as opposed to just an increase in diagnoses. One problem, says Linda Lotspeich, director of the Stanford Pervasive Developmental Disorders Clinic, is that "the rules in the DSM-IV don't work." The diagnostic criteria are subjective, like "Marked impairment in the use of nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction."

"How much 'eye-to-eye gaze' do you have to have to be normal?" asks Lotspeich. "How do you define what 'marked' is? In shades of gray, when does black become white?"

Some children will receive a diagnosis of classic autism, and another diagnosis of Asperger's syndrome, from two different clinicians. Tony Attwood's advice to parents is strictly practical: "Use the diagnosis that provides the services."

While diagnostic fuzziness may be contributing to a pervasive sense that autism is on the rise, Ron Huff, the consulting psychologist for the DDS who uncovered the statistical trend, does not believe that all we're seeing now is an increase in children who would have previously been tagged with some other disability, such as mental retardation - or overlooked as perfectly healthy, if quirky, kids.

"While we certainly need to do more research," says Huff, "I don't think the change in diagnostic criteria will account for all of this rise by any means."

The department is making its data available to the MIND Institute at the University of California at Davis, to tease out what's behind the numbers. The results of that research will be published next year. But the effects of a surging influx are already rippling through the local schools. Carol Zepecki, director of student services and special education for the Palo Alto Unified School District, is disturbed by what she's seeing. "To be honest with you, as I look back on the special-ed students I've worked with for 20 years, it's clear to me that these kids would not have been placed in another category. The numbers are definitely higher." Elizabeth Rochin, a special-ed teacher at Cupertino High, says local educators are scrambling to create new resources. "We know it's happening, because they're coming through our schools. Our director saw the iceberg approaching and said, 'We've got to build something for them.'"

The people scrambling hardest are parents. In-home therapy alone can cost $60,000 or more a year, and requires so much dedication that parents (particularly mothers) are often forced to quit their jobs and make managing a team of specialists their new 80-hour-a-week career. Before their children become eligible for state funding, parents must obtain a diagnosis from a qualified clinician, which requires hours of testing and observation. Local facilities, such as the Stanford Pervasive Development Disorders Clinic and its counterpart at UC San Francisco, are swamped. The Stanford clinic is able to perform only two or three diagnoses a week. It currently has a two- to six-month waiting list.

For Rick Rollens, former secretary of the California Senate and cofounder of the MIND Institute, the notion that there is a frightening increase in autism worldwide is no longer in question. "Anyone who says this epidemic is due to better diagnostics," he says, "has his head in the sand."




Autism's insidious style of onset is particularly cruel to parents, because for the first two years of life, nothing seems to be wrong. Their child is engaged with the world, progressing normally, taking first steps into language. Then, suddenly, some unknown cascade of neurological events washes it all away.

One father of an autistic child, Jonathan Shestack, describes what happened to his son, Dov, as "watching our sweet, beautiful boy disappear in front of our eyes." At two, Dov's first words - Mom, Dad, flower, park - abruptly retreated into silence. Over the next six months, Dov ceased to recognize his own name and the faces of his parents. It took Dov a year of intensive behavioral therapy to learn how to point. At age 9, after the most effective interventions available (such as the step-by-step behavioral training methods developed by Ivar Lovaas at UCLA), Dov can speak 20 words.

Even children who make significant progress require levels of day-to-day attention from their families that can best be described as heroic. Marnin Kligfeld is the founder of a software mergers-and-acquisitions firm. His wife, Margo Estrin, a doctor of internal medicine, is the daughter of Gerald Estrin, who was a mentor to many of the original architects of the Internet (see "Meet the Bellbusters," Wired 9.11, page 164). When their daughter, Leah, was 3, a pediatrician at Oakland Children's Hospital looked at her on the examining table and declared, "There is very little difference between your daughter and an animal. We have no idea what she will be able to do in the future." After eight years of interventions - behavioral training, occupational therapy, speech therapy - Leah is a happy, upbeat 11-year-old who downloads her favorite songs by the hundreds. And she is still deeply autistic.

Leah's first visit to the dentist required weeks of preparation, because autistic people are made deeply anxious by any change in routine. "We took pictures of the dentist's office and the staff, and drove Leah past the office several times," Kligfeld recalls. "Our dentist scheduled us for the end of the day, when there were no other patients, and set goals with us. The goal of the first session was to have Leah sit in the chair. The second session was so Leah could rehearse the steps involved in treatment without actually doing them. The dentist gave all of his equipment special names for her. Throughout this process, we used a large mirror so Leah could see exactly what was being done, to ensure that there were no surprises."

Daily ordeals like this, common in the autistic community, underline the folly of the hypothesis that prevailed among psychologists 20 years ago, who were convinced that autism was caused by a lack of parental affection. The influential psychiatrist Bruno Bettelheim aggressively promoted a theory that has come to be known as the "refrigerator mother" hypothesis. He declared in his best-selling book, The Empty Fortress, "The precipitating factor in infantile autism is the parent's wish that his child should not exist. ... To this the child responds with massive withdrawal." He prescribed "parentectomy" - removal of the child from the parents - and years of family therapy. His hypothesis added the burden of guilt to the grief of having an autistic child, and made autism a source of shame and secrecy, which hampered efforts to obtain clinical data. The hypothesis has been thoroughly discredited. Richard Pollak's The Creation of Dr. B exposed Bettelheim as a brilliant liar who concocted case histories and exaggerated both his experience with autistic children and the success of his treatments.
One thing nearly everyone in the field agrees on: genetic predisposition. Identical twins share the disorder 9 times out of 10.

But the debates about the causes of autism are certainly not over. Controversies rage about whether environmental factors - such as mercury and other chemicals in universally administered vaccines, industrial pollutants in air and water, and even certain foods - act as catalysts that trigger the disorder. Bernard Rimland, the first psychologist to oppose Bettelheim and promote the idea that autism was organic in origin, has become a leading advocate for intensified investigation in this area. The father of an autistic son, Rimland has been instrumental in marshaling medical expertise and family data to create better assessment protocols.

The one thing that almost all researchers in the field agree on is that genetic predisposition plays a crucial role in laying the neurological foundations of autism in most cases. Studies have shown that if one identical twin is autistic, there's a 90 percent chance that the other twin will also have the disorder. If parents have had one autistic child, the risk of their second child being autistic rises from 1 in 500 to 1 in 20. After two children with the disorder, the sobering odds are 1 in 3. (So many parents refrain from having more offspring after one autistic child, geneticists even have a term for it: stoppage.) The chances that the siblings of an autistic child will display one or more of the other developmental disorders with a known genetic basis - such as dyslexia or Tourette's syndrome - are also significantly higher than normal.

The bad news from Santa Clara County raises an inescapable question. Unless the genetic hypothesis is proven false, which is unlikely, regions with a higher than normal distribution of people on the autistic spectrum are something no researcher could ask for: living laboratories for the study of genetic expression. When the rain that fell on the Rain Man falls harder on certain communities than others, what becomes of the children?

The answer may be raining all over Silicon Valley. And one of the best hopes of finding a cure may be locked in the DNA sequences that produced the minds that have made this area the technological powerhouse of the world.




It's a familiar joke in the industry that many of the hardcore programmers in IT strongholds like Intel, Adobe, and Silicon Graphics - coming to work early, leaving late, sucking down Big Gulps in their cubicles while they code for hours - are residing somewhere in Asperger's domain. Kathryn Stewart, director of the Orion Academy, a high school for high-functioning kids in Moraga, California, calls Asperger's syndrome "the engineers' disorder." Bill Gates is regularly diagnosed in the press: His single-minded focus on technical minutiae, rocking motions, and flat tone of voice are all suggestive of an adult with some trace of the disorder. Dov's father told me that his friends in the Valley say many of their coworkers "could be diagnosed with ODD - they're odd." In Microserfs, novelist Douglas Coupland observes, "I think all tech people are slightly autistic."

Though no one has tried to convince the Valley's best and brightest to sign up for batteries of tests, the culture of the area has subtly evolved to meet the social needs of adults in high-functioning regions of the spectrum. In the geek warrens of engineering and R&D, social graces are beside the point. You can be as off-the-wall as you want to be, but if your code is bulletproof, no one's going to point out that you've been wearing the same shirt for two weeks. Autistic people have a hard time multitasking - particularly when one of the channels is face-to-face communication. Replacing the hubbub of the traditional office with a screen and an email address inserts a controllable interface between a programmer and the chaos of everyday life. Flattened workplace hierarchies are more comfortable for those who find it hard to read social cues. A WYSIWYG world, where respect and rewards are based strictly on merit, is an Asperger's dream.

Obviously, this kind of accommodation is not unique to the Valley. The halls of academe have long been a forgiving environment for absentminded professors. Temple Grandin - the inspiring and accomplished autistic woman profiled in Oliver Sacks' An Anthropologist on Mars - calls NASA the largest sheltered workshop in the world.

A recurring theme in case histories of autism, going all the way back to Kanner's and Asperger's original monographs, is an attraction to highly organized systems and complex machines. There's even a perennial cast of hackers: early adopters with a subversive streak. In 1944, Asperger wrote of a boy "chemist [who] uses all his money for experiments which often horrify his family and even steals to fund them." Another boy proved a mathematical error in Isaac Newton's calculations while he was still a freshman in college. A third escaped neighborhood bullies by taking lessons from an old watchmaker. And a fourth, wrote Asperger, "came to be preoccupied with fantastic inventions, such as spaceships and the like." Here he added, "one observes how remote from reality autistic interests really are" - a comment he qualified years later, when spaceships were no longer remote or fantastic, by joking that the inventors of spaceships might themselves be autistic.

Clumsy and easily overwhelmed in the physical world, autistic minds soar in the virtual realms of mathematics, symbols, and code. Asperger compared the children in his clinic to calculating machines: "intelligent automata" - a metaphor employed by many autistic people themselves to describe their own rule-based, image-driven thought processes. In her autobiography, Thinking in Pictures, Grandin compares her mind to a VCR. When she hears the word dog, she mentally replays what she calls "videotapes" of various dogs that she's seen, to arrive at something close to the average person's abstract notion of the category that includes all dogs. This visual concreteness has been a boon to her work as a designer of more humane machinery for handling livestock. Grandin sees the machines in her head and sets them running, debugging as she goes. When the design in her mind does everything it's supposed to, she draws a blueprint of what she sees.
"In another age, these men would have been monks, developing new ink for printing presses. Suddenly, they're reproducing at a much higher rate."

These days, the autistic fascinations with technology, ordered systems, visual modes of thinking, and subversive creativity have plenty of outlets. There's even a cheeky Asperger's term for the rest of us - NTs, "neurotypicals." Many children on the spectrum become obsessed with VCRs, PokÚmon, and computer games, working the joysticks until blisters appear on their fingers. (In the diagnostic lexicon, this kind of relentless behavior is called "perseveration.") Even when playing alongside someone their own age, however, autistic kids tend to play separately. Echoing Asperger, the director of the clinic in San Jose where I met Nick, Michelle Garcia Winner, suggests that "PokÚmon must have been invented by a team of Japanese engineers with Asperger." Attwood writes that computers "are an ideal interest for a person with Asperger's syndrome ... they are logical, consistent, and not prone to moods."

This affinity for computers gives teachers and parents leverage they can use to build on the natural strengths of autistic children. Many teenagers who lack the motor skills to write by hand find it easier to use a keyboard. At Orion Academy, every student is required to buy an iBook fitted with an AirPort card. Class notes are written on electronic whiteboards that port the instructional materials to the school server for retrieval. (At lunch, the iBooks are shut off, and if the kids want to play a two-person game, they're directed to a chess board.) The next generation of assistive technology is being designed by Neil Scott's Archimedes Project at Stanford. Scott's team is currently developing the equivalent of a PDA for autistic kids, able to parse subtle movements of an eyebrow or fingertip into streams of text, voice, or images. The devices will incorporate video cameras, head and eye tracking, intelligent agents, and speech recognition to suit the needs of the individual child.

The Valley is a self-selecting community where passionately bright people migrate from all over the world to make smart machines work smarter. The nuts-and-bolts practicality of hard labor among the bits appeals to the predilections of the high-functioning autistic mind. The hidden cost of building enclaves like this, however, may be lurking in the findings of nearly every major genetic study of autism in the last 10 years. Over and over again, researchers have concluded that the DNA scripts for autism are probably passed down not only by relatives who are classically autistic, but by those who display only a few typically autistic behaviors. (Geneticists call those who don't fit into the diagnostic pigeonholes "broad autistic phenotypes.")

The chilling possibility is that what's happening now is the first proof that the genes responsible for bestowing certain special gifts on slightly autistic adults - the very abilities that have made them dreamers and architects of our technological future - are capable of bringing a plague down on the best minds of the next generation. For parents employed in prominent IT firms here, the news of increased diagnoses of autism in their ranks is a confirmation of rumors that have quietly circulated for months. Every day, more and more of their coworkers are running into one another in the waiting rooms of local clinics, taking the first uncertain steps on a journey with their children that lasts for the rest of their lives.

In previous eras, even those who recognized early that autism might have a genetic underpinning considered it a disorder that only moved diagonally down branches of a family tree. Direct inheritance was almost out of the question, because autistic people rarely had children. The profoundly affected spent their lives in institutions, and those with Asperger's syndrome tended to be loners. They were the strange uncle who droned on in a tuneless voice, tending his private logs of baseball statistics or military arcana; the cousin who never married, celibate by choice, fussy about the arrangement of her things, who spoke in a lexicon mined reading dictionaries cover to cover.

The old line "insanity is hereditary, you get it from your kids" has a twist in the autistic world. It has become commonplace for parents to diagnose themselves as having Asperger's syndrome, or to pinpoint other relatives living on the spectrum, only after their own children have been diagnosed.

High tech hot spots like the Valley, and Route 128 outside of Boston, are a curious oxymoron: They're fraternal associations of loners. In these places, if you're a geek living in the high-functioning regions of the spectrum, your chances of meeting someone who shares your perseverating obsession (think Linux or Star Trek) are greatly expanded. As more women enter the IT workplace, guys who might never have had a prayer of finding a kindred spirit suddenly discover that she's hacking Perl scripts in the next cubicle.

One provocative hypothesis that might account for the rise of spectrum disorders in technically adept communities like Silicon Valley, some geneticists speculate, is an increase in assortative mating. Superficially, assortative mating is the blond gentleman who prefers blondes; the hyperverbal intellectual who meets her soul mate in the therapist's waiting room. There are additional pressures and incentives for autistic people to find companionship - if they wish to do so - with someone who is also on the spectrum. Grandin writes, "Marriages work out best when two people with autism marry or when a person marries a handicapped or eccentric spouse.... They are attracted because their intellects work on a similar wavelength."


That's not to say that geeks, even autistic ones, are attracted only to other geeks. Compensatory unions of opposites also thrive along the continuum, and in the last 10 years, geekitude has become sexy and associated with financial success. The lone-wolf programmer may be the research director of a major company, managing the back end of an IT empire at a comfortable remove from the actual clients. Says Bryna Siegel, author of The World of the Autistic Child and director of the PDD clinic at UCSF, "In another historical time, these men would have become monks, developing new ink for early printing presses. Suddenly they're making $150,000 a year with stock options. They're reproducing at a much higher rate."

Genetic hypotheses like these don't rule out environmental factors playing a role in the rising numbers. Autism is almost certainly not caused by the action of a single gene, but by some orchestration of multiple genes that may make the developing child more susceptible to a trigger in the environment. One consequence of increased reproduction among people carrying some of these genes might be to boost "genetic loading" in successive generations - leaving them more vulnerable to threats posed by toxins in vaccines, candida, or any number of agents lurking in the industrialized world.

At clinics and schools in the Valley, the observation that most parents of autistic kids are engineers and programmers who themselves display autistic behavior is not news. And it may not be news to other communities either. Last January, Microsoft became the first major US corporation to offer its employees insurance benefits to cover the cost of behavioral training for their autistic children. One Bay Area mother told me that when she was planning a move to Minnesota with her son, who has Asperger's syndrome, she asked the school district there if they could meet her son's needs. "They told me that the northwest quadrant of Rochester, where the IBMers congregate, has a large number of Asperger kids," she recalls. "It was recommended I move to that part of town."




For Dov's parents, Jonathan Shestack and Portia Iversen, Silicon Valley is the only place on Earth with enough critical mass of supercomputing resources, bio-informatics expertise, genomics savvy, pharmaceutical muscle, and VC dollars to boost autism research to the next phase. For six years, the organization they founded, Cure Autism Now, has led a focused assault on the iron-walled fortress of the medical establishment, including the creation of its own bank of DNA samples, available to any scientist in the field on a Web site called the Autism Genetic Resources Exchange (see "The Citizen Scientists," Wired 9.09, page 144).

At least a third of CAN's funding comes from donors in the Valley. Now Shestack and Iversen want to deliver the ultimate return on that investment: better treatments, smarter assistive technology - and, eventually, a cure.

"We have the human data," says Shestack. "Now we need the brute-force processing power. We need high-density SNP mapping and microarray analysis so we can design pharmaceutical interventions. We need Big Pharma to wake up to the fact that while 450,000 people in America may not be as large a market as for cholesterol drugs, we're talking about a demand for new products that will be needed from age 2 to age 70. We need new technology that measures modes of perception, and tools for neural retraining. And we need a Web site where families with a newly diagnosed kid can plug into a network of therapists in their town who have been rated by buyers - just like eBay."

The ultimate hack for a team of Valley programmers may turn out to be cracking the genetic code that makes them so good at what they do. Taking on that challenge will require extensive use of technology invented by two people who think in pictures: Bill Dreyer, who invented the first protein sequencer, and Carver Mead, the father of very large scale integrated circuits. As Dreyer explains, "I think in three-dimensional Technicolor." Neither Mead nor Dreyer is autistic, but there is a word for the way they think - dyslexic. Like autism, dyslexia seems to move down genetic pathways. Dreyer has three daughters who think in Technicolor.

One of the things that Dan Geschwind, director of the neurogenetics lab at UCLA, finds fascinating about dyslexia and autism is what they suggest about human intelligence: that certain kinds of excellence might require not just various modes of thinking, but different kinds of brains.

"Autism gets to fundamental issues of how we view talents and disabilities," he says. "The flip side of dyslexia is enhanced abilities in math and architecture. There may be an aspect of this going on with autism and assortative mating in places like Silicon Valley. In the parents, who carry a few of the genes, they're a good thing. In the kids, who carry too many, it's very bad."

Issues like this were at the crux of arguments that Bryna Siegel had with Bruno Bettelheim in a Stanford graduate seminar in the early '80s, published in Bettelheim's The Art of the Obvious. (Siegel's name was changed to Dan Berenson.) The text makes poignant reading, as two paradigms of scientific humanism clash in the night. Siegel told "Dr. B" that she wanted to do a large study of children with various developmental disorders to search for a shared biochemical defect. Bettelheim shot back that if such a marker were to be uncovered it would dehumanize autistic children, by making them essentially different from ourselves.

Still an iconoclast, Siegel questions whether a "cure" for autism could ever be found. "The genetics of autism may turn out to be no simpler to unravel than the genetics of personality. I think what we'll end up with is something more like, 'Mrs. Smith, here are the results of your amnio. There's a 1 in 10 chance that you'll have an autistic child, or the next Bill Gates. Would you like to have an abortion?'"


For UCSF neurologist Kirk Wilhelmsen - who describes himself and his son as being "somewhere on that grand spectrum" - such statements cut to the heart of the most difficult issue that autism raises for society. It may be that autistic people are essentially different from "normal" people, he says, and that it is precisely those differences that make them invaluable to the ongoing evolution of the human race.

"If we could eliminate the genes for things like autism, I think it would be disastrous," says Wilhelmsen. "The healthiest state for a gene pool is maximum diversity of things that might be good."

One of the first people to intuit the significance of this was Asperger himself - weaving his continuum like a protective blanket over the young patients in his clinic as the Nazis shipped so-called mental defectives to the camps. "It seems that for success in science and art," he wrote, "a dash of autism is essential."

For all we know, the first tools on earth might have been developed by a loner sitting at the back of the cave, chipping at thousands of rocks to find the one that made the sharpest spear, while the neurotypicals chattered away in the firelight. Perhaps certain arcane systems of logic, mathematics, music, and stories - particularly remote and fantastic ones - have been passed down from phenotype to phenotype, in parallel with the DNA that helped shape minds which would know exactly what to do with these strange and elegant creations.

Hanging on the wall of Bryna Siegel's clinic in San Francisco is a painting of a Victorian house at night, by Jessy Park, an autistic woman whose mother, Clara Claiborne Park, wrote one of the first accounts of raising a child with autism, The Siege. Now 40, Jessy still lives at home. In her recent book, Exiting Nirvana, Clara writes of having come to a profound sense of peace with all the ways that Jessy is.

Jessy sent Siegel a letter with her painting, in flowing handwriting and words that are - there is no other way to say it - marvelously autistic. "The lunar eclipse with 92% cover is below Cassiopeia. In the upper right-hand corner is Aurora Borealis. There are three sets of six-color pastel rainbow on the shingles, seven-color bright rainbow on the clapboards next to the drain pipe, six-color paler pastel rainbow around the circular window, six-color darker pastel rainbow on the rosette ..."

But the words aren't the thing. Jessy's painting is the thing. Our world, but not our world. A house under the night sky shining in all the colors of the spectrum.
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AS in Adults


Asperger syndrome and adults

Asperger syndrome is one of the autism spectrum disorders, and is classified as a developmental disorder that affects how the brain processes information. People with Asperger syndrome can show a wide range of behaviours and social skills, but common characteristics include difficulty in forming friendships, communication problems (such as an inability to listen or a tendency to take whatever is said to them literally), and an inability to understand social rules and body language.

There is no cure and no specific treatment. Asperger syndrome doesn't improve, although experience helps to build up coping skills. Social training, which teaches how to behave in different social situations, is generally more helpful than counselling. Cognitive Behaviour Therapy is being increasingly used to assist the person with Asperger Syndrome understand and manage their behavioural responses.

Typical adult symptoms
More males than females have Asperger syndrome. While every person who has the syndrome will experience different symptoms and severity of symptoms, some of the more common characteristics include:
  • Average or above average intelligence
  • Inability to think in abstract ways
  • Difficulties in empathising with others
  • Problems with understanding another person's point of view
  • Hampered conversational ability
  • Problems with controlling feelings such as anger, depression and anxiety
  • Adherence to routines and schedules, and stress if expected routine is disrupted
  • Inability to manage appropriate social conduct
  • Specialised fields of interest or hobbies.
The emotions of other people
A person with Asperger syndrome may have trouble understanding the emotions of other people, and the subtle messages that are sent by facial expression, eye contact and body language are often missed. Because of this, a person with Asperger syndrome might be seen as egotistical, selfish or uncaring. These are unfair labels, because the affected person is neurologically unable to understand other people's emotional states. They are usually shocked, upset and remorseful when told their actions were hurtful or inappropriate.

Sexual codes of conduct
Research into the sexual understanding of people with Asperger syndrome is in its infancy. Studies suggest that affected people are as interested in sex as anyone else, but many don't have the social or empathetic skills to successfully manage adult relationships.

Delayed understanding is common; for example, a person with Asperger syndrome aged in their 20s typically has the sexual codes of conduct befitting a teenager. Even affected people who are high achieving and academically or vocationally successful have trouble negotiating the 'hidden rules' of courtship. Inappropriate sexual behaviour can result.

Being a partner and parent
Some affected people can maintain relationships and parent children, although there are challenges. Dutch research suggests that the divorce rate for people with Asperger syndrome is around 80 per cent.

A common marital problem is unfair distribution of responsibilities. For example, the partner of a person with Asperger syndrome may be used to doing everything in the relationship when it is just the two of them. However, the partner may need practical and emotional support once children come along, which the person with Asperger syndrome is ill equipped to provide. When the partner expresses frustration or becomes upset that they're given no help of any kind, the person with Asperger syndrome is typically baffled. Tension in the relationship often makes their symptoms worse.

The workplace
The Commonwealth Department of Family and Community Services, in conjunction with a range of specialist employment services, helps to place people with disabilities in the workforce. A person with Asperger syndrome may find their job opportunities limited by their disability. It may help to choose a vocation that takes into account the individual's symptoms, and plays to the strengths rather than the weaknesses. The following career suggestions are adapted from material written by Temple Grandin, who has high-functioning autism and is an assistant professor at Colorado University, USA.

Careers to avoid - suggestions
Careers that rely on short term memory should be avoided. Examples include:
  • Cashier
  • Short order cook
  • Waitress
  • Taxi dispatcher
  • Air traffic controller
  • Receptionist.
Career suggestions for visual thinkers
Suggestions include:
  • Computer programming
  • Drafting
  • Commercial art
  • Photography
  • Equipment design
  • Mechanic
  • Appliance repair
  • Handcraft artisan
  • Webpage designer
  • Video game designer
  • Building maintenance
  • Building trades.
Career suggestions for those good at mathematics or music
Suggestions include:
  • Accounting
  • Computer programming
  • Engineering
  • Journalist, copy editor
  • Taxi driver
  • Piano (or other musical instrument) tuner
  • Filing positions
  • Statistician
  • Physician
  • Mathematician
  • Bank teller
  • Telemarketing.
Common issues for partners
An adult's diagnosis of Asperger syndrome often tends to follow their child's diagnosis of autism spectrum disorder. This 'double whammy' can be extremely distressing to the partner who has to cope simultaneously with both diagnoses. Counselling, or joining a support group where they can talk with other people who face the same challenges, can be helpful. Some common issues for partners include:
  • Feeling overly responsible for their partner.
  • Failure to have their own needs met by the relationship.
  • Lack of emotional support from family members and friends who don't fully understand or appreciate the extra strains placed on a relationship by Asperger syndrome.
  • A sense of isolation, because the challenges of their relationship are different and not easily understood by others.
  • Frustration, since problems in the relationship don't seem to improve despite great efforts.
  • Frequent wondering about whether or not to end the relationship.
  • Difficulties in accepting that their partner won't recover from Asperger syndrome.
  • After accepting that their partner's Asperger syndrome won't get better, common emotions include guilt, despair and disappointment.
Where to get help
  • Your doctor
  • Autism Victoria Tel. (03) 9885 0533
  • The Centre for Developmental Disability Health Victoria (CDDHV) Tel. (03) 9564 7511
  • Asperger Syndrome Support Network Tel. (03) 9845 2766
  • Bendigo Regional Autism/Asperger Network (BRAAN) Tel. (03) 5442 5926
  • Commonwealth Department of Community and Family Services Tel. 1300 653 227
  • Alpha Autism Employment Program Tel. (03) 9681 9311
Things to remember
  • A person with Asperger syndrome often has trouble understanding the emotions of other people, and the subtle messages that are sent by facial expression, eye contact and body language are often missed.
  • Research suggests that the divorce rate for people with Asperger syndrome is around 80 per cent.
  • Social training, which teaches how to behave in different social situations, is generally more helpful to a person with Asperger syndrome than counselling.
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ADHD.... It's not just for kids anymore...
It all seems impressive when you don't know what it means. (H. Rickey, 1987)
"Aye yam what aye yam." (Popeye)
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The computer lets you make more mistakes faster, with the exception of tequila and a handgun. (M. Radcliffe)
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Hyperlexia

The Syndrome of Hyperlexia vs. High Functioning Autism and Asperger's Syndrome

Phyllis Kupperman
Sally Bligh
Kathy Barouski


Center for Speech and Language Disorders
479 Spring Rd., Elmhurst. II. 60126
(708)530-8551



When we first met Abie at the age of three. he was very active, had temper tantrums, was echolalic, and did not appear to understand much of what was said to him. He had unusual fears and did not play well with other children. Yet he had been reading since the age of 2. He at first appeared to have characteristics of high-functioning autism or of Atypical Pervasive Developmental Disorder. As we watched him develop, however. it became evident to us that he also resembled the description in the literature of children with hyperlexia. Ararn & Healy (1988). Huttenlocher & Huttenlocher (1973). Now. four years later, Abie is in a regular first grade class. His language comprehension is 4 years above chronological age and his IQ is in the 120's. He makes inferences, comprehends verbal subtleties and understands humor. He transfers what he learns into new situations. He still. however. has a bit of difficulty socializing. He remains somewhat egocentric and complains that the other kids don't always do what he wants them to do.

We asked ourselves, "Is this child with hyperlexia at the top of the continuum of what would be considered high-functioning autism? Does he resemble those individuals described by Asperger? (Asperger 1944). Or is hyperlexia a separate subgroup of children with Pervasive Developmental Disorder? We began to look at other children in our caseload who exhibited the characteristics of precocious reading development and disordered language acquisition. with concomitant social and behavioral deficits. They were a surprisingly homogeneous group with predictable patterns of development. And, as we researched the literature, those studies of hyperlexia which accepted the criteria of precocious reading abilities emerging in preschool years within a context of disorders of language acquisition and comprehension. All presented cases with striking similarities to ours. Richman & Kitchell (1981), Cohen, Campbell & Gelardo (1987). Healy. et al. (1982).

The present paper will describe the pattern of development of 20 children who exhibit characteristics of the syndrome of hyperlexia as compiled from questionnaires completed by their parents. The questionnaire was designed to plot the various symptoms at 6 month intervals, so that the ebb and flow of particular symptoms could be seen longitudinally. Parents were encouraged to consult evaluation reports, IEPs, and medical records to assist in remembering their child's development. The data was then compiled at each 6 month interval and general patterns began to emerge. A pattern of development was considered to be characteristic if it was exhibited in 75% of the children in our study. This data was then compared to literature descriptions of individuals with high-functioning autism and Asperger's syndrome. (Future studies will compare responses to our questionnaire by parents of children in these two groups).

Since it was a criterion for inclusion in our study, all children read precociously before the age of 5. There were, however, individual differences in the emergence of reading. Some children were automatic decoders at a very young age. Others began as sight readers and later "cracked" the phonetic code. Some began reading only single words and when they began to read sentences, skipped over the "unimportant" little words. Comprehension of reading closely mirrored comprehension of verbal language, though the hyperlexic children generally responded better and at an earlier age, when presented with written information or questions. This characteristic differs from a savant skill in that it is not an isolated ability. Information acquired by reading can be accessed and language can be learned with the assistance of reading. The characteristic of precocious reading, while common in high-functioning autistic children, is not always present. Precocious reading was only occasionally mentioned in case histories of Asperger's Syndrome described by (Wing 1981).

Language acquisition in children with the syndrome hyperlexia followed a similar pattern in most subjects in this study. Most children's first words developed at 12-18 months, but approximately half' of the children lost those words and did not begin to regain them until after age two. Language then was acquired through Gestalt processing. Early speech and language attempts were echolalic (both immediate and delayed). Language was learned in "chunks" and whole phrases and even entire dialogues were used as conversation. There were abnormalities in form and content of language, with stereotypic intonation patterns, perseveration, pronoun reversals and idiosyncratic use of words or phrases. Comprehension of single words exceeded comprehension in context and interpretation of words was concrete and literal. Many hyperlexic children showed a marked improvement in their language abilities beginning at age 4- 1/2 to 5, although difficulties in holding social conversations persisted. This pattern of language acquisition is similar to that of many high-functioning autistic children reported in the literature. Difficulties with social language persist in autistic individuals throughout adulthood. Individuals with Asperger's syndrome are reported to have developed good grammatical language skills though they too have difficulty comprehending subtle, abstract language (Wing 1981).

In the early years, hyperlexic children in this study exhibited many of the behaviors typically associated with autism: self-stimulatory behaviors. need for routine, ritualistic behaviors. tantrums, sensitivity to sensory input (noise, odors. touch), general anxiety and specific unusual fears. These behaviors subsided substantially as growth in language, generally at age 4 1/2 to 5. These children were generally affectionate with their families and were better able to relate to adults than children. By age 5. they became able to participate in structured interactive games with peers and imaginative play developed, Difficulty in socializing and handling large groups remained problematic through the primary grades. Though hyperlexic children often succeed in regular education classrooms with some minor modifications in instruction. The diminishing of autistic symptoms at a relatively young age with the concomitant growth in language implicates language processing problems as a causal factor. This may also be true for high-functioning autistic children, though there may be other factors which would cause autistic behaviors to persist longer in this group. Descriptions of Asperger's syndrome include stereotypic movements of body and limbs, and intense fascination with one or two subjects to the exclusion of all else (Wing 1981).

Our group of children with hyperlexic syndrome generally had normal gross motor development and normal neurological tests. Fine motor skills were often delayed. Most were boys, though there were two girls in this study. Most had no family history of disorders, though several families were positive for autism and learning disability in the previous generation. Individuals with Apserger's Syndrome were described as clumsy and uncoordinated, while autistic individuals are often described as being very well coordinated.

While children with the syndrome of hyperlexia may be classified as having a Pervasive Developmental Disorder, and while there may be some similarities to children with autism and/or Asperger's syndrome, we would argue that there is merit in classifying this syndrome as a separate sub-category of P.D.D. The differentiating characteristics appear to center around the hyperlexic children's ability to develop higher level language skills and the children's innate desire to develop social relationships, though they may lack the pragmatic language skills to do so effectively. The primary reason for developing a specific diagnostic category for hyperlexia is to assure that hyperlexia is well understood so that appropriate treatment strategies can be developed. In our experience in speech and language therapy with these children, it is crucial that the reading skill be employed as a primary means of developing language. Reading can also be used for behavioral management and for assisting the child in understanding classroom routine. Because precocious reading is not expected in a child who exhibits a language disorder and aberrant behaviors, it is often regarded as a "splinter skill" and is not exploited as a means for learning. It is natural for a teacher to try restating a direction verbally when a child does not respond, but these children need the direction to be written so they have something tangible to look at. We also have used this approach with autistic children who read precociously. The major difference we have seen has been the autistic children's reduced ability to utilize the information acquired through reading within meaningful language.

Most of the children in our study have had intensive therapy which fully utilized their reading capacities and they have families who have been creative in devising ways to help these children learn and socialize. Certainly this will have an effect on the ultimate outcome for these children.
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ADHD.... It's not just for kids anymore...
It all seems impressive when you don't know what it means. (H. Rickey, 1987)
"Aye yam what aye yam." (Popeye)
"Sig personnas illegitum non carborundum." (unknown)
The computer lets you make more mistakes faster, with the exception of tequila and a handgun. (M. Radcliffe)
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Old 09-17-05, 10:01 PM
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Autistic Adults and Adolescents

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Autistic Adults and Adolescents

Autistic adolescents and adults are people you might encounter every day but not know it. There are many things you might think about us, but often they are not true.

Some of us may appear selfish or self-absorbed or egotistical because we do not respond adequately when someone says something, or because we talk on and on about one subject with little regard to the rest of the conversation.

We may look childish in some or all situations because we seem to overreact to things that other people would not react to at all. We may seem gullible and naive, and some people out there will take advantage of that. You may wonder why we never seen to learn that there are people in the world we can't trust.

Others may appear almost paranoid, trusting no one at all. Some might seem "psychotic" because of our eccentric behaviours or suspiciousness. Some of us might talk to ourselves out loud.

Some of us might seem changeable or "fake". This is because it is fairly common for autistic people to develop a coping mechanism of a "normal" looking persona with which to interact. Some of us have more than one such persona, and hence seem changeable. Sometimes this persona is fairly convincing, and other times it looks false and "put on".

Some of us might appear like loners, or eccentric loners. Some of us might appear as the opposite -- people who try hard to be social but don't know how.

Some of us might appear eccentric, and others might appear, in the common language, retarded. You might love us or hate us or like us or tolerate us or dislike us. You might keep your kids away from us because we might look like there is something wrong with us.

We might look heartless because we do not have the same emotions you do, or more often don't show them in the ways you expect. We might look too sensitive, or too insensitive, or both. We might seem too immature or too mature, or both.

We might do things we have done since we were kids. When we were kids, adults might have thought of some of these things as cute, but we are now adolescents and adults who are too old for cute. Now, such things might be irritating or annoying, at best.

We might have so much skill in one area that we seem to be deliberately trying not to understand another area. We might seem to be manipulative or callous when at one moment we can do something "complicated" like fix your computer, recite things, or do complex mathematics, and the next moment cannot see that you are upset, or what to do about it.

We might seem to ignore you, or seem to ignore your feelings. We might not know when to stop talking, or when to start. We might not be able to talk, or might talk oddly or in short repeated phrases. We might use extremely formal and precise language and intonation patterns, or speak in a monotone or singsong. We might talk what seems to be normally.

Some of us may have been diagnosed as children with autism. Some of us may have been diagnosed with attention deficit disorder. Some of us may not have been diagnosed with anything at all, or held other diagnoses. Some of us may have been called "psychotic". Some of us may have facial tics left over from decades of antipsychotic medications that did us no good. Some of us may have facial and other tics for no reason other than our neurological makeup.

We might now be undiagnosed, be diagnosed with autism, Asperger's Syndrome, atypical autism, or things that have nothing to do with developmental disabilities. We may have additional diagnoses of depression, anxiety, psychosis, personality disorders, epilepsy, or many other things. We might think of ourselves as "cured" (even some of us who are quite obviously still autistic), or might look forward to "cure", or might hate the idea of "cure". We might have "a few autistic traits".

We come from all different backgrounds, and have all different appearances. We are classified as high-functioning, low-functioning, anything in between, and any combination of functioning levels. Different people might classify us as different functioning levels depending on when and where they see us. We may obviously have something different about us, or might just appear odd in some ways. Some of us wouldn't appear different at all until you got to know us. We may have been lower-functioning, or higher-functioning, or the same level of functioning, as children. Our skills might fluctuate dramatically. We present our autism in as many ways as there are autistic people, and have as many opinions about it.

We may have high-paying jobs, or low-paying jobs, or no jobs. We may live alone or with our parents or in a group home or with roommates or have families. We may be students or work in any of many fields. We may live in a house or apartment or institution, or be homeless.

The thing we all have in common is that we are autistic. We may not always appear like the child that so many people have heard of, who rocks and bangs his head on the wall and does not make eye contact and is completely mute and will never speak and lives in an institution. We may not appear like the "Rainman" savant who does complex calculations in his head but is otherwise autistic. We may not be Einstein or the Silicon Valley computer programmer stereotype. We may look like these things sometimes but not others. But we are autistic. We share some of the same difficulties and the same advantages in being autistic. We have differences, yes -- everyone does -- but we do have that in common.

The next time you think of autistic children, remember that children grow up. The next time you think of someone who you get furious with because they just "don't get" something simple even though they can do some things that are complicated, remember us. The next time you see someone walking down the street flapping their hands in front of their face and making odd noises, remember us. They may not be autistic, but you never know. Autistic children grow up, into autistic adolescents and autistic adults. We do not appear always the same as autistic children, though we may have a lot in common with them that may or may not be visible to someone unfamiliar with autism.

Autistic adults and adolescents exist, and live in this society, but not necessarily connect to it normally, every day. We are out there, trying to live. Remember our existence.

A M Baggs, 1999

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Old 09-17-05, 10:06 PM
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A nice essay on Autism

The Truth of The Myth of The Lack of Recovery From Autism Modified 31 January 2002




There has been much written recently about the supposed "recovery" from autism that some people alleged to have made, or to have caused in children. Usually these people are those that sell some sort of treatment program, or else they are parents or autistic people that wish so very much for the autism to be gone that they blind themselves to the truth, and exist in a state of denial. Though these people love to "debunk" the "once an autistic, always an autistic" truism, the fact is that autism is a lifetime condition, and you do not recover from autism. That does not mean that significant improvement is not possible, or that there is no hope. Quite the contrary, in fact; if there is one thing I have learned in recent months, it is that there is always hope.

Autism is still largely unknown in terms of cause. While there are a lot of suspected triggers for autism, the only thing that has been proven so far is that it is a condition linked to genetics. Autism runs in families... there is no doubt about that, so I will not get into it here. However, it is also obvious when looking at the evidence that there is more to it than genetics alone. There is an environmental cause, or maybe there are many environmental causes. Many things are suspected, but so far there has been no credible evidence for any specific cause other than genetics, and perhaps rubella infection of the mother during pregnancy.

Whatever the cause, autism appears to be a condition that starts prenatally. There have been many recent discoveries of abnormalities in the autistic brain, and in some of these cases, such unusual development could only have happened prenatally. The autism is often unnoticed until around eighteen months, but that does not mean it was not there previously. The best evidence refutes the idea that autism is caused by vaccines or other postnatal insults. These abnormalities are permanent; the development that goes on during this time cannot be reversed. At the most basic level, these specific abnormalities ARE autism. The outward signals, like the familiar flapping, lack of eye contact, speech impairments, inability to be social, et cetera, are symptoms of the autism... but they are not the autism itself. Some things, like mental retardation and inability to speak, appear to be neurodevelopmental abnormalities caused by other symptoms of autism, namely auditory processing problems. It would be inaccurate to say that these things ARE autism, just as it would be incorrect to say that body aches, fever, and cough ARE the flu. The flu is an infection of the influenza virus, primarily in the lungs; the aches, fever, and cough are symptoms. The difference may seem unimportant, but it is not.

To people that see autism as a set of behaviors, it seems that autism may be curable. If the behaviors can be trained out of the child, the autism will cease to exist, right? They seem to think that autism is a bunch of habits that have to be broken. It is not. Autism is a brain abnormality, and training out the tell-tale behaviors does not make it go away. It hides it... nothing more. Those people that say that they are recovered autistics, or that their expensive treatment programs can sometimes "cure" autism, are missing the point. If any one of those "cured" autistics (assuming they were really autistic initially) were to be examined with fMRI (functional magnetic resonance imaging) or other scanning technology, the brain would show up as being autistic, not normal. The autistic behaviors are signs of autism, but they are not in themselves autism.

Autism is not a behavioral abnormality. It is not a set of nasty habits. It is not something that any treatment program can cure. Again, the most credible evidence shows that autism happens to a fetus long before birth, and that cannot be changed by teaching the child anything. This does not mean that treatment is undesirable or futile... it is not. However, the goal needs to be realistic. I think that the biggest single factor in determining outcome in autistic children is the severity of the auditory processing problems. Most, if not all, autistic children have these problems to some degree, but they vary greatly in severity. Those with minor problems often end up hyperverbal and above average in intelligence, more in the Asperger's pattern than in the classical autism pattern. Those with the worst problems may never develop receptive (and thus expressive) speech, and will be mentally retarded for life.

As I discussed in my article Practical Problems With ABA Programs, the brain develops according to patterns of usage, especially rapidly in the first few years of life. If the child's brain cannot process the auditory information coming in from the ears, he will hear a confusing jumble of noise, rather than coherent speech, when someone talks to him. The innate ability for a child to automatically learn language cannot proceed if the incoming auditory messages are scrambled. Thus, the neurons in the growing brain develop randomly rather than in patterns that result in verbal ability, and the ability to reason. The longer this auditory deficiency continues, the longer the neurons will continue to develop in a haphazard (and useless) manner, and the harder it will be to remediate the growing language difficulties. The longer the audio processing problems continue, the lower the child's intelligence is likely to be. It is vital to get the language processing centers working as early as possible in childhood. The most logical way to do this is to help the auditory processing centers to do their job. Any early treatment program for autistic children must center on getting those two areas of the brain working as soon as possible. In other words, the treatment program must take a neurodevelopmental approach rather than a behavioral approach, for maximum benefit.

Even if such a program is applied with maximum effect, the brain will still be an autistic brain. The child may end up with a condition closer to Asperger's Syndrome (a mild form of autism), and there is a good chance that he will go to normal schools and be quite successful in life, with little or no external assistance most of the time. These people may learn to imitate normal behavior quite well, and it may seem to them, and to others around them, that they are no longer autistic. Of course, though, they are. Inside the skull, the brain will still have a thinner posterior cortex, a smaller cerebellum, an abormally sized amygdala and corpus callosum, and be ~10% larger than the comparable normal brain (as well as have other abnormalities that are too complex to describe here). Changing the behavior to a more normal type does not change the abnormal "wiring" in the brain, and it is that abnormal wiring that IS autism.

I think that the majority of reported cases of recovery from autism are a result of the inability to really define what autism is. People that were diagnosed as severely autistic often are not expected to ever live independently, or even talk. Thus, it seems like a remarkable recovery when a "hopeless" person as such does learn to speak, to relate to others, and shows above-average intelligence. To that person's doctors, parents, and to himself (when he learns of how "bad" he was before), it appears that there has been an amazing recovery. In many of these cases, what really happened is that the person was high-functioning, but presented initially as low-functioning. This is quite common; it is often very hard to tell a high-functioning autistic from a low-functioning autistic during early childhood (since many of the differences in function level relate to development that takes place later in childhood). IQ tests that attempt to measure the abilities of nonverbal children as such are a joke, and not a funny one. The child that goes from "no hope" to a very high level of function seems to be recovered, but that is not the case. Similarly, a child that has severe auditory problems will present as very low functioning and nearly totally disconnected with the world. He will often seem to recover if his auditory centers and verbal centers are helped to function. These people still have autistic brains, though, and although the signs are more subtle, they are still present. In later years, the still-autistic child can be trained to emulate a normal person, but that does not mean he is one.

There have been a lot of tales of normal parents claiming to have cured their autistic children circulating on the internet lately. I have read these accounts, and it really saddens me. Since parents think (erroneously) that autism is a set of undesirable behaviors, they believe that training the child to act more normally (in other words, to act in accordance with NT neurology, not his own) is the same as curing autism. Those kids are not cured. They are trained seals. They are autistic as they ever were, living behind the mask that was forced upon them by unaccepting parents and professionals. Autistic children can be trained to act normal, just as normal children can be trained to act autistic. Do you think that if someone successfully trained a normal child to appear autistic, that he actually would be autistic? In other words, is it possible to cause autism in someone by training them to act autistic? Of course it is not. And in the very same way, it is impossible to remove the autism by training it away. The autism is still there, hidden under the normal-like concealing behaviors that were drilled into the child's mind.

When social demands on the "recovered" child increase, it will be evident that the autism is still there. I have heard some sad stories of bewildered parents saying, "How can this be? We cured that years ago!" They see it as a relapse, but it is not. It is the autism, which has always been present, showing itself yet again. This can be terribly distressing for parents and for the child, who often believes himself that he has been cured. It is like a second traumatic loss for the parents, who mourned their child's condition once already, years ago. Don't set yourself up for this letdown. Puberty and increasing social demands make the autism appear to come back.

You can see the autism in adults that claim to be recovered, too. No matter how hard they try, it is just not possible to maintain the illusion of normality all the time, even if they themselves believe they are cured. It just takes too much effort to pretend to be something you are not. There is a reason autistic people behave as they do... it is because their behaviors are normal for the brain configuration they have. This relationship is seen all over the animal kingdom. Cats act like cats because they have cat brains. Wolves act like wolves because they have wolf brains. Normal people act like normal people because they have normal people brains. And, of course, autistics act like autistics because they have autistic brains. No matter what they have been trained to act like in public, autistics are what they are, and that is autistic. Autistic brains are wired differently than normal brains, and that is permanent.

Some autistics make it into adulthood, still believing that they have been cured. Make no mistake, though; inside those heads is a brain that is as autistic as it ever was. Outwardly, the behavior may be superficially normal, but it is just an approximation, a poor facsimile of normality. Eye contact, body language, and other things like that are forms of communication, and autistics do not have the wiring in the brain to communicate that way. Sure, they can fake eye contact, but they still do not communicate with eye contact. They still do not know the normal person's "code" of nonverbal communication. If they do, it is something that must be processed cognitively, with a great deal of thought and effort-- so much so that they cannot process what the person may be saying verbally. As such, it is rather obvious that the "recovered" autistic adult is, in fact, autistic still. No matter how ingrained or habitual the normal-like behaviors have become, the fact is that they are still foreign behaviors to anyone with an autistic brain, and the autistic will never be able to use them as will a person for whom they are native behaviors.

Temple Grandin thought she was, and referred to herself as, a recovered autistic when she wrote her autobiographical book Emergence: Labeled Autistic in 1986. When she wrote her second book (nine years later), Thinking in Pictures, she simply called herself autistic, as she does to this day. Like all other adults who claim to be recovered (and who were really autistic in the first place), her autism was never really gone. But look at her today... she is a success, a leader in her field, a Ph.D. holder. Autistic people can succeed if they are allowed to do so. The time spent in futile efforts to teach away the autistic brain could be better spent preparing the person for a successful life as an autistic person. Most "intervention" for autistic children today aims to obliterate the autism, and this severely limits the efficacy of those programs. Although many of them have good effects in several ways, they are crippled by this ill-conceived notion that autism can be cured or reduced. It cannot... and it should not. Most autistics to whom I have communicated with would not wish to be cured. It is who we are; to cure the autism is to destroy the autistic, and most of us do not want to be destroyed. There is no normal person inside the autistic, waiting to be let out. The autism goes all the way to the center; strip away the autism and there will be nothing left.

I hold that autism itself is not a disability. That does not mean that many autistic people are not disabled by their condition; I know very well that many of them are severely incapacitated. However, I do not consider these incapacitations to be by the autism itself as much as the surrounding syndrome. I do not think that the sensory difficulties are a core part of the autism, although all autistics seem to have some of one form or another. I do not think that retardation or low IQ is a part of autism either, since it is a function of the sensory problems, not the autism itself (and not all autistics have such problems). I do not think that the anxiety and depression so common in autistics are part of the core condition either. In essence, all of the really nasty things about autism are not actually the autism itself-- they are the things that come with it, but are not core features in themselves.

Autism, when stripped of all of the negative things as above, is a condition where the person has more of an affinity for things or concepts than people. Absent the auditory processing problems, autistics (including those with AS) are often well above average in intelligence. Such people become inventors, scientists, engineers, entrepreneurs, and innovators, if they are permitted to use their unique abilities and not have their self-esteem crushed by the unyielding pressure normal people exert to conform and to be social. People that like to think about science and engineering rather than parties and socializing are vital for the advancement of humanity. Far from being impaired or disabled, these people simply have abilities in different areas than normal people-- abilities that are vital for society. As such, autistic people, and autism in general, should not be pitied or cured (as in the elimination of autism). By all means, we should help autistic children to use their senses in a useful way, which will connect them with the world and allow their speech and intelligence to develop. They will not be normal, but that is OK. Genius and greatness are abnormal, after all.

Being autistic is not like being mentally ill... it is not a disease that should be cured. Autistic people are just another equally-valid variety of human. If it would be objectionable to wish to prevent, "cure," or defeat certain races of people, it should be equally bad to advocate those things with regard to autistics. Imagine the furor that would be caused (and rightly so) it a university attempted to do research into preventing or "curing" the black (negroid) race, for example, in order to fix problems like sickle-cell anemia that are much more common in that group of people. If it is unacceptable to rid the world of any race, whether by eugenics or any other means, then it should be just as unacceptable to do it to autistics. Cure the problems that are genetically common within the group, eliminate the discrimination against the group, but do not try to wipe out the group.

Autistic people are a different kind of human... unique and wonderful people that are much more than the defective individuals that normal people see them as. As such, I find it extremely hard to support the idea of preventing, curing, defeating, overcoming, or recovering from autism. The idea that successful people that were diagnosed as autistic have overcome their autism presupposes that autism precludes success. That is a horrible thing to think... not just because it needlessly feeds into the idea that autism is tragic, but also because it simply is not true. They have not recovered from, overcome, or defeated their autism any more than a normal person has overcome his neurological typicality to become a success. To define autistics as inherently lacking of success potential only seeks to define the condition in terms of poor outcome, and to limit the aspirations of those with autism and those that care about them.

The people that claim to be recovered autistics are mostly high-functioning autistics that have been trained to hide their true nature and act like normal people. If this was done early enough in life, the person may have become so accustomed to the learned behaviors that he himself does not realize that his normality is a fašade. That does not change who and what people like that are, and it is a shame that they have to act like that which they are not to get treated like human beings. This points to a problem with society, not to a problem with autism. It puzzles me why people never stop and consider why it is so acceptable to ostracize autistics for being different. They blame the autism or the autistic person himself for not being accepted by the crowd; essentially, for not being normal.

I cannot see how it would be moral or right to teach a group of people to hide their true selves and live a lie for a lifetime so that they can be accepted and live a relatively normal life. There is an implicit acceptance of discrimination against these people inherent in that philosophy. Many people claim that by curing autism, or by preventing it in the future, such horrible treatment of people can be avoided. Yes, that is true. If we were able to develop a surgery that would make all races of people look like whatever race predominated in an area, and were to genetically engineer all future children to be like the norm, then racism could be eliminated too. Does that make such forced homogenization a justifiable goal? Elimination of racism by the elimination of differing races is not something any enlightened person would consider, so why should they consider elimination of discrimination against autistics by eliminating autistics to be any better?

I say that we should quit viewing autism as a horrible, tragic thing, and start seeing autistics as different, but still quite valuable and worthy. They are not defective, pathetic people that are a burden on society. We do need to work on finding a solution to the sensory difficulties that occur disproportionately in the autistic population, which are probably the cause of the all-too-common retardation and lack of verbal ability... just as we should find a solution to other problems that happen most often in certain groups of people, like sickle-cell anemia. Let's stop this silly and harmful practice of treating autism like a behavioral disorder rather than a neurological difference. Like it or not, autism is permanent, despite what some parents, teachers, and even some "former" autistics will tell you. That does not mean that a very high level of function is not possible. That should be the goal... to help the autistic person learn to be the best autistic he can be, not to make him seem normal. The autistic mind is too valuable a resource to waste by occupying it with such mundane tasks as presenting the appearance of normality.
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Old 01-11-06, 08:42 PM
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[quote=speedo]This link is quite interesting. It has several case studies and suggests that HFA might sometimes appear to onset in early to late adulthood.


My thinking is that the diagnoses in early to late adulthood are not due to a later onset, but rather misdiagnoses. In my case, it was a *missed* diagnosis, as I was not taken to a doctor for my lack of speech. I did finally start talking at about age 4 1/2. By the time I was in school, I was having great social difficulties, and was evaluated, and was considered as having "emotional problems". I had also been considered as having what today would be called ADHD. Now, because the diagnosis was done in adulthood, I received a PDD-NOS diagnosis. (rather than Asperger's syndrome, because speech was delayed in coming. Dave
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Old 01-11-06, 08:53 PM
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I thikn you are probabyl correct. I thought it was an interesating idea tho..

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Old 05-29-08, 12:00 AM
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Re: Mild Autism in Adults

Quote:
Originally Posted by speedo View Post
Here is more on autism in adults. I will post more info as I find it.
I hope nobody minds me using this forum as my personal index of citations..
It just seems to me that there is so little information about autism in adults, and most of us here are adults and desperately need this info so we can get a better understanding of ourselves and others.

Me
my son has autism and i have adhd. i've noticed many similarites in both of us that are way too uncanny. i'd like to know more about adult autism myself. i do know both diagnosis on are same spectrum but opposite ends. he has the hyperfocusing skills like i do. he is a genius in math and pragmatics. i'm the creative genius. it's funny, really. my daughter shows signs and will be tested for adhd this summer. i found your post relevant and interesting.
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Old 05-30-08, 01:16 AM
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Re: Mild Autism in Adults

Is there a difference between AS (asperger's) and HFA (high fx Autism)?
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Old 05-30-08, 01:18 AM
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Re: Mild Autism in Adults

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Originally Posted by QueensU_girl View Post
Is there a difference between AS (asperger's) and HFA (high fx Autism)?
I think there is delayed acquisition of language skills in HFA.
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Old 05-30-08, 03:22 AM
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Re: Mild Autism in Adults

To answer the most recent question: there is a delay of onset of language skills for HFA, but not in Asperger's. Aspies often have exceptional verbal language skills.

Thanks so much, Speedo, for posting all this info. You definitely took the Aspie approach, which I greatly admire! My father has Asperger's, he's retired now, but worked writing programs for satellite communications technology. He knows every computer language that exists and is extremely talented with that and all things mechanical. He spends a lot of time holed up in the garage inventing things.

I am Bipolar I and ADHD and read an article recently that there seems to be a genetic link between Bipolar I, Schizophrenia and Autism. Although the disorders are very different, there are definite similarities among the three. I am definitely not autistic, but children of autistic parents often have some autistic traits and I do. I have extreme sensory sensitivities, have auditory processing problems, and am an entirely visual thinker. Oftentimes, it takes me a great while to find words to express the images that I see in my mind. I can also be very logical; however, I see the end first and then have to go back and reason through the entire process to explain it to someone else. I am also excellent at remembering very weird minute details, but am a walking executive of dysfunction. I also have weird rituals that must be adhered to no matter what (the checkbook must be kept on the radiator, the minutes for the alarm time an alarm clock must only be prime numbers).

There is a history of mental illness to varying degrees on both sides of my family as well as ADHD, so I am a strong believer in the genetic link between the three.

I'm not sure if this was link was listed, but I post occasionally on Wrong Planet (I am not sure if it's against the rules to put a link to another forum-- moderators please tell me if I broke a rule in mentioning it) and it is a wonderful discussion forum for individuals with Asperger's, HFA, ADHD. There are many highly intelligent people that post there on a variety of interesting topics. If you have a question, people will be racing to give you very detailed, well-researched answers!
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Old 05-30-08, 07:26 PM
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Re: Mild Autism in Adults

With regard to differences between HFA and AS. There are quite a few:

1) Later onset in Aspergers. Aspies generally aren't diagnosable until after age 5 or so. In the case of autism it is usually diagnosable by age 3.

2) since aspies have no speech delay they tend to have a higher verbal IQ than performance IQ. Autistics often have a performance IQ higher than the verbal IQ.

3) Neurological differences..... There is evidence to suggest that aspie brains have a greater abundance of white matter than NT's while auties tend to have more grey matter than NT's. (NT=neurotypical person). It looks as though aspies and autistics both have problems with the ratio of white matter relative to grey matter. In either case you end up with poor connectivity between various regions of the brain.

4) Head size differences during development. As I recall (I'm not sure) aspie kids will experience a rate of head growth that is higher than normal (and higher than auties) early in their development while autistic kids just tend to have bigger than normal heads as adults. The bottom line is that both aspies and auties frequently have big heads but they do it a little differently.


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